53bf2699-d7ea-46bc-a810-4a7bba235d28/5-0
00:00:03.447 --> 00:00:07.098
today with Al Valerin,
the VP and CMIO of Northwell Health

53bf2699-d7ea-46bc-a810-4a7bba235d28/5-1
00:00:07.098 --> 00:00:10.687
Northern Market. Al,
thanks so much for joining us today.

53bf2699-d7ea-46bc-a810-4a7bba235d28/6-0
00:00:11.127 --> 00:00:13.487
Thank you for allowing me to participate.
Appreciate that.

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-0
00:00:13.967 --> 00:00:17.209
So for our listeners,
Northwell Health is a health system

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-1
00:00:17.209 --> 00:00:21.623
headquartered in New Hyde Park, New York,
with 7,000 beds across 28 hospitals,

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-2
00:00:21.623 --> 00:00:24.641
supported by 16,000 physicians,
quite a large system.

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-3
00:00:24.641 --> 00:00:28.665
I'd like to set some context, Al,
before we dive into the conversation.

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-4
00:00:28.665 --> 00:00:31.962
So for our listeners,
Northwell Health is currently in the

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-5
00:00:31.962 --> 00:00:36.041
midst of systematically consolidating and
retiring legacy EHRs and other

53bf2699-d7ea-46bc-a810-4a7bba235d28/8-6
00:00:36.041 --> 00:00:36.767
applications,

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-0
00:00:36.967 --> 00:00:40.148
into one unified platform as part of a
massive multi-year $1.

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-1
00:00:40.148 --> 00:00:42.970
2 billion enterprise Epic EHR rollout.
So by doing so,

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-2
00:00:42.970 --> 00:00:46.612
Northwell is eliminating the need to
maintain the vast physical server

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-3
00:00:46.612 --> 00:00:50.665
infrastructure and dedicated local data
room environments that previously kept

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-4
00:00:50.665 --> 00:00:54.256
those fragmented apps running,
rather than hosting or maintaining its

53bf2699-d7ea-46bc-a810-4a7bba235d28/9-5
00:00:54.256 --> 00:00:57.487
own traditional data center hardware for
major infrastructure,

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-0
00:00:57.727 --> 00:01:00.385
Northwell shifted heavily to cloud
providers,

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-1
00:01:00.385 --> 00:01:05.123
designating Google Cloud Platform as its
preferred partner while also shifting to

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-2
00:01:05.123 --> 00:01:09.167
some peripheral systems like including
Oracle Cloud. So question, Al,

53bf2699-d7ea-46bc-a810-4a7bba235d28/10-0
00:01:08.767 --> 00:01:08.927
Mm.

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-3
00:01:09.167 --> 00:01:11.999
that was a mouthful,
so I'm going to get to you.

53bf2699-d7ea-46bc-a810-4a7bba235d28/11-0
00:01:10.207 --> 00:01:11.567
Yeah, yes.

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-4
00:01:11.999 --> 00:01:14.599
As the data center exit and GCP move
happen,

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-5
00:01:14.599 --> 00:01:19.452
how does that change what's possible for
Northwell's clinical AI translation layer,

53bf2699-d7ea-46bc-a810-4a7bba235d28/12-6
00:01:19.452 --> 00:01:22.167
and is the migration an enabler or
constraint?

53bf2699-d7ea-46bc-a810-4a7bba235d28/13-0
00:01:23.247 --> 00:01:28.239
The translation is an enabler,
because what we're trying to do is create

53bf2699-d7ea-46bc-a810-4a7bba235d28/13-1
00:01:28.239 --> 00:01:33.573
its own data hub cloud that we fill in
the information and connect across our

53bf2699-d7ea-46bc-a810-4a7bba235d28/13-2
00:01:33.573 --> 00:01:36.581
network.
So it'll be a seamless transition.

53bf2699-d7ea-46bc-a810-4a7bba235d28/13-3
00:01:36.581 --> 00:01:39.590
Once we're completed with that
unification,

53bf2699-d7ea-46bc-a810-4a7bba235d28/13-4
00:01:39.590 --> 00:01:43.487
the patients and the clinicians can work
from a singular

53bf2699-d7ea-46bc-a810-4a7bba235d28/15-0
00:01:45.167 --> 00:01:49.902
place of truth, the EMR itself,
and all the information that comes into

53bf2699-d7ea-46bc-a810-4a7bba235d28/15-1
00:01:49.902 --> 00:01:54.439
the network can be facilitated as a
single plane of glass over every

53bf2699-d7ea-46bc-a810-4a7bba235d28/15-2
00:01:54.439 --> 00:01:59.633
patient's informational aspect that will
allow better care and care across our

53bf2699-d7ea-46bc-a810-4a7bba235d28/15-3
00:01:59.633 --> 00:02:02.329
network.
Now that we're covering all the

53bf2699-d7ea-46bc-a810-4a7bba235d28/15-4
00:02:02.329 --> 00:02:04.367
territories within Long Island,

53bf2699-d7ea-46bc-a810-4a7bba235d28/16-0
00:02:04.607 --> 00:02:08.177
New York, Manhattan,
as well as Westchester and now

53bf2699-d7ea-46bc-a810-4a7bba235d28/16-1
00:02:08.177 --> 00:02:11.335
Connecticut,
we have to have that unification

53bf2699-d7ea-46bc-a810-4a7bba235d28/16-2
00:02:11.335 --> 00:02:15.247
available for any care possible anywhere
in our network.

53bf2699-d7ea-46bc-a810-4a7bba235d28/17-0
00:02:15.887 --> 00:02:21.327
So when you're considering an AI rollout
across this massive of an IDN,

53bf2699-d7ea-46bc-a810-4a7bba235d28/17-1
00:02:21.327 --> 00:02:26.767
how are you considering AI workloads as a
cost driver for the GCP plan?

53bf2699-d7ea-46bc-a810-4a7bba235d28/18-0
00:02:27.967 --> 00:02:33.532
The understanding is developing our own,
and what they've done is created an AI

53bf2699-d7ea-46bc-a810-4a7bba235d28/18-1
00:02:33.532 --> 00:02:36.801
hub.
So it allows a unified AI delivery across

53bf2699-d7ea-46bc-a810-4a7bba235d28/18-2
00:02:36.801 --> 00:02:41.184
our network for all those who have access
to it. So therefore,

53bf2699-d7ea-46bc-a810-4a7bba235d28/18-3
00:02:41.184 --> 00:02:46.887
the agents and all of the data available
to do work on is within our own control.

53bf2699-d7ea-46bc-a810-4a7bba235d28/19-0
00:02:47.167 --> 00:02:51.626
Therefore, anyone,
anywhere can be facilitating the

53bf2699-d7ea-46bc-a810-4a7bba235d28/19-1
00:02:51.626 --> 00:02:57.114
utilization of the agents and doing work,
research, developing,

53bf2699-d7ea-46bc-a810-4a7bba235d28/19-2
00:02:57.114 --> 00:03:02.687
creating environments,
all within our own AI hub infrastructure.

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-0
00:03:03.247 --> 00:03:06.442
So Al,
I know a lot of my listeners to Healthy

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-1
00:03:06.442 --> 00:03:11.267
Uptime podcast are also similarly
thinking about how they can roll out

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-2
00:03:11.267 --> 00:03:14.801
different AI pilots and scale them
enterprise-wide.

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-3
00:03:14.801 --> 00:03:20.375
I'm wondering how Northwell has developed
an orchestration layer and a governance

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-4
00:03:20.375 --> 00:03:25.472
structure in order to ensure that these
programs are able to be rolled out

53bf2699-d7ea-46bc-a810-4a7bba235d28/20-5
00:03:25.472 --> 00:03:26.287
system-wide?

53bf2699-d7ea-46bc-a810-4a7bba235d28/21-0
00:03:25.847 --> 00:03:31.719
A lot of this lives underneath the
auspices of our Senior Vice President,

53bf2699-d7ea-46bc-a810-4a7bba235d28/21-1
00:03:31.719 --> 00:03:36.241
Eric Dr. Cruzin.
Eric is a tremendous thought leader and

53bf2699-d7ea-46bc-a810-4a7bba235d28/21-2
00:03:36.241 --> 00:03:42.191
an innovator and has specific teams
around every one of those innovations.

53bf2699-d7ea-46bc-a810-4a7bba235d28/21-3
00:03:42.191 --> 00:03:45.047
And working with the innovation lead

53bf2699-d7ea-46bc-a810-4a7bba235d28/22-0
00:03:45.327 --> 00:03:50.590
can focus in on evaluating projects that
are being best facilitated to be grown

53bf2699-d7ea-46bc-a810-4a7bba235d28/22-1
00:03:50.590 --> 00:03:55.392
within our own infrastructure,
as well as benefiting both clinicians and

53bf2699-d7ea-46bc-a810-4a7bba235d28/22-2
00:03:55.392 --> 00:03:59.997
patients throughout our network.
So pilots can start out in different

53bf2699-d7ea-46bc-a810-4a7bba235d28/22-3
00:03:59.997 --> 00:04:03.155
areas,
but as we move together in understanding

53bf2699-d7ea-46bc-a810-4a7bba235d28/22-4
00:04:03.155 --> 00:04:04.207
what works best,

53bf2699-d7ea-46bc-a810-4a7bba235d28/23-0
00:04:04.847 --> 00:04:09.412
facilitating, let's say,
an app for cancer care or understanding

53bf2699-d7ea-46bc-a810-4a7bba235d28/23-1
00:04:09.412 --> 00:04:13.204
of wayfinding.
Those kind of things can be started in

53bf2699-d7ea-46bc-a810-4a7bba235d28/23-2
00:04:13.204 --> 00:04:18.822
one area because we all have access to
information and then built out utilizing

53bf2699-d7ea-46bc-a810-4a7bba235d28/23-3
00:04:18.822 --> 00:04:22.403
the team under Dr.
Cruz's area so that allows that

53bf2699-d7ea-46bc-a810-4a7bba235d28/23-4
00:04:22.403 --> 00:04:23.807
implementation to be

53bf2699-d7ea-46bc-a810-4a7bba235d28/24-0
00:04:24.047 --> 00:04:26.447
Extrapolated across our network very
easily.

53bf2699-d7ea-46bc-a810-4a7bba235d28/25-0
00:04:26.927 --> 00:04:31.089
So as Northwell is seeking to exit some
of its data centers,

53bf2699-d7ea-46bc-a810-4a7bba235d28/25-1
00:04:31.089 --> 00:04:36.614
which clinical and operational systems
are you experiencing some of the greatest

53bf2699-d7ea-46bc-a810-4a7bba235d28/25-2
00:04:36.614 --> 00:04:40.844
difficulties in moving?
Which ones are you electing to retain

53bf2699-d7ea-46bc-a810-4a7bba235d28/25-3
00:04:40.844 --> 00:04:44.187
on-prem?
And do you ever worry about downtime or

53bf2699-d7ea-46bc-a810-4a7bba235d28/25-4
00:04:44.187 --> 00:04:45.687
clinical risk in while

53bf2699-d7ea-46bc-a810-4a7bba235d28/26-0
00:04:45.767 --> 00:04:48.367
associated with exiting some of these
data centers.

