The 229 Podcast

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.
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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

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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
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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.
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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

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Bill Russell, Drex DeFord, and Sarah Richardson dissect J.P. Morgan healthcare presentations to reveal what's really being asked of technology leaders in 2026. The era of transformation talk is over; executives want friction reduced, margins improved, and growth enabled. Bill shares insights from CMIO conversations showing leaders moving beyond EHR optimization to solve real business challenges around patient access and clinical workflows. Drex and Sarah debate whether the shift toward operational excellence means CIOs should prepare to run pharmacy and lab departments next.
Key Points:
04:26 Challenges and Opportunities in Healthcare IT
10:17 Cybersecurity and Operational Focus
17:17 EHR Systems and Operational Efficiency
23:11 Hostage Crisis and Final Thoughts
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February 5, 2026: Jennifer Goldman, VP, CMIO, and Chief of Primary Care at Memorial Healthcare System, reveals why most patient access initiatives fail before they start. The problem isn't technology; it's template management, physician engagement, and clinical escalation workflows that non-clinical call centers can't navigate. Jennifer shares how Memorial added 10,000 same-day access visits by standardizing primary care templates and creating bi-directional governance forums. But the real challenge? Specialty care operates differently, requiring clinical escalation tools and trust-building between operations teams and centralized scheduling. This conversation exposes the hidden operational complexities that determine whether access innovation succeeds or becomes another failed IT project.
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Key Points:
01:07 Challenges in Patient Access
05:28 The Evolving Role of the CMIO
06:57 Success Stories and Innovations

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