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Apr 2, 2026
CIOsurge Podcast - CIO Lloyd Fobi
CIOsurge Podcast - CIO Lloyd Fobi
00:00
30:06
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Transcript
0:02
Thank, thank you so much for, for joining. You know, I was really excited about this, uh, this conversation.
0:08
You know, we, we've met a couple times and, you know, I really love your vision for, uh, how you're trying to transform healthcare and how you go about it with your clients.
0:18
Um, just to start off, do, do you mind just giving a quick overview on your, your background, maybe how you got into healthcare and, and why you're so passionate about, um, solving some complex IT problems for the, the healthcare space, particularly?
0:33
Absolutely. Um, and Zach, thank you so much for, for having me here today. I, I think, you know, we, we all are in healthcare because of a calling, and we all get this calling in, in different fashions.
0:45
You know, some people have, um, a significant health scare that brings them into this space.
0:50
Others is handed down from parents who were, who were clinicians, and they saw them put in huge amounts of time to take care of patients. Um, mi-mine is a, it's a, it's a combination of a handful of things.
1:03
I, I am blessed to have a host of siblings that are clinicians and, and doctors, and my mother is, is also a clinician and doctor.
1:10
And, um, at a very young age, she, she dragged me across the continent of Africa to, to work as her data intake person in, in a river blindness project as a-- for WHO, sponsored by the Gates Foundation.
1:23
And we were going to remote villages and, um, administer medication. And you really started recognizing that, um, healthcare is, is a universal need, um, regardless of wherever you go.
1:35
And it struck a chord in me knowing that, um, I wanted to find a way to, to better the world, to change the way we deliver care.
1:43
And what I've usually said to people who ask me this question is that I, I just simply try to be a, a droplet of water.
1:49
Um, and if that droplet can, can cause a, a wave that leads to a tsunami that then changes healthcare, then I, I know on, on my dying bed, I would, I would, I would smile that I, I contributed to be able to move this world forward.
2:07
Get off me here. Yeah, ama-amazing story, Lloyd. Um, you know, that, that definitely resonates.
2:13
I think a lot of the folks kind of in my circles, they've got similar, um, moments that really propelled them into the, the healthcare space. Um, you know, I wanted to dive into, you know, a couple areas.
2:25
We, we, we have a ton of healthcare CIOs and CISOs that are, are subscribers to CIO Surge and, um, you know, one big thing that is, is pretty consistent across the board is a lot of these folks are looking for strategies to, um, reduce budget, you know, especially with Medicare and Medicaid really affecting most systems', um, budgetary view going into this year and next year.
2:50
Um, as you kinda interact with your clients and other CIOs, what are some strategies that, that, um, you've developed and that you've seen successful in helping accomplish some of those budget savings for, for those types of organizations?
3:04
Ab-absolutely. I, I think, um, every CIO would know the, the three, the three pinnacles, right? You have, you have people, you have process, you have technology.
3:12
Um, and I usually love adding a third-- a fourth in there talking about environment.
3:18
Um, it's so important to note that those three first live in an environment that is critical, and that environment is the relationship with, with peer executives, relationship with organizational strategy.
3:30
Um, the first one is you have to think about your people as transformative.
3:34
Um, most health systems today are always in a cost reduction, and they think it's about, um, layoff of people, but it's actually a great asset to recognize that word has to change from layoff to transformation.
3:45
If you can take the same person who is an Epic analyst and transform them from an Epic analyst to an Epic deliver customer care person on the side of a physician, you've actually accelerated your value in that person because all of a sudden, your end user is thinking about using the product differently.
4:04
And to try to be vendor-agnostic, and I'll call out one EMR, but the same principle applies in all pieces of technology, right?
4:12
If you are able to take the experts who sit most of the times behind a computer and give them the skill sets to be able to interact with the end user, then you're going to drive value in your business.
4:24
Now, where we have been successful in my past iterations has usually been around those pieces.
4:30
We have found our savings in actually increasing the usage of our technology system, which equates into more revenue generation for a health system.
4:41
So your cost reductions can necessarily come, not from necessarily reducing overhead spend by not-- but by not increasing overhead spend and using the same overhead spend to generate more value.
