bb64fa90-b240-47fd-8973-0ded3a100b41/6-0
00:00:03.348 --> 00:00:08.391
with Zafar Chowdhury,
the former CDAIO of Seattle Children's

bb64fa90-b240-47fd-8973-0ded3a100b41/6-1
00:00:08.391 --> 00:00:14.425
and a healthcare industry expert for 40
years and a former or a licensed

bb64fa90-b240-47fd-8973-0ded3a100b41/6-2
00:00:14.425 --> 00:00:19.468
internist. So Zafar,
thank you so much for joining us today.

bb64fa90-b240-47fd-8973-0ded3a100b41/5-0
00:00:20.148 --> 00:00:21.308
Thank you for having me, Jordan.

bb64fa90-b240-47fd-8973-0ded3a100b41/8-0
00:00:21.788 --> 00:00:25.595
So today we're going to be discussing
trends in health IT,

bb64fa90-b240-47fd-8973-0ded3a100b41/8-1
00:00:25.595 --> 00:00:30.177
especially we want to focus on
specializing health IT versus commodity

bb64fa90-b240-47fd-8973-0ded3a100b41/8-2
00:00:30.177 --> 00:00:34.630
health IT. So if you could,
could we just start off by defining what

bb64fa90-b240-47fd-8973-0ded3a100b41/8-3
00:00:34.630 --> 00:00:39.599
those two concepts are and why would
anybody be interested in moving towards

bb64fa90-b240-47fd-8973-0ded3a100b41/8-4
00:00:39.599 --> 00:00:41.148
commoditizing health IT?

bb64fa90-b240-47fd-8973-0ded3a100b41/9-0
00:00:41.868 --> 00:00:45.117
Yeah,
so if you look at the services that

bb64fa90-b240-47fd-8973-0ded3a100b41/9-1
00:00:45.117 --> 00:00:49.991
health systems actually deliver to their
clinicians and users,

bb64fa90-b240-47fd-8973-0ded3a100b41/9-2
00:00:49.991 --> 00:00:54.943
you can divide those.
So they're the specialty services running

bb64fa90-b240-47fd-8973-0ded3a100b41/9-3
00:00:54.943 --> 00:01:00.668
unique applications like the electronic
medical record, like ERP systems,

bb64fa90-b240-47fd-8973-0ded3a100b41/11-0
00:01:01.068 --> 00:01:06.178
other clinical systems.
Those are specialized services in my

bb64fa90-b240-47fd-8973-0ded3a100b41/11-1
00:01:06.178 --> 00:01:10.283
definition.
Whereas you have commodity services,

bb64fa90-b240-47fd-8973-0ded3a100b41/11-2
00:01:10.283 --> 00:01:16.567
which you can buy or supply from anywhere,
and that includes data centers,

bb64fa90-b240-47fd-8973-0ded3a100b41/11-3
00:01:16.567 --> 00:01:20.588
infrastructure, desktop services,
service desk,

bb64fa90-b240-47fd-8973-0ded3a100b41/13-0
00:01:22.188 --> 00:01:26.235
analytics,
those type of services are services that

bb64fa90-b240-47fd-8973-0ded3a100b41/13-1
00:01:26.235 --> 00:01:30.048
you can actually buy from anyone.
Traditionally,

bb64fa90-b240-47fd-8973-0ded3a100b41/13-2
00:01:30.048 --> 00:01:35.418
health systems have had a singular
service where they do everything,

bb64fa90-b240-47fd-8973-0ded3a100b41/13-3
00:01:35.418 --> 00:01:40.476
infrastructure, networking, service desk,
clinical applications,

bb64fa90-b240-47fd-8973-0ded3a100b41/13-4
00:01:40.476 --> 00:01:42.188
business applications.

bb64fa90-b240-47fd-8973-0ded3a100b41/14-0
00:01:42.388 --> 00:01:49.179
They do everything for the health system.
But as we start moving towards a time and

bb64fa90-b240-47fd-8973-0ded3a100b41/12-0
00:01:43.628 --> 00:01:44.188
Mhm.

bb64fa90-b240-47fd-8973-0ded3a100b41/14-1
00:01:49.179 --> 00:01:55.728
a climate in healthcare where new federal
bills will put the squeeze on hospital

bb64fa90-b240-47fd-8973-0ded3a100b41/14-2
00:01:55.728 --> 00:02:01.388
systems and hospital systems will lose
revenue or have to be smarter,

bb64fa90-b240-47fd-8973-0ded3a100b41/15-0
00:02:01.788 --> 00:02:06.995
with the money that they earn,
then health IT groups in health systems

bb64fa90-b240-47fd-8973-0ded3a100b41/15-1
00:02:06.995 --> 00:02:12.421
need to start thinking about what are
they really good at providing their

bb64fa90-b240-47fd-8973-0ded3a100b41/15-2
00:02:12.421 --> 00:02:18.215
customers and what are the things they
could buy on scale from someone else to

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00:02:18.215 --> 00:02:20.708
help provide the service they need

bb64fa90-b240-47fd-8973-0ded3a100b41/16-0
00:02:20.828 --> 00:02:25.055
at the service level that they need it at,
around the clock,

bb64fa90-b240-47fd-8973-0ded3a100b41/16-1
00:02:25.055 --> 00:02:30.045
at a price point that makes more sense.
Because to give you an example,

bb64fa90-b240-47fd-8973-0ded3a100b41/16-2
00:02:30.045 --> 00:02:33.233
if you run a data center in downtown
Seattle,

bb64fa90-b240-47fd-8973-0ded3a100b41/16-3
00:02:33.233 --> 00:02:38.707
you hire people to run that data center.
You're paying top dollar rates from a

bb64fa90-b240-47fd-8973-0ded3a100b41/16-4
00:02:38.707 --> 00:02:42.588
labor perspective as well as a real
estate perspective.

bb64fa90-b240-47fd-8973-0ded3a100b41/17-0
00:02:43.628 --> 00:02:48.181
And clinical space is more valuable than
data center space,

bb64fa90-b240-47fd-8973-0ded3a100b41/17-1
00:02:48.181 --> 00:02:54.328
because you can generate revenue. Now,
if you don't do that in downtown Seattle,

bb64fa90-b240-47fd-8973-0ded3a100b41/17-2
00:02:54.328 --> 00:02:57.895
and you do that in rural Texas,
as an example,

bb64fa90-b240-47fd-8973-0ded3a100b41/17-3
00:02:57.895 --> 00:03:02.828
the costs are lower for labor,
for real estate, per square foot.

