Latest / Becker’s Healthcare Podcast / Informatics, AI Governance, and Cybersecurity with Joseph Izzo, MD

Transcript

Informatics, AI Governance, and Cybersecurity with Joseph Izzo, MD · Becker’s Healthcare Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
• 0:04
  leaders together to unpack the most pressing issues
• 0:06
  facing the industry.
• 0:08
  And every year, those conversations shift in profound
• 0:10
  and unexpected ways.
• 0:12
  This April, more than 3,500
• 0:14
  healthcare executives will return to Chicago for Becker's
• 0:17
  sixteenth annual meeting. Seven ninety five elite speakers
• 0:21
  will offer new lessons, new case studies, and
• 0:24
  predictions about what comes next.
• 0:26
  Join us April 13 through the sixteenth.
• 0:29
  For the agenda and event details, visit beckershospitalreview.com
• 0:33
  and click on the events tab in the
• 0:35
  upper right.
• 0:38
  This is Scott Becker with the Becker's Healthcare
• 0:41
  Podcast.
• 0:42
  We're we're thrilled today to be joined by
• 0:44
  doctor Joseph Izzo. And doctor Izzo is the
• 0:47
  chief medical information officer at the San San
• 0:50
  Joaquin General Hospital.
• 0:52
  He's also a Rutgers graduate, Robert Wood Johnson
• 0:55
  Medical School,
• 0:57
  emergency physician.
• 0:58
  Doctor Izzo, can you take a moment and
• 1:00
  introduce yourself? Thank you.
• 1:03
  Yeah. Of course. And it's, it's great to
• 1:04
  be here, Scott. Thank you for having me.
• 1:06
  Like you mentioned, I I'm a practicing emergency
• 1:09
  physician. I'm CMIO for San Joaquin. That's a
• 1:11
  public teaching hospital and level two trauma center
• 1:14
  out in Central Valley, California.
• 1:16
  And in my role, I I lead our
• 1:18
  informatics and clinical analytics teams, oversee the innovation
• 1:21
  and AI governance strategy, and serve as a
• 1:23
  liaison between our frontline clinicians and our technology
• 1:26
  and IT teams. And, actually, as you mentioned,
• 1:29
  my background is actually in computer science before
• 1:32
  medicine, which really shapes how I work at
• 1:33
  that intersection of clinical care and technology. But,
• 1:36
  of course, I am speaking from my own
• 1:38
  experiences and observations, and I I appreciate you
• 1:40
  having me here. Well well, thank you so
• 1:42
  much for joining us. And and talk about
• 1:43
  that, that intersection of being a physician, an
• 1:46
  emergency physician,
• 1:47
  computer science, background,
• 1:50
  and and and and talk about what trends
• 1:52
  you're watching at the intersection of these two
• 1:54
  things, which seems to be at the middle
• 1:55
  of everything.
• 1:56
  Talk a little bit about that that computer
• 1:58
  science and and medical background.
• 2:00
  Yeah. I I think, like most people in
• 2:02
  my position,
• 2:03
  there's been a a major wave of innovation.
• 2:06
  We've certainly seen it over the last few
• 2:08
  years with larger English models, and that's translated,
• 2:10
  to Ambien AI and scribes,
• 2:13
  clinical search or information retrieval tools. And that's
• 2:16
  really exploded,
• 2:17
  among physician and clinician use.
• 2:20
  But, it's interesting that I I don't know
• 2:22
  that anything else has quite reached that level
• 2:24
  yet. And so, I'm I'm constantly monitoring trends
• 2:27
  for any promising areas. And I actually saw
• 2:28
  some,
• 2:29
  at the recent Becker's IT in October where
• 2:31
  there was some progress in clinical summarization,
• 2:35
  agent communication tools, scheduling referral assistance,
• 2:38
  tools embedded within the EMR, and even some
• 2:41
  operational applications. And I'm especially looking, for how
• 2:44
  that applies to smaller community hospital settings like
• 2:46
  ours.
• 2:48
  At the same time, though, and and and
• 2:49
  maybe this ties a little bit into a
• 2:51
  cyber security background, I'm equally focused on where
• 2:54
  innovation may be outpacing our safeguards.
• 2:57
  You know, we are constantly looking to make
• 2:59
  sure our tools are safe, responsibly
• 3:02
  implemented, and secure,
• 3:04
  and,
• 3:04
  particularly
• 3:06
  cautious about those solutions that are unvetted and
• 3:08
  maybe actually marketed directly to clinicians and in
• 3:11
  some ways skirt governance,
• 3:13
  because those actually drastically expand the threat surface.
• 3:15
  And we also call that shadow AI or
• 3:17
  IT, and that's something we need to be
• 3:18
  very cautious and aware of. And I think
• 3:21
  the two of that reflects your question in
• 3:23
  probably a trend in itself, how the CMIO
• 3:26
  role and folks in my position have found
• 3:28
  ourselves changing in the recent years.
• 3:30
  You know, traditionally, we were the clinicians that
• 3:32
  were
• 3:33
  good at the computer systems, good at the
• 3:35
  electronic medical record, but now we're wearing a
• 3:38
  a lot of hats by necessity. That includes
• 3:40
  governance,
• 3:41
  cybersecurity, like I mentioned, regulatory awareness. And it
• 3:44
  seems like it's very important now to stay
• 3:46
  one step ahead
• 3:47
  and really deepen our understanding of each of
• 3:49
  those required aspects as this technology explosion continues.
• 3:53
  Thank you. And and take a moment on
• 3:56
  let me ask you a couple of different
• 3:57
  questions. You mentioned a couple of things that
• 3:58
  are really interesting. This concern about technology versus
• 4:01
  guardrails, innovation versus governance, cybersecurity
• 4:05
  concerns, and so forth. Well, let me start
• 4:07
  on one side of that, which is what
• 4:10
  technology
• 4:10
  and and and your point is so well
• 4:12
  taken on a small mid sized hospital versus
• 4:14
  a $30,000,000,000
• 4:15
  system. Right. And you you have you have
• 4:17
  a chance to work across both quite frankly.
• 4:20
  What technology are you excited about
• 4:22
  at at a smaller general hospital
• 4:25
  that just excites you that that may be
• 4:27
  useful
• 4:28
  to the system, to providing patient care, to
• 4:30
  to physicians, nurses? What what what technology excites
• 4:34
  you?
• 4:35
  You know, I
• 4:36
  I wanna say that this wave of innovation
• 4:38
  we're talking about is really exciting because how
• 4:40
  quick the clinicians are adopting to the technology,
• 4:43
  wanting to get involved,
• 4:44
  bringing new tools to the table. But I
• 4:46
  also I I do wanna mention that that
• 4:48
  that bread and butter of informatics is also
• 4:50
  really
• 4:51
  energizing,
• 4:52
  because there there we haven't solved everything like
• 4:55
  like we've been talking about. And even in
• 4:57
  2026,
• 4:58
  there's something still satisfying actually about
• 5:01
  improving workflows and usabilities in in such a
• 5:03
  way that
• 5:05
  everyday clinical practice is easier and safer for
• 5:07
  those frontline teams.
• 5:09
  And it's it's still, to this day where
• 5:12
  even a small workflow change or small, introduction
• 5:17
  of innovative solutions can actually go a long
• 5:19
  way, and that is actually a large part
• 5:21
  of what drives me.
• 5:23
  And talk about informatics because, you know, so
• 5:26
  many of us that are not
• 5:28
  CMIOs
• 5:29
  or or not in the informatics space.
• 5:31
  Give me a definition of informatics. That's my
• 5:33
  dumb question for the day, but I think
• 5:36
  many of us would like to know.
• 5:38
  Give us a definition from a from a
• 5:40
  computer science person, somebody who's got your background.
• 5:42
  What does informatics mean exactly? Just give me
• 5:45
  that if you don't mind.
• 5:46
  You know, I fair. I really do think,
• 5:49
  simple is better. I that those folks who
• 5:52
  sit at the intersection between clinical front lines
• 5:55
  and,
• 5:56
  technology innovation, digital transformation.
• 5:59
  And, you know, we're not purely IT. We're
• 6:01
  not purely clinical. We we share that background,
• 6:03
  and that really allows us to serve as
• 6:05
  liaisons and translate between the two, which and,
• 6:08
  traditionally, not not anymore. Things are changing. Traditionally,
• 6:11
  those two groups have been siloed and have
• 6:14
  had different outcomes and goals, but I actually
• 6:16
  see them overlapping. And that's where folks like
• 6:17
  us, I think, really shine.
• 6:19
  So, doctor, so here here's the question. You
• 6:21
  would have also mentioned
• 6:23
  concerns about cybersecurity,
• 6:25
  and and you've got some systems running literally
• 6:27
  thousands of different modules, software programs, stuff like
• 6:30
  that, many trying to cut down. Where do
• 6:32
  you see the biggest risk from a cybersecurity
• 6:34
  standpoint, and where does that where does that
• 6:36
  keep you up at night?
