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450- Healthcare AI Needs a Reality Check w/Mikkel Finsen · You've Been Heard

• 0:00
  Speaker A: You start talking about predictive AI, where some of the junior staff, even doctors and nurses, I started to type in questions to an AI agent saying, I have a patient with these symptoms, what prescription should I give? And then generative AI comes up with an answer. Sure, that they can ask all these questions, but they still have to go back and validate it because we only misdiagnosis away from a lawsuit and that's what we need to be cautious of. While a lot of people say AI is going to be revolutionizing within the healthcare, I fully agree. And I think it has a lot of excellent use cases, especially in large hospitals and labs and X rays and all those. And also within not for profit. We just have to be a little bit more conservative when it comes to the deployment of AI, in my opinion, to make sure we do it in a controlled manner so we know exactly what the AI tool will do, where the data is stored, how the data is being processed, and what the staff have access to and how they use that data.
• 1:05
  Speaker B: After talking with IT leaders, I've come to discover one thing. And it's the same thing. You know, it's the same thing everyone else knows, whether they want to admit it out loud or not. Nothing gets done in any company without it touching it. Nothing. But here's the thing. When everything's on fire, when nothing's working, when the ransomware hits, when the whole business grinds to a halt, it is completely indispensable. You're the most valuable asset in the company. But when everything's running like a well oiled Tesla, you're a line item, a cost center on a spreadsheet. You've done the work, you've built the career, you've earned your seat at the executive roundtable. But having a seat at the table is one thing. How much nicer would it be to actually be heard? This is you've Been Heard.
• 1:59
  Speaker C: Well, welcome back to you've Been Heard, the show where we pull back the curtain for current IT leaders and rising stars aiming for their own seat at the table. We've tossed out the corporate scripts for real unvarnished talk about what it actually takes to lead Mikkel. A huge welcome. We're thrilled you decided to join us today and trade stories with us over at you've Been heard dot com. Sitting in the guest chair today is Mikkel Thinsen, a technology leader who blends European executive roots with modern digital transformation and cybersecurity expertise. What makes Mikkel's perspective so refreshing is his global no nonsense approach to scaling operations. Proving that strong technical architecture only matters if it directly translates into real world business resilience and empowered people. Mikal, we got plenty of room or plenty of ground to cover, but the mic is yours first. Mind introducing yourself and sharing what your ride to the leadership chair looks like?
• 3:04
  Speaker A: Thank you Mike and it's a pleasure to be here. So yes, I'm Michal Finston. I am born and bred in Denmark, a few thousand miles away from the east coast of the US but but my journey started obviously many years ago. I started out in interior design, consigning offices and warehouses. So it was not exactly the traditional IT path. And somewhere along those lines I decided I was going to try something else before I committed fully to a future in interior design in Denmark. And I took a year off and went to Ireland of all places and meet the Irish people and back then we call the Celtic Tiger, which is basically the boom, the technology boom that happened in Ireland in the in the mid-90s and late-90s and I took on my first IT support role in with IBM and I was there in tech support. I knew nothing about computers at that point so I had a deep dive into tech tech support and ended up doing tech support for IBM across Scandinavia to start with and then the US market and then after 13 months in tech support in IBM you burn out doing tech support after a while. But I get a job with KBMG in Ireland and that was a significant change in IT support in moving into a corporate infrastructure, a corporate network where we now support users in face to face. But it was really start to my technology journey and then I started at the help desk and I gradually worked my way up in the organization that was there in KBMG in total for over 2 decades. Spending my first 12ish years at KPMG in Ireland and then moved to the us but was always of the belief that take the opportunities as you're given and when you work through your youth. And then some jobs in KBMG were exciting, some were probably not. But I took the opportunities that was given to me and I jumped on projects, I jumped on new technologies and new initiatives and gradually worked my way up to become, should I say the right hand man of the cio, the director there at that time and learned a tremendous amount of stuff about project management, business management, but also technologies. And I was surrounded by people who knew technologies a lot better than I did. I could support it, I could speak with end users, I could help them understand the technology challenges we're facing. But the Real heroes in my world were the people I worked with at KBMG in the operations teams and support teams who really knew the technologies and I learned a lot from them and also how to manage people with technologies. And then I was gradually promoted to help desk manager to business and operations manager and then director. And then magically I was asked to join a global team in the US and moved across to the US in 2011 and took on a global director role