4:53
Now, as you think about that strategy, the environment is very important. You have to have an environment that is willing to go down a pathway with you.
5:01
Now, we all know we have vendors who have been escalating costs, costs for hardware across the industry. That also then presents the next step of, of process. That's where we jump into that middle of process.
5:13
Now, when you think about your vendor strategy, the word I now start changing to is partner. And everybody uses it, but the proof is in the pudding. The proof is in the pudding of that are they truly your partner?
5:24
Are they truly gonna come into your community, whether it's doing foundation events, you name it, and participate in giving back to that community?
5:32
And if you can reduce that footprint of partners and being very strategic in who you use as partners, then you can there again find savings, um, in that regard because you're able to bundle packages better.
5:45
You're able to actually do joint negotiations with other peer hospitals, which is something that we as CIOs actually have to think about.
5:51
Nobody has stopped us from saying, "I'm gonna call the hospital down the street, and we are going to jointly negotiate
5:58
a contract with a vendor or with a future partner."Those are things where us in our own circle, we have to recognize it's so important that we start playing into in there, right? Because guess what?
6:09
On the other side of the aisle, vendors are doing that. They're partnering together. You see the big announcements.
6:15
Google will partner with Epic, Microsoft will partner with so and so, and then they come sell us a product.
6:21
How do we shift out of our normal realm of operandus and actually start partnering peer to peers to approach these vendors and partners and come up with a different form of relationship? Then technology, of course.
6:32
AI is here to stay, a-and I'm preaching to the choir. I think we all believe that it's gonna be transformative. We are seeing the change.
6:39
The piece that I'll leave us with and where there's opportunity for cost savings is the word I... the phrase I leave everybody to think about is human baseline.
6:47
The opportunity to think about AI from a human baseline perspective is critical.
6:53
Not to compare AI to how a human would do it, but recognize that the human creates the baseline to the very best level they can operate, then AI takes it from there.
7:04
So anytime you're looking at an opportunity for cost savings in this opportunity is, first of all, analyzing technology from how well would a human do it? Let's take a phone call. How well do my humans take a phone call?
7:19
What is their error rate? What is the drop rate from that human taking a phone call? Most hospitals it averages around eighteen percent.
7:26
Now, from there, if I place a human age-- uh, an AI agent at the top of that human baseline created, can they take me from eighteen percent to nine percent or five percent, right?
7:40
And that is a mistake I think a lot of us CIOs sometimes make is that we try to compare the human directly to the AI.
7:46
And if when we do that, we see our organization say, "Well, the AI made nine percent res-- um, mistakes." Well, what was the human baseline of errors first created? That is so important to establish.
7:58
And if you can establish that, it's simply now a psychological effect you're playing with your peers to recognize the savings are already built in, and they should be captured and measured properly.
8:08
So as I said, environment is critical, and those three pieces of the triangle sit in that environment as we think about the opportunity to drive efficiency in healthcare. Ma-makes total sense.
8:20
You know, completely agree with, with your strategy and, um, you know, h-how to really look at cost savings from a big picture standpoint, you know, not just looking at the, the, the P&L and the spreadsheet at the end of the day.
8:33
Um, so, so great, great feedback there. You mentioned AI, um, uh, a lot of, a lot of our sub-subscribers are--
8:43
might be in the more the test phase of really testing out use cases that are gonna work specific to, to the healthcare, um, field. Um,
8:51
what are, what are maybe, you know, one to two use cases if you're a CIO, and you're just beginning your journey to test AI and get it into production, what are maybe one to two use cases that are, are easy-easier wins, um, to really implement and, a-and, and how would you, how would you evaluate implementing those types of solutions?
9:13
Yeah. I think that's a great, great opportunity, and, and I was blessed to have the opportunity to play with one here, not a couple of months ago.
9:20
Um, i-in my, in my last opportunity as a CIO, we actually, um, set a target to, to get out of the reporting business. That was a challenge I laid out for my team. And the methodology was simple.
9:32
I said, "If you really think about the need and the demand for data on the front end to drive operations, us from an IT perspective, we're creating a bottleneck."
