Latest / Becker’s Healthcare Digital Health + Health IT / Steven Ramirez, Chief Information Security Officer at Renown Health

Transcript

Steven Ramirez, Chief Information Security Officer at Renown Health · Becker’s Healthcare Digital Health + Health IT

• 0:00
  This is Laura Dirdo with the Becker's Healthcare
• 0:02
  podcast.
• 0:03
  I'm thrilled today to be joined by Steven
• 0:05
  Ramirez, chief information security and tech officer for
• 0:08
  Renown Health. Steven, it's a pleasure to have
• 0:09
  you on the podcast today. Hey, Laura. Great
• 0:12
  to be with you. Absolutely. Now I know
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  it's always fascinating to speak with you because
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  you've got such a great big picture and
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  and future focused view of technology, cybersecurity,
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  considering all the different things that are happening
• 0:24
  in health care today,
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  AI, as well as government policy changes and
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  more. So, you know, I'm looking forward to
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  this conversation.
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  But before we begin, for those who are
• 0:33
  just starting to listen to the Becker's Healthcare
• 0:35
  podcast, can you introduce yourself and tell us
• 0:37
  a little bit more about your background?
• 0:39
  Yes.
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  Again, good to be with you. My name
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  is Steven Ramirez, and I'm the chief information
• 0:44
  security and tech officer at Renown Health. I've
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  been there for almost four years.
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  Renown Health is up in Northern Nevada, so
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  it covers the Reno, Tahoe area. We're a
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  integrated health system,
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  four different locations and
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  fresh transplant center, you know, urgent care. We're
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  the area trauma center. So really a lot
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  of different service lines that we have that
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  are to serve our community and looking to
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  grow different components of that moving forward.
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  That's great to hear. And, you know,
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  I am excited to kinda talk to you
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  because I I think there's such a diverse
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  patient population that you serve and certainly a
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  lot of, key considerations in that when you
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  think about cybersecurity. So, can you give us
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  a little lay of the land? What's happening
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  right now? What are you is top of
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  mind for you, the opportunities and headwinds that
• 1:33
  you have your eye on?
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  Well, there's a lot in cybersecurity.
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  I think that just, you know, AI is
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  continuing to be
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  a buzzword, but a lot more of that's,
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  coming to fruition that we saw
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  over the weekend that
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  there was news that the Chinese government did
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  the first ever AI autonomous attack on some
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  various interests.
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  So, you know, we've been talking for it
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  a long time to really say how is
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  AI gonna be used for the, you know,
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  good, bad, and the ugly. We finally saw
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  how threat actors can leverage it
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  to target various organizations. So that's something that
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  is we're continuing to look at our cybersecurity
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  posture, hygiene,
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  and emerging threats to really keep front and
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  center of mind that AI is only gonna
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  get more sophisticated
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  in tactics and techniques, but also
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  somebody that might not have a lot of
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  technical acumen is gonna be able to do
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  a lot more with getting up to speed
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  and becoming more sophisticated
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  just on AI being able to enable their
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  overall tech
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  ability that they used to not be able
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  to do, and really just help fast track
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  a lot of the attacks
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  from, you know, phishing to social engineering to,
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  you know, being able to do reconnaissance. You
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  know, before threat actors would look at your
• 2:44
  organization for weeks, months, etcetera, they can learn
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  so much about the organization, you know, leadership,
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  players, service lines, partners, and all of that
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  in a click of a button or a
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  phrase. So that's really where
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  we're having to stay up to speed and,
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  you know, continue to evolve and make sure
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  that we're, you know, addressing these risks as
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  we move forward.
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  That makes a lot of sense and is,
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  you know, really fascinating to hear about,
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  the Chinese government that first ever autonomous attack
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  using AI.
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  When you look at AI, you know, within
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  the health care space,
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  in particular,
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  thinking through, you know, on the organization side,
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  what are some of the things that,
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  chief information security officers and just any leaders
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  within the health care space need to think
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  about and
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  and understand when it comes to AI, and
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  they're trying to look at their strategy, trying
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  to be safe, but
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  at the same time, wanting to be, you
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  know, on the forefront of the technology
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  in leveraging it to the best of their
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  capabilities.
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  So what do you really have to watch
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  out for if you're a leader,
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  of the health care system trying to figure
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  out, you know, what AI is gonna make
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  sense for you?