there spark KBMG Global and had a wonderful 10 years there as well where I really learned a lot more about not no longer being hands on but trying to manage resources and managing projects and services and also level set end user expectations. But working in Europe and working in US is very different when it comes to both culture and just work environment. So the first year at KBMT US or the US was certainly, should I say a culture shock because there's certain things you could do in Ireland you couldn't do in the us so certain ways of interacting with people that works in Europe but doesn't work in us. So I spent a few years learning that changed, but it was certainly still valuable learnings both from a political environment where you have these people running around with saws on their elbows and trying to cut each other down, get ahead of the curve. And then you have others maybe like me, a little bit more subdued, sitting back and making sure things are working and trying to provide the best service we can. And then at a certain point in my career, after more than two decades with kbmg, I had to decide what does my future look like. I was still relatively young, but I had also unfortunately encountered a serious medical issue. So that required me to just look a little bit differently at life. And while I loved my colleagues and working at kbmg, I also realized that it was putting a strain on my health. So I decided to look and see what's outside of kpmg. It is very daunting when you have spent two decades in an organization to start interviewing again, start looking for jobs. Do I have all the requirements? Do I have all the certificates? Do I have the experience needed? But I came across this opportunity at Opendoor where I am now, where the CEO was a wonderful woman and she was trying to build an enterprise ready IT organization. There was a significant step down in regards to managing people. I went from managing 20 people in the US and I don't know how many people in India and now I was joining a team of five including me. But it was not necessarily the size of the organization that matters, it was More the challenges and opportunities ahead that I kind of like predicted. And we had the opportunity to really rebuild the entire IT organization from scratch, including building the infrastructure, building the security, building the, the service management attitude towards how we provide services within the organization, helping the organization grow and use the technologies better. So that really appealed to me and I was grateful that I got the opportunity to join Opendoor. And I've been there ever since of course and over the years have developed a close relationship with the senior leadership within the organization. And we've now built a team of 20 ish IT professionals that are providing services to about a thousand people across the area where we operate. But it's been a fantastic journey in the sense of all the challenges, especially coming from corporate America and into healthcare, into a nonprofit healthcare. But we now have to use the money more carefully and really decide. If you buy something, it has to be something you can really leverage for next three, five, seven years. So it wasn't just built and deployed now we had to be more cautious. So that changed my learnings a lot. And then coming into healthcare with a lot of new acronyms, with a lot of new priorities, the mission statement suddenly became even more important. So it was very difficult to. Not difficult, it's not the right word. It was challenging to adapt from corporate America to non profit healthcare. But I will also say the first five years of my existence here was focusing primarily on technologies, which is the same whether you're in a corporate or non for profit. You're still managing technologies, you're still managing people with technical experiences and skills. So that is the same. It's just how do we apply it to the business and the business mission and objectives.
• 9:53
  Speaker B: Most IoT leaders don't need more technology, they need less noise. Over the years, infrastructure quietly gets complicated. Multiple locations, multiple Internet providers, different contracts, separate bills. Infrastructure reactive support. Nobody plans it that way, it just happens. What we do is vendor neutral advisory. That means we don't sell platforms or force change. We start with low friction areas. Internet, telecom, Microsoft licensing. Places where complexity builds quietly and can usually be cleaned up without disruption or capex. Sometimes we find savings, sometimes we find nothing. Either way the outcome is the same. More clarity, less distraction and it that's boring in the best way possible. If you want a second set of eyes from people who sit on the buying side of enterprise infrastructure every day, just go to you've beenherd.com and answer the questions to simplify, streamline and save.
• 10:48
  Speaker C: So I've heard three topics that I'd really love to dive in a little bit more on one just because you've got a unique perspective. I haven't had a chance to talk to somebody who's come across the pond, so to speak, and I'd love to understand a little bit more of those differences that you were talking about in the culture of the things that you could do in Europe that couldn't do in America and or just the cultural differences. So if you don't mind starting there and then we'll kind of dive a little deeper into the nonprofit and the for profit and then quadrupling the size of your team over the period of time that you've been at Open Door. But tell me a little bit more about the cultural differences between the different countries.