bb64fa90-b240-47fd-8973-0ded3a100b41/18-0
00:03:03.308 --> 00:03:06.620
So you can actually reduce your costs
that way.

bb64fa90-b240-47fd-8973-0ded3a100b41/18-1
00:03:06.620 --> 00:03:09.725
So I think people need to think about,
well,

bb64fa90-b240-47fd-8973-0ded3a100b41/18-2
00:03:09.725 --> 00:03:15.520
what services are the frontline services
they need to keep employees trained up on?

bb64fa90-b240-47fd-8973-0ded3a100b41/18-3
00:03:15.520 --> 00:03:18.694
So yeah, things like EMR,
clinical workflows,

bb64fa90-b240-47fd-8973-0ded3a100b41/18-4
00:03:18.694 --> 00:03:21.868
you need those people to help the
clinicians.

bb64fa90-b240-47fd-8973-0ded3a100b41/19-0
00:03:21.948 --> 00:03:26.329
day in, day out. But look,
turning on a server, adding storage,

bb64fa90-b240-47fd-8973-0ded3a100b41/19-1
00:03:26.329 --> 00:03:30.437
configuring a network switch,
making sure your Wi-Fi works,

bb64fa90-b240-47fd-8973-0ded3a100b41/19-2
00:03:30.437 --> 00:03:35.161
making sure that a doctor has a working
laptop or a working desktop,

bb64fa90-b240-47fd-8973-0ded3a100b41/19-3
00:03:35.161 --> 00:03:39.200
or even a printer, yes, God forbid,
we still use printers,

bb64fa90-b240-47fd-8973-0ded3a100b41/19-4
00:03:39.200 --> 00:03:42.828
then those need to be thought of in a
different way.

bb64fa90-b240-47fd-8973-0ded3a100b41/20-0
00:03:43.988 --> 00:03:48.623
So it sounds like there are a lot of
value adds and opportunities for cost

bb64fa90-b240-47fd-8973-0ded3a100b41/20-1
00:03:48.623 --> 00:03:52.145
reductions by outsourcing this
commoditized IT services.

bb64fa90-b240-47fd-8973-0ded3a100b41/20-2
00:03:52.145 --> 00:03:56.903
And I hear you distinguishing between the
specialty services that need to be

bb64fa90-b240-47fd-8973-0ded3a100b41/20-3
00:03:56.903 --> 00:04:01.971
providing support to revenue generating
activities on site versus those commodity

bb64fa90-b240-47fd-8973-0ded3a100b41/20-4
00:04:01.971 --> 00:04:03.948
services that can be outsourced.

bb64fa90-b240-47fd-8973-0ded3a100b41/21-0
00:04:04.268 --> 00:04:07.518
I suppose,
I know that when you were CDAIO of

bb64fa90-b240-47fd-8973-0ded3a100b41/21-1
00:04:07.518 --> 00:04:11.899
Seattle Children's,
you made a decision to outsource not only

bb64fa90-b240-47fd-8973-0ded3a100b41/21-2
00:04:11.899 --> 00:04:15.150
Epic hosting,
but also hosting of third party

bb64fa90-b240-47fd-8973-0ded3a100b41/21-3
00:04:15.150 --> 00:04:18.542
applications.
And part of that process entailed

bb64fa90-b240-47fd-8973-0ded3a100b41/21-4
00:04:18.542 --> 00:04:23.771
rebadging some of your employees.
I think a lot of leadership that may be

bb64fa90-b240-47fd-8973-0ded3a100b41/21-5
00:04:23.771 --> 00:04:24.548
considering

bb64fa90-b240-47fd-8973-0ded3a100b41/22-0
00:04:25.228 --> 00:04:29.281
commodity buying their IT services from
elsewhere may be concerned about the

bb64fa90-b240-47fd-8973-0ded3a100b41/22-1
00:04:29.281 --> 00:04:33.177
welfare of their employees. And again,
you did mention how labor costs in

bb64fa90-b240-47fd-8973-0ded3a100b41/22-2
00:04:33.177 --> 00:04:36.125
addition to real estate costs might be
less in Seattle.

bb64fa90-b240-47fd-8973-0ded3a100b41/22-3
00:04:36.125 --> 00:04:40.073
So suppose you have a whole cadre of
employees who have been loyal to you.

bb64fa90-b240-47fd-8973-0ded3a100b41/22-4
00:04:40.073 --> 00:04:43.547
You want to take care of them.
They're generating whatever income

bb64fa90-b240-47fd-8973-0ded3a100b41/22-5
00:04:43.547 --> 00:04:47.548
they're generating and you're looking to
generate savings from that income.

bb64fa90-b240-47fd-8973-0ded3a100b41/23-0
00:04:47.868 --> 00:04:52.842
by potentially moving them, as you say,
to Texas or outsourcing them globally.

bb64fa90-b240-47fd-8973-0ded3a100b41/23-1
00:04:52.842 --> 00:04:56.682
How would you speak to that executive
leader, maybe the CIO,

bb64fa90-b240-47fd-8973-0ded3a100b41/23-2
00:04:56.682 --> 00:05:01.719
who's thinking about doing this and how
he could handle the opportunity to take

bb64fa90-b240-47fd-8973-0ded3a100b41/23-3
00:05:01.719 --> 00:05:05.308
care of his people while also reducing
his or her costs?

bb64fa90-b240-47fd-8973-0ded3a100b41/24-0
00:05:06.028 --> 00:05:08.973
Yeah,
so I think you don't start this journey

bb64fa90-b240-47fd-8973-0ded3a100b41/24-1
00:05:08.973 --> 00:05:12.943
just focusing on cost.
I think if you've had loyal employees,

bb64fa90-b240-47fd-8973-0ded3a100b41/24-2
00:05:12.943 --> 00:05:17.296
you have to think about them.
You have to think about their future,

bb64fa90-b240-47fd-8973-0ded3a100b41/24-3
00:05:17.296 --> 00:05:21.906
you have to think about their growth,
and you have to think about their

bb64fa90-b240-47fd-8973-0ded3a100b41/24-4
00:05:21.906 --> 00:05:24.787
training.
All the things we don't do well in

bb64fa90-b240-47fd-8973-0ded3a100b41/24-5
00:05:24.787 --> 00:05:27.348
healthcare. So if you look at any health

bb64fa90-b240-47fd-8973-0ded3a100b41/25-0
00:05:27.628 --> 00:05:31.103
system IT budget,
they spend minimal amounts on staff

bb64fa90-b240-47fd-8973-0ded3a100b41/25-1
00:05:31.103 --> 00:05:35.157
training every year.
So employees don't get the best training,

bb64fa90-b240-47fd-8973-0ded3a100b41/25-2
00:05:35.157 --> 00:05:38.760
the best certifications,
the best educational programs.