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  Well, it's really critical to,
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  have strong governance because
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  there's a lot of different AI
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  buzzwords and what is AI and not AI.
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  So it's like there's machine learning. There's,
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  you know, just using it for searching. There's
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  autonomous AI that use, you know, machine learning.
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  Like, there's there's different components that make up
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  AI. So it's like, you first need to
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  be educated on
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  what is and isn't AI,
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  how it's used in the organization or as
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  a subset of a variant of another
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  application and or system. But it's also important
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  to understand the build versus buy question as
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  part of this governance structure that you really
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  need to understand. Is this something that you
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  wanna go with a tried and true partner?
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  So like the Microsofts of the world, the
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  epics that, you know, have embedded and road
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  maps with AI versus, you know, thinking that
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  we're gonna try to build it, create a
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  lot of these components ourselves, that it's a
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  lot more
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  mean time to maturity,
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  easier to implement, easier to manage, easier to
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  secure if it's with one of your partners.
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  So that's really very important to that, but
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  also having strong data governance because, again, like
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  a lot of different tools, it's dependent on
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  data. If it's either,
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  you know, from a machine learning, you know,
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  looking at activities and components over time or
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  actually leveraging the data to make decisions, because
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  I know there's a lot of opportunity
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  on that on both sides of the house
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  on looking at, you know, those two different
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  types of AI. So it's again, that's the
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  importance of AI use cases, the
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  crawl, run, walk, and, you know, also doing
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  due diligence
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  to really make sure that you you are
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  protecting your organization from a data protection standpoint,
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  that there's a lot of different security tools
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  that we can leverage to make sure that
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  we're keeping everything in house, making sure that
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  data isn't being misused, and that we're really
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  just supporting the clinicians in the intended use.
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  Absolutely. A 100. I I think that's such
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  helpful advice and and really, great bullet points
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  to take back and understand and apply to,
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  your own organization.
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  Now I think when you look at the
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  future, you're thinking about growth, from an organizational
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  strategic standpoint. I know there's a lot of
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  initiatives out there,
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  trying to, you know, continue to expand access
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  to care and apply technology.
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  What does it look like for you when
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  you're thinking about growth and adding value to
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  the organization overall? What's important,
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  for you to do in a part to
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  your, executive team,
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  to make sure that on the cybersecurity side,
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  everything is in top shape?
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  It's important for us to make sure that
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  we're
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  aligning to the strategy and growth of the
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  organization
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  just because of how technology is enabled and
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  the digital front door that we're continuing
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  to grow,
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  optimize, and expand to really, you know, support
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  our patients is that that's just expanding your
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  risk
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  your risk profile,
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  and it's really just important that everybody understands
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  that when we're looking at various technology that,
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  you know, we're able to always use good
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  cybersecurity
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  hygiene,
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  good
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  good practices in place, and I think that
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  that all goes into the cybersecurity culture, just
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  the mindset. So it's really, again, important that
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  as a CISO of the organization
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  that we we have various committees. So it's
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  always important that we're, I always say, being
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  storytellers. So we need to understand about
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  educating people. Like, we had just spoke to
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  the first autonomous AI attack. You know, that's
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  gonna go out on being a blitz in,
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  you know, my governance risk and compliance, our
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  audit and compliance steering committee, our operational compliance
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  meetings, like, really helping say, guys, this is
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  a lot of what we've been focusing on,
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  building the foundation,
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  putting our investments and controls to help protect
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  about this.
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  So it's, again, building in that layered
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  approach to really just make sure that,
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  we're protecting
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  against today's threats and the threats of tomorrow
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  with how technology is just continuing to evolve.
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  So, again, being a good partner,
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  educating staff on what's going on in the
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  world because, again, they're looking at, you know,
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  headwinds and other strategic components on their side
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  of the house. So it's really just important
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  that if it's ingrained into people's DNA,
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  they know cybersecurity is an important pillar to
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  what we need to do as an organization,
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  that it just helps become naturally. So that's
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  just where, again, my role to help really
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  just spread the gospel, I like to say,
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  internally to really make sure that we're we're
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  partnering with our business, that they understand what
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  we're here to do, how we're here to
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  help, and then abound around the frameworks and
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  foundations that we're doing to make sure we're
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  securing the organization.