• 11:35
  Speaker A: At least I can only speak from Ireland versus KBMG Global and Global might not be the same as KB&G US but certainly in Ireland I had the sense and feeling of being a lot more in a group where we trusted each other, where we worked closely, we went out for pint and on Wednesday, Thursday and Fridays and sometimes Tuesdays and we trusted each other. We had very direct and honest conversations. You learn to use a lot of interesting words and when you work in Ireland, but it's just part of the culture and it's a wonderful atmosphere to be in and we achieved something and when we said we're going to have it done by September, lo and behold we would get it deployed by September. And that meant worked on weekends and we pulled together and I think everybody were committed to the same direction and the same outcomes and coming over to the U.S. i just felt many times you had to be more careful with how you expressed yourself because. And I don't, I don't know if it's sensitivity thing, whatever it is, but it sounds really harsh but a lot more fake at times in the sense of you had to be a lot more overly positive. You couldn't be direct, you couldn't necessarily say things didn't work where it should be or we haven't done a good enough job. It was. You always had to be careful with how you got perceived and how people looked at you and what came out of your mouth. At times, even if you were frustrated, you had to be really mindful of those things. But then on the flip side, the activities you saw at these large organizations like kbmg, all that is wonderful, but it's just different personalities. And I just never felt that, never developed that close relationship with the team. At least with the team I worked with in the US As I saw In Ireland. So listen, I'm still in touch with colleagues in Ireland people. Within six months of leaving kbmg, it was like I'd never been there before. Nobody contacted you. And I just. Even though you spent 10 years together on Haring projects, you're like, hang on, was this all just fake then? And then you start wondering, why invest so much personally in an organization or in a team if all you're in there just for achieving your own personal goals and figure out how can I get head instead of the other ones? So that was just my biggest takeaway from those organizations. Now I'm back in an environment where we have a strong team, we have a good relationship with everybody, we try to socialize, we try to get to know each other. And I think it's definitely more to what I used to be. I still have to be careful with some of my bad behaviors I might have learned in an Irish setting. But that's just something part of growing up too.
• 14:07
  Speaker C: Yeah. And I was actually going to ask how much that influenced the way you're building the team now that you're empowering them and the design of what you've grown since you've joined the new organization.
• 14:21
  Speaker A: I try to empower my staff to do what they're hired to do, but I certainly still have certain ambitions and plans that I want to achieve. And then I try to kind of push that in that direction and I let them decide how do we deploy things, best practices or how do we configure the network. But I still have my opinions and we will still have honest conversations. And yes, sometimes people think it's personal, but nothing is personal. So it's just a matter of just airing and sharing the issues we see and so we can learn and get better. That's the whole aim of it. It's not to put anybody down. And if that's the way it's perceived, then that's certainly not my intention. And that's the thing. I still need to learn and get better at it.
• 15:01
  Speaker C: Yeah, I struggle with that myself sometimes. Just not going forward with the vision that we have and seeing and trying to impart that and some of those differences and sometimes just being honest. But I've found that I much prefer to be honest. And the saying that I've come up with or twisted the truth is always the best. The trick is in the delivery. Yep, proof is inputting isn't so always the best policy. The trick is in the delivery. That's what I was trying to articulate. So the challenges of moving from corporate America into the nonprofit world. And then being there, I assume with the IT team quadrupling in size, that the general workforce also went through a huge growth over the last seven years that you've been there. How much has the workforce in general grown compared to the IT team?
• 16:03
  Speaker A: The IT team grew significantly, whereas the general organization did not. Because we still had seven clinics and fewer school based clinics as well. And staff headcounts in those areas really stayed, not static. We still grew. We got on to more providers and to see more patients. But it did grow significantly compared to any other organization during the first four years of me being here. But that was part of the plan that I discussed with the CEO when I joined was that we needed to build a team worthy to support the organization. And so we didn't have technical outages, we didn't have a slow response time. So we could actually support the organization and then help them use the technologies to deliver patient care. So that was always the agreement. And that investment was made over roughly four years that we had agreed to move from 5 up to 12 or 13, I believe it was. And what then happened is we actually inquired another organizations within the same area. We are focusing primarily on behavioral health. So we were about 550. They came in with about 350, 400 people. So staffing wise, we've almost doubled. And because of that, we also brought in a few more IT staff to help support the extra growth in staff. Instead of having and neatly 20 side across the area, we now have 45ish sites. So we now have a lot more people and equipment to support as well. So that was the business case for increasing it.