bb64fa90-b240-47fd-8973-0ded3a100b41/25-3
00:05:38.760 --> 00:05:41.913
It's just not enough money to go around.
So yes,

bb64fa90-b240-47fd-8973-0ded3a100b41/25-4
00:05:41.913 --> 00:05:46.160
you have to absolutely think about the
people. This type of work,

bb64fa90-b240-47fd-8973-0ded3a100b41/25-5
00:05:46.160 --> 00:05:48.348
buying services from someone else,

bb64fa90-b240-47fd-8973-0ded3a100b41/28-0
00:05:48.748 --> 00:05:54.588
It's 100% a change management program.
So you have to have good communication,

bb64fa90-b240-47fd-8973-0ded3a100b41/26-0
00:05:52.308 --> 00:05:52.908
Mm-hmm.

bb64fa90-b240-47fd-8973-0ded3a100b41/28-1
00:05:54.588 --> 00:05:57.840
good reasons as to why you do it.
And look,

bb64fa90-b240-47fd-8973-0ded3a100b41/28-2
00:05:57.840 --> 00:06:01.388
I did not do it predominantly for saving
money.

bb64fa90-b240-47fd-8973-0ded3a100b41/27-0
00:06:01.588 --> 00:06:02.068
Mhm.

bb64fa90-b240-47fd-8973-0ded3a100b41/29-0
00:06:02.388 --> 00:06:08.163
Many of the problems we had was how do we
give the best service delivery around the

bb64fa90-b240-47fd-8973-0ded3a100b41/29-1
00:06:08.163 --> 00:06:11.395
clock?
And with the best teams in the world on

bb64fa90-b240-47fd-8973-0ded3a100b41/29-2
00:06:11.395 --> 00:06:14.901
the ground,
none of your teams can work 24 hours a

bb64fa90-b240-47fd-8973-0ded3a100b41/29-3
00:06:14.901 --> 00:06:18.958
day. They just can't.
Just as much it's very difficult for

bb64fa90-b240-47fd-8973-0ded3a100b41/29-4
00:06:18.958 --> 00:06:21.708
health systems to provide the best SLAs.

bb64fa90-b240-47fd-8973-0ded3a100b41/30-0
00:06:22.268 --> 00:06:26.320
Uptime. You know,
I defined a service as part of this where

bb64fa90-b240-47fd-8973-0ded3a100b41/30-1
00:06:26.320 --> 00:06:29.696
I wanted an uptime of five nines on every
system.

bb64fa90-b240-47fd-8973-0ded3a100b41/30-2
00:06:29.696 --> 00:06:34.558
That's very hard to achieve internally
without buying more hardware and

bb64fa90-b240-47fd-8973-0ded3a100b41/30-3
00:06:34.558 --> 00:06:39.555
accumulating more technical debt.
The other thing we were trying to solve

bb64fa90-b240-47fd-8973-0ded3a100b41/30-4
00:06:39.555 --> 00:06:41.108
for was technical debt.

bb64fa90-b240-47fd-8973-0ded3a100b41/31-0
00:06:41.188 --> 00:06:44.521
because in the traditional model of
buying infrastructure,

bb64fa90-b240-47fd-8973-0ded3a100b41/31-1
00:06:44.521 --> 00:06:45.708
networking equipment.

bb64fa90-b240-47fd-8973-0ded3a100b41/32-0
00:06:46.908 --> 00:06:50.793
You go out, you buy all this equipment,
you use your capital money,

bb64fa90-b240-47fd-8973-0ded3a100b41/32-1
00:06:50.793 --> 00:06:54.277
comes with a warranty,
and then you deprecate that equipment

bb64fa90-b240-47fd-8973-0ded3a100b41/32-2
00:06:54.277 --> 00:06:57.934
over a five to seven-year life cycle.
Once you hit seven years,

bb64fa90-b240-47fd-8973-0ded3a100b41/32-3
00:06:57.934 --> 00:07:01.590
the equipment's outdated.
You then need a couple 100 million to

bb64fa90-b240-47fd-8973-0ded3a100b41/32-4
00:07:01.590 --> 00:07:06.046
refresh that equipment in a climate where
there isn't a couple of 100 million

bb64fa90-b240-47fd-8973-0ded3a100b41/32-5
00:07:06.046 --> 00:07:07.988
sitting around in a health system.

bb64fa90-b240-47fd-8973-0ded3a100b41/33-0
00:07:08.748 --> 00:07:12.540
With A consumption-based service with a
third party,

bb64fa90-b240-47fd-8973-0ded3a100b41/33-1
00:07:12.540 --> 00:07:18.336
they will keep your equipment running to
a standard that you have requested in a

bb64fa90-b240-47fd-8973-0ded3a100b41/33-2
00:07:18.336 --> 00:07:21.913
contract,
and you won't have to worry about those

bb64fa90-b240-47fd-8973-0ded3a100b41/33-3
00:07:21.913 --> 00:07:27.566
$100 million hits every seven years of
buying new equipment because it's baked

bb64fa90-b240-47fd-8973-0ded3a100b41/33-4
00:07:27.566 --> 00:07:30.428
into the contract. If you rebadge teams,

bb64fa90-b240-47fd-8973-0ded3a100b41/35-0
00:07:30.588 --> 00:07:33.978
Yes, it's difficult.
It's a change management program.

bb64fa90-b240-47fd-8973-0ded3a100b41/35-1
00:07:33.978 --> 00:07:38.539
But when you look at the teams,
the teams will get access to a technology

bb64fa90-b240-47fd-8973-0ded3a100b41/35-2
00:07:38.539 --> 00:07:41.805
vendor that you,
whoever you choose to partner with,

bb64fa90-b240-47fd-8973-0ded3a100b41/35-3
00:07:41.805 --> 00:07:46.428
that technology vendor will give them the
training that they were lacking.

bb64fa90-b240-47fd-8973-0ded3a100b41/34-0
00:07:46.988 --> 00:07:47.468
Mhm.

bb64fa90-b240-47fd-8973-0ded3a100b41/36-0
00:07:47.588 --> 00:07:52.676
give them access to improve themselves
and even grow within that company.

