622 - From Legacy Systems to AI-Driven Healthcare: Tackling Cybersecurity and Innovation at DHF26

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Speaker B: Welcome to the Talking Health Tech Podcast. My name is Peter Birch. To today on the show I'm excited to be joined by Cameron McBride from Western Health, Chris Fisher from Ireland, and Jerome Nguyen from Endpoint. Focus, gents, thanks so much for joining me today.

Speaker C: Thanks for having me. Thanks for having us.

Speaker B: We're going to do some mic sharing around because we've got the full house in the, in the booth here. Um, and it's great to actually have all these different perspectives on the, the topic we're going to unpack, but, um, it would probably be good to kind of set the scene and frame things up. I might go to you, Cameron, firstly, um, introduce yourself, tell us a bit more about you, the work you do and particularly for Western Health, um, for those unfamiliar with as well.

Speaker D: Yeah. So I'm Cameron McBride, uh, Divisional Director of Digital Technology Services at Western Health. Western Health is a large acute public health service in the west of Melbourne in Victoria. Uh, we have a fairly spread, uh, out catchment area, uh, all the way out to uh, Backus Marsh and Melton, up to Sunbury. We've got a new facility coming online, uh, next year in Point Cook. Uh, we went live with our new footscray hospital, uh, just in February, which is very exciting for us. But, uh, yeah, I look after uh, the IT function at Western Health. Uh, Lily Liu, who's been on the podcast previously, looks after our clinical applications and we work together to try and uh, move technology forward at Western Health.

Speaker B: Amazing. Chris, what about yourself?

Speaker C: So, Chris Fisher, I head up the solution engineering here for Ireland, for Asia Pacific and Japan. Um, been working with Ireland first, boots on the ground. We're less than 12 months in region but we're starting to grow very quickly. And Ireland as an organization is really helping to reshape the way we look at the modern workspace. And when you think about healthcare and the challenges that they face, most of the time when we're looking at a healthcare scenario, it's people don't really want to be interfacing with technology. They want to just make sure that is as seamless as possible so they can deal with the patients that are sitting in front of them and that's really a large impact that Islands had. Healthcare for us is around 35% of our business as we grow across the globe. So it's a really significant sector for us. And you know we've got a lot of large organizations that are relying ah, on Islands, um, to help improve that practitioner uh, workspace.

Speaker B: Really interesting. Keen to explore that more in a bit. What about yourself?

Speaker E: My name is Jerome Nguyen, I am the solutions architect for Endpoint Ficus. Uh, we work with um, healthcare organizations uh, across Victoria in implementing secure solutions like Ireland. We were the first partner, one of the first uh, the first partner with Ireland in Australia and we have assisted Western Health in rolling that out.

Speaker B: Nice stuff. It is a like um, it's always great to talk about those like implementation partners and their experiences in rolling out different technologies and I guess you get to see the, the real world kind of translation of here's the capability of the technology, here's the needs of the health system. Um, in your experience, uh, what are ah, some of those challenges that healthcare systems are facing in terms of implementing new innovative, cool technologies but then they've got their existing kind of day to day of healthcare that needs to happen.

Speaker E: Well, the first issue would be m, dealing with the legacy apps and accessing those legacy apps via insecure browsers, which is you know, the consumer browser like Edge and Chrome and you don't know what extensions are ah, sitting in the background, what it's recording, you don't know what PII is getting recorded and you know, you don't know about the passwords, how secure the passwords are, if there's any key loggers on the system. So the first step is to, we implemented island and we had that peace of mind where we know that the users are browsing all the SaaS apps or the legacy apps within a secure encapsulated space and that just, yeah, a lot of, there's a lot of peace of mind around that.

Speaker B: And Chris, the, the world of cybersecurity and the technology tools that enable more secure systems, um, it's kind of difficult to keep up in terms of the like there's no shortage of tools and solutions available and people you know, positioning themselves to be able to assist which is, which is great with spoil of choice. But how does island fit into that landscape?