• 17:35
  Speaker C: Okay, it makes sense. And then I'm sure that there's other metrics that the organization's been using to judge growth. The velocity, the yes, it's a nonprofit, but you're still working through. And profits or revenue versus cost.
• 17:51
  Speaker A: Yeah. So our main driver is obviously patient visits. So the more patients we see, the better for us. In regards to revenue, we are what they call a federally qualified health center. So we do get some payments from the federal for each visit we have. But it's still important for us to make sure our providers are fully utilized. Monday to Saturday, see as many patients as we can, obviously give them the odd few minutes for lunch and administrative work. But we do want them to see as many patients as possible. And that drives our revenue up, or at least our operations budget up. But on the flip side, we need to also make sure we kind of match and don't exceed operational costs. So we always look at where we can get preferential pricing from vendors. Microsoft, I will say, has been phenomenal when it comes to supporting nonprofits. We've certainly availed a lot from them, but those are. The relationship we're building now with vendors is to not. We're not trying to get in on a cheap here. We certainly want the technologies that support and deliver the outcomes we want, but we still want to make sure we do it for a reasonable price. We're not kpmg. We can't afford to buy Rolls Royce for every application we buy. So we look more critically at the applications and the needs we have and say, do we really need this? Do we need all these 10 bells and whistles, or can we get away with five of them and then we get price accordingly? But nowadays you see vendors increase their prices year and year. We just got the threats that some of our products might increase with up to 40%, which is ridiculous. It's like daylight robbery. So, and that brings us then to the next point is now we have to make sure we spend the money wisely. And then we have to go and say, okay, well, is there another product that can help us achieve the same things for less? So that's what we're up against. Every year when we look at our budget, we try to stay not flat, but we certainly try to stay relatively flat on our operational budget again to support the patient visits and the goals of the organization. And on the capital side, we've certainly gone down year on year since I joined because we have invested a lot. What we do now is refreshes and stuff like that.
• 20:04
  Speaker C: So when you first joined the organization, what were the largest projects that you initially felt so needed to be tackled first?
• 20:15
  Speaker A: The first piece was the service management aspect. We didn't have a ticketing system, so we needed somewhere where we can start logging track tickets because people were emailing, calling us and stuff didn't get done. We didn't know what actually happening. And we didn't have an inventory of all the servers and applications that we had. And we had a lot of old equipment that we ran in the organization because of hand me downs and just because nobody had invested in it. So those things were definitely important. I did join in 2019 and then the first thing that really hit us was the mobility of computers. And when Covid hit in February and March of 2020. So at that point, the next big challenge was to convert a large percentage of our staff from desktop computers to laptop computer so they could work remotely. And that took a lot of enagling to get done. But that was certainly one of the bigger challenges for us besides getting inventory, besides getting a ticketing system up and running and start looking at refreshes. But that accelerated a fair few things. And then just while we were at it in Covid as well, we might as well just get the ransomware attack out of the way. So we did that in August of 2020 as well. So within the first 12 months of me joining Healthcare, I certainly been rattled a few times with both Covid and somewhere. But it's also at that time you see who your staff players were and how that really brought the team very close together. So those are the challenges.
• 21:43
  Speaker C: So just out of curiosity, when Covid was going on, while you guys were facing that, everybody went mobile and dispersed some. Did your team stay in the office or did you guys disperse also and you were able to get that close knit team while being physically separated?
• 22:02
  Speaker A: For the first few months we were dispersed and we did put up a quick hybrid setup where people would be in the office and we would sit in different locations of the building. But I will admit that as soon as the ransomware hit, it was like all hands on deck. We had to forget about these distances, we had to set up a war room, we had to go through, get all systems listed out and start recovering from the ransom. Where at that point we were just in the office every day. And that's how we've been ever since, pretty much. We have started to introduce some hybrid, but that's just because people are looking for it. But we were pretty much in the office all the time. And I actually got a letter from the company that I needed to keep in the car in case I got stopped during COVID and say I'm allowed to drive, which was quite serious. Surreal. But it was interesting.
• 22:48
  Speaker C: Yeah.
• 22:48
  Speaker A: And I used to carry one of
• 22:50
  Speaker C: those letters with me too, just in case.
• 22:52
  Speaker A: The commute was awesome during COVID I have to say. It was. Yeah.
• 22:56
  Speaker C: Nobody on the road, you know, made it so that you get there quick and easy. Okay, so refresh the infrastructure added in ticketing system to be able to help see what was going on, to recognize so that you could solve larger problems, recurrent problems, making things more efficient, adding mobility into all of the employees and helping them out that. Then where'd you head next after that, after things started, settled down a little bit and then you guys got back into regular business? 22, 23. What happened a couple years ago?
• 23:32
  Speaker A: Well, actually in 2020 is was when we kicked off a number of projects as a result of ransomware. So we rebuilt our entire network with new networking equipment and decommissioned a number of servers and off site data centers and started moving a lot of things to the cloud. And I had a very productive conversation with the board during the ransomware as well. And at that point we also decided to and they were open to the idea of investing a lot more in the cyber security world. So we now started adding a number of cybersecurity tools to our toolkit. So 2020 and 2021 were very busy when it comes to technologies and deploying services and moving to the cloud and consolidating. So that was really the focus of it at that point. Then we also start discussing with HR about setting up a new HR system for them. And we migrated to that as well as part of 2021, 22. And then we, we looked at intranet to be better at communicating with the organization on promoting internally all the good stuff that's being done by it, by hr, by finance, by the clinicals and then and centralizing a lot of that internally, one location. And then a couple years ago we started the whole finance optimization where we work closely with finance and implementing a new ERP system. So we've done pretty much the whole thing now except we have not replaced our EHR system and which is 80% of our business. So that's something that is not done lightly. So we're leaving that for now. But I think the beauty of me coming in at this time I did to where I am now is all the stuff we have been involved with. It is now the trusted advisor of the organization. I have a seat at the board. I meet with the CEO on a weekly basis and we talk about everything to do with it and how we're performing and not performing and share progress with the board. And they actively listen and ask questions and sometimes challenging questions, which is good. And I think that's really been the focus for the last couple of years is to get better at interacting with the senior leadership and listening more to their business and trying to say okay, we've done all this now. Now how can we help drive more efficiencies into the operations and what technologies can we help you guys with? But one challenge that has been is moving from corporate to nonprofit. Healthcare is corporate. Everybody knows how to use computer. Everybody uses it every day. It is part of their world, part of their existence. Once we move into healthcare, 80% of our organization are patient facing. They couldn't care less About Outlook. They focus on seeing the patient, they focus on getting patients healthy, getting them treatments. So their application, which is the ehr, is their critical component. So in corporate America, if outlook went down, we couldn't do anything. If our EHR goes down, then we're screwed because now we can't see patient records. We can treat patients, but it just becomes more challenging. So we now have to shift focus on understanding what technologies are important. And that was a bit of a shift in the beginning, but we've learned that now, so that's for sure.
• 26:49
  Speaker C: No, it's good thing. I mean, one of the common threads that I hear from our peers is, is understanding the operation or understanding the business. It's really critical that we can talk to them about the business and we look at what we're doing as how it impacts and helps or detracts from the business and trying to make sure that it doesn't detract from the business. But one of the things that you mentioned that I'm curious about, as you came on board, it seemed like you had the CEO's trust from the beginning. But then with all of those events that happened in 2021, you really earned it too. So I'm kind of curious about that and how much you think being tempered by the fire really helped give you the seat or were you entrusted with that seat and then being tempered by the fires helped really show to the rest of the board and the C suite the value that you, you were bringing to the team and the team that you were building. I thoughts about that.
• 27:58
  Speaker A: Yeah, I certainly think the number of forest fires we experienced in 2020 certainly made us earn our stripes and, and show value and show that we were the right team and the right individuals for the task. I think a lot of the things that happened in 2020 fast tracked the plans. I had already shared with the board in October of 2019 when I joined and say these are some of the findings that I think we need to address. Unfortunately, some of these things materialized sooner than I had hoped for. So we had to work it in a warp speed almost at a time. But I think that hopefully showed, or I know it showed the board and the CEO that we do have selfishly that I am the right person to lead the team to get things done. And we have a great group of people here to deliver on those things to and support the organization. So as I said, it got fast tracked significantly because of the events that the outside of our control to start with.
• 28:52
  Speaker C: So let's jump forward a little bit. And we'll jump Back to like 23 and some of the influences that happened there. But like currently you're talking about the HR and looking at that. What other projects or major things are on your roadmap in the next couple of years? What has your focus been since all of the initial upheavals have kind of tapered?
• 29:18
  Speaker A: I think we deployed some fantastic technologies and expensive technologies, but I also think that we quickly learned that some of those technologies were something we probably didn't need or would never utilize fully. So we start scaling back on some of those and we identified duplicate technologies we had deployed for endpoint protection, for example. And so we had two of them instead of just one. And then, and then we also went all in with, with our network, I should say. Not that it matters, but we deployed a Cisco network back in 2020 and started looking at SD WAN and all kind of fantastic things they could offer. But I'm not sure if we got the wrong engineers on the job from our vendor or if we weren't ready for the technology itself or if this is just beyond a small nonprofit we have. But we quickly realized that implementing some of these modern or very well spoken of technologies like SD WAN and this whole notion of zero trust, it actually overcomplicated our network and caused a lot of internal network issues that caused our ESR to go slowly and then it started going down and there was just a lot of noise on the network. So we've actually ripped a lot of that out again and going now reassessing what we did back in 2223 for SD Wednesday. Hang on, we don't really need this. So now we actually ripping some of that out again and going back to, should I say almost a do over of our network and starting simple again. Say what do we actually need? And then start deploying it like that. I think we just grabbed over too much and they caused issues.
• 30:54
  Speaker C: I'm curious, when you say that you're dialing back, are you still leaving the SD WAN infrastructure? Are you like taking a tree step back towards like MPLs?
• 31:04
  Speaker A: Well, not necessarily MPLs, but certainly close to it. But we're stripping a lot of the SD WAN out of it just to have a much simpler network and what we believe is more secure. We will add it on, I'm sure again in a year or two once we are comfortable with the foundation of the network running smoothly again. We're actually shifting from one vendor to another so we're using that opportunity to level set that as well. So that's what we're doing, but while still maintaining security of our network, of course. And so that's the reason why.
• 31:36
  Speaker C: Okay, all right, interesting. I haven't heard of too many people taking that pause and that step back. We typically move towards the SD WAN and just keep going after it.
• 31:48
  Speaker A: And we did try, but I said I'm not too sure if our skill set weren't ready for it or if it was more of the consultants. The company we hired persuade us to go full on in. And we never really got it configured correctly because the premise of SD Grant is awesome and we do want to move to that level again. But I think we just have to almost level set our organization again to say, okay, let's just take a breather and say, okay, everything is working. Let's get it configured correctly. Let's make sure we don't have any issues. Especially because we have 40 odd sites and we want to make sure that communication between the site is running seamlessly and that our EH is performing and secure. So that's really our main goal and it is performing. We just have these oops issues at the time, which I'm sure everybody does. I just get a bit more frustrated when I see it.
• 32:38
  Speaker C: Yeah. And anytime we slow down the organization by making the EHR or the ERP or whatever primary system we're using for providing services to the organization, anytime we slow that down, that causes a lot of frustration and usually you get to hear a lot of chirping birds about how things are going.
• 33:00
  Speaker A: Yeah. And as I said before, if Outlook goes down, it's really just the administrators or the HR admins leadership and IT that are kind of like, oh, I can't send an email and then it's a Microsoft that had a flip on the east coast or whatever. But if our EHR goes down, then we'll know about it and quickly.
• 33:19
  Speaker C: Yeah, because they can still provide care, but now their care is based on immediate observation versus oh, here's the history.
• 33:26
  Speaker A: And yeah, and I think that was one of the biggest learning points for me is to level set the primary systems that need to be up all the time and understand the urgency and importance of that system and make sure that end users, we're comfortable that we knew how to support the platform. Listen, if we have a slowness or an outage and whether it's our cause or not, most of the time it's an ISP that has gone down to a site or Microsoft link probe, for example, but still they see it as an IT outage and then that's what we need to avoid.
• 34:02
  Speaker C: Yeah. And you know what, this little bit of advice that we're talking about right now applies to anybody in any IT leadership role at any organization. Understand what are the applications that the organization needs, that the business needs for operation? Because that's what they care about. Yeah, they're just trying to get the job done.