9:42
The time frame it took for my operator to request data, for me to turn it around and give it back to them, we were talking days at best, weeks at most, months usually in there, right?
9:55
So you, you saw this, this environment create itself where IT was seen as a bottleneck. Now, how do you change that concept and say, "Actually, I want to become a business driver"?
10:07
'Cause if you can become a business driver as a CIO, all of a sudden you're a valuable asset and not a cost center in that regard. Now, what we ended up embarking on was work to actually take...
10:18
We, we tested it in supply chain.
10:19
Supply chain is where we started, and we took our supply chain data, we pulled it out of the ERP we're using at the time, Workday, and actually then overlaid, um, some Databricks over the top and then put a conversational layer right over the top of that.
10:34
Technically, we created our own version of, of, of a ChatGPT or whatever tool you use to stay on our set of data. And then we handed it to the end user,
10:45
and we watched our supply chain director go from a pessimist to an all-time optimist and wanted more.
10:52
Because all of a sudden, information that would take him an average of three to five weeks to find out was taking him three to five minutes to find out, and he was becoming the driver of what he wanted to see.
11:06
Now, this is, as you said, it's a test case. It's a use case. It's important to understand the capability, the power. This is what we now have to understand is that's a great example.
11:16
But some things we learned along the way, which is critical to note, some of the three great things we learned out the way is, one, we could do it, which is important. Great.
11:24
Two, there was a hunger and demand to get information quicker, which we also already knew. And three, which was critical for us, is the information is actually there, and the technology is well advanced to drive this.
11:38
Now, on the flip side, the things that we learned that were not so great, the ability to humanize AI into the healthcare space is critical, right?
11:48
We have to spend the time to educate the end user, to educate our teams on what this is going to do, because very quickly we saw the AI get pitted against the human of job loss, right?
12:01
Back again to that human baseline, right? And these are the lessons learned. You only learn them when you're in the experience, right? And now you get a chance to come out.
12:08
The second thing we learned was-How do you validate? How do you validate something that is moving so quickly, right? And, and there's, this, this has not been solved yet in industry.
12:17
We see it in ChatGPT and Claude and Anthropic, all of them. How many times you put in something, you ask it, and it actually hallucinates? So where's the world to validate the information we're seeing?
12:30
How are you going to do that now in healthcare? You have to do that and do it very well. So I had to start thinking about my team structure very differently.
12:37
I had to think about who was going to police this information or who was gonna police this environment, right? Mm-hmm.
12:43
And then third and last is now you went from a demand of reports of people wanting reports to a demand of people wanting more access to data. But either way, what I learned is we also just shifted the bottleneck.
12:54
We might have moved the reports closer to them, but what we did is we moved the bottleneck further upstream- Mm-hmm...of access in there. So we shifted from a report request bottleneck to an access bottleneck.
13:08
'Cause now who should have access to this world ocean of a data lake to be able to query information on, make predictions on, and deliver on, right? 'Cause guess what?
13:18
If you put HR information in very well, now should Zach be able to come on and say, "I want to see how much the CEO makes." And he's able to...
13:26
You know, so you, you recognize the bottleneck where you're shifting, and that's where I say is there are three stages right now in AI development in healthcare.
13:33
There is the stage where it has very little effect, um, in there, in things like supply chain, equipment, things of that nature. Yeah, you can play.
13:41
There's the middle that most people are still comfortable living with, which is on the business side. And then there's a highly, highly very sensitive space on the clinical side- Mm-hmm...in there.
13:52
And what I've come to recognize is the need for the right stakeholders is critical.
13:56
When you go to start building things AI-wise on, on the clinical side, you need the clinical stakeholders at the table because they are the ones that will validate that human baseline.
14:06
They are the ones that will be able to tell you, are you seeing hallucination in this data or are you not? Mm-hmm. Us who write models and LLMs, great, we can do it.
14:15
But without that stakeholder body, the validation of your test result is very, very difficult to do. Same would fall as you get into the business realm.
14:24
So the importance to create the right AI governance, the right structure before you move from a phase one to a phase three of difficulty level is so important in there.
14:35
So my advice to all of my CIO friends and COO friends that are debating this is, it's great. Anytime you see somebody bring you an AI tool, I always say there are three questions to ask.
14:45
Ask about the human baseline, ask about the validation, and ask about what tier this thing is gonna play in.
14:53
Is this at the front end tier where there's very little risk, middle tier or cl-clinical, middle tier it being the business. M-makes total, total sense, and I completely agree with, with all those points.
15:04
Um, enablement is key. You know, making sure that we, we, we get the, the stakeholders aligned with the, the business objectives, extremely critical. And, and then, uh, reviewing the data.
15:17
You know, rev-reviewing the data, making sure it's accurate, um, it's usable, and folks are getting value out of it, right? 'Cause I see a lot of folks investing in AI, but what, what's gonna be the long-term value?
15:28
You know- One second...if we're spending three, six months developing a program or a system, it better have that, that value on the, on the back end, um, a-as you deploy it. So ma-makes sense.
15:39
Let, let's pivot, uh, um, really quickly, Lloyd. Um, I know we both had a chance to experience, uh, ViVE in LA, one of the, the major healthcare, um, you know, technology healthcare-focused events of the year.
15:52
Um, a lot of folks in our community, you know, weren't able to, to travel out to LA for the event. Um, you know, what are some of your takeaways from, from, from that event?
16:02
In particular, you know, a lot of your peers on the CIO, CISO side, um, what was some of their feedback? I'd love to hear what the general conversation was like at the event for you. A-absolutely.
16:14
Um, first of all, ViVE is, is one of these events that is truly tailored to a healthcare, um, technology executive, and, um, it's designed to be able to increase peer interaction, which is critical.
16:27
Um, and you know this very well, Zach, 'cause we talked about it around, um, there, there's a lot of noise in the industry, so you need peer validation, you need data validation, and you need environment validation, right?
16:39
So where, where ViVE plays is in that environment validation, but it then gives you the opportunity to validate it amongst peers. Who's using this tool? What are the wins?
16:50
You can do the rounding with a peer to hear about a piece of technology.
16:53
There were a couple of groups that definitely stood out that they are advancing their, their pieces of technology very well, and we subsequently saw further announcements come out.
17:02
One of the ones I, I absolutely, um, um, think they're on, they're on the cutting edge here is Regard, Regard Health.
17:07
They actually just came into Microsoft's environment as one of the, the selected few, um, clinical documentation, um, diag-- front-end diagnosis tools that I believe would shift the industry.
17:19
Um, it, it is critical that when we go to places like ViVE, that we try to sift around who are the players in the space that are gonna drive some of this work forward in there.
17:30
But at the end of the day, what is so critical about a place like ViVE is, is the peers, right? Mm-hmm.
17:35
Watching what my own peers are doing in industry from whether it's a, it's a major healthcare system on the East Coast or a rural healthcare system in, in Washington, seeing that they're already thinking about these problems or what AI is gonna do to the environment or what staff s-shortages are gonna do into the environment is important, right?
17:54
One of the conversations that was big was the rural health transformation dollars. Um, we know it's coming. We know it's here to stay.
18:00
People trying to strategize of how do we make sure that this once in a lifetime opportunity, we're strategic about it, and we drive high-end value to ensure that we have secured our environments and technology perspective, device integrations, right?
18:15
I, I, I saw a great piece of technology around, um, um, an eye selfie that is able to take my blood temperature and, and look at my skin tone and tell me sickness, and all these things that we know are built on AI in the back.
18:28
I was able to round and test that with different peers, and we had great debates around bias, skin to- skin tone differences.
18:36
How is it showing that information to show that it has worked through its bias componentsRight?
18:41
I have a peer who predominantly is in the FQHC world, and in his world, he's dealing with over thirty different languages in his community. Wow.
18:51
How are we using technology to reduce the burden on clinicians in that space?
18:55
The problems are-- And this is the joy of some of the consultation work I'm doing today, is I'm seeing the problems from so many different angles. You know, they say, ask the question, how do you eat an elephant, right?
