Max - 00:00:03: Welcome to Emerging Cyber Risk, a podcast by Ignyte and Secure Robotics. We share our expertise on cyber risk and artificial intelligence to help you prepare for risk management of emerging technologies. We’re your hosts, Max Aulakh...
Joel - 00:00:18: And Joel Yonts. Join us as we dive into the development of AI, the evolution of cybersecurity, and other topics driving change in the cyber risk outlook.
Max - 00:00:26: Hey, thank you, everyone, for listening in today. Today, we are going to be speaking with Chris Rogers. Chris is a friend of mine, we went to school together. Some of the things that we’ll be covering are just first just learning Chris’ journey, but really then diving into access to healthcare, personalization of data, privacy, all of these things, and the intersection of artificial intelligence. With that in mind, let’s get started. So, Joel, you want to give us a little bit of a recap into this, and then let’s get right into it.
Joel - 00:00:59: Certainly. Well, I look forward to today’s discussion. It’s going to be certainly great talking with Chris, someone who’s made the transitions that he has. I’ll let him tell his story here in a moment. It’s going to be a little bit more focused on the human element, which is certainly an important side of cybersecurity and AI. So I’m not going to spend a whole lot of time because I really want to get into this conversation. Chris, why don’t you kick us off and tell us about yourself and specifically your journey from CISO to Chief Operating Officer and also some of the other things you’re passionate about, like universal access to healthcare and so forth. So, Chris.
Chris - 00:01:29: Excellent. Well, first, thank you. Joel. It was nice to make your acquaintance today. Max, I looked it up, and I think you and I met at the University of Texas in 2015. So it’s been a while, and it’s been great to keep up with you from there. And yeah, I do think we’ll do a little bit more on the human side by going deep into the technology and pros and cons and privacy and security concerns, but all those as they relate to how we use technology to better healthcare and a better healthcare experience for everybody. So my journey, because I know Max and I talked a little bit about that move from being the CISO/CSO into the COO, but I’ve kind of even got to start before that to say, how did I even get into security in the first place? And funny enough, it’ll lead very much into that human journey and why that’s so important to me now. I was a social ethicist writing my dissertation in graduate school and had my second child with my wonderful wife, and I needed a job really badly. And about that point, a gentleman who would be important to over 20 years of my life after that was looking to go into business in e-education and really kind of combine technology and people and instruction in an education offering a little bit ahead of its time. And knew he kind of needed somebody who knew how to do business and knew how to do education and knew something kind of about technology and how they came together. So I joined this company really to kind of combine the power of the World Wide Web with instruction, with the support of remote students and virtual learning. And that’s how I got into this world that I’ve kind of never left. And it started very much on the human element, both what I was studying and my need for employment at that time. So I really got deeper into the operational side of the business for a while, had an opportunity to serve as an expat in the Philippines during a period of rapid growth in the company, and was very much exposed to a lot of functions there. I was neither in tech nor operations nor sales/support, but a little bit of everything—facilities, security, compliance, workforce, operations—really helped me partner with some wonderful people around me to build and mature this environment. And then came back to the US and much more focused on a technology role. And that’s where I spent the last 17 years before leaving that environment and making this transition that y’all are asking me about. I was very much purely technology, but more technology from the business side. In other words, I’m not an engineer by trade. I’m not a coder by trade. I have all of the requisite security certs a security leader should have, but I always came at IT and security much more than running a business. Looking at this internally, we were not a technology company, but we were a technology-enabled company, but it was always for me to run it like a business. Who’s my supply chain? Who are my partners? Who’s my internal customer, my external customer? What are our service levels? How do we keep clear lines of communication? How does the security team not be the SPU, the Sales Prevention Unit, which is what it was when, according to some, we first took over, but really one that helped the business analyze risk and opportunities and then effectively communicates to our prospective clients and current clients in a way that explained what we were doing to help enable and move the business forward?
Joel - 00:05:12: I was just going to say, I hear you talking, and you almost sounded a little bit apologetic about being a technologist, but what I hear is what you were saying—that builds the best cybersecurity programs, what you just said. And so that’s...
Chris - 00:05:25: Oh, absolutely. Yeah, no, I, um, not the least bit apologetic for not coming at it from the technical side because I was surrounded and am still today in a different role by some of the smartest technologists that I’ve ever met across multiple industries and that ability to really be the conductor of bringing the best of everyone’s skills into a way to drive the business forward was that’s what was exciting for me. And then, as I moved deeper into the Security side, as well as the compliance, in addition to the security had all of what you would consider the standard parts of compliance that might fit within a security or a tech organization. So SOCs, GCC, PCI, you know, HITRUST, HIPAA, all those areas. But I always knew that for me, the bigger picture was I wanted to run an entity. That did not mean I needed to run a company, but it meant I wanted to be able to operationalize a function and run it as an operational unit. And I had the benefit because so much, well, first, it’s always a matter of, are you in the right place at the right time? Are you surrounded by the ability to seize on opportunities that you can? Because things like making moves from Princeton, New Jersey, to Hays, Kansas, to Tampa, Florida, to Manila, Philippines, back to Tampa, Florida, without an incredibly supportive wife that allowed those things to be able to happen without those opportunities being presented to me, I wouldn’t have been in a position to take them. And as well as the fact of being in an organization that was very intent on wanting to learn where you were going. So I had a CEO that I could sit down and talk to about where my career was potentially, from his perspective, going to be in five to ten years. I had a CIO who I could work with to say, how are we going to work together to make this organization the best it can be? And I don’t think this is where my career in this company is going to end up. And to have both the caring and the trust of an environment to be able to have those types of conversations is a pure gift. I recognize that every day, but I had very clearly had a path with our CIO and with our CEO that was going to ultimately take me out of technology and security as the person running that into either the operational head of a business unit in healthcare and/or into more chief administrative type role, combining multiple support functions, again, leading ultimately to more of a general manager type function. So that’s where my career was headed. It was there through intentionality on my part but also through incredible caring, openness, and willingness to have those conversations with the leadership I was with. And then we sold. It was not planned. We were a public company. We got a fantastic offer. Financially, it was a no-brainer for us to do that. And I sat back and said, well, OK, you know, I guess I’m going to be a security and technologist for the rest of my career. Great. Made a good career out of it so far. And started talking to some new folks who were also very open, looking back at operational experience, looking at all of the different areas that I had been able to touch over time, looking at what I wanted to do, and looking at where our company needed to go. And ended up with a company that very much combines human services and technology. One in three Americans has access to one of our clinical or nonclinical services, which is a combination of clinicians and non-clinicians doing clinical engagement, nurse advice line, online scheduling, gaps in care, and health risk assessments—but using 20+ years of proprietary technology to undergird our internal services, as well as SaaS platforms that we’ve developed and have into the market externally, and so found me in the perfect position to combine a lot of skills and a lot of interests with a company with a mission that just meant a lot to me. So that was a lot, Max. But you asked me to paint that picture of how one gets from point A to point B to point C. And that’s about as direct as I can make that path. And it’s more direct than it probably was in reality.
Max - 00:10:18: I think Chris, you’ve had a rare opportunity for a CEO to take interest in their team members and a CIO to carve your path, which I think is fantastic. But on your part, you mentioned intentionality. Right? So, any leader doesn’t matter where they are; if they’re not intentional about where they need to go, where they need to take the organization, it’s going to be a missed opportunity on their path, right? On their part.
Chris - 00:10:42: No, I mean, you can’t; this is where I always try to be very direct and very careful with the people that I am fortunate enough to be able to lead, hopefully coach, mentor. My job’s largely to make decisions, provide them air cover, make sure they get the direction they need, and soundboard their ideas cause these are all executives that I have the pleasure of leading. But that level and a level or so down, I’m like, you can never ever wait for someone to manage your career. If you’re not in there saying, you know, where do you see my strengths and weaknesses, I kind of feel like I will be good at this, or wow, I got assigned to this task, I found out I really took a lot of pleasure in doing that. Don’t ever count on someone doing it for you. And that’s where I try to be very direct, or I try to be very cautious. That can sound really easy. There are people who work in organizations that aren’t open to those types of conversations that are not surrounded by people that are willing or able to be open to those types of directions. And so you can’t just say, I’m going to go do it, but if you don’t go do it, it’s never going to happen. Cause nobody’s going to do it for you.
Joel - 00:11:55: And I love that intentionality thread, Max, that you’re talking about, you know, going after it. Now it seems like it’s probably not a coincidence that you’re in healthcare. And one of the things you’re personally passionate about is universal healthcare or access to healthcare. Is there a correlation between the two?
