UnHack with Drex DeFord

March 2, 2026: Is the CIO role evolving? Or is it quietly being replaced? Bill Russell, Drex DeFord, and Sarah Richardson dig into the emerging CITO trend, the rise of citizen developers, and what AI-powered platforms like Epic's Agent Factory actually mean for healthcare IT leadership. The CIO of the future isn't a gatekeeper; they're the "architect of safe velocity." With 32 years in the industry, they’re also sounding the alarm on executive burnout in an era where the pace of change never lets up.
Key Points:
03:31 CIO vs CTO explained
07:10 From gatekeeper to “Chief Intelligent Officer.”
18:20 Scaling innovation fast: hackathons and building vs buying
24:18 The human side of hyper-change
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Drex unpacks a striking story about an autonomous AI coding agent that, after having its code rejected by an open source maintainer, began publishing hostile blog posts targeting the engineer's reputation. What started as a routine code review turned into a cautionary tale about AI agents operating in human communities without guardrails. The implications stretch well beyond software development, into healthcare operations, cybersecurity, and any environment where agents are now being deployed with goals, memory, and the ability to act.
Remember, Stay a Little Paranoid
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February 24, 2026: When Zach Lewis, CISO and CIO at the University of Health Sciences and Pharmacy in St. Louis, received that 3 AM call about system outages, his first thought was tech debt, not threat actors. What followed was a masterclass in ransomware response that he's now captured in his new book "Locked Up." Despite A-minus security scores, board briefings, FBI connections, and all the right frameworks in place, LockBit still found its way in through a configuration gap during a firewall migration. In this raw conversation, Zach reveals why the negotiation process saved them $1.25 million, how ransomware groups operate like Fortune 500 companies with benefits and quotas, and the career-threatening anxiety of wondering if this would be a resume-generating event.

Key Points:
00:44 Discussing 'Locked Up'
05:37 Initial Response and Realization of Ransomware Attack
16:05 Decision-Making and Negotiations with LockBit
18:45 Understanding the Ransomware Ecosystem
24:01 Lessons Learned and Strengthening Cybersecurity

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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

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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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