bb64fa90-b240-47fd-8973-0ded3a100b41/36-1
00:07:52.676 --> 00:07:58.108
Because if you look at a small pediatric
health system with a small footprint,

bb64fa90-b240-47fd-8973-0ded3a100b41/36-2
00:07:58.108 --> 00:08:02.577
how far can you really go?
How far can you really progress as an

bb64fa90-b240-47fd-8973-0ded3a100b41/36-3
00:08:02.577 --> 00:08:06.428
employee before you have to leave and
find another job?

bb64fa90-b240-47fd-8973-0ded3a100b41/37-0
00:08:07.388 --> 00:08:12.575
If you look at a big technology company
that's global,

bb64fa90-b240-47fd-8973-0ded3a100b41/37-1
00:08:12.575 --> 00:08:17.007
they have numerous ways to move, grow,
expand,

bb64fa90-b240-47fd-8973-0ded3a100b41/37-2
00:08:17.007 --> 00:08:24.268
serve more clients in that exact same
company because they're global, right?

bb64fa90-b240-47fd-8973-0ded3a100b41/38-0
00:08:24.308 --> 00:08:28.607
So I'd like to turn back to your goal.
I heard you mention that the goal wasn't

bb64fa90-b240-47fd-8973-0ded3a100b41/38-1
00:08:28.607 --> 00:08:33.013
necessarily to save money or provide more
training or certification opportunities

bb64fa90-b240-47fd-8973-0ded3a100b41/38-2
00:08:33.013 --> 00:08:36.291
for your employees,
but essentially your goal was to fulfill

bb64fa90-b240-47fd-8973-0ded3a100b41/38-3
00:08:36.291 --> 00:08:39.086
your mission,
which was support the organization in

bb64fa90-b240-47fd-8973-0ded3a100b41/38-4
00:08:39.086 --> 00:08:42.632
order to provide the best service
delivery around the clock. Now,

bb64fa90-b240-47fd-8973-0ded3a100b41/38-5
00:08:42.632 --> 00:08:45.588
you dialed in and said,
in order to do that, I want...

bb64fa90-b240-47fd-8973-0ded3a100b41/39-0
00:08:45.708 --> 00:08:50.143
certain service level agreements,
I want 5 nines of uptime,

bb64fa90-b240-47fd-8973-0ded3a100b41/39-1
00:08:50.143 --> 00:08:56.353
and I want to be able to kind of amortize
my capital costs in a predictive way over

bb64fa90-b240-47fd-8973-0ded3a100b41/39-2
00:08:56.353 --> 00:08:57.388
time. So many.

bb64fa90-b240-47fd-8973-0ded3a100b41/40-0
00:08:56.668 --> 00:09:01.918
Yeah, we also, just to add,
we also wanted to make sure that the

bb64fa90-b240-47fd-8973-0ded3a100b41/40-1
00:09:01.918 --> 00:09:04.988
employees also had gainful employment.

bb64fa90-b240-47fd-8973-0ded3a100b41/41-0
00:09:06.268 --> 00:09:10.348
Because they will still be supporting our
mission, just wearing a different t-shirt.

bb64fa90-b240-47fd-8973-0ded3a100b41/42-0
00:09:10.748 --> 00:09:14.114
Correct.
So many CIOs listening to this episode

bb64fa90-b240-47fd-8973-0ded3a100b41/42-1
00:09:14.114 --> 00:09:17.761
right now says, all right,
I kind of buy into that.

bb64fa90-b240-47fd-8973-0ded3a100b41/42-2
00:09:17.761 --> 00:09:23.582
That's also my goal. It's also my concern.
Maybe we're going to choose Epic hosted

bb64fa90-b240-47fd-8973-0ded3a100b41/42-3
00:09:23.582 --> 00:09:27.088
by Epic.
Maybe we're looking to host Epic and GCP

bb64fa90-b240-47fd-8973-0ded3a100b41/42-4
00:09:27.088 --> 00:09:31.156
or Azure or AWS.
And I think they might want to hear your

bb64fa90-b240-47fd-8973-0ded3a100b41/42-5
00:09:31.156 --> 00:09:32.348
opinion about why

bb64fa90-b240-47fd-8973-0ded3a100b41/43-0
00:09:32.988 --> 00:09:36.689
hosting in a private cloud versus what
they should consider if they're

bb64fa90-b240-47fd-8973-0ded3a100b41/43-1
00:09:36.689 --> 00:09:39.868
considering hyperscale public cloud or
perpetuating on-prem.

bb64fa90-b240-47fd-8973-0ded3a100b41/45-0
00:09:40.668 --> 00:09:43.767
So there's nothing wrong with public
cloud.

bb64fa90-b240-47fd-8973-0ded3a100b41/45-1
00:09:43.767 --> 00:09:47.992
The challenge with public cloud becomes
twofold. So one is,

bb64fa90-b240-47fd-8973-0ded3a100b41/45-2
00:09:47.992 --> 00:09:53.555
I have not come across in my work in this,
I've not come across a public cloud

bb64fa90-b240-47fd-8973-0ded3a100b41/45-3
00:09:53.555 --> 00:09:57.499
service that will guarantee 5 nines
uptime on anything.

bb64fa90-b240-47fd-8973-0ded3a100b41/45-4
00:09:57.499 --> 00:10:00.668
The standard public clouds are only 3
nines.

bb64fa90-b240-47fd-8973-0ded3a100b41/44-0
00:09:57.948 --> 00:09:58.108
Mm.

bb64fa90-b240-47fd-8973-0ded3a100b41/46-0
00:10:01.548 --> 00:10:05.946
Their SLAs are not typically backed by
financial penalties,

bb64fa90-b240-47fd-8973-0ded3a100b41/46-1
00:10:05.946 --> 00:10:10.638
more so by service credits.
And to run a stack in public cloud,

bb64fa90-b240-47fd-8973-0ded3a100b41/46-2
00:10:10.638 --> 00:10:14.303
you would still need a team of people to
do that.