• 34:23
  Speaker A: Absolutely. That's the same with anybody. You know, there are certain tools in any organization that are more important than others. And I would say that was a learning from. So before our ransomware attacks, we had actually gone through and mapped out all the applications we had and, and who uses them and the priority of those applications or the criticality, I could say, of those applications. So when we actually started doing the recover of the ransomware, we knew exactly which applications to go with first and get them up and running first. And, and that's how I think we recovered relatively fast.
• 34:56
  Speaker C: Yeah, that's a foundational step within any disaster recovery plan is trying to figure out all of those pieces. Who's the owner of it, who's the user of it, how many people are using it, what's its priority within the organization. So 23, you're dealing with scaling back the network and suddenly this OpenAI starts showing up and ChatGPT starts showing up. What's happening in your around those topics?
• 35:26
  Speaker A: We're a lot more conservative when it comes to AI. We are, again, I'm not trying to downplay who we are and what we do, but we are much more focused on patient care. Listen, I know AI is by many organizations touted as being the next big thing and everybody has to do it and we're going to get rid of so many employees and stuff like that. I'm a little bit more cautious in the sense of, sure, we all want AI, but we also have to understand what AI actually brings to the organization. And some organizations, they just deploy AI just because they think they have to. I think we've had some good conversations within the organization to say, let's look at AI that would actually make an impact on patient services and operational effectiveness and start looking at, okay, what can we help with the providers with to stop reducing a provider burnout? Okay, let's look at some ambient AI to sit in the exam room, help them take notes, get it into the EHR and at least say, now you can close the notes quicker. You don't need to type it up at 8 or 9 o' clock at night and then start again 7 o' clock in the morning. And I think that has been something that we have prioritized. Now we're starting to look at others is again operational efficiency, more on how do we do prior authorization and how can we help, how can AI help that workflow? And again, it's very much focused on patient facing activities. And sure we are looking at AI for IT operations we're looking at through our erp, but our main focus is really around the patient facing stuff. But we do want to do it in a controlled way. So I established an AI governance group back in January. We meet once every six or seven weeks to talk about AI initiatives and challenges, policies, setting the guardrails up and making sure we understand how and when to use AI. I fully know that AI has been used the last 18 months or 2 years by staff using ChatGPT and those tools. And we are looking at which of those tools can we start shutting off and say don't use this with it within your organization. But we have to understand and accept that AI is there. And now we just have to provide the guardrails and the controls around how do we manage what's being uploaded, what's being shared and provide staff with the necessary training on how to use these tools effectively.
• 37:47
  Speaker C: Yeah, and you guys have the fun of all of the HIPAA protected information also, so you could be very careful about that and make sure that the people who don't normally use email are aware of the ramifications of dealing with that and asking those kinds of questions.
• 38:05
  Speaker A: Especially if you start talking about predictive AI where some of the junior staff, even doctors and, and nurses are starting to type in questions to an AI agent saying I have a patient with these symptoms, you know, what prescription should I give? And then generative AI comes up with an answer. Sure, that they can ask all these questions, but they still have to go back and validate it because we only misdiagnosis away from a lawsuit. And that's what we need to be cautious of. While a lot of people say AI is going to be revolutionizing within the healthcare, fully agree. And I think it has a lot of excellent use cases, especially in large hospitals and labs and X rays and all those. And also within not for profit, we just have to be a little bit more conservative when it comes to the deployment of AI, in my opinion, to make sure we do it in a controlled manner so we know exactly what the AI tool will do, where the data is stored, how the data is being processed and what the staff have access to and how they use that data. So it is a little Bit more complicated I think within healthcare and that's why we Little bit more conservative.
• 39:08
  Speaker C: No, that's good. And you're starting off in the right place with the oversight or the steering committee and the governance committee over that and then just working with your data to make sure that that's solid. And then we've got to educate all of our people how to use it, when to use it, why to use it, when to trust it, when not to trust it, because well, AI told me to. Is never the defense or not a viable defense. And I'm sure we're still facing our times of hearing people use that.
• 39:39
  Speaker A: Yeah, absolutely.