Chris - 00:12:12: There is a correlation in so far as I was in a very fortunate position to be able to take my time and figure out what I wanted to do next, what type of company I wanted to be with, what type of role I wanted, the industry that I wanted. And this is one of a couple of industries that would have pulled me back in. Very much looking at healthcare, I’ll be honest; I had another interest of mine at that time. I would have been a COO or an executive role in managing a security firm, right? Not so much being the security head inside of an organization, but again, I very much like running the business. That’s an area where I get a lot of career satisfaction out of. But this is an area that I am very passionate about. My son is an oncology PA. My mother is a retired nurse practitioner. My aunt’s a medical ethicist. My grandfather was an ear, nose, and throat surgeon. So I’ve kind of been surrounded by this for a while. And I have this kind of mixed view. It’s, we were in a leadership meeting not too long ago, and we’re kind of just talking, and one of our leaders threw out something, just a very spur-of-the-moment comment, and she says, you know, what we do matters. And then, towards the end of that meeting, we did one of these little things where you kind of throw the nerf ball, and you got to catch it and say, what’s an aha moment out of this. And I said, it’s not an aha moment because I think I knew it, but the way it was simply articulated, what we do matters. Right. And I think merely working and doing good for a company or an industry and supporting your family means your work matters. But if you also have the ability to work in an industry where what you do makes an impact on lives in a very material way, I consider that special. Now, where I said I have mixed views is, on the one hand, we have one of the most advanced and best healthcare systems in the world. On the other hand, we have a healthcare system that can meet social determinants of health and access to care and socioeconomic environments, and just Insurance, money, and complexity make our healthcare system, which can provide the best care on the planet, also one that can be exceptionally hard to navigate. And so to work in a company that is really partnering with some of the best healthcare companies in the world for them to be able to fully achieve what they need to do and to make healthcare better for all of us. Yeah. That means a lot to me. It’s a passion that I’m really enjoying.
Max - 00:15:06: Yeah. Chris, it’s no secret that we do have the world’s best, but it can always be improved. Right? Personally, coming from another country, I can say that I’ve lived through it, but then, at the same time, every Indian has a whole bunch of doctors in the family. And we’re no different. Right? And yes, there are market inefficiencies. There's a lack of data access, right? Sometimes, you can’t make decisions because of that. And then of course, there are pockets in the United States where there definitely needs to be more in terms of just population health management. How do we manage some of the environments that don’t have access to those things at all, right? Where we’ve got the best of the best in the world, but then we see pockets where we’ve got nothing, right? And I agree, when I was serving in the military, same kind of thing where, yes, you have a job, you come into the job, but if you can make a real-world impact on people's lives, that’s an amazing added bonus, right, to what you do. So that’s fantastic.
Chris - 00:16:12: And it’s so ripe to bring to bear learnings from a career in customer care, technical support, patient support, because the company I was with a significant amount of healthcare for the Canadian government and had a large DME support group internally. When you look at the consumer market, not patient markets, get completely out of healthcare for a minute. And you look at what’s going on with hyper-personalization and consumerization and self-service and, and, you know, access to your data and your ability to find information you need on kind of your fingertips. And then you come on, and I have my best friend who is a radiation oncologist with a researcher and a practitioner and the head of a radiation oncology unit. And so, so much of what I hear is the cutting edge high tech. When you think of medicine, and you think of the extraordinary uses of technology in the use of radiation and in imaging, and we’ll talk a little bit, Joel, I’m sure about AI in neurological and radiological imaging evaluation. And then you look at in Tampa, I was at this area where they were showing these robotics where there’s a high tech lab, and the surgeon can use robotics in there to do surgery across the world. I literally watched a surgeon using robots in Tampa to peel a grape somewhere in Europe. And you think that’s amazing. And it is when you’re really deep into medical, but when you get to the patient and when you get to things like scheduling and your data and interoperability and transferring from one to another, and then your payer talking to your provider, our industry is way behind and has so much to learn. And consumerization of healthcare is going to push our industry to bring these best practices in the use of technology to what we do.
Joel - 00:18:18: That was one of the things I’ve been dying to ask you. I know you’re so deep in the medical field that if we talk about automation, specifically artificial intelligence, that is an amazing and enabling technology that it’s also a multiplier. It can take knowledge and capabilities and push it out to the edge of machinery, potentially, especially in diagnostics, without the need for additional humans or oversight. Do you think that’s going to help bridge the gap, or do you think it’s going to further widen it for those who are not technology-enabled?
Chris - 00:18:46: Wow, that’s a little question. How many hours do we want to talk? I very much, Joel, think it’s going to do both. Give me a minute, and let me tell you how I separate this. So one, let’s talk about the patient, if you will, and then maybe the care provider, the nurse, the NP, the physician, the PA, the surgeon, not to mention the administrators, and then, of course, the ecosystem, the payers. Every one of those is going to be impacted in a different way by technology. Now, one thing I will get out right up front, Joel, which is where you were kind of saying, which is not really, I think, a healthcare problem to be solved, but a societal one, is the more and more technology comes to bear in the patient’s engagement with their care, the more the gap of those who have access and understanding and use of technology, everything from the devices to the understanding, to the connectivity and those that don’t are going to create a wider gap and a bigger problem. Now, what I don’t believe is that the healthcare industry is necessarily the one that has to—they’re certainly not going to adopt better use of technology for consumers and patients to be able to interact with their members with their insurance companies and their providers and their DME companies because some people can’t have access to the technology. But I would hope that all parties always understand you need to find an avenue, a human avenue, for those who don’t have immediate access to technology. And that’s a lot of what, when we’re building, say, gaps in care strategies, and we’re trying to think everything from a digital-first environment for those that don’t really want to talk to a human being, and they much prefer to get an SMS or a text message to a web link where they can self-serve a form, or they can kind of, and maybe never need to talk to a person at all. But then there’s the others that maybe have a preference or don’t have access to that technology. So that’s kind of a big question. Now, when you get into the use of automation and AI and machine learning, all different things, the media is conflating way too often so that AIs become like the cloud. What does it mean? It’s everything. It’s a lot of things, but if we want to talk about generative AI in just a minute, maybe the ChatGPT consumerization part or the Bard part from Google. But artificial intelligence, from the provider’s perspective, I think is increasingly going to be transformed. I mean, when you start looking at what AI is doing in imaging, right? And in neurological diagnoses and tumor diagnoses, it’s already the case that it’s having just an amazing impact because, you know, it’s going to tirelessly run and model out all the possible options. So take that a step further and think about the oncologist who comes in in the morning and they’ve had, they’ve had their digital assistant, their AI assistant, running through all their patient imaging overnight and then prioritizing for them, those that they feel have an immediate need for human interaction versus those that can maybe wait till later in the day—transformation, absolutely.
Joel - 00:22:13: Well, we’ve already seen that, at times, the diagnostic capabilities are outpacing what humans can do. I’ve heard there was one study that said AI could detect certain types of tumors, maybe up to a year ahead of humans year ahead.
Chris - 00:22:24: My fear, though, is when you take all of that and apply it maybe on the consumer side, and this isn’t doctors are ready, consumers are not—that’s paternalistic and not at all what I’m saying. But what I am saying is you’ll notice all that imaging; it’s still the case that it’s running these scenarios and detecting and providing to a human subject matter expert to then make some form of a professional opinion on. My fear on the consumer side is just what you said, Joel; so much better that you’ve got access to this entire world of information that’s all been kind of read, even today, the Dr. Google effect, right? It’s like, I read a study the other day; it was like 2017 and 2022. So, right before and after the pandemic, this one happened to be in Canada. It was like two out of five, so 40% or so of Canadians said they’d Googled some kind of a symptom. And that was like over 70% in 2022. So this is massive, but when you Google something, you get backlinks with all these possible things that you could be looking at. And you can kind of go, and then you’ve got to compare them, and then you got to re-Google, it takes some work. Maybe you then take it to your doctor. With a generative AI, and you know, Google Bard trying to be a little better at this than OpenAI or ChatGPT. I have no dog in the fight. It’s just, here’s a concern of mine where they’re going. It’s presenting to you authoritative answers, right? Not a whole bunch of things for you to think about and compare. Well, I don’t know if you’ve been reading, but there’s this huge spike right now in colorectal cancer for people, you know, more in their 30s and 40s, not in their 50s and 60s. We don’t fully understand why yet, but one of the things that we do understand is that a lot of these younger folks have not gone in to get treated because they’ve Googled their symptoms and they’ve been told they have hemorrhoids. And then things get really bad, and they go in, and they have colorectal cancer, and that’s Google. So what’s going to happen when you’ve got generative AI that is taking all of the information available to it at a point in time? Still, a year or two back from us hasn’t even caught up with the rise in colorectal cancer, and it’s not going to hint to you; it’s just going to say you got hemorrhoids to go by Preparation H.