bb64fa90-b240-47fd-8973-0ded3a100b41/46-3
00:10:14.303 --> 00:10:19.948
And the public cloud companies don't
rebadge your teams, nor do they provide

bb64fa90-b240-47fd-8973-0ded3a100b41/48-0
00:10:20.268 --> 00:10:25.144
a managed service in the public cloud,
they'll recommend a partner for you to do

bb64fa90-b240-47fd-8973-0ded3a100b41/48-1
00:10:25.144 --> 00:10:29.960
that. So now you've got a hosting company,
which is the public cloud to manage,

bb64fa90-b240-47fd-8973-0ded3a100b41/48-2
00:10:29.960 --> 00:10:34.655
and then a third party who may rebadge
your teams to manage that public cloud

bb64fa90-b240-47fd-8973-0ded3a100b41/48-3
00:10:34.655 --> 00:10:37.665
instance.
So now you're dealing with two vendors,

bb64fa90-b240-47fd-8973-0ded3a100b41/48-4
00:10:37.665 --> 00:10:38.508
two contracts,

bb64fa90-b240-47fd-8973-0ded3a100b41/49-0
00:10:38.868 --> 00:10:43.118
two times the complexity.
When you look at a private cloud,

bb64fa90-b240-47fd-8973-0ded3a100b41/49-1
00:10:43.118 --> 00:10:48.289
or I like to call a clinically first
cloud, when you look at that model,

bb64fa90-b240-47fd-8973-0ded3a100b41/49-2
00:10:48.289 --> 00:10:53.106
you as a CIO shouldn't care what hardware
it sits on where it sits.

bb64fa90-b240-47fd-8973-0ded3a100b41/49-3
00:10:53.106 --> 00:10:57.569
What you should care about is,
can you get the service levels?

bb64fa90-b240-47fd-8973-0ded3a100b41/49-4
00:10:57.569 --> 00:10:58.348
Can you get

bb64fa90-b240-47fd-8973-0ded3a100b41/50-0
00:10:58.428 --> 00:11:02.493
the vendor, whoever vendor you choose,
can you get the vendor to run it,

bb64fa90-b240-47fd-8973-0ded3a100b41/50-1
00:11:02.493 --> 00:11:04.108
support it, feed it, grow it?

bb64fa90-b240-47fd-8973-0ded3a100b41/51-0
00:11:05.268 --> 00:11:08.442
And also,
can you get the vendor to control your

bb64fa90-b240-47fd-8973-0ded3a100b41/51-1
00:11:08.442 --> 00:11:12.976
consumption costs for a duration of the
contract? So in public cloud,

bb64fa90-b240-47fd-8973-0ded3a100b41/51-2
00:11:12.976 --> 00:11:17.445
it's very rare that any public cloud
company is going to sign up to,

bb64fa90-b240-47fd-8973-0ded3a100b41/51-3
00:11:17.445 --> 00:11:22.822
this is the maximum amount you will pay
every year because it's consumption based.

bb64fa90-b240-47fd-8973-0ded3a100b41/51-4
00:11:22.822 --> 00:11:26.708
And if you grow,
they don't typically build growth into it.

bb64fa90-b240-47fd-8973-0ded3a100b41/52-0
00:11:27.228 --> 00:11:32.878
But in a private cloud type of model,
you can define what your consumption is,

bb64fa90-b240-47fd-8973-0ded3a100b41/52-1
00:11:32.878 --> 00:11:37.742
what your max consumption may be,
what your growth factor would be,

bb64fa90-b240-47fd-8973-0ded3a100b41/52-2
00:11:37.742 --> 00:11:43.321
and then you end up getting a fixed price
engagement for the duration of your

bb64fa90-b240-47fd-8973-0ded3a100b41/52-3
00:11:43.321 --> 00:11:46.468
negotiation.
So whether that's a three-year

bb64fa90-b240-47fd-8973-0ded3a100b41/53-0
00:11:46.588 --> 00:11:52.008
five year, seven-year, 10 year.
It's all up to you what you want to do

bb64fa90-b240-47fd-8973-0ded3a100b41/53-1
00:11:52.008 --> 00:11:56.053
for your health system.
But if you can then do that,

bb64fa90-b240-47fd-8973-0ded3a100b41/53-2
00:11:56.053 --> 00:12:02.237
you are now assured A trajectory for your
organization that is palatable year on

bb64fa90-b240-47fd-8973-0ded3a100b41/53-3
00:12:02.237 --> 00:12:05.748
year.
And that helps CFOs to future planning.

bb64fa90-b240-47fd-8973-0ded3a100b41/54-0
00:12:06.428 --> 00:12:06.828
Right?

bb64fa90-b240-47fd-8973-0ded3a100b41/55-0
00:12:06.748 --> 00:12:11.012
So, Zafir, as you mentioned,
consumption-based pricing and controlling

bb64fa90-b240-47fd-8973-0ded3a100b41/55-1
00:12:11.012 --> 00:12:14.255
costs over time.
I think many of our listeners may be

bb64fa90-b240-47fd-8973-0ded3a100b41/55-2
00:12:14.255 --> 00:12:19.120
thinking about the elephant in the room,
which these days is AI and token usage,

bb64fa90-b240-47fd-8973-0ded3a100b41/55-3
00:12:19.120 --> 00:12:23.685
which sometimes I've heard of some health
systems using their entire annual

bb64fa90-b240-47fd-8973-0ded3a100b41/55-4
00:12:23.685 --> 00:12:27.228
contract worth of tokens in the first
quarter of the year.

bb64fa90-b240-47fd-8973-0ded3a100b41/57-0
00:12:27.708 --> 00:12:34.599
So do you have any thoughts about how,
within the context of private versus

bb64fa90-b240-47fd-8973-0ded3a100b41/57-1
00:12:34.599 --> 00:12:39.585
hyperscaler,
when we're building out AI infrastructure

bb64fa90-b240-47fd-8973-0ded3a100b41/57-2
00:12:39.585 --> 00:12:46.748
and we want to ensure that we can control
the pricing and the costs associated

bb64fa90-b240-47fd-8973-0ded3a100b41/58-0
00:12:46.908 --> 00:12:50.828
With AI,
what sort of questions do we need to be

bb64fa90-b240-47fd-8973-0ded3a100b41/58-1
00:12:50.828 --> 00:12:51.388
asking?

bb64fa90-b240-47fd-8973-0ded3a100b41/59-0
00:12:51.548 --> 00:12:56.875
Well, that's the biggest,
biggest problem that systems are going to

bb64fa90-b240-47fd-8973-0ded3a100b41/59-1
00:12:56.875 --> 00:13:01.184
face, right?
The explosive growth of utilization of AI

bb64fa90-b240-47fd-8973-0ded3a100b41/59-2
00:13:01.184 --> 00:13:04.631
and then the consumption of tokens.
So yes,

bb64fa90-b240-47fd-8973-0ded3a100b41/59-3
00:13:04.631 --> 00:13:10.428
if you get into a contract with a
hyperscaler in a public cloud scenario,

bb64fa90-b240-47fd-8973-0ded3a100b41/61-0
00:13:10.828 --> 00:13:14.993
you will consume tokens and you may have
a cap on tokens.