• 39:41
  Speaker C: So through all of the discussions today and all of these things that we've been talking about, are there any thoughts or any things that you want to share with our peers at the same level or with those that are following behind us? Any hard earned lessons that you'd love to save somebody else? The page Pain of learning this is
• 40:03
  Speaker A: where my background might differ slightly from others is I shared my plans with my leadership, with my manager and have very open and transparent, you know, conversations about where we did good and where we did bad and then if we do bad, how do we get better and, and make sure I have the buy in from my leadership to or for my stakeholders for the various projects and initiatives we do. Sure, some of the technical stuff is something that I think we're hired to do like installing network and maintain that. But what I'm talking about is more on projects that has a deeper impact on the business like the ERP project or the HR project. Listen, I was spearheading the meetings, the demos, the RFP process with multiple vendors, but at the end of the day it was HR or finance final decision on which product they want to go with. They play a very important role in getting the requirements right, getting the demos right, getting the questions right, and then picking a system that they believe is the best suited for their operations. And then we will help implement it and help managing that part of their costs as well. And then the user adoption is always a challenge and but that's really how I would recommend most people deal with into making sure that the business and the stakeholders are involved in as many decisions as possible so we can help grow the organization well and it's awesome
• 41:28
  Speaker C: advice because the more that we involve the leaders of these different groups that we're trying to help with technology, the better informed they are. Then they bring more of their people into the discussion and those people get a chance to have say in which product we're choosing and implementing for them and that it's on target for what they're trying to accomplish and how it affects their day to day. So you get that buy in at the beginning instead of trying to train it in after the fact. Because trying to train buy in, I have yet to hear anybody run a course on how to train buy in.
• 42:09
  Speaker A: Yeah, I'm not sure it's something you can train on. It's more of how you tell stories, how you interact with your peers and your leaders.
• 42:19
  Speaker C: I promised you a question at the beginning of this and so now I think it's about time to find out. Make a prediction. What do you think that we might be talking about as IT leaders in 18 months that we're not talking about today? What's your prediction?
• 42:35
  Speaker A: I, I do think AI is going to be talking about again in 12, 18 months. I don't think it's, it's going to be heavily deployed as some gurus say it will be. And I think it's something we need to take stock of in 12, 18 months time and really assess where are we with the whole AI conversation, the whole AI data centers, the whole AI governance, the whole data management within AI. I think we've given it too much free reign and I think we need to figure out a way of getting some control of AI and how it's actually deployed. Everybody can sit on their lounge chair in a garden and just do nothing. While AI is working, we still have to learn, we still have to skill up our staff and we still have to make sure that the AI tools actually work the way we want them to work. And you can have 20 year old kids writing AI agents but at the same time someone needs to understand the end to end process in order for it to make sure that the data that comes out of the AI is actually validated somehow so that we create in 12 ways on SIM. We're going to have to have a. Not a reset, but showing a reality check on where we are with AI and how it's operating within the governments, within healthcare, within businesses in general.
• 43:44
  Speaker C: Yeah, I tend to agree on that one. Any final parting thoughts? Anything you want to leave your peers with or you got any side projects or personal projects that you want to
• 43:54
  Speaker A: promote work Life balance often changes when you move into a non for profit. Right now I'm able to help my team at least try to work 9 to 5, spend time with their families and friends over the weekends. We try to avoid having projects running over the weekends or nights. It will happen with certain changes and stuff like that. But by and large we try to do everything nine to five, whereas in corporate America, often you could easily work 60, 70 or 80 hours a week and get calls on Saturdays and Sundays from around the world, which destroys your work life balance, which I think is important.
• 44:28
  Speaker C: I fully agree on that. That work life balance. As a young man I went to one extreme and now as I'm getting a little on or long in the tooth, as they like to say, I definitely think that it's one of the most important things that we can protect for ourselves and for our teams is that work life balance.
• 44:48
  Speaker A: Yeah. And I think it's important to show the younger generations as well as you can still achieve a lot of things within the normal time span. And let's just plan differently and plan it out based on the workloads we have. And then I think that would help them a lot.
• 45:00
  Speaker C: Yeah. And that's a challenge though, learning how to plan all of that out and to achieve those goals like. Like you were talking about with your team in Ireland. Meeting those goals is paramount default credit.
• 45:12
  Speaker A: Absolutely.
• 45:14
  Speaker C: Mikkel, thank you very much for your time and your experience. We truly appreciate that and hope to see you and more of the listeners at the you've been heard.com community. Please stop by, join us, listen in, or join in on the conversation. Help us talk about these kinds of topics and the best ways to handle them. There's so much that we can teach each other without having to compete with each other, which is nice.