Max - 00:24:46: I think we’re going to see a lot. I’ve heard this complaint from physicians and others where as soon as you Google something and you can find the symptoms and all of that, people start to self-medicate. So this whole artificial intelligence capability, the ability to have a natural dialogue in the way you want it, pretend to be a doctor, and tell me what’s wrong with me. I can imagine somebody asking that question, right? And now you’ll have a case of unverified medical advice, essentially hitting the consumer base. And they may not have access to actual healthcare. So this is the best they got. This is the best option. And it’s actually one of the worst options.
Chris - 00:25:27: Maybe. So you just hit up something that’s, I’m a little bit excited. I know I’m a little schizophrenic on this topic—or a bad term—I’m a little bit split, kind of on two different things. So one, when we go back to access to care, Max, and then you said something really important that I wish people would do. You started talking about using generative AI using relatively sophisticated prompts. Most people who just got invited into Microsoft’s trial of ChatGPT, aren’t really thinking about using sophisticated prompts. I would feel a lot better if you said if you started feeding it, and then we’ll get into a privacy and data security issue in a minute; I am a blank-year-old white male obese with such and such conditions. I want you to pretend so-and-so the last time I went to the doctor was blank. I had a colonoscopy at blank. I found this. If somebody would do that, I would feel a lot better. No. Is it going to replace actually having a routine set of interactions with your primary care physician and getting age-appropriate screens? Absolutely not. But if you’re outside good access to the healthcare system or in an area where you’re not, and at least you can use something foundational to then go make a judgment to hopefully reach out for care with better—then I’m all for that. And then we talk about where I do, like, if you look at DocsGPT, which is still in beta, I believe, I don’t think it’s out yet. It’s allowing to take out some of that kind of just minutia administrative burnout, but the doctor or the care provider is always providing a human review of what’s being written for presented because, come on, let’s face it, you can get some really authoritative BS and trying to mix facts from fiction, from reality for not. And you’re not a healthcare provider, and you’re not a healthcare expert? And then all of a sudden, you’re reading this? I’m concerned.
Joel - 00:27:35: That’s actually, I was going to mention that every time I use an LLM, it’s like a game of three truths and a lie. One of them is a bold-faced lie, but it said it was such vigor that you’re inclined to believe it.
Max - 00:27:46: You want to believe it.
Joel - 00:27:48: Yeah. But that is built inherent to the way the LLM works. You know, we can get into it, but there are other AI technologies like knowledge management that need to come to bear to solve some of these problems, not just pure LLM, but the point is, is you’re talking about solving it with AI, but there’s a lot of things that we’ve got to figure out about quality of data, but also what’s the best algorithms to give repeatedly good response because having an 85% success rate is fine unless that is so far off the mark, it becomes a danger to the people using it. And that’s something else we’ve got to figure out as we move into healthcare.
Chris - 00:28:23: Yes, absolutely, because that 15% can be all the difference in the world. At the same time, though, my concerns about generative AI are more time-bound to now, and they’re also much more acute than my concerns and excitement about the use of various forms of AI, machine learning, automation, taking data for personalization purposes that I believe we should be focusing so much more on. I mean, this is where the ability for automation, basic machine learning, and certain forms of predictive analytics to impact the day-to-day of healthcare are tremendous. I mean, the burnout of the note-taking, why can’t you have someone tagging on now? Do you want to trust all the note-taking? One of your guests, prior guests, I don’t know if it’s against the rules to reference prior guests. We’re saying what it’s going to be like when I get my sidekick to read all the emails that Joel sent me and go ahead and predict some responses and send them to Joel, and then Joel gets his sidekick to read the responses. The next thing you know, there’s been a conversation that really isn’t between us but between our sidekicks.
Max - 00:29:38: Between the systems.
Chris - 00:29:39: Yeah, so you need humans looking at it, but that ability to be cranking through and doing note-taking, go for it. Even things like patient scheduling. So, one of the things that we do from both a SaaS perspective and a human live agent perspective, and in the best case, combining machine intelligence with human ingenuity, is a lot of online scheduling for folks. Okay. What if scheduling learned a whole lot more about you? What if we started talking about hyper-personalization, kind of like for the consumer environment? I knew that you worked the night shift, right? I knew what gender of physician you preferred. I knew what age you preferred. I knew whether you preferred a certain age or gender of a physician for a specialist versus your PCP. I knew that you had some kids at home. So then, all of a sudden, there’s an appointment. I know the likelihood you aren’t going to make it, but then I also know something about the reason you need to be seen and whether the criticality to your healthcare and then maybe I even know something about whether or not you potentially have some mental health or health issues that is one of the biggest reasons people miss appointments. And so I know when I need to remind one person more about their appointments than the other or when to schedule it. And then if they don’t show, I know the urgency with which they need to reschedule and can pick the best likelihood for them on when they’re going to be available, and then I’m pushing a schedule to them and asking for confirmation, why aren’t we doing that? We can do that. Now, we are doing some of that with both humans and technology and machine learning, but I’m saying I just take that and push it across our industry. One of the areas to answer my own questions because people are really nervous. Well, one is healthcare so fragmented that it’s hard to get data to talk from one EMR to another EMR to one system to another, to one provider to another. But the other is that’s a lot of data.
Max - 00:31:32: But Chris, I would counter that, like, if we make the lives of consumers easier, we’ve seen historically, like with Facebook and everywhere else, consumers are very quick to give up on their privacies. And then later on, you know, we complain about it, like, oh, hey, you got all my likes, you got all my dislikes and clicks and everything, right? Now, I care for privacy. But I think in healthcare, if we’re talking the consumer side, we’ll start to see rapid kind of access. I almost see it like there’s a database that my cousin, he’s a physician, and he gave me access to, it’s called UpToDate. It’s by Medline. And because I always ask them the question, like, hey, how do you know what’s wrong with me? How do you know? There’s this thing called UpToDate, and that’s what they use. They punch it in, and then it gives, you know, it’s well-researched information. It’s not just Google, right? But I think with this whole AI and what’s happening today, it’s going to make medicine much more approachable to the layman, right? It’s like if you connect it into a sophisticated data set, and then all of a sudden you can understand it in a normal human language, that consumer will be like, yeah, take my EHR record. I don’t want to tell you what I did. Here it is. Take it. But I don’t know. I think that’s what we’re going to start to see. That’s why we haven’t, in my opinion, that’s why we haven’t really explored it yet is because we, you know, we haven’t really made it that easy for the consumers. But the minute we do...
Chris - 00:33:01: But the consumers are starting to demand it more. And to your point, you said several things, Max, that I think are key. One, you kind of talked about how you know when you’re talking to a provider with the database; let’s go back in ancient history here and back to when Einstein was, not Albert, you know, Einstein, IBM was kind of working with the doctors and how we’re kind of doing. What they found out is for routine matters, your primary care physician as a human is more effective than a machine. We’re more than a decade ago, right? However, where the AI or the machine is better is in identifying things that are potentially wrong with you because of a series of different factors that you brought to bear with; it’s much more, it’s not nearly as common, and it’s not something that your primary care physician is going to be up to date. So combining the two is really where you get the best. Now let’s fast forward to just a piece that just came out last month or so, saying that they use ChatGPT to give a response to some patients from their care provider, and seven out of patients surveyed in this study preferred what they got from the generative AI than they did from their provider, okay? Now, if seven out of ten people preferred it because they just liked the news, they were getting better, that’s a problem. But if seven out of liked it because it, even as a machine, was speaking with more empathy and care and, in your terms, Max, in more understandable daily language, then what’s the learning there about combining somebody who can give the technical, okay, let’s go back into our world of IT and security, somebody who can translate the technology into like the business opportunity and the risk. And if you can combine those, fantastic. And then the other thing that you just said that I think is super key is the amount of data you’ve got to give up for that hyper-personalization is a little different when it’s my likes and my vacation photos than it is when it’s my healthcare data, which is some of the most coveted bad guy information out there and some of the most personal information we have. So we darn sure better know what we’re doing from a privacy and security standpoint when we start collecting that type of data to provide those types of experiences.
Joel - 00:35:22: Yeah, and that’s awesome. And I hear you say, I like that concept of melding together human ability with AI enablement and that to get that next level. I think you started with an analogy around the surgery, the robotic and AI-assisted surgery, but it’s across the board. What we’re going to see is a level of capability that we were never able to obtain before. But talking about the risks of this, and I think I already know the answer, but thinking through what happens when, just follow that surgery example, when medical schools on the practical side, 95% of the training is robot-assisted surgery or AI-assisted surgery, there might be an old school class that says how to do it the old way, but maybe, and then maybe it’s elective. But what happens when we become so dependent upon that? I guess I don’t know the answer to it other than say that becomes a risk. When you start talking about dependence on healthcare, that’s a whole other level than just money or transportation. This is your health. So, are there any thoughts or any work that you see from the inside out that’s working to make sure we’re securing some of this stuff as we’re bringing it in?