53bf2699-d7ea-46bc-a810-4a7bba235d28/27-0
00:04:48.927 --> 00:04:52.702
Well, actually,
it's unifying the data itself into one

53bf2699-d7ea-46bc-a810-4a7bba235d28/27-1
00:04:52.702 --> 00:04:57.369
data cloud, one large lake,
so that eventually we'll have one point

53bf2699-d7ea-46bc-a810-4a7bba235d28/27-2
00:04:57.369 --> 00:05:01.487
of access for the truth of all that
information. Right now,

53bf2699-d7ea-46bc-a810-4a7bba235d28/27-3
00:05:01.487 --> 00:05:06.634
as we're going through the processes of
rolling out Epic in several of our

53bf2699-d7ea-46bc-a810-4a7bba235d28/27-4
00:05:06.634 --> 00:05:09.447
locations, we're mitigating two pieces of

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-0
00:05:09.567 --> 00:05:14.263
pre and post activation to another
facilitate best care possible with the

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-1
00:05:14.263 --> 00:05:17.054
data.
But the data is secured in one simple

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-2
00:05:17.054 --> 00:05:19.846
area.
And all we're doing is going from one

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-3
00:05:19.846 --> 00:05:23.019
process,
just like we have Oracle data going into

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-4
00:05:23.019 --> 00:05:28.094
the cloud. Eventually we'll repoint it,
everything will be on the Epic install.

53bf2699-d7ea-46bc-a810-4a7bba235d28/29-5
00:05:28.094 --> 00:05:29.807
But that Oracle information

53bf2699-d7ea-46bc-a810-4a7bba235d28/30-0
00:05:30.007 --> 00:05:34.916
will be available to our clinician moving
forward for any access to their patient

53bf2699-d7ea-46bc-a810-4a7bba235d28/28-0
00:05:30.167 --> 00:05:30.647
Mhm.

53bf2699-d7ea-46bc-a810-4a7bba235d28/30-1
00:05:34.916 --> 00:05:38.927
information after we migrate over to the
Epic Cloud down the road.

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-0
00:05:39.407 --> 00:05:42.663
So sometimes migrations tend to stretch
internal teams,

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-1
00:05:42.663 --> 00:05:46.907
especially to ensure business continuity
with post-migration operations.

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-2
00:05:46.907 --> 00:05:50.570
So that's like things like monitoring,
patching, cost control,

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-3
00:05:50.570 --> 00:05:54.174
incidence response.
Some organizations have turned to managed

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-4
00:05:54.174 --> 00:05:57.430
services providers.
Other organizations have elected to

53bf2699-d7ea-46bc-a810-4a7bba235d28/31-5
00:05:57.430 --> 00:05:58.127
manage these

53bf2699-d7ea-46bc-a810-4a7bba235d28/32-0
00:05:58.247 --> 00:06:02.544
post-migration operations internally.
How has Northwell arrived at its strategy

53bf2699-d7ea-46bc-a810-4a7bba235d28/32-1
00:06:02.544 --> 00:06:05.658
to run the new environments once a
migration is complete?

53bf2699-d7ea-46bc-a810-4a7bba235d28/32-2
00:06:05.658 --> 00:06:09.847
And have you found any skills or capacity
gaps that peer organizations facing

53bf2699-d7ea-46bc-a810-4a7bba235d28/32-3
00:06:09.847 --> 00:06:11.887
similar situations should be aware of?

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-0
00:06:12.647 --> 00:06:15.147
No,
I think the best part is going through

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-1
00:06:15.147 --> 00:06:18.809
that first activation,
which took the longest and was the most

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-2
00:06:18.809 --> 00:06:21.366
complex.
As they went along from phase one,

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-3
00:06:21.366 --> 00:06:24.505
wave one and wave 2,
now they're going to wave three,

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-4
00:06:24.505 --> 00:06:28.689
the efficiencies and understanding what
really needs to be done and the

53bf2699-d7ea-46bc-a810-4a7bba235d28/33-5
00:06:28.689 --> 00:06:30.607
experience that needs to be done.

53bf2699-d7ea-46bc-a810-4a7bba235d28/35-0
00:06:30.927 --> 00:06:36.158
and the number of people that needed to
be done become more focused and less

53bf2699-d7ea-46bc-a810-4a7bba235d28/35-1
00:06:36.158 --> 00:06:40.980
reliant upon any external support.
So eventually it becomes a routine,

53bf2699-d7ea-46bc-a810-4a7bba235d28/35-2
00:06:40.980 --> 00:06:46.210
relatively routine type of migration
going from where you are today into the

53bf2699-d7ea-46bc-a810-4a7bba235d28/34-0
00:06:46.127 --> 00:06:46.607
Mhm.

53bf2699-d7ea-46bc-a810-4a7bba235d28/35-3
00:06:46.210 --> 00:06:50.014
new environment.
The work that's being done really is a

53bf2699-d7ea-46bc-a810-4a7bba235d28/35-4
00:06:50.014 --> 00:06:52.527
focus on the Epic install. Right now,

53bf2699-d7ea-46bc-a810-4a7bba235d28/36-0
00:06:52.767 --> 00:06:56.416
Everything is kind of like, let's support,
but let's focus on Epic.

53bf2699-d7ea-46bc-a810-4a7bba235d28/36-1
00:06:56.416 --> 00:07:00.493
And that's the goal right now until we
complete all of the Epic activations

53bf2699-d7ea-46bc-a810-4a7bba235d28/36-2
00:07:00.493 --> 00:07:01.727
throughout the network.

53bf2699-d7ea-46bc-a810-4a7bba235d28/37-0
00:07:02.207 --> 00:07:06.795
So when an organization, many, many,
Epic owns the lion's share of the

53bf2699-d7ea-46bc-a810-4a7bba235d28/37-1
00:07:06.795 --> 00:07:12.157
healthcare provider market in the US and
has obviously a global footprint as well.