• 6:38
  One of my concerns is is actually the
• 6:40
  nonmalicious actor, if you will, the person who's
• 6:42
  trying to
• 6:43
  maybe make a change to improve their work
• 6:45
  workflow,
• 6:46
  see more patients,
• 6:47
  and is actually attracted to those tools that
• 6:49
  are marketed directly to clinicians to solve those
• 6:52
  burdens.
• 6:53
  That introduced, like I mentioned, a larger threat
• 6:55
  surface, I believe, and it it causes,
• 6:58
  scenarios where we may not actually have control
• 7:01
  of where our data is going
• 7:03
  and,
• 7:04
  what's being what what is being used for,
• 7:06
  whether it's going to third parties.
• 7:08
  And I've I've heard from talking to other
• 7:10
  colleagues in the space, some of the conversations
• 7:12
  I had in October, that there isn't a
• 7:14
  really great answer for that that isn't making
• 7:16
  sure that you bring these folks to the
• 7:18
  table, explain the importance of governance, explain the
• 7:20
  importance of cybersecurity,
• 7:22
  and their responsibility
• 7:23
  to the patients and their data.
• 7:25
  The talk for a second, doctor Izzo, about
• 7:27
  this year, 2026.
• 7:29
  What are you most focused and excited about?
• 7:32
  Sure.
• 7:34
  You know, from from an organizational standpoint, there
• 7:36
  there's two things that I I think really
• 7:38
  stand out, and actually reflect a conversation I
• 7:40
  had with some of your team on a
• 7:42
  on a previous podcast, and that's about towards
• 7:45
  innovation and AI governance and,
• 7:47
  also towards data driven care. You know, I
• 7:49
  I'd mentioned we had a strong foundation that
• 7:51
  we built with clear policy, a governance framework.
• 7:54
  But over the last year, it's it's grown
• 7:56
  very iteratively into a robust,
• 7:59
  multidisciplinary structure. I mentioned that more and more
• 8:01
  clinical staff are are interested in getting part
• 8:03
  of the discussion, and the the group is
• 8:06
  represented
• 8:06
  by a number of clinical leaders, frontline staff,
• 8:09
  nursing,
• 8:10
  IT, pharmacy,
• 8:12
  operations, and security among others at that table.
• 8:15
  And the the the discussion, as I mentioned,
• 8:17
  is very lively. There's there's this very thoughtful
• 8:19
  responsible process now for evaluating existing tools and
• 8:22
  even looking at new ones and particularly looking
• 8:25
  at the tools through the lens of
• 8:27
  what's really important. Right? Like, patient safety, potential
• 8:30
  bias, responsible deployment. And I I'm really impressed
• 8:33
  that we're not above revisiting. We're very comfortable
• 8:36
  revisiting decisions that we've made in the past
• 8:38
  as technology and the landscape evolves. And then
• 8:41
  I I when I mentioned, data driven care
• 8:43
  in the past, you know, I I mentioned
• 8:44
  unifying disparate data sources and a few very
• 8:47
  strong use cases, and that's truly expanded over
• 8:50
  the last, year, maybe year and a half
• 8:53
  into population health and quality initiatives across the
• 8:56
  system. And that's including areas like maternal health,
• 8:59
  early recovery after surgery. And both of these
• 9:01
  are, I think, are are kinda tied back
• 9:03
  to your question on informatics and and where
• 9:05
  the landscape is changing in that. This is
• 9:07
  a really great example of what's possible when
• 9:08
  you have clinical leadership, IT,
• 9:11
  informatics truly working together to a shared goal
• 9:13
  and not staying in silos.
• 9:16
  Thank you.
• 9:17
  Take a moment. I doctor Izzo, you've got
• 9:20
  this great career at the intersection of health
• 9:22
  care technology.
• 9:24
  You're a leader, CMIO.
• 9:26
  You're also a practicing emergency physician.
• 9:29
  Talk a bit about what advice do you
• 9:32
  give to
• 9:34
  emerging leaders about staying energized, about doing several
• 9:37
  things, about staying excited about what they do.
• 9:40
  What advice do you give to emerging leader
• 9:41
  physicians?
• 9:43
  Yeah. You know, with with everything that we
• 9:45
  just talked about, I think that most important
• 9:47
  lesson is leadership is gonna be continuous evolution,
• 9:50
  and it's very important, at least for me,
• 9:52
  that I stay curious and keep learning. And
• 9:54
  that that could be something new. It could
• 9:56
  also be deepening understanding of of something within
• 9:58
  our domains because no matter what, that pace
• 10:01
  of change is is is pretty much astronomical
• 10:03
  now, if you will. But what I I've
• 10:05
  learned also is that we don't really have
• 10:07
  to do this alone.