Speaker C: Yeah, it's a, it's a good question. And you know I've been in cybersecurity for a little over 20 years now and I've seen it change rapidly. I think when you Go back to the crux of what we use day to day. 90% of our time is spent in a browser. And when you think about the genesis of the browser is really, you know, for us to go surf the Internet. And then along came this big company like Google that made millions or trillions of dollars through advertising and they started to shape what that browser was doing. So ultimately we ended up with a system that we're spending 90% of our time in that's really consumer grade, which is designed to drive ad revenue for some large organizations and not really fit for purpose for an enterprise. So we came up with new technologies to build layers of control around what, ah, fundamentally was an insecure solution. So you think we've layered in proxies, we've layered in DLP solutions, we've landed in access solutions. And uh, I guess the thing we used to say in cybersecurity was if we only impact the user marginally, then that's not so bad.

Speaker B: Yeah.

Speaker C: The reality is we impact a little bit and a little bit more than a little bit more and a little bit more. And then we end up scratching our heads going, how do we end up in a situation where this user experience is completely awful?

Speaker B: It's just this one thing.

Speaker C: Exactly. And then, you know, we go, well, we're still not quite sure that we really understand the endpoint that somebody's coming from, so I'm going to jam a VDI solution in front of it and make that user experience even more awful. And that's really where we see, you know, Ireland's position in this space is about how do we still have the control that an organization and enterprise needs to make sure that we're protecting our business, we're doing the right thing by their customers, but how do we bring the user experience back? At the end of the day, the Internet was built for a browser to connect to a website, not to have 12 layers of garbage in between it. So this is really where Island's taking that control, pushing it back into the browser itself. If we get into some of the technical elements and we think about encryption and the philosophies that different people have around, should we decrypt traffic that's going in and out of an organization. There's privacy concerns, there's changes that are being done to regulations that some say you can, some say you can't. And then there's this whole post quantum cipher thing coming along which is going to make it almost impossible at a network level to do this again. These controls that we've built aren't going to be fit for purpose for very long. So placing that control back to the browser, knowing that we understand what the user's doing, having user context and a cloud world, the user really that the user identity becomes a perimeter. So having all of that and that control means that we can now eliminate what's in between and start to deliver a far greater experience for our end users.

Speaker E: Yeah.

Speaker B: What about you Cameron? Does that kind of uh, vibe check out in the real world?

Speaker D: Yeah, I think so. I think, you know, we all sort of went on this journey especially after Covid, working from home, uh, connecting up to software as a service. I think most of us look to the National Institute of Standards and Technology zero trust architecture as a way forward, uh, which you know, eventually leads you to thinking about secure uh, access, uh, at the edge. But routing all of your traffic through somebody else's data center is not performant, uh, I guess, um, whereas really what you ultimately want to do is have something like the browser, uh, wrap your arms around all of those different external connections and just make sure it's secure. Uh, I think the browser being the control plane where all of that visibility policy can be configured and it's almost irrelevant which device it's on because it's secure. Uh, I think it allows you to have that comfort knowing that you're not exposing, you know, portals out to the public Internet that people could potentially compromise. Everything's behind that uh, secure layer of having the browser's access point.

Speaker B: Yeah. Now that's interesting how it's like kind of that the segue or the gateway into other areas, it's not necessarily like um, data directly kind of going. It's all those kind of corners and things that aren't really thought about that. Once you get into the details it's um, it becomes an issue. I want to come back to Chris for a second because thinking about a platform like island that you know, pulling together different parts of an enterprise on one, one part of me is like this seems like a tidy technology solution and it's trying to um, put things all in the right places. Um, but is it like what does it actually enable from a healthcare point of view? Because if it's like, is it just tidying up that infrastructure on the back end side of things in terms of, you know, making sure it's secure or is there other kind of subsequential, like by getting that right, what does that enable?

Speaker C: So it's really interesting. We've been doing a lot of work with healthcare systems and I'll walk you through an example of, you know, what, ah, a practitioner was telling me their pain was as they were trying to get into their systems on a day to day basis. So in order for them to get to the electronic medical record system within their own hospital, they had to go one tap on, wait for a Citrix session to start up, which then took them to another Citrix session to then take them into an electronic medical record system that they could then type in. Now that process was taking somewhere typically between four and seven minutes for that to load up. I'm looking at your face going, who waits four to seven minutes to get access to.

Speaker B: I'm pretty sure this episode's gone for four to seven minutes.