53bf2699-d7ea-46bc-a810-4a7bba235d28/37-2
00:07:12.157 --> 00:07:17.067
There are a few options a provider
organization has for hosting their Epic.

53bf2699-d7ea-46bc-a810-4a7bba235d28/37-3
00:07:17.067 --> 00:07:22.494
One, they can host it themselves on-prem.
Two, they can elect to have Epic host it.

53bf2699-d7ea-46bc-a810-4a7bba235d28/37-4
00:07:22.494 --> 00:07:24.367
They can host it in their own

53bf2699-d7ea-46bc-a810-4a7bba235d28/38-0
00:07:24.607 --> 00:07:28.708
hyperscaler cloud tenant,
or they could have a private cloud

53bf2699-d7ea-46bc-a810-4a7bba235d28/38-1
00:07:28.708 --> 00:07:32.069
instance,
sometimes by themselves or as a managed

53bf2699-d7ea-46bc-a810-4a7bba235d28/38-2
00:07:32.069 --> 00:07:35.431
solution.
How did Northwell think about where the

53bf2699-d7ea-46bc-a810-4a7bba235d28/38-3
00:07:35.431 --> 00:07:40.136
best place was to install Epic,
and how important was it to co-locate

53bf2699-d7ea-46bc-a810-4a7bba235d28/38-4
00:07:40.136 --> 00:07:42.287
non-Epic applications with Epic?

53bf2699-d7ea-46bc-a810-4a7bba235d28/39-0
00:07:43.087 --> 00:07:47.497
Going through the understanding of the
applications that went live,

53bf2699-d7ea-46bc-a810-4a7bba235d28/39-1
00:07:47.497 --> 00:07:52.036
they looked at Epic and Epic adjacent and
Epic non-reliant platforms.

53bf2699-d7ea-46bc-a810-4a7bba235d28/39-2
00:07:52.036 --> 00:07:57.288
So when we are looking at our section,
going from where we are in Oracle over to

53bf2699-d7ea-46bc-a810-4a7bba235d28/39-3
00:07:57.288 --> 00:08:00.984
the Epic side,
we had to facilitate the best practice of

53bf2699-d7ea-46bc-a810-4a7bba235d28/39-4
00:08:00.984 --> 00:08:01.567
what Epic

53bf2699-d7ea-46bc-a810-4a7bba235d28/41-0
00:08:01.887 --> 00:08:06.725
Had to offer from the beginning,
and then remove anything that's not

53bf2699-d7ea-46bc-a810-4a7bba235d28/41-1
00:08:06.725 --> 00:08:10.862
relevant to what we want to do in our
current environment,

53bf2699-d7ea-46bc-a810-4a7bba235d28/41-2
00:08:10.862 --> 00:08:15.489
because Epic would have that install.
Utilizing that methodology,

53bf2699-d7ea-46bc-a810-4a7bba235d28/40-0
00:08:12.487 --> 00:08:12.967
Mmh.

53bf2699-d7ea-46bc-a810-4a7bba235d28/41-3
00:08:15.489 --> 00:08:20.887
we've consolidated and refined the
ability of taking Epic adjacent and Epic.

53bf2699-d7ea-46bc-a810-4a7bba235d28/42-0
00:08:20.967 --> 00:08:26.260
actual EMR workflows and translating or
working to translate what we currently

53bf2699-d7ea-46bc-a810-4a7bba235d28/42-1
00:08:26.260 --> 00:08:31.084
have into that Epic environment that
allows us to be co-habitating that

53bf2699-d7ea-46bc-a810-4a7bba235d28/42-2
00:08:31.084 --> 00:08:34.635
information across our network.
So now in the cloud,

53bf2699-d7ea-46bc-a810-4a7bba235d28/42-3
00:08:34.635 --> 00:08:39.927
we can facilitate better access to that
information and workflows and updates.

53bf2699-d7ea-46bc-a810-4a7bba235d28/43-0
00:08:40.007 --> 00:08:44.218
States singularly within one instance
across our network,

53bf2699-d7ea-46bc-a810-4a7bba235d28/43-1
00:08:44.218 --> 00:08:49.807
once we're live with our final activation
in our network in our modem, yeah.

53bf2699-d7ea-46bc-a810-4a7bba235d28/45-0
00:08:49.087 --> 00:08:51.282
Just to just to be clear for our
listeners,

53bf2699-d7ea-46bc-a810-4a7bba235d28/44-0
00:08:51.167 --> 00:08:51.527
Yeah.

53bf2699-d7ea-46bc-a810-4a7bba235d28/45-1
00:08:51.282 --> 00:08:53.327
where are you hosting your Epic instance?

53bf2699-d7ea-46bc-a810-4a7bba235d28/48-0
00:08:54.887 --> 00:08:57.775
That's a good question.
I apologize that I am not.

53bf2699-d7ea-46bc-a810-4a7bba235d28/46-0
00:08:56.847 --> 00:08:57.327
Yes.

53bf2699-d7ea-46bc-a810-4a7bba235d28/48-1
00:08:57.775 --> 00:09:00.493
I'm not into all of that technology
aspect yet,

53bf2699-d7ea-46bc-a810-4a7bba235d28/48-2
00:09:00.493 --> 00:09:04.287
'cause we're just coming on board with
with that unification with.

53bf2699-d7ea-46bc-a810-4a7bba235d28/47-0
00:09:01.327 --> 00:09:01.727
Got it.

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-0
00:09:02.767 --> 00:09:05.275
Yeah. So,
and then how are you thinking about

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-1
00:09:05.275 --> 00:09:08.436
governance, security,
and compliance for AI in the cloud?

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-2
00:09:08.436 --> 00:09:11.324
So I know that you're working Google
Cloud Platform,

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-3
00:09:11.324 --> 00:09:15.630
but especially when it comes to personal
health information, model monitoring,

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-4
00:09:15.630 --> 00:09:18.900
audit requirements,
what are you thinking about governance,

53bf2699-d7ea-46bc-a810-4a7bba235d28/49-5
00:09:18.900 --> 00:09:21.407
security,
and compliance for AI in the cloud?

53bf2699-d7ea-46bc-a810-4a7bba235d28/50-0
00:09:21.447 --> 00:09:21.767
Cloud.

53bf2699-d7ea-46bc-a810-4a7bba235d28/51-0
00:09:22.447 --> 00:09:27.438
I think AI in the cloud that we control
is the most secure way.

53bf2699-d7ea-46bc-a810-4a7bba235d28/51-1
00:09:27.438 --> 00:09:33.052
We don't allow any external or
third-party applications or agents to be

53bf2699-d7ea-46bc-a810-4a7bba235d28/51-2
00:09:33.052 --> 00:09:38.120
loaded into our own deployed devices or
within our cloud itself.

53bf2699-d7ea-46bc-a810-4a7bba235d28/51-3
00:09:38.120 --> 00:09:40.927
Anyone who wants to facilitate those

53bf2699-d7ea-46bc-a810-4a7bba235d28/52-0
00:09:41.047 --> 00:09:45.205
external agents, the shadow agents,
are not allowed to come into our

53bf2699-d7ea-46bc-a810-4a7bba235d28/52-1
00:09:45.205 --> 00:09:49.724
environment to do so. So it's very,
very secure. So we control the agents,

53bf2699-d7ea-46bc-a810-4a7bba235d28/52-2
00:09:49.724 --> 00:09:53.339
we control the data,
and when that data hub is very secured

53bf2699-d7ea-46bc-a810-4a7bba235d28/52-3
00:09:53.339 --> 00:09:58.159
within our environment to deploy those
once they are approved by the governance

53bf2699-d7ea-46bc-a810-4a7bba235d28/52-4
00:09:58.159 --> 00:10:00.207
within our own evaluation process.

53bf2699-d7ea-46bc-a810-4a7bba235d28/53-0
00:10:00.847 --> 00:10:04.646
So you're the CMIO of Northwell Health
Northern Market.

53bf2699-d7ea-46bc-a810-4a7bba235d28/53-1
00:10:04.646 --> 00:10:09.733
So you're in many organizations,
this title means that you are somewhat of

53bf2699-d7ea-46bc-a810-4a7bba235d28/53-2
00:10:09.733 --> 00:10:14.753
a liaison between many of the providers
and the rest of leadership at the

53bf2699-d7ea-46bc-a810-4a7bba235d28/53-3
00:10:14.753 --> 00:10:19.637
organization. How would you say,
what are some of the greatest concerns

53bf2699-d7ea-46bc-a810-4a7bba235d28/53-4
00:10:19.637 --> 00:10:24.927
that you'd say are bubbling up to the
surface from your frontline clinicians?

53bf2699-d7ea-46bc-a810-4a7bba235d28/55-0
00:10:25.327 --> 00:10:30.491
And what kind of arguments or
conversations are you having with the

53bf2699-d7ea-46bc-a810-4a7bba235d28/55-1
00:10:30.491 --> 00:10:34.287
rest of the C-suite on behalf of those
providers?

53bf2699-d7ea-46bc-a810-4a7bba235d28/56-0
00:10:34.767 --> 00:10:39.341
The biggest question I get is what
happens to my data once we move over?

53bf2699-d7ea-46bc-a810-4a7bba235d28/56-1
00:10:39.341 --> 00:10:43.790
What happens to my patient information
once we go over to the new EMR?

53bf2699-d7ea-46bc-a810-4a7bba235d28/56-2
00:10:43.790 --> 00:10:48.426
And those questions are very well
addressed by what's already taken place

53bf2699-d7ea-46bc-a810-4a7bba235d28/56-3
00:10:48.426 --> 00:10:51.245
in the 1st wave and 2nd wave of
integration.

53bf2699-d7ea-46bc-a810-4a7bba235d28/56-4
00:10:51.245 --> 00:10:54.127
It's clear to me and clear to them once
we've

53bf2699-d7ea-46bc-a810-4a7bba235d28/58-0
00:10:54.287 --> 00:10:57.979
discussed this,
that Northwell has done a fantastic job

53bf2699-d7ea-46bc-a810-4a7bba235d28/58-1
00:10:57.979 --> 00:11:02.924
in enhancing and maintaining prior
medical records in the new environment.

53bf2699-d7ea-46bc-a810-4a7bba235d28/58-2
00:11:02.924 --> 00:11:08.001
And facilitating that access to care
really benefits the patients who can go

53bf2699-d7ea-46bc-a810-4a7bba235d28/58-3
00:11:08.001 --> 00:11:12.813
see anyone anywhere in the network,
but also the clinicians who need the

53bf2699-d7ea-46bc-a810-4a7bba235d28/58-4
00:11:12.813 --> 00:11:14.527
access to that information

53bf2699-d7ea-46bc-a810-4a7bba235d28/59-0
00:11:14.847 --> 00:11:19.960
from when that patient starts out
someplace else and moves into, let's say,

53bf2699-d7ea-46bc-a810-4a7bba235d28/59-1
00:11:19.960 --> 00:11:25.342
our neighborhood or our region and has
that information from the New York State

53bf2699-d7ea-46bc-a810-4a7bba235d28/59-2
00:11:25.342 --> 00:11:28.571
locations.
So I think trust and I think knowing

53bf2699-d7ea-46bc-a810-4a7bba235d28/59-3
00:11:28.571 --> 00:11:33.482
what's going on in the other activations
and learning about that is best

53bf2699-d7ea-46bc-a810-4a7bba235d28/59-4
00:11:33.482 --> 00:11:35.567
facilitated by myself, my team,

53bf2699-d7ea-46bc-a810-4a7bba235d28/60-0
00:11:35.727 --> 00:11:40.112
going and looking at the activation and
go lives that are there in other sections

53bf2699-d7ea-46bc-a810-4a7bba235d28/60-1
00:11:40.112 --> 00:11:44.497
and bringing that back to our network to
better explain what to expect when we go

53bf2699-d7ea-46bc-a810-4a7bba235d28/60-2
00:11:44.497 --> 00:11:46.047
live in our Wave 5 migration.