• 10:08
  Through conversations like these, conferences,
• 10:11
  professional communities, some discussions among peers, you know,
• 10:14
  it's it's incredibly valued. I would actually just
• 10:16
  listen and share best practices because everyone, I
• 10:19
  think, is in the same boat for this.
• 10:21
  And to take actually a step further, stepping
• 10:23
  or, you know, moving outside of your comfort
• 10:25
  zone has been significant for me. I feel
• 10:27
  like I've gained so much from actually listening
• 10:29
  to frontline teams,
• 10:31
  partnering with people in other departments, even in
• 10:33
  areas traditionally where informatics may not have been
• 10:36
  involved.
• 10:37
  Because, you know, like, we're going past that
• 10:38
  point of silos, but some of the best
• 10:40
  progress I've seen actually comes from such interdisciplinary
• 10:42
  and maybe even cross system collaborations.
• 10:46
  And and and and take a second on
• 10:48
  that that piece of change.
• 10:50
  It it seems like, you know, that the
• 10:53
  piece of change
• 10:54
  could be so scary for so many people
• 10:56
  that that piece of change. I mean, in
• 10:58
  some ways, it leads you back to just
• 10:59
  do your job because it's so scary out
• 11:01
  there with so so many things that are
• 11:02
  changing. How do you deal with that pace
• 11:04
  of change?
• 11:05
  You know, it's not easy.
• 11:07
  I will say that I I think I
• 11:08
  said it before
• 11:10
  that
• 11:11
  the barrier for entry is much lower than
• 11:13
  it's been with many of these tools to
• 11:15
  help guide. You know, some of our students
• 11:18
  and residents talk about how they augment their
• 11:21
  studying with some of the available tools. And
• 11:24
  I really think that that, drives the point
• 11:26
  home is that if you're moving a little
• 11:27
  bit outside of your comfort zone and embracing
• 11:29
  some of this technology, it may actually,
• 11:32
  in some ways, paradoxically soften the the overwhelming
• 11:35
  feelings behind tackling that new learning or this
• 11:37
  new tech that new pace of change.
• 11:40
  Thank you. It it it does seem
• 11:42
  really challenging for so many, and and then
• 11:45
  it seems like I mean, you do this
• 11:47
  mix of things. You're in a leadership role.
• 11:48
  You do emergency physician shifts. Both of those
• 11:51
  are stressful, but it might seem sometimes if
• 11:53
  you could focus your mind on just doing
• 11:55
  emergency care that it'd be meant it must
• 11:57
  be nice sometimes to have those shifts. We're
• 11:59
  not thinking about all the leadership technology and
• 12:01
  changes and things that are going on. Or
• 12:03
  how do you how do you balance that?
• 12:05
  Actually, in in some ways, I I would
• 12:07
  say that this helps augment the shifts in
• 12:09
  some way because
• 12:11
  it it means I I understand the system
• 12:13
  behind the where I'm practicing.
• 12:16
  And particularly
• 12:17
  since technology you know, the the EMR has
• 12:19
  has effectively become one of our our vital
• 12:22
  tools in the care of a patient. And
• 12:23
  being able to understand, some of the nuances
• 12:25
  of that and how how that really integrates
• 12:28
  into our practice, actually, I think sometimes makes
• 12:30
  those shifts, a little bit more grounded, to
• 12:32
  be honest.
• 12:33
  No. No. I love that. And for those
• 12:35
  people that talk about, oh my god. The
• 12:37
  EMR is too complicated. We have to get
• 12:38
  rid of it. We're never getting away from
• 12:40
  the EMR. We need it. So we better
• 12:41
  find a way to work with it. I
• 12:43
  mean, that that discussion is twenty years old
• 12:45
  already.
• 12:45
  Okay. But no. You're I mean, we we
• 12:47
  the EMR is so critical. I mean, it's
• 12:49
  a patient perspective. You get some place, they've
• 12:51
  already got a lot of your records, and
• 12:52
  they're not having to there's less and less
• 12:54
  having to piece everything together because they've already
• 12:56
  got it. It's so critical
• 12:57
  as you go across sites, across places, across
• 13:00
  states, everything. No. I I couldn't agree with
• 13:01
  you more. Thank you so much, doctor Izzo.
• 13:03
  Was there anything that I didn't ask you
• 13:05
  that I should have asked you?
• 13:07
  No. No. I I think, this has been
• 13:09
  a wonderful discussion, and I I really appreciate
• 13:11
  it as always, having me. Well well, I
• 13:13
  appreciate you taking the time in the, in
• 13:15
  the in the middle of the day to
• 13:17
  do this. Just a great pleasure to visit
• 13:19
  me, doctor Izzo. Amazing career. Thank you so
• 13:21
  much for joining us.