Healthcare is Hard: A Podcast for Insiders

The episode contains a handful of genuine practitioner observations - on pilot design for scale, principle-based decision-making, and the exponential-vs-linear adoption gap - but they are diluted by extended banter, mutual admiration, and broadly-stated observations that never get developed to a level a senior operator couldn't derive independently.

“designing pilots to learn for scale is one of the practices that we sort of eventually had. There's no reason to pilot it if you're not going to learn something that's going to help you grow it in the end”

“change is exponential. Our ability to adopt is linear”

Almost every framework invoked - exponential change vs. linear adoption, signal vs. noise, driverless-cars-as-AI-adoption-analogy, pilot-to-scale, principle-based governance - is already widely circulated; there is no contrarian or first-principles argument advanced, and the closing 10-year prediction explicitly declines to commit to anything specific.

“It's not just governance for the sort of machine learning based models. It's really different with generative AI”

“the technology has been there for a while, right? It's like we have to figure out how to adopt it”

Laura Wilt is a genuine senior practitioner - EVP/CDO of a 50,000-employee health system, prior operational leadership at Ochsner, and an Epic veteran - making her a credible operator who has done this at scale; however, the conversation does not fully exploit her depth, leaving her caliber underutilised relative to what the role implies.

“we're going to be the leading health system in the nation for technology and AI and digital”

“we had gone live in mid 22 with a workday HCM and payroll implementation. And there were some challenges with that”

A small number of concrete data points appear - 22,000 Ask Emmy users, 7,000 weekly actives, 50,000 employees, mid-2022 Workday go-live - but most of the conversation stays at a strategic or conceptual level with no ROI figures, cost data, or before/after outcome metrics to anchor claims.

“we have, like, we just opened it up for patients. We've had over 22,000 people use it so far, and it's like 7,000 weekly active users right now”

“you guys, this is approximations but you have 50,000 employees, 12,000 physicians, 2,000 advanced practice clinicians”

Keith frequently delivers compound, self-answering questions that give Laura an easy pass rather than probing for specifics, and the bookend banter with a second host plus closing mutual praise consumes meaningful runtime; there is virtually no productive pushback or follow-up that forces a harder or more precise answer.

“I'm always amazed that you've. You've always got this smile and you've always got a very positive outlook on this”

“I'm just kind of playing off sort of how your point of how you came into Sutter and kind of said, look, we got to fix some of the core before we can go forward”