Chris - 00:36:31: Yes. So, healthcare systems were some of the prime targets leading into COVID for cybersecurity attacks. During COVID, other than a few of your ransomware gangs that decided they were going to lay off schools or healthcare facilities, that was the minority uptick in their attacks due to the likelihood and the risk calculation for someone to elect payment because of the lives that were at stake. So, within the healthcare arena, there is significant work being done in security. I mean, HITRUST is fascinating to see how they’re kind of combining the different types of areas. When you look at the EMRs and all the different types of multi-factor authentication, I mean, I can go way beyond just kind of the basics because it sounds like I’m just repeating the basics. I’ve kind of set that up, though, to say where I think the future is. And the future is we’ve got to follow the data, right? And here’s why. As we collect more and more data on individuals that we need in order to provide better healthcare, not only a more personalized experience like one would expect from Amazon but guess who’s getting heavily into healthcare as well? Amazon. So people are going to start expecting that experience, but also because of the types of data that I want to collect on you to be able to better diagnose you and the types of data that I want to be able to better treat you. I am, in effect, building a digital avatar of you, and I might make a case that I need to treat that digital avatar of you with the same societal protections that I treat you. And that is to me, it’s where I get really excited is I recognize all of the criticalities of what I would call foundational security compliance. I mean, the CIA triad is not going anywhere. Your basic compliance is not going anywhere. Your basic access controls and this is where we could dig in, and you need—AI is both the enemy of security, so you’re going to need AI to fight AI to be the benefit of security, just like the kid from Princeton wrote the tool professors using ChatGPT to find people that use ChatGPT to write their papers. So, we use the tool against itself. So you could go on and on and on there. I’m interested in that combination of ethics and data and security and personalization so that we think about how we want to treat this digital person of the future that is going to become so essential for us and our interaction within the healthcare space.
Max - 00:39:27: I think, Chris, what this sparks is just kind of a thought. It’s probably way out there, but man, I can just imagine some future regulatory reform on fighting for rights for this digital person.
Chris - 00:39:40: Hey, Max, you get a digital person, throw a little AI in there. It’s kind of crazy.
Max - 00:39:45: I don’t have that many rights, but I want my digital self to have more.
Chris - 00:39:51: I’ll let Joel tackle that one. So Joel, what happens when you take my avatar and then you add in some generative AI, and it starts to get scary? I’m sorry.
Max - 00:39:59: Roger’s version belongs to me.
Joel - 00:40:02: Oh man. Yeah. That’s going to be interesting. And then the digital avatar doesn’t need the original anymore. I mean, we can just keep going.
Max - 00:40:12: But no, I do believe there will be some aspects of that that will go beyond security. It really gets into the ethics side of it. And we’ve seen that with artists, for example, where, hey, your name, your picture, your looks, whatever it is, belongs to us as the record holders, right? Because they own the intellectual property of that famous person, right? So that’s a property matter from an intellectual property perspective. I can imagine a digital twin of a person; if somebody has collected it, harnessed it, structured the information so you can diagnose anything you want about that individual, that becomes almost like a property because it’s a collection of data of some company. So I can almost imagine that sort of scenario where we’re treating that information as almost like a digital twin slash, a property of some organization.
Chris - 00:41:11: Chris, that’s beyond. And those are the things we’ve got to think about. But this is what’s so—think of what we’re living through, what I consider to be the incredible fortune of being the oldest child of the two oldest children over on mom’s side, the oldest. So I spent my summers with my grandparents, and when they needed a break from me, they shipped me to my great-grandparents, right? And so I remember thinking, my great-grandfather said, you know, gosh, what would it have been like to really see cars come into being and then in your lifetime, not only see a car but see a person walk on the moon? And I said I will never see that kind of transformative event. And I’m not sure that’s true now because we’re in this situation. And when I’m watching 60 Minutes and in two episodes across three weeks, I see the CEO of Google and the president of a division of Microsoft both say, we are going to need regulation. Okay, wait a minute. Did I really just hear this? And then I see, you know, folks like Musk kind of saying, look, there’s—we’re in a transformative moment. And yeah, we have every right to be nervous and where is it going to go and what do we have to do? And we’re going to have to think about new ways to regulate and legislate ethical models we haven’t had before. But the reason we have to do all that is because we have this power coming forward to make our lives so much better. And then I look at healthcare and everything from as simple as when do I see my doctor or my NP or my PA and when can I get in and what do I need to do and how quickly I get the results. I love the fact that I get my lab results at the exact same time that my primary care person does. Now, if I’m going to go and make my own healthcare decisions on those, shame on me, but if I’m going to inform myself on what those mean, so I can have a meaningful conversation with my healthcare provider... So yeah, it’s scary. It’s super exciting. And then when we really get into privacy and data, you know, I got that little song going We Ain’t Seen Nothin’ Yet. I mean, because it’s a whole new world coming at us. But I want to embrace it. I want to be like, okay, this is my person walking on the moon. I never thought I’d see that.
Max - 00:43:19: Yeah, I think it is very exciting to even imagine, right, a brand new future that isn’t here yet. And I agree like the regulators are, it's the very first time where we’re seeing pro-business people that are usually not all about legislation saying, hold on, something is happening. Everything about your voice, the imagery, everything about a human can be encapsulated. And what does that mean? Right? It’s fun, but it’s also, you can be very nervous about it, like in terms of deep fakes and all sorts of things that we’ve already seen on the news, right?
Chris - 00:43:53: Oh, it is not to be taken lightly. So when I was chatting with Joel, when we weren’t on the podcast, and I told him it’s like, I’m a cautious adopter. I’m super excited. I love the fact that we’re doing with our SaaS platforms and combining our people with our platforms in order to break down these barriers of care. It's energized, but I’m not taking any of this lightly. I mean, the ability to tell the truth from fiction may today just be a problem with an authoritative blurb from a generative AI, but what does that mean for the future of disinformation and misinformation and our children and reality and facts? I can go down the dark path, but one of your guests went down the Star Trek route, so I’ll do the Star Wars one for a minute. I’m going into the path, and I can feel the Dark Side over here, but I’m sticking with the Light, man. I’m sticking with positivity.
Max - 00:44:50: We’re with you. We teeter-totter between the two, but we’re with you.
Joel - 00:44:54: Absolutely. I mean, the reality is it’s coming. There is no stopping it. We can talk about this halt on AI, whether that was smart or not, that was asked for. The reality is it’s coming. It’s coming like a freight train, and it’s our job, the people that are in a position to influence it, to talk about it, to figure this out, to do just that, because it’s going to arrive, and unless we figure it out and inject as best we can safety precautions into it, it’s going to arrive in a state that we really don’t want. I feel like a personal; you talk about personal burden, that’s my personal burden is to help usher in this age of AI that’s coming.
Chris - 00:45:29: I agree. I think we are in a position where it’s not just technologists and security people and risk people and compliance people and the overburdened legal folks. We’re in a place where we need philosophers and ethicists and people to all be kind of talking together. And I love the fact that Joel, there are people like you doing research on AI from a security perspective and a privacy perspective. And Max, you’re kind of making sure the government and the rest of the world stays compliant and secure and knows how to structure this stuff. And so when we start getting into what some of those regulations and things look like, you got a voice on how it is today from how it is there. And we need to take a breath. And let’s go all the way back to where we started. Intentionality. Because one of the things when you get into personalization and hyper-personalization and helping make decisions and making lives, people with data is intentional and make sure you’re doing it for the benefit of the patient, the member, the consumer, and not just manipulating them in ways that could be so easy to do for your benefit as a company. And to me, that’s ethics as much as it is anything else.
Max - 00:46:44: Ethics and morality, Chris. That’s really where it comes down to. Chris, we’re at the tail end. Man, I wish I could continue to just...
Chris - 00:46:51: Oh, this was a blast.
Max - 00:46:52: This was awesome, man. This is a very unique kind of conversation we had, and we really appreciate it. But I think there’ll be more conversations like this because I think when we really just get into it, it does come down to ethics and being intentional about what we’re doing. And so me and Joel, I wanted to thank you for coming on the show and just being a wonderful guest.
Chris - 00:47:14: Thank you so much for the invitation. Thank you for the discussions today. And I loved your podcast, and I look forward to great things to come. And thanks for having me.
Joel - 00:47:25: Awesome.
Max - 00:47:26: Emerging Cyber Risk is brought to you by Ignyte and Secure Robotics. To find out more about Ignite and Secure Robotics, visit ignyteplatform.com or securerobotics.ai.
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Joel - 00:00:18: And Joel Yonts. Join us as we dive into the development of AI, the evolution of cybersecurity, and other topics driving change in the cyber risk outlook.
Max - 00:00:26: Hey, thank you, everyone, for listening in today. Today, we are going to be speaking with Chris Rogers. Chris is a friend of mine, we went to school together. Some of the things that we’ll be covering are just first just learning Chris’ journey, but really then diving into access to healthcare, personalization of data, privacy, all of these things, and the intersection of artificial intelligence. With that in mind, let’s get started. So, Joel, you want to give us a little bit of a recap into this, and then let’s get right into it.
Joel - 00:00:59: Certainly. Well, I look forward to today’s discussion. It’s going to be certainly great talking with Chris, someone who’s made the transitions that he has. I’ll let him tell his story here in a moment. It’s going to be a little bit more focused on the human element, which is certainly an important side of cybersecurity and AI. So I’m not going to spend a whole lot of time because I really want to get into this conversation. Chris, why don’t you kick us off and tell us about yourself and specifically your journey from CISO to Chief Operating Officer and also some of the other things you’re passionate about, like universal access to healthcare and so forth. So, Chris.
Chris - 00:01:29: Excellent. Well, first, thank you. Joel. It was nice to make your acquaintance today. Max, I looked it up, and I think you and I met at the University of Texas in 2015. So it’s been a while, and it’s been great to keep up with you from there. And yeah, I do think we’ll do a little bit more on the human side by going deep into the technology and pros and cons and privacy and security concerns, but all those as they relate to how we use technology to better healthcare and a better healthcare experience for everybody. So my journey, because I know Max and I talked a little bit about that move from being the CISO/CSO into the COO, but I’ve kind of even got to start before that to say, how did I even get into security in the first place? And funny enough, it’ll lead very much into that human journey and why that’s so important to me now. I was a social ethicist writing my dissertation in graduate school and had my second child with my wonderful wife, and I needed a job really badly. And about that point, a gentleman who would be important to over 20 years of my life after that was looking to go into business in e-education and really kind of combine technology and people and instruction in an education offering a little bit ahead of its time. And knew he kind of needed somebody who knew how to do business and knew how to do education and knew something kind of about technology and how they came together. So I joined this company really to kind of combine the power of the World Wide Web with instruction, with the support of remote students and virtual learning. And that’s how I got into this world that I’ve kind of never left. And it started very much on the human element, both what I was studying and my need for employment at that time. So I really got deeper into the operational side of the business for a while, had an opportunity to serve as an expat in the Philippines during a period of rapid growth in the company, and was very much exposed to a lot of functions there. I was neither in tech nor operations nor sales/support, but a little bit of everything—facilities, security, compliance, workforce, operations—really helped me partner with some wonderful people around me to build and mature this environment. And then came back to the US and much more focused on a technology role. And that’s where I spent the last 17 years before leaving that environment and making this transition that y’all are asking me about. I was very much purely technology, but more technology from the business side. In other words, I’m not an engineer by trade. I’m not a coder by trade. I have all of the requisite security certs a security leader should have, but I always came at IT and security much more than running a business. Looking at this internally, we were not a technology company, but we were a technology-enabled company, but it was always for me to run it like a business. Who’s my supply chain? Who are my partners? Who’s my internal customer, my external customer? What are our service levels? How do we keep clear lines of communication? How does the security team not be the SPU, the Sales Prevention Unit, which is what it was when, according to some, we first took over, but really one that helped the business analyze risk and opportunities and then effectively communicates to our prospective clients and current clients in a way that explained what we were doing to help enable and move the business forward?
Joel - 00:05:12: I was just going to say, I hear you talking, and you almost sounded a little bit apologetic about being a technologist, but what I hear is what you were saying—that builds the best cybersecurity programs, what you just said. And so that’s...
Chris - 00:05:25: Oh, absolutely. Yeah, no, I, um, not the least bit apologetic for not coming at it from the technical side because I was surrounded and am still today in a different role by some of the smartest technologists that I’ve ever met across multiple industries and that ability to really be the conductor of bringing the best of everyone’s skills into a way to drive the business forward was that’s what was exciting for me. And then, as I moved deeper into the Security side, as well as the compliance, in addition to the security had all of what you would consider the standard parts of compliance that might fit within a security or a tech organization. So SOCs, GCC, PCI, you know, HITRUST, HIPAA, all those areas. But I always knew that for me, the bigger picture was I wanted to run an entity. That did not mean I needed to run a company, but it meant I wanted to be able to operationalize a function and run it as an operational unit. And I had the benefit because so much, well, first, it’s always a matter of, are you in the right place at the right time? Are you surrounded by the ability to seize on opportunities that you can? Because things like making moves from Princeton, New Jersey, to Hays, Kansas, to Tampa, Florida, to Manila, Philippines, back to Tampa, Florida, without an incredibly supportive wife that allowed those things to be able to happen without those opportunities being presented to me, I wouldn’t have been in a position to take them. And as well as the fact of being in an organization that was very intent on wanting to learn where you were going. So I had a CEO that I could sit down and talk to about where my career was potentially, from his perspective, going to be in five to ten years. I had a CIO who I could work with to say, how are we going to work together to make this organization the best it can be? And I don’t think this is where my career in this company is going to end up. And to have both the caring and the trust of an environment to be able to have those types of conversations is a pure gift. I recognize that every day, but I had very clearly had a path with our CIO and with our CEO that was going to ultimately take me out of technology and security as the person running that into either the operational head of a business unit in healthcare and/or into more chief administrative type role, combining multiple support functions, again, leading ultimately to more of a general manager type function. So that’s where my career was headed. It was there through intentionality on my part but also through incredible caring, openness, and willingness to have those conversations with the leadership I was with. And then we sold. It was not planned. We were a public company. We got a fantastic offer. Financially, it was a no-brainer for us to do that. And I sat back and said, well, OK, you know, I guess I’m going to be a security and technologist for the rest of my career. Great. Made a good career out of it so far. And started talking to some new folks who were also very open, looking back at operational experience, looking at all of the different areas that I had been able to touch over time, looking at what I wanted to do, and looking at where our company needed to go. And ended up with a company that very much combines human services and technology. One in three Americans has access to one of our clinical or nonclinical services, which is a combination of clinicians and non-clinicians doing clinical engagement, nurse advice line, online scheduling, gaps in care, and health risk assessments—but using 20+ years of proprietary technology to undergird our internal services, as well as SaaS platforms that we’ve developed and have into the market externally, and so found me in the perfect position to combine a lot of skills and a lot of interests with a company with a mission that just meant a lot to me. So that was a lot, Max. But you asked me to paint that picture of how one gets from point A to point B to point C. And that’s about as direct as I can make that path. And it’s more direct than it probably was in reality.
Max - 00:10:18: I think Chris, you’ve had a rare opportunity for a CEO to take interest in their team members and a CIO to carve your path, which I think is fantastic. But on your part, you mentioned intentionality. Right? So, any leader doesn’t matter where they are; if they’re not intentional about where they need to go, where they need to take the organization, it’s going to be a missed opportunity on their path, right? On their part.
Chris - 00:10:42: No, I mean, you can’t; this is where I always try to be very direct and very careful with the people that I am fortunate enough to be able to lead, hopefully coach, mentor. My job’s largely to make decisions, provide them air cover, make sure they get the direction they need, and soundboard their ideas cause these are all executives that I have the pleasure of leading. But that level and a level or so down, I’m like, you can never ever wait for someone to manage your career. If you’re not in there saying, you know, where do you see my strengths and weaknesses, I kind of feel like I will be good at this, or wow, I got assigned to this task, I found out I really took a lot of pleasure in doing that. Don’t ever count on someone doing it for you. And that’s where I try to be very direct, or I try to be very cautious. That can sound really easy. There are people who work in organizations that aren’t open to those types of conversations that are not surrounded by people that are willing or able to be open to those types of directions. And so you can’t just say, I’m going to go do it, but if you don’t go do it, it’s never going to happen. Cause nobody’s going to do it for you.
Joel - 00:11:55: And I love that intentionality thread, Max, that you’re talking about, you know, going after it. Now it seems like it’s probably not a coincidence that you’re in healthcare. And one of the things you’re personally passionate about is universal healthcare or access to healthcare. Is there a correlation between the two?
Chris - 00:12:12: There is a correlation in so far as I was in a very fortunate position to be able to take my time and figure out what I wanted to do next, what type of company I wanted to be with, what type of role I wanted, the industry that I wanted. And this is one of a couple of industries that would have pulled me back in. Very much looking at healthcare, I’ll be honest; I had another interest of mine at that time. I would have been a COO or an executive role in managing a security firm, right? Not so much being the security head inside of an organization, but again, I very much like running the business. That’s an area where I get a lot of career satisfaction out of. But this is an area that I am very passionate about. My son is an oncology PA. My mother is a retired nurse practitioner. My aunt’s a medical ethicist. My grandfather was an ear, nose, and throat surgeon. So I’ve kind of been surrounded by this for a while. And I have this kind of mixed view. It’s, we were in a leadership meeting not too long ago, and we’re kind of just talking, and one of our leaders threw out something, just a very spur-of-the-moment comment, and she says, you know, what we do matters. And then, towards the end of that meeting, we did one of these little things where you kind of throw the nerf ball, and you got to catch it and say, what’s an aha moment out of this. And I said, it’s not an aha moment because I think I knew it, but the way it was simply articulated, what we do matters. Right. And I think merely working and doing good for a company or an industry and supporting your family means your work matters. But if you also have the ability to work in an industry where what you do makes an impact on lives in a very material way, I consider that special. Now, where I said I have mixed views is, on the one hand, we have one of the most advanced and best healthcare systems in the world. On the other hand, we have a healthcare system that can meet social determinants of health and access to care and socioeconomic environments, and just Insurance, money, and complexity make our healthcare system, which can provide the best care on the planet, also one that can be exceptionally hard to navigate. And so to work in a company that is really partnering with some of the best healthcare companies in the world for them to be able to fully achieve what they need to do and to make healthcare better for all of us. Yeah. That means a lot to me. It’s a passion that I’m really enjoying.
Max - 00:15:06: Yeah. Chris, it’s no secret that we do have the world’s best, but it can always be improved. Right? Personally, coming from another country, I can say that I’ve lived through it, but then, at the same time, every Indian has a whole bunch of doctors in the family. And we’re no different. Right? And yes, there are market inefficiencies. There's a lack of data access, right? Sometimes, you can’t make decisions because of that. And then of course, there are pockets in the United States where there definitely needs to be more in terms of just population health management. How do we manage some of the environments that don’t have access to those things at all, right? Where we’ve got the best of the best in the world, but then we see pockets where we’ve got nothing, right? And I agree, when I was serving in the military, same kind of thing where, yes, you have a job, you come into the job, but if you can make a real-world impact on people's lives, that’s an amazing added bonus, right, to what you do. So that’s fantastic.
Chris - 00:16:12: And it’s so ripe to bring to bear learnings from a career in customer care, technical support, patient support, because the company I was with a significant amount of healthcare for the Canadian government and had a large DME support group internally. When you look at the consumer market, not patient markets, get completely out of healthcare for a minute. And you look at what’s going on with hyper-personalization and consumerization and self-service and, and, you know, access to your data and your ability to find information you need on kind of your fingertips. And then you come on, and I have my best friend who is a radiation oncologist with a researcher and a practitioner and the head of a radiation oncology unit. And so, so much of what I hear is the cutting edge high tech. When you think of medicine, and you think of the extraordinary uses of technology in the use of radiation and in imaging, and we’ll talk a little bit, Joel, I’m sure about AI in neurological and radiological imaging evaluation. And then you look at in Tampa, I was at this area where they were showing these robotics where there’s a high tech lab, and the surgeon can use robotics in there to do surgery across the world. I literally watched a surgeon using robots in Tampa to peel a grape somewhere in Europe. And you think that’s amazing. And it is when you’re really deep into medical, but when you get to the patient and when you get to things like scheduling and your data and interoperability and transferring from one to another, and then your payer talking to your provider, our industry is way behind and has so much to learn. And consumerization of healthcare is going to push our industry to bring these best practices in the use of technology to what we do.
Joel - 00:18:18: That was one of the things I’ve been dying to ask you. I know you’re so deep in the medical field that if we talk about automation, specifically artificial intelligence, that is an amazing and enabling technology that it’s also a multiplier. It can take knowledge and capabilities and push it out to the edge of machinery, potentially, especially in diagnostics, without the need for additional humans or oversight. Do you think that’s going to help bridge the gap, or do you think it’s going to further widen it for those who are not technology-enabled?
Chris - 00:18:46: Wow, that’s a little question. How many hours do we want to talk? I very much, Joel, think it’s going to do both. Give me a minute, and let me tell you how I separate this. So one, let’s talk about the patient, if you will, and then maybe the care provider, the nurse, the NP, the physician, the PA, the surgeon, not to mention the administrators, and then, of course, the ecosystem, the payers. Every one of those is going to be impacted in a different way by technology. Now, one thing I will get out right up front, Joel, which is where you were kind of saying, which is not really, I think, a healthcare problem to be solved, but a societal one, is the more and more technology comes to bear in the patient’s engagement with their care, the more the gap of those who have access and understanding and use of technology, everything from the devices to the understanding, to the connectivity and those that don’t are going to create a wider gap and a bigger problem. Now, what I don’t believe is that the healthcare industry is necessarily the one that has to—they’re certainly not going to adopt better use of technology for consumers and patients to be able to interact with their members with their insurance companies and their providers and their DME companies because some people can’t have access to the technology. But I would hope that all parties always understand you need to find an avenue, a human avenue, for those who don’t have immediate access to technology. And that’s a lot of what, when we’re building, say, gaps in care strategies, and we’re trying to think everything from a digital-first environment for those that don’t really want to talk to a human being, and they much prefer to get an SMS or a text message to a web link where they can self-serve a form, or they can kind of, and maybe never need to talk to a person at all. But then there’s the others that maybe have a preference or don’t have access to that technology. So that’s kind of a big question. Now, when you get into the use of automation and AI and machine learning, all different things, the media is conflating way too often so that AIs become like the cloud. What does it mean? It’s everything. It’s a lot of things, but if we want to talk about generative AI in just a minute, maybe the ChatGPT consumerization part or the Bard part from Google. But artificial intelligence, from the provider’s perspective, I think is increasingly going to be transformed. I mean, when you start looking at what AI is doing in imaging, right? And in neurological diagnoses and tumor diagnoses, it’s already the case that it’s having just an amazing impact because, you know, it’s going to tirelessly run and model out all the possible options. So take that a step further and think about the oncologist who comes in in the morning and they’ve had, they’ve had their digital assistant, their AI assistant, running through all their patient imaging overnight and then prioritizing for them, those that they feel have an immediate need for human interaction versus those that can maybe wait till later in the day—transformation, absolutely.
Joel - 00:22:13: Well, we’ve already seen that, at times, the diagnostic capabilities are outpacing what humans can do. I’ve heard there was one study that said AI could detect certain types of tumors, maybe up to a year ahead of humans year ahead.
Chris - 00:22:24: My fear, though, is when you take all of that and apply it maybe on the consumer side, and this isn’t doctors are ready, consumers are not—that’s paternalistic and not at all what I’m saying. But what I am saying is you’ll notice all that imaging; it’s still the case that it’s running these scenarios and detecting and providing to a human subject matter expert to then make some form of a professional opinion on. My fear on the consumer side is just what you said, Joel; so much better that you’ve got access to this entire world of information that’s all been kind of read, even today, the Dr. Google effect, right? It’s like, I read a study the other day; it was like 2017 and 2022. So, right before and after the pandemic, this one happened to be in Canada. It was like two out of five, so 40% or so of Canadians said they’d Googled some kind of a symptom. And that was like over 70% in 2022. So this is massive, but when you Google something, you get backlinks with all these possible things that you could be looking at. And you can kind of go, and then you’ve got to compare them, and then you got to re-Google, it takes some work. Maybe you then take it to your doctor. With a generative AI, and you know, Google Bard trying to be a little better at this than OpenAI or ChatGPT. I have no dog in the fight. It’s just, here’s a concern of mine where they’re going. It’s presenting to you authoritative answers, right? Not a whole bunch of things for you to think about and compare. Well, I don’t know if you’ve been reading, but there’s this huge spike right now in colorectal cancer for people, you know, more in their 30s and 40s, not in their 50s and 60s. We don’t fully understand why yet, but one of the things that we do understand is that a lot of these younger folks have not gone in to get treated because they’ve Googled their symptoms and they’ve been told they have hemorrhoids. And then things get really bad, and they go in, and they have colorectal cancer, and that’s Google. So what’s going to happen when you’ve got generative AI that is taking all of the information available to it at a point in time? Still, a year or two back from us hasn’t even caught up with the rise in colorectal cancer, and it’s not going to hint to you; it’s just going to say you got hemorrhoids to go by Preparation H.
Max - 00:24:46: I think we’re going to see a lot. I’ve heard this complaint from physicians and others where as soon as you Google something and you can find the symptoms and all of that, people start to self-medicate. So this whole artificial intelligence capability, the ability to have a natural dialogue in the way you want it, pretend to be a doctor, and tell me what’s wrong with me. I can imagine somebody asking that question, right? And now you’ll have a case of unverified medical advice, essentially hitting the consumer base. And they may not have access to actual healthcare. So this is the best they got. This is the best option. And it’s actually one of the worst options.
Chris - 00:25:27: Maybe. So you just hit up something that’s, I’m a little bit excited. I know I’m a little schizophrenic on this topic—or a bad term—I’m a little bit split, kind of on two different things. So one, when we go back to access to care, Max, and then you said something really important that I wish people would do. You started talking about using generative AI using relatively sophisticated prompts. Most people who just got invited into Microsoft’s trial of ChatGPT, aren’t really thinking about using sophisticated prompts. I would feel a lot better if you said if you started feeding it, and then we’ll get into a privacy and data security issue in a minute; I am a blank-year-old white male obese with such and such conditions. I want you to pretend so-and-so the last time I went to the doctor was blank. I had a colonoscopy at blank. I found this. If somebody would do that, I would feel a lot better. No. Is it going to replace actually having a routine set of interactions with your primary care physician and getting age-appropriate screens? Absolutely not. But if you’re outside good access to the healthcare system or in an area where you’re not, and at least you can use something foundational to then go make a judgment to hopefully reach out for care with better—then I’m all for that. And then we talk about where I do, like, if you look at DocsGPT, which is still in beta, I believe, I don’t think it’s out yet. It’s allowing to take out some of that kind of just minutia administrative burnout, but the doctor or the care provider is always providing a human review of what’s being written for presented because, come on, let’s face it, you can get some really authoritative BS and trying to mix facts from fiction, from reality for not. And you’re not a healthcare provider, and you’re not a healthcare expert? And then all of a sudden, you’re reading this? I’m concerned.
Joel - 00:27:35: That’s actually, I was going to mention that every time I use an LLM, it’s like a game of three truths and a lie. One of them is a bold-faced lie, but it said it was such vigor that you’re inclined to believe it.
Max - 00:27:46: You want to believe it.
Joel - 00:27:48: Yeah. But that is built inherent to the way the LLM works. You know, we can get into it, but there are other AI technologies like knowledge management that need to come to bear to solve some of these problems, not just pure LLM, but the point is, is you’re talking about solving it with AI, but there’s a lot of things that we’ve got to figure out about quality of data, but also what’s the best algorithms to give repeatedly good response because having an 85% success rate is fine unless that is so far off the mark, it becomes a danger to the people using it. And that’s something else we’ve got to figure out as we move into healthcare.
Chris - 00:28:23: Yes, absolutely, because that 15% can be all the difference in the world. At the same time, though, my concerns about generative AI are more time-bound to now, and they’re also much more acute than my concerns and excitement about the use of various forms of AI, machine learning, automation, taking data for personalization purposes that I believe we should be focusing so much more on. I mean, this is where the ability for automation, basic machine learning, and certain forms of predictive analytics to impact the day-to-day of healthcare are tremendous. I mean, the burnout of the note-taking, why can’t you have someone tagging on now? Do you want to trust all the note-taking? One of your guests, prior guests, I don’t know if it’s against the rules to reference prior guests. We’re saying what it’s going to be like when I get my sidekick to read all the emails that Joel sent me and go ahead and predict some responses and send them to Joel, and then Joel gets his sidekick to read the responses. The next thing you know, there’s been a conversation that really isn’t between us but between our sidekicks.
Max - 00:29:38: Between the systems.
Chris - 00:29:39: Yeah, so you need humans looking at it, but that ability to be cranking through and doing note-taking, go for it. Even things like patient scheduling. So, one of the things that we do from both a SaaS perspective and a human live agent perspective, and in the best case, combining machine intelligence with human ingenuity, is a lot of online scheduling for folks. Okay. What if scheduling learned a whole lot more about you? What if we started talking about hyper-personalization, kind of like for the consumer environment? I knew that you worked the night shift, right? I knew what gender of physician you preferred. I knew what age you preferred. I knew whether you preferred a certain age or gender of a physician for a specialist versus your PCP. I knew that you had some kids at home. So then, all of a sudden, there’s an appointment. I know the likelihood you aren’t going to make it, but then I also know something about the reason you need to be seen and whether the criticality to your healthcare and then maybe I even know something about whether or not you potentially have some mental health or health issues that is one of the biggest reasons people miss appointments. And so I know when I need to remind one person more about their appointments than the other or when to schedule it. And then if they don’t show, I know the urgency with which they need to reschedule and can pick the best likelihood for them on when they’re going to be available, and then I’m pushing a schedule to them and asking for confirmation, why aren’t we doing that? We can do that. Now, we are doing some of that with both humans and technology and machine learning, but I’m saying I just take that and push it across our industry. One of the areas to answer my own questions because people are really nervous. Well, one is healthcare so fragmented that it’s hard to get data to talk from one EMR to another EMR to one system to another, to one provider to another. But the other is that’s a lot of data.
Max - 00:31:32: But Chris, I would counter that, like, if we make the lives of consumers easier, we’ve seen historically, like with Facebook and everywhere else, consumers are very quick to give up on their privacies. And then later on, you know, we complain about it, like, oh, hey, you got all my likes, you got all my dislikes and clicks and everything, right? Now, I care for privacy. But I think in healthcare, if we’re talking the consumer side, we’ll start to see rapid kind of access. I almost see it like there’s a database that my cousin, he’s a physician, and he gave me access to, it’s called UpToDate. It’s by Medline. And because I always ask them the question, like, hey, how do you know what’s wrong with me? How do you know? There’s this thing called UpToDate, and that’s what they use. They punch it in, and then it gives, you know, it’s well-researched information. It’s not just Google, right? But I think with this whole AI and what’s happening today, it’s going to make medicine much more approachable to the layman, right? It’s like if you connect it into a sophisticated data set, and then all of a sudden you can understand it in a normal human language, that consumer will be like, yeah, take my EHR record. I don’t want to tell you what I did. Here it is. Take it. But I don’t know. I think that’s what we’re going to start to see. That’s why we haven’t, in my opinion, that’s why we haven’t really explored it yet is because we, you know, we haven’t really made it that easy for the consumers. But the minute we do...
Chris - 00:33:01: But the consumers are starting to demand it more. And to your point, you said several things, Max, that I think are key. One, you kind of talked about how you know when you’re talking to a provider with the database; let’s go back in ancient history here and back to when Einstein was, not Albert, you know, Einstein, IBM was kind of working with the doctors and how we’re kind of doing. What they found out is for routine matters, your primary care physician as a human is more effective than a machine. We’re more than a decade ago, right? However, where the AI or the machine is better is in identifying things that are potentially wrong with you because of a series of different factors that you brought to bear with; it’s much more, it’s not nearly as common, and it’s not something that your primary care physician is going to be up to date. So combining the two is really where you get the best. Now let’s fast forward to just a piece that just came out last month or so, saying that they use ChatGPT to give a response to some patients from their care provider, and seven out of patients surveyed in this study preferred what they got from the generative AI than they did from their provider, okay? Now, if seven out of ten people preferred it because they just liked the news, they were getting better, that’s a problem. But if seven out of liked it because it, even as a machine, was speaking with more empathy and care and, in your terms, Max, in more understandable daily language, then what’s the learning there about combining somebody who can give the technical, okay, let’s go back into our world of IT and security, somebody who can translate the technology into like the business opportunity and the risk. And if you can combine those, fantastic. And then the other thing that you just said that I think is super key is the amount of data you’ve got to give up for that hyper-personalization is a little different when it’s my likes and my vacation photos than it is when it’s my healthcare data, which is some of the most coveted bad guy information out there and some of the most personal information we have. So we darn sure better know what we’re doing from a privacy and security standpoint when we start collecting that type of data to provide those types of experiences.
Joel - 00:35:22: Yeah, and that’s awesome. And I hear you say, I like that concept of melding together human ability with AI enablement and that to get that next level. I think you started with an analogy around the surgery, the robotic and AI-assisted surgery, but it’s across the board. What we’re going to see is a level of capability that we were never able to obtain before. But talking about the risks of this, and I think I already know the answer, but thinking through what happens when, just follow that surgery example, when medical schools on the practical side, 95% of the training is robot-assisted surgery or AI-assisted surgery, there might be an old school class that says how to do it the old way, but maybe, and then maybe it’s elective. But what happens when we become so dependent upon that? I guess I don’t know the answer to it other than say that becomes a risk. When you start talking about dependence on healthcare, that’s a whole other level than just money or transportation. This is your health. So, are there any thoughts or any work that you see from the inside out that’s working to make sure we’re securing some of this stuff as we’re bringing it in?