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-0
00:11:46.527 --> 00:11:49.898
So I think I'd like to segue for a moment
to staffing,

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-1
00:11:49.898 --> 00:11:53.390
which is a little bit more apropos to
what's facing you.

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-2
00:11:53.390 --> 00:11:58.231
So many organizations across the country
are growing and consolidating. M&

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-3
00:11:58.231 --> 00:12:02.337
A activity is vibrant and in the news
every single day. Northwell,

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-4
00:12:02.337 --> 00:12:05.707
it's no secret,
has been doing it since they were Long

53bf2699-d7ea-46bc-a810-4a7bba235d28/61-5
00:12:05.707 --> 00:12:09.567
Island Jewish and began growing on Long
Island, New York City.

53bf2699-d7ea-46bc-a810-4a7bba235d28/62-0
00:12:09.807 --> 00:12:13.226
just branched into Connecticut with an
acquisition.

53bf2699-d7ea-46bc-a810-4a7bba235d28/62-1
00:12:13.226 --> 00:12:17.960
And so I think staffing issues is
something that is of interest to many

53bf2699-d7ea-46bc-a810-4a7bba235d28/62-2
00:12:17.960 --> 00:12:21.116
listeners. You know,
when we acquire new staff,

53bf2699-d7ea-46bc-a810-4a7bba235d28/62-3
00:12:21.116 --> 00:12:25.456
how do we rebadge them?
How do we not only incorporate their Epic

53bf2699-d7ea-46bc-a810-4a7bba235d28/62-4
00:12:25.456 --> 00:12:30.847
instance or their AllScripts or Meditech
or Oracle CERN or whatever their EHR is,

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-0
00:12:31.127 --> 00:12:36.090
So it's not only the clinical data,
but it's also making sure that we have

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-1
00:12:36.090 --> 00:12:40.127
adequate talent and also efficient talent,
right? So how do,

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-2
00:12:40.127 --> 00:12:43.303
what would you say kind of as a word of
advice,

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-3
00:12:43.303 --> 00:12:48.729
maybe to yourself a few years ago prior
to some of Northwell's acquisitions or to

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-4
00:12:48.729 --> 00:12:52.236
somebody listening who's going through
these things,

53bf2699-d7ea-46bc-a810-4a7bba235d28/63-5
00:12:52.236 --> 00:12:54.287
how do you think about staffing

53bf2699-d7ea-46bc-a810-4a7bba235d28/64-0
00:12:55.007 --> 00:12:57.727
to support these technological
initiatives.

53bf2699-d7ea-46bc-a810-4a7bba235d28/65-0
00:12:59.567 --> 00:13:03.417
You've developed your own environment,
your own milieu.

53bf2699-d7ea-46bc-a810-4a7bba235d28/65-1
00:13:03.417 --> 00:13:08.847
I would just say we've been live on our
own essence of Oracle for eight years,

53bf2699-d7ea-46bc-a810-4a7bba235d28/65-2
00:13:08.847 --> 00:13:11.735
10 years,
very comfortable developing and

53bf2699-d7ea-46bc-a810-4a7bba235d28/65-3
00:13:11.735 --> 00:13:17.096
innovating and supporting and really
addressing the progression of innovation

53bf2699-d7ea-46bc-a810-4a7bba235d28/65-4
00:13:17.096 --> 00:13:18.127
within our EMR.

53bf2699-d7ea-46bc-a810-4a7bba235d28/66-0
00:13:18.367 --> 00:13:21.416
up to this point.
And working with Northwell,

53bf2699-d7ea-46bc-a810-4a7bba235d28/66-1
00:13:21.416 --> 00:13:26.520
they've been very good in understanding
what we've done and listened to what

53bf2699-d7ea-46bc-a810-4a7bba235d28/66-2
00:13:26.520 --> 00:13:32.087
needs to be continued until we are on one
platform. So transparency, collaboration,

53bf2699-d7ea-46bc-a810-4a7bba235d28/66-3
00:13:32.087 --> 00:13:36.329
and interaction is a very,
very important part of this process.

53bf2699-d7ea-46bc-a810-4a7bba235d28/66-4
00:13:36.329 --> 00:13:41.167
And communication to our employees,
they've done a great job in terms of

53bf2699-d7ea-46bc-a810-4a7bba235d28/67-0
00:13:41.367 --> 00:13:45.319
helping our employees, not just IT,
but every employee,

53bf2699-d7ea-46bc-a810-4a7bba235d28/67-1
00:13:45.319 --> 00:13:50.470
become welcome and understanding that
their efforts over the last years,

53bf2699-d7ea-46bc-a810-4a7bba235d28/67-2
00:13:50.470 --> 00:13:54.210
it doesn't matter how long they've been
at Newvance,

53bf2699-d7ea-46bc-a810-4a7bba235d28/67-3
00:13:54.210 --> 00:13:59.784
has created an enterprise that they're
very happy to bring on board into their

53bf2699-d7ea-46bc-a810-4a7bba235d28/67-4
00:13:59.784 --> 00:14:00.207
larger

53bf2699-d7ea-46bc-a810-4a7bba235d28/68-0
00:14:00.687 --> 00:14:05.801
universe. Communication, respect,
and interaction is really the important

53bf2699-d7ea-46bc-a810-4a7bba235d28/68-1
00:14:05.801 --> 00:14:09.187
part of all this, those process.
Moving forward,

53bf2699-d7ea-46bc-a810-4a7bba235d28/68-2
00:14:09.187 --> 00:14:14.370
there has not been any doubt in my mind
that the market has been very well

53bf2699-d7ea-46bc-a810-4a7bba235d28/68-3
00:14:14.370 --> 00:14:19.967
respected and supported in the continuous
goals that we have started to achieve.

