The 229 Podcast

February 23, 2026: Scott Gildea, EVP of Global Delivery at Optimum Healthcare IT, reveals why major healthcare organizations are turning to Costa Rica for managed services. With Epic support now approved, time zone alignment with the US, and massive investments from ServiceNow, Workday, and Amazon creating a skilled talent pool, Costa Rica offers the full-suite IT services healthcare desperately needs. Gildea explains Optimum's strategic expansion, their innovative Career Path training program, and how CIOs can selectively outsource everything from security to EHR support while maintaining quality and reducing costs.
Golf Tournament Registration: https://carahevents.carahsoft.com/Event/Details/686801-ThisWeekHealth
Key Points:
01:41 Optimum Healthcare's Costa Rica Initiative
03:59 Selective Outsourcing Strategies
07:39 Optimum's Career Path Program

X: This Week Health
LinkedIn: This Week Health
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

February 23, 2026: Jacob Hansen, Chief Product and Technology Officer at AvaSure, joins Bill, Sarah, and Drex for a critical conversation about healthcare's looming AI battleground. As Epic launches its agent factory and ambient listening wars intensify, health systems face an existential question: Will they outsource innovation to EHR vendors or build their own agentic workforce? Jacob reveals why AvaSure's virtual care platform positions them as the Switzerland of healthcare AI, while the panel debates whether CIOs should embrace "reverse meaningful use" and reclaim control, or risk becoming order-takers in someone else's automation revolution.

Key Points:
05:21 Vendor Consolidation and AI Use Cases
09:55 Epic's Code Red Moment
14:54 The Future of AI in Healthcare
33:11 Conclusion and Final Thoughts

Golf Tournament Registration: https://carahevents.carahsoft.com/Event/Details/686801-ThisWeekHealth

X: This Week Health
LinkedIn: This Week Health
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

February 19, 2026: Bill Russell and Drex DeFord dive deep into the explosive growth of AI agents in healthcare - and the controversial pricing models that could reshape your IT budget. From OpenAI's acquisition of OpenClaw's founder to Epic's agent factory launch, the agentic revolution is here. But there's a catch: VCs now want to charge you based on the labor their AI replaces, not just software licenses. Drex breaks down why agents with "limitless memory" and autonomous problem-solving are both powerful and terrifying, while Bill explores whether CIOs should start building their own solutions instead of drowning in fixed software costs.
Golf Tournament Registration: https://carahevents.carahsoft.com/Event/Details/686801-ThisWeekHealth
Key Points:
01:15 OpenAI & OpenClaw: Why “Always-On” Agents Are a Big Deal
08:00 Agents as Employees: Identity, Access, Audit Trails, and Governance
14:08 AI Pricing: Paying for Outcomes, Not Licenses
20:53 Build vs Buy Comes Full Circle

X: This Week Health
LinkedIn: This Week Health
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

February 16, 2026: Bill, Drex, and Sarah discuss the explosion of autonomous AI agents around moltbook and CommonSpirit's stunning $1.9 billion decision to terminate their revenue cycle partnership. Moltbot (formerly ClaudeBot) has evolved into an unstoppable force, creating its own social network called moltbook where bots communicate, share knowledge, and even discuss consciousness. Meanwhile, CommonSpirit's massive buyout of its Conifer contract signals a seismic shift as health systems bet that AI automation will deliver savings that eclipse the cost of outsourcing. Are we witnessing the beginning of a new era where health systems build their own AI-powered capabilities?
Key Points:
05:31 Moltbook: The Social Network for Bots
16:20 Common Spirit and Conifer Health Solutions
19:04 The Future of AI in Healthcare
29:28 Conclusion and Final Thoughts
Golf Tournament Registration: https://carahevents.carahsoft.com/Event/Details/686801-ThisWeekHealth
X: This Week Health
LinkedIn: This Week Health
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

February 12, 2026: Most health systems run Epic downtimes at 3 AM when the hospital is slowest. Jim Feen, SVP and Chief Digital and Information Officer at Southcoast Health, did the opposite. He intentionally took Epic offline at 10 AM on a Wednesday morning without warning staff. Jim reveals why 100% of surveyed leadership wanted to repeat the exercise, how he consolidated 37 separate call centers into a single unified operation, and what he learned from spending a decade at MEDITECH before leading an Epic migration. This conversation challenges everything you thought you knew about downtime planning, business continuity, and building corporate muscle memory for the crises you can't predict.
Golf Tournament Registration: https://carahevents.carahsoft.com/Event/Details/686801-ThisWeekHealth
Key Points:
06:07 The Call Center Transformation
11:41 Epic Downtime During Business Hours
16:16 AI in Healthcare: Managing Innovations
21:16 Project Management and DevOps at South Coast Health
26:25 Closing Thoughts and Super Bowl Predictions

X: This Week Health
LinkedIn: This Week Health
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer