The 229 Podcast

When Marshfield Clinic joined Sanford Health in January 2025, revenue cycle did not wait on the technology. Work queues had sat for a long time, so the combined team blitzed them with extra hands. Roxi Foreman, VP Tech Services at Sanford Health, calls revenue cycle a great example of shared strengths, and she runs governance as a three-footed stool: clinical, revenue cycle, and IT deciding together.

That only holds up on trust. "Every plan is intended to deviate," Roxi said, so her teams review their projects every week, and the measure of trust on a team is whether a leader will admit a goal slipped. A prior auth summit that put clinical, patient access, and tech leaders in one room proved it: "our KPIs came out better and the team came out stronger." Next, she wants patients to book care the way they book everything else, with a text, without working out which specialty they need.

Chapters:
0:00 Welcome, Roxi Foreman
1:50 From integration to shared strengths
3:28 Harmony Healthcare IT
3:59 Revenue cycle did not wait
4:59 Putting people in their strengths
6:24 Governance and the three-footed stool
8:07 Ping Identity
8:36 When the plan deviates
10:34 Trust across the aisle
12:16 Rackspace
13:04 The prior auth summit
15:44 Where patient access needs investment
18:02 Two to three years ahead
20:00 Booking care with a text
22:02 Thank you, Roxi

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November 4, 2026: Donald Pollard, Field CTO at SHI, joins Drex DeFord. A health system is told to get AI in and to say what it returns. Donald has three customers in Nashville where two agents stuck in a loop produced a $40,000 bill. A year of budget can be gone in a quarter once the work runs on a meter.
The other half is the work. He wants the hard problem, not an email summary. A forward deployed engineer sits with the person who does the job. His claim: a working system in someone's hands by the fourth day, including at smaller systems. On the bill, an AI router prices a routine question at a nickel per million tokens instead of $50.
Key Points:
0:00 Drex and Donald Pollard

1:08 End the Shift

2:34 Pressured to Put AI In

4:33 Two Billion Hours Short

5:22 The Hard Problem

11:52 Seven Systems, One Patient

18:09 Two Agents, a $40,000 Bill

19:27 A Nickel or Fifty Dollars

20:43 Close

LinkedIn: 229Project
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October 28, 2026: Larger health systems are moving governance, risk and compliance work onto a single platform. Jay Stewart, Chief Revenue Officer at Meditology Services, sees what happens after the move. The platform may solve the problem "80, 85% of the way," and then the team customizes it. "And once you do that, you really start to lose a lot of the efficiency," Jay said.
"The technology is just one piece of that puzzle," he added. Automating without a good foundation does not help, so Jay wants the people and process work nailed down first, and that is where he sees many organizations asking for help. Skip that step, and the team has automated a process it never fixed.
Key Points:
00:00 Who Meditology Is

01:59 From Imaging Sales to Third-Party Risk

03:06 Meditology Services

03:31 Budget Scrutiny Reaches the CFO

06:21 GRC and the One-Platform Approach

07:55 Resilience and Third-Party Risk

09:37 Lab Services, Plan B, Plan D

11:20 AI Inside the Vendor App

13:34 Legislation and HIPAA

15:23 Tottenham and Close

Keep up to date on the latest in health IT:
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October 27, 2026: An application the physicians liked, still on Server 2012 and TLS 1.0, was offline the day after Dan Holland's team priced the risk. Holland, chief information security officer at Tampa General Hospital, had the math: $750,000 of annualized loss against a $100,000 upgrade. "Vulnerability is not a risk," Holland tells Drex DeFord.
Holland used the same math to set tolerance thresholds in Tampa General's risk policy and to inform the insurance limits the hospital doubled this year. Jim Bowie, his predecessor, now at Zscaler, opens the episode and hands Drex the $5 horse question. "You don't want to put a $10 fence around a $5 horse," Holland says. With limited resources, the dollar figure decides where the fence goes.
Key Points:
00:06 Jim Bowie

07:18 Fortified Health

07:51 Dan Holland

11:21 Vulnerability Is Not a Risk

20:27 Cyber Hero

27:46 A $5 Horse

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October 22, 2026: Lori Boisjoli has sat at 229 tables as a CIO. Now she is joining 229Project as a Principal, and this conversation with Bill Russell is her welcome to the community. She learned BASIC in high school, took a coding job at IDX in Burlington, Vermont, and soon decided she could not just sit in a cube. She later became CIO of the six-hospital University of Vermont Health system, which went through a cyber attack nearly five years ago. Other CIOs still ask her to share that experience with their executives, sometimes to "scare the hell out of our C-suite."

Now she will host those tables, and she wants each room to leave with more than a takeaway: if a group agrees AI belongs in contract language, she wants that group to propose the language. That instinct goes back to Sharp HealthCare, where she spent the better part of nine months building the hospital side, and the team threw her a baby shower for her firstborn. "It is about the relationships," Lori said. For members, that means a host who was recently in their chair and wants every session to give them something they can use.

Key Points:

0:00 Welcome, Lori

1:03 Atlanta and the resilience panel

3:52 Restore by service, not by tier

5:07 Sharing the story with other C-suites

7:01 AI before joining 229Project

9:25 Agents that work while you sleep

11:31 Carve out time for innovation

12:53 From IDX and Allscripts to the provider side

16:27 "It is about the relationships"

19:20 What she hopes to build with members

21:08 Hosting the room

LinkedIn: 229Project

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