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  That makes a lot of sense, and it's
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  just really helpful to understand. I'm thinking from
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  that lens of,
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  being you know, setting up the governance, the
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  right committees,
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  compliance, and more. And, you know, from your
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  perspective, as you see the landscape changing with
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  AI and and just becoming more sophisticated
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  technologically,
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  is there anything that you have to do
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  differently,
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  with your teams or the the cybersecurity
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  and and IT folks working with you? You
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  know, are you looking for any skills, expertise,
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  or or something that, you know, you're more
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  often partnering with other organizations again to, you
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  know, make sure that you're in a great
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  place?
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  No. I think that's a great question that
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  I think
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  the hype of AI
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  really makes people think that we have to
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  change our approach.
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  But from cybersecurity
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  practice that if we focus on the fundamentals,
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  I've always said that, that it'll set us
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  up to
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  be successful in any net new technology, emerging
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  risk, etcetera. Because if you really think about
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  looking at phishing, social engineering, that's gonna, you
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  know, be some something that threat actors are
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  using,
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  you know, to try
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  to target our organizations. If you're thinking about
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  vulnerability management and patching,
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  that's gonna, you know, apply to AI and
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  technologies as well.
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  If you're talking about data governance and data
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  management, that applies to that as well. Data
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  loss prevention, that just becomes a little bit
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  more paramount on, you know, the fast pace
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  of data, it needing more data,
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  looking at monitoring and alerting. So if you
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  know, I can go on and on a
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  lot of about this access controls. But, again,
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  if we're doing a lot of that very
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  well,
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  can really mature in some of these key
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  areas, that it'll set us up for success
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  for, you know, how we wanna use AI,
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  how we can protect about
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  protect our organization from threat actors, but also
• 10:15
  mishandling internally. So, again,
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  it's really sticking to those fundamentals will help
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  us grow,
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  holistically regardless of what technology is out there.
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  So it's it's really important to, you know,
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  just articulate that, make sure that your cybersecurity
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  strategy
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  is sound and more focused on
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  practices and principles than trying to nip off
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  every net new tech and or risk that
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  rolls around the corner.
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  Kind of like emergency management, I like to
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  have an all hazard approach that, you know,
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  we can't spend all day just thinking about,
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  you know, what if this, what if that.
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  It needs to just be like, we're gonna
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  focus on identity. Regardless of a type of
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  attack, we're gonna have, you know, alerting,
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  isolation,
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  etcetera,
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  associated with that. So, again, really, any cybersecurity
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  hygiene practice
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  approach can apply to technologies like AI and
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  and enable us to protect the organization
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  just organically,
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  if we're doing our jobs well.
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  That's a great philosophy and just fascinating to
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  think about having that true north and, you
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  know, finding a way that you can really,
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  stay grounded no matter what happens.
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  I'm curious too, you know, in looking at
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  the next year or so, I know a
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  lot of organizations are seeing some financial challenges,
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  potentially,
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  funding cuts and those kinds of things. And
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  so, you know, for those who may be
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  tightening the belt straps a little bit, what
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  is one risk or investment that's really still
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  worth making this year, especially given,
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  you know, how quickly things are changing the
• 11:46
  technology as well as the cybersecurity space?
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  Well, governance is free. So I think that
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  it's always important. Strong governance goes a long
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  way within the organization,
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  being creative
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  in how you can attack different components. Like,
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  for example, we see, you know, a rise
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  in phishing,
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  you know, targeting various players. We've been invested
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  a lot in, you know, technologies, awareness, training,
• 12:11
  etcetera, but have also just looked at blocking
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  certain
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  roles from having external email. So it's like,
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  that's a no low cost
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  concept. So I think that as we continue
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  to look at the headwinds and potentially needing
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  to, as you said, you know, look at
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  cost reductions, you know, staying flat from our
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  overall budgets, it's really important to think outside
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  of the box, do a lot of the
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  foundational elements, do those very well versus chasing
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  all the shiny bright objects within
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  IT. I think focusing on identity access managements
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  are the most critical component. I consider myself
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  an identity junkie that 80% of all cybersecurity
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  events and attacks stem from
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  an identity based attack. So if you think
• 12:56
  about multifactor authentication, privileged access management,
• 13:00
  identity governance, looking at, you know, into service
• 13:03
  accounts, looking into more than just those components,
• 13:06
  building a defense in-depth strategically
• 13:09
  on
• 13:10
  identity
• 13:11
  will go a long way for organizations. So
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  I think any way that you can better
• 13:16
  focus on identity access management versus people coming
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  and going from the organization,
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  that that's of the utmost importance. And then
• 13:23
  having data in analytics
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  help drive decisions moving forward that I like
• 13:29
  to use. The example of the movie Moneyball,
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  you know, that they had the strategic and
• 13:33
  analytics guy that was going in to make,
• 13:35
  you know, different decisions on that. That that
• 13:37
  really having analytics, we've talked about it for
• 13:39
  a long time. I think AI is where
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  that can help us look at things on
• 13:44
  what's working well, you know, other areas that
• 13:46
  we can focus on,
• 13:47
  and really just help us drive and be
• 13:50
  more tactical,
• 13:51
  in this. And I think that, again,
• 13:54
  yeah, just
• 13:55
  will go a long way in a good
• 13:57
  organizational culture as well because,
• 13:59
  it takes everybody in the organization to be
• 14:02
  successful.