53bf2699-d7ea-46bc-a810-4a7bba235d28/69-0
00:14:20.167 --> 00:14:24.527
and will continue to achieve within the
Northwell environment.

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-0
00:14:25.087 --> 00:14:29.750
So we are approaching the end of this
podcast episode, so two final questions.

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-1
00:14:29.750 --> 00:14:32.406
One,
I'd like to circle back to what we were

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-2
00:14:32.406 --> 00:14:35.063
discussing at the beginning of this
episode.

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-3
00:14:35.063 --> 00:14:39.726
So we're talking about the intersection
of the data center strategy and the AI

53bf2699-d7ea-46bc-a810-4a7bba235d28/70-0
00:14:35.327 --> 00:14:35.407
The.

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-4
00:14:39.726 --> 00:14:42.618
strategy.
And I'm wondering if you can offer any

53bf2699-d7ea-46bc-a810-4a7bba235d28/71-5
00:14:42.618 --> 00:14:44.447
words of advice or insight into

53bf2699-d7ea-46bc-a810-4a7bba235d28/74-0
00:14:44.647 --> 00:14:48.857
how those two play together.
Because AI is something that everybody's

53bf2699-d7ea-46bc-a810-4a7bba235d28/74-1
00:14:48.857 --> 00:14:52.405
doing, is quite novel,
and also kind of moving out of data

53bf2699-d7ea-46bc-a810-4a7bba235d28/74-2
00:14:52.405 --> 00:14:55.351
centers,
on-prem data centers into cloud hosting

53bf2699-d7ea-46bc-a810-4a7bba235d28/74-3
00:14:55.351 --> 00:14:58.358
is something that's happening across the
country.

53bf2699-d7ea-46bc-a810-4a7bba235d28/72-0
00:14:55.407 --> 00:14:55.727
But...

53bf2699-d7ea-46bc-a810-4a7bba235d28/73-0
00:14:57.087 --> 00:14:57.567
Sure.

53bf2699-d7ea-46bc-a810-4a7bba235d28/74-4
00:14:58.358 --> 00:15:02.687
So I'm wondering how those two trends
have aligned at Northwell Health.

53bf2699-d7ea-46bc-a810-4a7bba235d28/75-0
00:15:03.247 --> 00:15:09.090
I think the best part to look at for us
is understanding what we went through to

53bf2699-d7ea-46bc-a810-4a7bba235d28/75-1
00:15:09.090 --> 00:15:13.923
our tradition into the AI workflows.
We had our own AI governance,

53bf2699-d7ea-46bc-a810-4a7bba235d28/75-2
00:15:13.923 --> 00:15:18.900
we had our own AI initiatives,
and when we integrated ourselves with

53bf2699-d7ea-46bc-a810-4a7bba235d28/75-3
00:15:18.900 --> 00:15:22.651
Northwell,
they gave us a whole new area to migrate

53bf2699-d7ea-46bc-a810-4a7bba235d28/75-4
00:15:22.651 --> 00:15:25.247
our information on. We went from AWS

53bf2699-d7ea-46bc-a810-4a7bba235d28/76-0
00:15:25.487 --> 00:15:30.779
into the Google Cloud GCP,
and they're able to take that information,

53bf2699-d7ea-46bc-a810-4a7bba235d28/76-1
00:15:30.779 --> 00:15:35.390
that data that we've created,
and allow us access into their

53bf2699-d7ea-46bc-a810-4a7bba235d28/76-2
00:15:35.390 --> 00:15:40.152
environment by doing so. So in essence,
they work in parallel.

53bf2699-d7ea-46bc-a810-4a7bba235d28/76-3
00:15:40.152 --> 00:15:45.518
The governance around data is as
important as the governance around AI

53bf2699-d7ea-46bc-a810-4a7bba235d28/76-4
00:15:45.518 --> 00:15:46.047
because

53bf2699-d7ea-46bc-a810-4a7bba235d28/78-0
00:15:46.207 --> 00:15:51.340
AI requires that data to be well,
to excel the capacities of AI,

53bf2699-d7ea-46bc-a810-4a7bba235d28/78-1
00:15:51.340 --> 00:15:57.104
we need all that information,
that data easily accessible to our agents.

53bf2699-d7ea-46bc-a810-4a7bba235d28/77-0
00:15:54.847 --> 00:15:55.327
Mhm.

53bf2699-d7ea-46bc-a810-4a7bba235d28/78-2
00:15:57.104 --> 00:16:03.421
So the synergy there is very important,
being led by the innovations group over

53bf2699-d7ea-46bc-a810-4a7bba235d28/78-3
00:16:03.421 --> 00:16:04.447
at Northwell.

53bf2699-d7ea-46bc-a810-4a7bba235d28/80-0
00:16:04.927 --> 00:16:08.091
So Al,
we've covered a bunch of ground today.

53bf2699-d7ea-46bc-a810-4a7bba235d28/79-0
00:16:05.727 --> 00:16:06.127
Yeah.

53bf2699-d7ea-46bc-a810-4a7bba235d28/80-1
00:16:08.091 --> 00:16:12.356
We've discussed the data center exit and
transition into GCP.

53bf2699-d7ea-46bc-a810-4a7bba235d28/80-2
00:16:12.356 --> 00:16:15.726
We've talked about AI strategy under Dr.
Cruzin,

53bf2699-d7ea-46bc-a810-4a7bba235d28/80-3
00:16:15.726 --> 00:16:21.229
and we've talked about data migration.
We've talked a little bit about staffing

53bf2699-d7ea-46bc-a810-4a7bba235d28/80-4
00:16:21.229 --> 00:16:23.567
and about governance in the cloud.

53bf2699-d7ea-46bc-a810-4a7bba235d28/81-0
00:16:24.127 --> 00:16:28.432
We've talked about being responsive to
particular provider questions,

53bf2699-d7ea-46bc-a810-4a7bba235d28/81-1
00:16:28.432 --> 00:16:33.289
especially around what happens to legacy
data and legacy EMRs when moving to a

53bf2699-d7ea-46bc-a810-4a7bba235d28/81-2
00:16:33.289 --> 00:16:37.655
singular unified Epic instance.
I'm wondering if anyone's listening to

53bf2699-d7ea-46bc-a810-4a7bba235d28/81-3
00:16:37.655 --> 00:16:42.328
this episode at a peer institution across
the United States somewhere else,

53bf2699-d7ea-46bc-a810-4a7bba235d28/81-4
00:16:42.328 --> 00:16:47.247
and do you have any words of advice on
any of these topics? You know, there are

53bf2699-d7ea-46bc-a810-4a7bba235d28/82-0
00:16:47.367 --> 00:16:52.466
They're about to engage and to enter into
their phase of development that Northwell

53bf2699-d7ea-46bc-a810-4a7bba235d28/82-1
00:16:52.466 --> 00:16:55.258
is already engaging or has just emerged
from.

53bf2699-d7ea-46bc-a810-4a7bba235d28/82-2
00:16:55.258 --> 00:16:57.807
What words of advice do you have for them?

53bf2699-d7ea-46bc-a810-4a7bba235d28/83-0
00:16:58.447 --> 00:17:04.669
I think understanding what the end users'
opinions are and listening to what the

53bf2699-d7ea-46bc-a810-4a7bba235d28/83-1
00:17:04.669 --> 00:17:10.430
experience has been thus far before
engaging into any new changes, listen,

53bf2699-d7ea-46bc-a810-4a7bba235d28/83-2
00:17:10.430 --> 00:17:16.114
and then facilitate that transition
between past state into future state.

53bf2699-d7ea-46bc-a810-4a7bba235d28/83-3
00:17:16.114 --> 00:17:17.727
By understanding that

53bf2699-d7ea-46bc-a810-4a7bba235d28/84-0
00:17:17.927 --> 00:17:22.833
There are still people there who really
enjoy what they're doing and want to

53bf2699-d7ea-46bc-a810-4a7bba235d28/84-1
00:17:22.833 --> 00:17:27.548
continue doing this in through the
integration and not just lose sight of

53bf2699-d7ea-46bc-a810-4a7bba235d28/84-2
00:17:27.548 --> 00:17:30.861
the fact that they're joining a larger
institution.

53bf2699-d7ea-46bc-a810-4a7bba235d28/84-3
00:17:30.861 --> 00:17:35.449
There's a lot of really smart people
across the new network that can be

53bf2699-d7ea-46bc-a810-4a7bba235d28/84-4
00:17:35.449 --> 00:17:37.487
facilitated in new opportunities

53bf2699-d7ea-46bc-a810-4a7bba235d28/85-0
00:17:37.647 --> 00:17:41.327
that are facilitated through the larger
network integration.

53bf2699-d7ea-46bc-a810-4a7bba235d28/86-0
00:17:41.647 --> 00:17:45.424
Is there anything that you've learned
that you wish you had known at the start

53bf2699-d7ea-46bc-a810-4a7bba235d28/86-1
00:17:45.424 --> 00:17:49.104
of this thing or any surprises that you
came across that you were like, wow,

53bf2699-d7ea-46bc-a810-4a7bba235d28/86-2
00:17:49.104 --> 00:17:51.207
I wish I'd known this before that
happened?

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-0
00:17:51.727 --> 00:17:54.967
I think the best part is Northwest has
done a very,

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-1
00:17:54.967 --> 00:17:58.643
very good job with communicating right
from the beginning.

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-2
00:17:58.643 --> 00:18:03.690
And to be able to ask questions early is
probably one thing that everyone should

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-3
00:18:03.690 --> 00:18:07.054
be able to do.
And I wish I had done that sooner than

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-4
00:18:07.054 --> 00:18:11.789
ask the questions right out front.
Nobody is holding it against you for not

53bf2699-d7ea-46bc-a810-4a7bba235d28/87-5
00:18:11.789 --> 00:18:12.287
knowing.

53bf2699-d7ea-46bc-a810-4a7bba235d28/88-0
00:18:12.447 --> 00:18:17.698
It's our job to know the best we can from
anyone that can give us information that

53bf2699-d7ea-46bc-a810-4a7bba235d28/88-1
00:18:17.698 --> 00:18:22.821
we can best facilitate to our own people
to help guide them into the integration

53bf2699-d7ea-46bc-a810-4a7bba235d28/88-2
00:18:22.821 --> 00:18:23.327
process.

53bf2699-d7ea-46bc-a810-4a7bba235d28/89-0
00:18:23.567 --> 00:18:26.354
So for our listeners,
this has been Al Villarreal,

53bf2699-d7ea-46bc-a810-4a7bba235d28/89-1
00:18:26.354 --> 00:18:29.468
the VP and CMIO of Northwell Health
Northern Market. Al,

53bf2699-d7ea-46bc-a810-4a7bba235d28/89-2
00:18:29.468 --> 00:18:32.527
I would like to thank you so much for
joining us today.