bb64fa90-b240-47fd-8973-0ded3a100b41/61-1
00:13:14.993 --> 00:13:20.739
Problem with that would be you run out of
them in two weeks of the first month,

bb64fa90-b240-47fd-8973-0ded3a100b41/61-2
00:13:20.739 --> 00:13:24.114
right?
And then you have to pay more and more.

bb64fa90-b240-47fd-8973-0ded3a100b41/61-3
00:13:24.114 --> 00:13:29.644
And there's numerous news reports of
health of systems running out of tokens

bb64fa90-b240-47fd-8973-0ded3a100b41/60-0
00:13:28.268 --> 00:13:28.428
Mm.

bb64fa90-b240-47fd-8973-0ded3a100b41/61-4
00:13:29.644 --> 00:13:29.788
or

bb64fa90-b240-47fd-8973-0ded3a100b41/62-0
00:13:30.028 --> 00:13:34.884
not predicting their future costs.
I truly believe that as a CIO,

bb64fa90-b240-47fd-8973-0ded3a100b41/62-1
00:13:34.884 --> 00:13:38.563
you need to think about who can you
partner with,

bb64fa90-b240-47fd-8973-0ded3a100b41/62-2
00:13:38.563 --> 00:13:43.934
which vendor can you partner with to
potentially build an instance of AI

bb64fa90-b240-47fd-8973-0ded3a100b41/62-3
00:13:43.934 --> 00:13:49.379
dedicated to your health system.
So you can actually build AI and you can

bb64fa90-b240-47fd-8973-0ded3a100b41/62-4
00:13:49.379 --> 00:13:52.028
even use open source AI, but you can

bb64fa90-b240-47fd-8973-0ded3a100b41/63-0
00:13:52.428 --> 00:13:59.921
that in a private cloud setting where the
vendor will absolutely give you a fixed

bb64fa90-b240-47fd-8973-0ded3a100b41/63-1
00:13:59.921 --> 00:14:05.494
monthly cost to have unlimited
consumption of that dedicated

bb64fa90-b240-47fd-8973-0ded3a100b41/63-2
00:14:05.494 --> 00:14:10.520
infrastructure.
So now you can control and manage your

bb64fa90-b240-47fd-8973-0ded3a100b41/63-3
00:14:10.520 --> 00:14:11.068
costs.

bb64fa90-b240-47fd-8973-0ded3a100b41/64-0
00:14:11.388 --> 00:14:16.352
Because one thing I noticed when I
deployed AI was as people get familiar

bb64fa90-b240-47fd-8973-0ded3a100b41/64-1
00:14:16.352 --> 00:14:20.042
with it as end users and customers in a
health system,

bb64fa90-b240-47fd-8973-0ded3a100b41/64-2
00:14:20.042 --> 00:14:23.598
they absolutely go gangbusters in
utilization on it.

bb64fa90-b240-47fd-8973-0ded3a100b41/64-3
00:14:23.598 --> 00:14:28.428
There's just no way of controlling it.
But if you can work with someone

bb64fa90-b240-47fd-8973-0ded3a100b41/65-0
00:14:29.308 --> 00:14:34.812
have a strategic partner where you get a
private cloud that runs the models of AI

bb64fa90-b240-47fd-8973-0ded3a100b41/65-1
00:14:34.812 --> 00:14:39.712
that you want, whatever those are,
and some want to use open source type

bb64fa90-b240-47fd-8973-0ded3a100b41/65-2
00:14:39.712 --> 00:14:44.075
models, it doesn't matter really.
Whatever models you build in a

bb64fa90-b240-47fd-8973-0ded3a100b41/65-3
00:14:44.075 --> 00:14:47.163
encapsulated private cloud AI
infrastructure,

bb64fa90-b240-47fd-8973-0ded3a100b41/65-4
00:14:47.163 --> 00:14:50.788
those models will allow you to have
controlled costs,

bb64fa90-b240-47fd-8973-0ded3a100b41/66-0
00:14:50.908 --> 00:14:53.814
per month,
and then it will also allow your

bb64fa90-b240-47fd-8973-0ded3a100b41/66-1
00:14:53.814 --> 00:14:58.967
customers to use that infrastructure as
much as they want for the duration of

bb64fa90-b240-47fd-8973-0ded3a100b41/66-2
00:14:58.967 --> 00:15:02.534
that month.
That's where I think people need to think

bb64fa90-b240-47fd-8973-0ded3a100b41/66-3
00:15:02.534 --> 00:15:05.836
about how are they going to get a handle
on this.

bb64fa90-b240-47fd-8973-0ded3a100b41/66-4
00:15:05.836 --> 00:15:11.451
If you keep putting stuff in public cloud,
it's super great if you're a public cloud

bb64fa90-b240-47fd-8973-0ded3a100b41/66-5
00:15:11.451 --> 00:15:12.508
provider because

bb64fa90-b240-47fd-8973-0ded3a100b41/67-0
00:15:12.748 --> 00:15:17.887
more tokens, more money, more revenue.
But from a health system perspective,

bb64fa90-b240-47fd-8973-0ded3a100b41/67-1
00:15:17.887 --> 00:15:21.090
when you do your planning for your fiscal
year,

bb64fa90-b240-47fd-8973-0ded3a100b41/67-2
00:15:21.090 --> 00:15:25.628
you get a finite amount of money to run
that service from your CFO.

bb64fa90-b240-47fd-8973-0ded3a100b41/68-0
00:15:26.988 --> 00:15:31.865
There's no increase in consumption.
There's none of that that is allowed for

bb64fa90-b240-47fd-8973-0ded3a100b41/68-1
00:15:31.865 --> 00:15:35.601
in a health system.
You can't go back to your CFO and say,

bb64fa90-b240-47fd-8973-0ded3a100b41/68-2
00:15:35.601 --> 00:15:38.641
well,
I'm half a million or 5 million overspent

bb64fa90-b240-47fd-8973-0ded3a100b41/68-3
00:15:38.641 --> 00:15:43.708
on infrastructure and I need more money.
Because that doesn't happen mid-cycle.