• 14:03
  And by having
• 14:04
  your end users
• 14:06
  fully trained, aware, and, you know,
• 14:09
  drinking the Kool Aid on what we need
• 14:10
  to do. I like to say that it's
• 14:12
  really really goes a long way because there
• 14:14
  are are some of our bigger risk items
• 14:17
  we need to look at, but also our
• 14:18
  first line of defense. So always leveraging them
• 14:21
  to really help us fight our good fight,
• 14:23
  for what we're doing at Renault.
• 14:26
  Absolutely. I love that. And, you know, when
• 14:28
  you speak about governance being so important and
• 14:30
  actually, you know,
• 14:32
  being
• 14:33
  a no cost, way you can be preventative,
• 14:36
  on some of the cybersecurity and attack fronts.
• 14:39
  Is there anything unique that you do at
• 14:41
  Renown that's worked particularly well and or, you
• 14:43
  know, looking into next year, anything you're trying
• 14:45
  to do a little bit differently to meet
• 14:47
  the needs of the day?
• 14:48
  Well, we're always trying to
• 14:50
  we wanna not be Swiss cheese on our
• 14:52
  intake process, so I think that building layers
• 14:55
  to that's super important. So our
• 14:58
  our president's council
• 15:00
  team has final approval of a lot a
• 15:02
  lot of the various projects that are coming
• 15:04
  in. We have a phase gate process as
• 15:06
  well. So that's a multifaceted group that has
• 15:09
  finance,
• 15:10
  IT,
• 15:12
  legal, you know, various stakeholders throughout the organization
• 15:14
  to look at different pieces. So that's, you
• 15:16
  know, a good governance structure. We also have
• 15:19
  an intake of doing cybersecurity
• 15:22
  assessments,
• 15:23
  AI assessments that we've rolled that out,
• 15:26
  and looking at various subsets of that as
• 15:28
  well. So I think that that's very important
• 15:30
  to, you know, make sure a technology that's
• 15:32
  coming in does or doesn't have AI capabilities
• 15:35
  so that once you have it,
• 15:37
  you're not dealing with the problem after the
• 15:39
  fact. So getting that much information upfront and
• 15:42
  then understanding how that tech's gonna work in
• 15:44
  your ecosystem is part
• 15:46
  of a onboarding and review session. So, again,
• 15:48
  as you're saying, we have various layers, and
• 15:50
  then, ultimately,
• 15:51
  I sign off on our DocuSign process before
• 15:54
  anything's purchased,
• 15:56
  because then that's ensuring that we did do
• 15:58
  a security review.
• 16:00
  Again, that's a lot more work, but puts
• 16:02
  the accountability on us to make sure that
• 16:04
  we're actually reviewing,
• 16:07
  looking at the cybersecurity
• 16:08
  posture,
• 16:09
  looking at any risk that some technologies might
• 16:11
  be bringing into the organization.
• 16:13
  But just again,
• 16:15
  multiple committees seems like it can be tiresome,
• 16:17
  but, you know, having different targeted components like
• 16:20
  us having a governance risk and compliance that
• 16:22
  we can speak more to compliance, privacy, and
• 16:24
  security aspects, as well as data governance,
• 16:27
  which is a key component to that. And
• 16:29
  then having our, you know, committees on onboarding
• 16:32
  and looking at new technology from a strategic
• 16:34
  perspective, and then thinking about our audit and
• 16:36
  compliance committee, and then thinking about our business
• 16:39
  continuity and disaster recovery committee,
• 16:41
  and then our emergency management committee. So it's
• 16:43
  like we have so many various committees that
• 16:45
  are centralized on, you know, driving their strategic
• 16:48
  work streams, but there's always such a big
• 16:51
  subset on data protection, cybersecurity,
• 16:53
  and that that that enables us to make
• 16:56
  sure that we have that seat at the
• 16:57
  table and we're partnering with the organization to
• 17:00
  really make sure that, you know, we have
• 17:01
  an understanding of, you know, where we're going,
• 17:04
  what we're currently doing, and being able to
• 17:06
  have those discussions as needed.
