UnHack with Drex DeFord

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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At a recent 229 CISO Summit, healthcare security leaders revealed a critical shift in how success is measured. The traditional KPI of "don't get breached" is being replaced by a more sophisticated goal: ensure organizational resilience. Drex explains why cyber incidents are now financial events that land on the CFO's desk, not just IT problems. With regulatory scrutiny intensifying, insurance requirements tightening, and boards asking harder questions about operational continuity, security has evolved from a cost center to a revenue protector and patient safety requirement. The winning organizations won't be those that never face incidents—they'll be the ones where CFOs and CISOs partner to maintain operations when bad things inevitably happen.
Remember, Stay a Little Paranoid
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February 9, 2026: 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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