bb64fa90-b240-47fd-8973-0ded3a100b41/69-0
00:15:44.108 --> 00:15:46.938
So, Zaphyr,
as we approach the end of this podcast

bb64fa90-b240-47fd-8973-0ded3a100b41/69-1
00:15:46.938 --> 00:15:49.767
episode,
there's another significant topic that is

bb64fa90-b240-47fd-8973-0ded3a100b41/69-2
00:15:49.767 --> 00:15:52.597
all over everybody's minds.
We already covered AI,

bb64fa90-b240-47fd-8973-0ded3a100b41/69-3
00:15:52.597 --> 00:15:56.481
we covered public-private cloud,
but one thing I'd like to address is

bb64fa90-b240-47fd-8973-0ded3a100b41/69-4
00:15:56.481 --> 00:15:59.921
cybersecurity. Now,
everyone may recall the change healthcare

bb64fa90-b240-47fd-8973-0ded3a100b41/69-5
00:15:59.921 --> 00:16:04.415
attack from early 2025 that completely
disrupted a lot of health systems revenue

bb64fa90-b240-47fd-8973-0ded3a100b41/69-6
00:16:04.415 --> 00:16:04.748
cycle.

bb64fa90-b240-47fd-8973-0ded3a100b41/70-0
00:16:04.948 --> 00:16:07.977
from any patients who came with a united
coverage.

bb64fa90-b240-47fd-8973-0ded3a100b41/70-1
00:16:07.977 --> 00:16:12.313
And there have been many instances of
ransomware and other cyber attacks

bb64fa90-b240-47fd-8973-0ded3a100b41/70-2
00:16:12.313 --> 00:16:17.065
hitting IDNs across the nation and other
specialty healthcare delivery systems.

bb64fa90-b240-47fd-8973-0ded3a100b41/70-3
00:16:17.065 --> 00:16:21.104
I'd like to kind of give you an
opportunity to speak to perhaps the

bb64fa90-b240-47fd-8973-0ded3a100b41/70-4
00:16:21.104 --> 00:16:25.915
differences between public and private
cloud when it comes to cyber security and

bb64fa90-b240-47fd-8973-0ded3a100b41/70-5
00:16:25.915 --> 00:16:26.628
what sort of

bb64fa90-b240-47fd-8973-0ded3a100b41/71-0
00:16:26.708 --> 00:16:33.324
things CIOs should be keeping in mind as
they try to protect their organization in

bb64fa90-b240-47fd-8973-0ded3a100b41/71-1
00:16:33.324 --> 00:16:37.948
this day and age with AI-generated
cybersecurity threats.

bb64fa90-b240-47fd-8973-0ded3a100b41/72-0
00:16:38.908 --> 00:16:42.736
Yeah, so that's a very,
very good question in a climate where

bb64fa90-b240-47fd-8973-0ded3a100b41/72-1
00:16:42.736 --> 00:16:47.862
cyber is always keeping CIOs up at night.
If you run your own data center and your

bb64fa90-b240-47fd-8973-0ded3a100b41/72-2
00:16:47.862 --> 00:16:51.567
own infrastructure,
you need to provide a layer of security

bb64fa90-b240-47fd-8973-0ded3a100b41/72-3
00:16:51.567 --> 00:16:55.951
on top of that infrastructure,
and you need to provide that around the

bb64fa90-b240-47fd-8973-0ded3a100b41/72-4
00:16:55.951 --> 00:16:58.668
clock. That's really hard,
expensive to do.

bb64fa90-b240-47fd-8973-0ded3a100b41/73-0
00:16:59.068 --> 00:17:04.318
And hiring or retaining the best
cybersecurity professionals in your team

bb64fa90-b240-47fd-8973-0ded3a100b41/73-1
00:17:04.318 --> 00:17:09.142
is cost prohibitive for most. Now,
if you think about public cloud,

bb64fa90-b240-47fd-8973-0ded3a100b41/73-2
00:17:09.142 --> 00:17:14.959
now public cloud is better because they
have teams of security professionals that

bb64fa90-b240-47fd-8973-0ded3a100b41/73-3
00:17:14.959 --> 00:17:17.868
are actually keeping an eye on the prize.

bb64fa90-b240-47fd-8973-0ded3a100b41/74-0
00:17:18.028 --> 00:17:21.708
around the clock.
So that's really important.

bb64fa90-b240-47fd-8973-0ded3a100b41/74-1
00:17:21.708 --> 00:17:27.788
But the challenge is they give you
standardized security that they apply to

bb64fa90-b240-47fd-8973-0ded3a100b41/74-2
00:17:27.788 --> 00:17:33.148
a whole series of customers.
So you as a customer have less say in

bb64fa90-b240-47fd-8973-0ded3a100b41/74-3
00:17:33.148 --> 00:17:37.148
what you would need in terms of cyber
protection.

bb64fa90-b240-47fd-8973-0ded3a100b41/75-0
00:17:37.868 --> 00:17:42.200
They do a very good job, though,
in the public cloud. Now,

bb64fa90-b240-47fd-8973-0ded3a100b41/75-1
00:17:42.200 --> 00:17:46.606
in private cloud,
you as a CIO or your CISO can define in a

bb64fa90-b240-47fd-8973-0ded3a100b41/75-2
00:17:46.606 --> 00:17:52.407
contract what that service provider will
provide in terms of cyber protection,

bb64fa90-b240-47fd-8973-0ded3a100b41/75-3
00:17:52.407 --> 00:17:57.106
what audits will happen,
what levels of compliance will happen.

bb64fa90-b240-47fd-8973-0ded3a100b41/75-4
00:17:57.106 --> 00:17:58.428
It's more bespoke.

bb64fa90-b240-47fd-8973-0ded3a100b41/76-0
00:17:58.988 --> 00:18:03.777
So you can define what you think your
health system needs, or in this case,

bb64fa90-b240-47fd-8973-0ded3a100b41/76-1
00:18:03.777 --> 00:18:08.188
what your CISO recommends that you need
to protect your organization.

bb64fa90-b240-47fd-8973-0ded3a100b41/77-0
00:18:08.988 --> 00:18:13.331
And it'll be slightly different because
some health systems are just hospitals

bb64fa90-b240-47fd-8973-0ded3a100b41/77-1
00:18:13.331 --> 00:18:15.970
and clinics.
Some health systems are hospitals,

bb64fa90-b240-47fd-8973-0ded3a100b41/77-2
00:18:15.970 --> 00:18:19.763
clinics, and research institutes,
because they have a whole bunch of

bb64fa90-b240-47fd-8973-0ded3a100b41/77-3
00:18:19.763 --> 00:18:22.346
researchers.
And that security posture will be

bb64fa90-b240-47fd-8973-0ded3a100b41/77-4
00:18:22.346 --> 00:18:25.480
slightly different.
So I think the agility you have in a

bb64fa90-b240-47fd-8973-0ded3a100b41/77-5
00:18:25.480 --> 00:18:29.108
private cloud partnership setting is the
infrastructure is built.