• 17:09
  That's so helpful to understand. Thank you for
• 17:11
  digging a little bit deeper there. Now before
• 17:13
  we wrap up, I'm curious, what do you
• 17:15
  see as some of the best opportunities for
• 17:16
  growth in the future?
• 17:19
  Well, I think to what you said before,
• 17:21
  I think that we're getting to a point
• 17:22
  that technology and AI will be able to
• 17:25
  help
• 17:26
  push the envelope on
• 17:28
  doing some, you know, maybe level one, level
• 17:30
  two stuff. I think voice
• 17:33
  calling and AI
• 17:34
  is gonna be a huge opportunity for driving
• 17:36
  costs down from a service desk perspective. Because
• 17:39
  if you think about it, you know, we've
• 17:40
  come a long way in just that evolution
• 17:42
  of
• 17:43
  calling
• 17:44
  a service desk. You talk to the live
• 17:45
  agent, then we've gone to, like, the IVR
• 17:48
  perspective where you can press 1 for this
• 17:49
  issue, press 2 for this, to now to
• 17:52
  the point that we have autonomous AI that
• 17:54
  you're seeing, like, with Alexa and Siri's, who's
• 17:57
  probably gonna turn on as I say your
• 17:58
  name. But really that conversational
• 18:01
  component. That if you think about being able
• 18:03
  to build knowledge base
• 18:05
  for some of the key areas that we're
• 18:07
  seeing in IT from, you know, reporting an
• 18:09
  incident to I need my password reset to
• 18:12
  how how do I do this, how do
• 18:13
  I do that. There's some very high level
• 18:15
  pieces that we could start to look at
• 18:17
  building into that that can help drive down
• 18:19
  the necessity of
• 18:21
  having
• 18:22
  a service desk fully staffed to that and
• 18:24
  be able to scale up and down to,
• 18:26
  you know, some more basic elements to that.
• 18:28
  So I think that's where AI can do
• 18:30
  that as well
• 18:32
  as meeting and note taking and, you know,
• 18:34
  research
• 18:35
  and, you know, decision analytics, you know, once
• 18:38
  we get to that point. So I think
• 18:39
  that there's a lot of opportunity
• 18:41
  just in the progression that we're seeing AI
• 18:44
  and being able
• 18:45
  to actually start to deliver in some of
• 18:47
  these key areas, as well as I've seen,
• 18:49
  you know, night and day
• 18:51
  expansions and actual usability with on the clinical
• 18:54
  side for how they're gonna be able to
• 18:56
  use it to, you know,
• 18:58
  help curb physician burnout that we've been talking
• 19:00
  about forever more process optimization,
• 19:03
  you know, real time
• 19:04
  data analytic and,
• 19:06
  you know, a lot of different opportunities to
• 19:08
  that. So it's really exciting to be in
• 19:10
  technology right now. Also, it's kind of scary,
• 19:13
  on the cybersecurity side. But, again, that I
• 19:16
  think this is a great time for us
• 19:17
  to be able to leverage that, and that'll
• 19:19
  challenge a lot of health systems
• 19:22
  moving forward with us seeing some of these
• 19:24
  headwinds on how we can better leverage that,
• 19:27
  that technology to help us out, kind of
• 19:30
  on curbing expenses of staffing.
• 19:33
  Fantastic.
• 19:34
  That you know, it seems like a really
• 19:36
  great opportunity and something that I know a
• 19:38
  lot of organizations would welcome the technology,
• 19:41
  to do more of that on on the
• 19:42
  call desk, especially, and then how else they
• 19:44
  can leverage AI out in a smart and
• 19:46
  meaningful way. Steven, thank you so much for
• 19:48
  joining us on the podcast today. This has
• 19:50
  been such a fascinating and informative conversation, and
• 19:53
  I look forward to connecting with you again
• 19:54
  soon.
• 19:55
  Look forward to it. Thank you so much.