Chris - 00:36:31: Yes. So, healthcare systems were some of the prime targets leading into COVID for cybersecurity attacks. During COVID, other than a few of your ransomware gangs that decided they were going to lay off schools or healthcare facilities, that was the minority uptick in their attacks due to the likelihood and the risk calculation for someone to elect payment because of the lives that were at stake. So, within the healthcare arena, there is significant work being done in security. I mean, HITRUST is fascinating to see how they’re kind of combining the different types of areas. When you look at the EMRs and all the different types of multi-factor authentication, I mean, I can go way beyond just kind of the basics because it sounds like I’m just repeating the basics. I’ve kind of set that up, though, to say where I think the future is. And the future is we’ve got to follow the data, right? And here’s why. As we collect more and more data on individuals that we need in order to provide better healthcare, not only a more personalized experience like one would expect from Amazon but guess who’s getting heavily into healthcare as well? Amazon. So people are going to start expecting that experience, but also because of the types of data that I want to collect on you to be able to better diagnose you and the types of data that I want to be able to better treat you. I am, in effect, building a digital avatar of you, and I might make a case that I need to treat that digital avatar of you with the same societal protections that I treat you. And that is to me, it’s where I get really excited is I recognize all of the criticalities of what I would call foundational security compliance. I mean, the CIA triad is not going anywhere. Your basic compliance is not going anywhere. Your basic access controls and this is where we could dig in, and you need—AI is both the enemy of security, so you’re going to need AI to fight AI to be the benefit of security, just like the kid from Princeton wrote the tool professors using ChatGPT to find people that use ChatGPT to write their papers. So, we use the tool against itself. So you could go on and on and on there. I’m interested in that combination of ethics and data and security and personalization so that we think about how we want to treat this digital person of the future that is going to become so essential for us and our interaction within the healthcare space.
Max - 00:39:27: I think, Chris, what this sparks is just kind of a thought. It’s probably way out there, but man, I can just imagine some future regulatory reform on fighting for rights for this digital person.
Chris - 00:39:40: Hey, Max, you get a digital person, throw a little AI in there. It’s kind of crazy.
Max - 00:39:45: I don’t have that many rights, but I want my digital self to have more.
Chris - 00:39:51: I’ll let Joel tackle that one. So Joel, what happens when you take my avatar and then you add in some generative AI, and it starts to get scary? I’m sorry.
Max - 00:39:59: Roger’s version belongs to me.
Joel - 00:40:02: Oh man. Yeah. That’s going to be interesting. And then the digital avatar doesn’t need the original anymore. I mean, we can just keep going.
Max - 00:40:12: But no, I do believe there will be some aspects of that that will go beyond security. It really gets into the ethics side of it. And we’ve seen that with artists, for example, where, hey, your name, your picture, your looks, whatever it is, belongs to us as the record holders, right? Because they own the intellectual property of that famous person, right? So that’s a property matter from an intellectual property perspective. I can imagine a digital twin of a person; if somebody has collected it, harnessed it, structured the information so you can diagnose anything you want about that individual, that becomes almost like a property because it’s a collection of data of some company. So I can almost imagine that sort of scenario where we’re treating that information as almost like a digital twin slash, a property of some organization.
Chris - 00:41:11: Chris, that’s beyond. And those are the things we’ve got to think about. But this is what’s so—think of what we’re living through, what I consider to be the incredible fortune of being the oldest child of the two oldest children over on mom’s side, the oldest. So I spent my summers with my grandparents, and when they needed a break from me, they shipped me to my great-grandparents, right? And so I remember thinking, my great-grandfather said, you know, gosh, what would it have been like to really see cars come into being and then in your lifetime, not only see a car but see a person walk on the moon? And I said I will never see that kind of transformative event. And I’m not sure that’s true now because we’re in this situation. And when I’m watching 60 Minutes and in two episodes across three weeks, I see the CEO of Google and the president of a division of Microsoft both say, we are going to need regulation. Okay, wait a minute. Did I really just hear this? And then I see, you know, folks like Musk kind of saying, look, there’s—we’re in a transformative moment. And yeah, we have every right to be nervous and where is it going to go and what do we have to do? And we’re going to have to think about new ways to regulate and legislate ethical models we haven’t had before. But the reason we have to do all that is because we have this power coming forward to make our lives so much better. And then I look at healthcare and everything from as simple as when do I see my doctor or my NP or my PA and when can I get in and what do I need to do and how quickly I get the results. I love the fact that I get my lab results at the exact same time that my primary care person does. Now, if I’m going to go and make my own healthcare decisions on those, shame on me, but if I’m going to inform myself on what those mean, so I can have a meaningful conversation with my healthcare provider... So yeah, it’s scary. It’s super exciting. And then when we really get into privacy and data, you know, I got that little song going We Ain’t Seen Nothin’ Yet. I mean, because it’s a whole new world coming at us. But I want to embrace it. I want to be like, okay, this is my person walking on the moon. I never thought I’d see that.
Max - 00:43:19: Yeah, I think it is very exciting to even imagine, right, a brand new future that isn’t here yet. And I agree like the regulators are, it's the very first time where we’re seeing pro-business people that are usually not all about legislation saying, hold on, something is happening. Everything about your voice, the imagery, everything about a human can be encapsulated. And what does that mean? Right? It’s fun, but it’s also, you can be very nervous about it, like in terms of deep fakes and all sorts of things that we’ve already seen on the news, right?
Chris - 00:43:53: Oh, it is not to be taken lightly. So when I was chatting with Joel, when we weren’t on the podcast, and I told him it’s like, I’m a cautious adopter. I’m super excited. I love the fact that we’re doing with our SaaS platforms and combining our people with our platforms in order to break down these barriers of care. It's energized, but I’m not taking any of this lightly. I mean, the ability to tell the truth from fiction may today just be a problem with an authoritative blurb from a generative AI, but what does that mean for the future of disinformation and misinformation and our children and reality and facts? I can go down the dark path, but one of your guests went down the Star Trek route, so I’ll do the Star Wars one for a minute. I’m going into the path, and I can feel the Dark Side over here, but I’m sticking with the Light, man. I’m sticking with positivity.
Max - 00:44:50: We’re with you. We teeter-totter between the two, but we’re with you.
Joel - 00:44:54: Absolutely. I mean, the reality is it’s coming. There is no stopping it. We can talk about this halt on AI, whether that was smart or not, that was asked for. The reality is it’s coming. It’s coming like a freight train, and it’s our job, the people that are in a position to influence it, to talk about it, to figure this out, to do just that, because it’s going to arrive, and unless we figure it out and inject as best we can safety precautions into it, it’s going to arrive in a state that we really don’t want. I feel like a personal; you talk about personal burden, that’s my personal burden is to help usher in this age of AI that’s coming.
Chris - 00:45:29: I agree. I think we are in a position where it’s not just technologists and security people and risk people and compliance people and the overburdened legal folks. We’re in a place where we need philosophers and ethicists and people to all be kind of talking together. And I love the fact that Joel, there are people like you doing research on AI from a security perspective and a privacy perspective. And Max, you’re kind of making sure the government and the rest of the world stays compliant and secure and knows how to structure this stuff. And so when we start getting into what some of those regulations and things look like, you got a voice on how it is today from how it is there. And we need to take a breath. And let’s go all the way back to where we started. Intentionality. Because one of the things when you get into personalization and hyper-personalization and helping make decisions and making lives, people with data is intentional and make sure you’re doing it for the benefit of the patient, the member, the consumer, and not just manipulating them in ways that could be so easy to do for your benefit as a company. And to me, that’s ethics as much as it is anything else.
Max - 00:46:44: Ethics and morality, Chris. That’s really where it comes down to. Chris, we’re at the tail end. Man, I wish I could continue to just...
Chris - 00:46:51: Oh, this was a blast.
Max - 00:46:52: This was awesome, man. This is a very unique kind of conversation we had, and we really appreciate it. But I think there’ll be more conversations like this because I think when we really just get into it, it does come down to ethics and being intentional about what we’re doing. And so me and Joel, I wanted to thank you for coming on the show and just being a wonderful guest.
Chris - 00:47:14: Thank you so much for the invitation. Thank you for the discussions today. And I loved your podcast, and I look forward to great things to come. And thanks for having me.
Joel - 00:47:25: Awesome.
Max - 00:47:26: Emerging Cyber Risk is brought to you by Ignyte and Secure Robotics. To find out more about Ignite and Secure Robotics, visit ignyteplatform.com or securerobotics.ai.
Joel - 00:47:37: Make sure to search for Cyber in Apple Podcasts, Spotify, and Google Podcasts, or anywhere else podcasts are found. And make sure to click Subscribe so you don’t miss any future episodes. On behalf of the team here at Ignite and Secure Robotics, thanks for listening.