bb64fa90-b240-47fd-8973-0ded3a100b41/78-0
00:18:29.188 --> 00:18:34.189
To your specification,
it is on an SLA that you have agreed to,

bb64fa90-b240-47fd-8973-0ded3a100b41/78-1
00:18:34.189 --> 00:18:39.113
backed by financial penalties,
with a high uptime, a high RTO,

bb64fa90-b240-47fd-8973-0ded3a100b41/78-2
00:18:39.113 --> 00:18:45.208
and a high RPO, and then at the same time,
the security that wraps around it,

bb64fa90-b240-47fd-8973-0ded3a100b41/78-3
00:18:45.208 --> 00:18:49.428
which is provided by a well-qualified
team from that.

bb64fa90-b240-47fd-8973-0ded3a100b41/80-0
00:18:49.948 --> 00:18:54.693
strategic partner is to the specification
that your CISO wants for your

bb64fa90-b240-47fd-8973-0ded3a100b41/79-0
00:18:51.548 --> 00:18:51.708
Yeah.

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00:18:54.693 --> 00:18:58.055
organization and how to protect your
organization.

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00:18:58.055 --> 00:19:01.548
That's very hard to achieve in a public
cloud model.

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00:19:02.268 --> 00:19:06.224
So last question,
we're wrapping up this episode now.

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00:19:06.224 --> 00:19:12.012
Any words of advice to yourself a few
years ago as you began your journey down

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00:19:12.012 --> 00:19:16.188
towards a commoditized health IT
infrastructure process?

bb64fa90-b240-47fd-8973-0ded3a100b41/82-0
00:19:17.068 --> 00:19:20.892
Yeah,
so my advice to anyone is don't start the

bb64fa90-b240-47fd-8973-0ded3a100b41/82-1
00:19:20.892 --> 00:19:27.266
journey with a predefined exit, right?
Start the journey with what problem am I

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00:19:27.266 --> 00:19:32.444
trying to solve and look at multiple ways
of trying to solve it.

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00:19:32.444 --> 00:19:36.268
So it's not that I did not with my team
look at

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00:19:36.588 --> 00:19:41.366
public cloud, private cloud,
in-house services before we made the

bb64fa90-b240-47fd-8973-0ded3a100b41/83-1
00:19:41.366 --> 00:19:47.303
decision. You have to do the exercise.
You also have to do the change management,

bb64fa90-b240-47fd-8973-0ded3a100b41/83-2
00:19:47.303 --> 00:19:51.647
how much that's going to cost.
Look at your technical debt,

bb64fa90-b240-47fd-8973-0ded3a100b41/83-3
00:19:51.647 --> 00:19:56.788
but also build a model and a business
case that makes financial sense.

bb64fa90-b240-47fd-8973-0ded3a100b41/84-0
00:19:57.068 --> 00:20:00.571
for your organization.
So the answer isn't finite here, right?

bb64fa90-b240-47fd-8973-0ded3a100b41/84-1
00:20:00.571 --> 00:20:03.352
The answer is very much,
look at all the options.

bb64fa90-b240-47fd-8973-0ded3a100b41/84-2
00:20:03.352 --> 00:20:07.745
And don't forget the in-house option.
You should always look at the do-nothing

bb64fa90-b240-47fd-8973-0ded3a100b41/84-3
00:20:07.745 --> 00:20:12.026
in-house option. So we always look at,
I've always looked at three different

bb64fa90-b240-47fd-8973-0ded3a100b41/84-4
00:20:12.026 --> 00:20:16.308
ways of skinning the cat, as they say.
So when you're starting this journey,

bb64fa90-b240-47fd-8973-0ded3a100b41/85-0
00:20:16.788 --> 00:20:20.725
Build a model for each one of the
possibilities that you may have.

bb64fa90-b240-47fd-8973-0ded3a100b41/85-1
00:20:20.725 --> 00:20:24.191
Define a business case, define,
speak to the stakeholders.

bb64fa90-b240-47fd-8973-0ded3a100b41/85-2
00:20:24.191 --> 00:20:27.541
You do need good governance.
So get governance involved,

bb64fa90-b240-47fd-8973-0ded3a100b41/85-3
00:20:27.541 --> 00:20:30.479
stakeholder engagement.
What do researchers want?

bb64fa90-b240-47fd-8973-0ded3a100b41/85-4
00:20:30.479 --> 00:20:33.299
What do hospitalists want?
What do nurses want?

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00:20:33.299 --> 00:20:35.708
What do allied health professionals want?

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00:20:36.708 --> 00:20:41.404
And I'll leave you with this.
If you go and walk through a health

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00:20:41.404 --> 00:20:44.534
system and you ask any clinician,
you know,

bb64fa90-b240-47fd-8973-0ded3a100b41/88-2
00:20:44.534 --> 00:20:49.870
how much downtime can you take on any
system, the answer will always be 0.

bb64fa90-b240-47fd-8973-0ded3a100b41/87-0
00:20:49.628 --> 00:20:50.108
Mhm.

bb64fa90-b240-47fd-8973-0ded3a100b41/88-3
00:20:49.870 --> 00:20:54.708
It's not for IT professionals to tell
clinicians what they can get.

bb64fa90-b240-47fd-8973-0ded3a100b41/89-0
00:20:55.108 --> 00:21:00.490
It's for IT professionals to listen to
the customers that they serve and then

bb64fa90-b240-47fd-8973-0ded3a100b41/89-1
00:21:00.490 --> 00:21:03.664
try to provide services to serve those
needs,

bb64fa90-b240-47fd-8973-0ded3a100b41/89-2
00:21:03.664 --> 00:21:06.148
not the needs that you come up with.

bb64fa90-b240-47fd-8973-0ded3a100b41/91-0
00:21:06.948 --> 00:21:10.238
Well, Zafar,
I'd like to thank you for joining us

bb64fa90-b240-47fd-8973-0ded3a100b41/91-1
00:21:10.238 --> 00:21:14.253
today. And for our listeners,
this has been Zafar Chowdhury,

bb64fa90-b240-47fd-8973-0ded3a100b41/91-2
00:21:14.253 --> 00:21:19.188
the former CDAIO of Seattle Children's.
Wonderful conversation. Thank you.

bb64fa90-b240-47fd-8973-0ded3a100b41/90-0
00:21:19.588 --> 00:21:20.308
Thank you, Jordan.