Speaker C: You know, you think about that and they're, they're in a rush. You know, if you're in an emergency situation and they're trying to get access to a patient record and they're waiting four minutes to get that, well, they've got a patient in front of them that needs urgent care, but they're just trying to figure out do they have any allergies. Yeah, like this is something that causes a real world impact and this is where if we can accelerate that process. So not only do they not need to type in their password, their username and password twice, but we can seamlessly get them to the point where they go, I click on my icon to get to my medical record, the, the identity, uh, is taken care of and it's passed through so we know exactly who the user is, is getting to where they need to, uh, and within split seconds they now have that information in front of them. Yeah, that's today. Let's talk about AI a little bit because it would be remiss of me not to do it. I'm a vendor, we have to do this, these sorts of things. But I actually look at AI in the medical world as something that could be really transformative in the way that a practitioner is going to work with a patient but then have to not interact with the system. If we think of agentic and the process, we could end up with what really is going to be the interface for a practitioner, uh, to technology. If we can get to a stage where they literally have maybe a set of glasses, something that can provide them the information they need, where it is and they can just talk to an agent, well, there's still going to be a presentation layer and this is really where something like a browser enables that to move forward. Whereas right now if we were doing this across the traditional infrastructure, there's no way you could deliver that out. And that's where I think patient care will become even more greatly benefited. We can remove that legacy technology and start investing in the future of where we're seeing agentic AI head to.

Speaker B: That makes sense. I like that.

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Speaker B: Um, Jerome, the, you know, talks a bit about from the healthcare, maybe the providers or the um, end user's point of view, but with the IT teams that you speak to in healthcare, what are the benefits they're seeing?

Speaker E: Um, the analytics, the logs, the audit logs and access, seeing what the uh, user is accessing in the browser, understanding the behavior and accessing that information on the single pane of glass. That just makes life so much easier. And with island, you have your customized reports based on, based on the information and what you are after. It's very customizable. You do have uh, really good dashboards. But if you want to dig deeper into these island dashboards, you can customize them in advanced mode and yeah, ah, fast information for the it, for the

Speaker B: IT admin makes a lot of sense. It's a question I ask a bit because I'm always fascinating the answer, like what the, what that actually looks like in practice. Because, um, and it takes a lot of time to invest in new technologies and ways to kind of, you know, innovate what we're doing. If you're in the cybersecurity side, for example, it's like, okay, we're going to kind of rebuild or redo what we, what we do and um, that's going to Be a change process and it'll be lovely if you could just kind of hit pause on everything and let you kind of build that thing and then start again, maybe like gradually build it in. You got a lot of healthcare to deliver on a day to day and you've got to bring a lot of humans along in that process. How do you go about those kind of implementations of technologies within a health setting when you've got a lot of healthcare to do right now?

Speaker D: Yeah, I mean I think you've hit it on the head. Like there's so much complexity, there's so much opportunities. What do you put your effort behind? I think what we identified with Ireland was that it was a drastic uh, simplification of uh, IT service delivery. I think previously we had a whole bunch of vendors, a whole bunch of technologies trying to deliver out these applications that clinicians need to have fast access to. Uh, Citrix is probably an example of that. Um, so we're reevaluating that from you know, first principles way of thinking to say, okay, well if you've got a workstation on wheels, what if we just put island on that instead of say a presentation layer and then allowed you know, tap on, tap off capability, uh, and then work slowly towards session portability between uh, those workstation on wheels, allowing clinicians to go say a medication room back to the patient. Um, just understanding the requirements and then using canvas like island to sort of identify how we can drastically simplify that, keep it simple, secure and cost effective.

Speaker B: Yeah, no, very cool. Hey Jerome. Chris was talking earlier about you know, building for the future and um, getting that foundation.

Speaker A: Right.

Speaker B: So yeah, it says to me like there's always kind of new capabilities and innovations and uh, features I guess to um, uh, unlock for health systems. What are some of the new things that you've been working with health systems to implement through this kind of setup.

Speaker E: So one of the latest, um, latest releases was Island Desktop. So we've been working with Western Health with uh, Island Desktop and giving them access um, to their thicc apps without the need for using VPN and just tunneling the uh, traffic securely through their machines back into Western Health to access those thicc apps. Yeah.

Speaker B: And what does that enable then?

Speaker E: Enables remote access without the um, waiting or connecting into vpn.

Speaker B: And so yeah, I can see then the benefits of like that. Again, time saved and hopefully the simplicity and the other bits and pieces that can come from, from doing something like that. Um, there's I think about the environment that you have to operate in. Chris um, yes, you can have all the best kind of, it could be technically secure and all that kind of stuff. But then there's also the compliance side. It's got, it's got to tick these boxes, so to speak. And I don't mean to be flipping about compliance because obviously there for a reason, important, but if it doesn't meet these requirements, um, it doesn't get out of the gate. How do you kind of balance, particularly for a global organization too? Like there's a lot of compliance everywhere these days.

Speaker C: Yeah. And that really comes back down to how you design an architect, a product to start with. Um, compliance was something that we were aware of. We've, you know, in terms of the product team or a very mature team has had to deal with these situations, you know, But I guess one of the unique things is we're starting from scratch. So we get to use the benefit of the global scale that we see through hyperscalers. And we've been able to design a solution that takes advantage of the fact that we can have data in multiple countries. So we can look at Australian customers and go, you know what, we can keep that data in Australia. We can make sure that all the information that island has is sitting in the right spot. We can actually look at it from two views as well. And it's not just about island data. It's then about what are the applications that you're signing up to that are telling you that your information is staying in Australia. But is it really? And we've had a couple of healthcare organizations that have signed up for services that would say, you know, our data is to reside in Australia, but yet they're seeing stuff head towards the US and the Philippines and other places and they're able to pick that up from the telemetry that we can pull back. We can also look at things like how well is the application performing and provide that end user experience view as well. And look at, you know, why am I making 12 different connections across the globe when I'm in this application? What's the application actually doing? So we can start to pick up, you know, potentially where organizations have been through a compliance requirement. They've ticked all the boxes, but maybe the application doesn't quite work the way they thought it did and get to that stage. So it's actually looking at it from two angles from a compliance element. It's what we do. But it's also what are the applications you're interacting with on a day to day basis and what are they doing?

Speaker B: Yeah, makes a Lot of sense. Hey, lastly Cameron, the um, thinking about future state or what you're working towards, this team continues to evolve. All the challenges of healthcare, increasing demand and a plethora of different technology options that are available. How are you reconciling all of those different moving parts and what does that look like for Western Health?

Speaker D: Yeah, sure. So there's probably two key areas that we're looking at. The first one in Ireland is around AI skills. So uh, with the user's consent, uh, you know, if you've got all your applications that are web based within Ireland, you know, you could record uh, the activity, the workflow that people are doing, that people are doing across those different applications and then build that as a skill that can be reproduced by that staff member. So they'll uh, have these range of different options where they can just click in. It will do some of the administration work that takes them away from spending uh, time with patients. And I think that's something that we're really excited about to see what that opportunity could provide for us. Beyond that, we've got a collaboration between uh, Victoria University and Western Health, uh, where we're looking into uh, AI coding and doing that in a secure way where we can sort of ring fence that with islands. So that's only accessible within the browser to those areas that are doing uh, early uh, prototyping for workflows or use cases that we're wanting to see within the environment and then we can take that from there. But at least we uh, on the front foot in terms of understanding what those capabilities look like and we can take advantage of.

Speaker B: Yeah, you know, I mean that doesn't look a lot of thinking for me in terms of what that potentially could mean for, you know, like in healthcare. We often think, oh, that would be cool if you could do this with some of these technologies. But I mean it's healthcare, so you can't do that, um, because it doesn't live inside a remote browser, inside a remote browser, inside a vpn, inside of this. Because that's how we do do things before, um, when you're talking about like building skills out and like the AI coding piece is just not usually, not even been on the register or how would you do that safely. So hopefully that unlocks kindness and thinking for others too, to be able to have that conversation with um, Endpoint in Ireland and kind of continue on that journey too because looking forward to doing more conversations on the podcast and just unpacking what that means here in Australia for healthcare. So gents, I really appreciate making time for this conversation. Thanks so much.

Speaker D: Thanks for having us very much.

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