19:06
A bite at a time. Yeah. [laughs] And, and how do I know you're holding the elephant? 'Cause we, we are all holding on to this elephant of healthcare, five trillion dollar industry, from a different part.
19:17
So being humble enough to say I need to learn how he's seeing it from his world in FQHC versus how she's seeing it from her world in coastal rural America to deep in America West to major system of an HCA, for example, that spans multiple.
19:33
We are all looking at the same problem.
19:35
What Vibe provided was the venue to be able to have these conversations and cross-compare our cards, recognizing that we're pulling from the same deck, but my four of spade is different from your four of hearts, um, in there as we get to play this game.
19:50
Awesome. Awesome. Great, great points, Lloyd.
19:53
I, I think, um, you know, one, one area, uh, that a lot of, um, our community struggles with is, you know, well, it's a, it's a blessing and a curse at the end of the day with AI because there's so much innovation going on and so many new vendors coming into market.
20:11
Um, but the, you know, that, that's, like, the exciting point.
20:14
Um, but h-h- a lot of folks are struggling with how do you do due diligence on these companies and make sure that they're gonna be there for the long term, they're gonna continue to innovate, they actually work.
20:26
You know, there's a lot of fluff in the market on the vendor side. Yep. What, what are some maybe questions that, you know, you can equip our community with to, to really validate that this company is real? Absolutely.
20:38
A-and, um, I, I'm-- I have a joy of playing in this space right now. Um, the, the first one I always say is, um, is around data, right? It's not about the fanciness of the tool. It's around the data.
20:51
So to all my CIO friends, you have to maintain ownership of your data. So the first questions you want to ask is, do I get to maintain ownership of my data with me using your AI tool?
21:06
And if I maintain ownership of my data, now show me your model because you want to be able to ensure that that model works on a diverse data set.
21:18
Because most of the times, if I just give you my data, I could, I don't wanna use the word manipulate, but I could massage it to fit the outcomes I want to see for my AI model.
21:29
So as a CIO, I have to recognize that there's an increase in knowledge that I have to now own in saying, "I have all of these patient information that my system is sitting on."
21:41
I have an accountability to not just hand it across to a vendor, but to validate what they are doing to make sure that it works on my data set, on my population set.
21:51
So the first question you have to ask is around ownership of data, validation of their model with data sets in there.
21:59
Any solid vendor in the space that is worth the weight in gold or in salt should be able to show you and answer you that question. All right?
22:07
Then the second, right, which we have in the past have said, "Okay, who else is using it?" Now, we have to be more tactical with that question. Who else like me is using it in there?
22:20
And you can see that plays right off the first question, okay? Because Mayo using it does not equate that it's the best tool for an FQHC in North, in North Carolina to use it in there.
22:32
So the question is, who else like me is using it so that I can now stratify the outcomes that we're seeing.
22:39
And like me could mean population mix, could mean patient and payer mix, could mean size and volume mix in there, right? 'Cause now we are playing in a sphere of information.
22:54
And you, you might think simple things, even like clinical documentation, right?
22:58
Because if I have a high Medicare population mix, that set of AI is going to interact very differently in the multiple pieces of information that a physician is documenting on, compared to if I am a place with
23:12
a payer mix of private insurers- Mm-hmm...in there, right?
23:16
So these are the pieces that you have to recognize fit different sets of information, and the tool might be different for one person in a bigger market versus a smaller market 'cause their data sets in the back are built and modeled differently.
23:31
And then third, in there, we have come to the world where the price point and cost in healthcare is on a consistent, consistent compression curve in the- Mm...healthcare systems are seeing a reduction in their payment methodologies, so we have to share that cost with our vendors, right?
23:50
And I always challenge my CIOs, and they know this very well. Most of the companies we deal with either have taken piggy money or are publicly traded. Um, spend some time and watch their margins at the end of the year.
24:02
Most of them are double digits. I don't know many health systems that are pulling double-digit margins. [laughs] I mean... Right? So now the question is risk-sharing.
24:13
If you're going to be going out to play with a vendor who claims they can change the outcomes in your health system, let's put our money where our mouth is. Let's go into a risk-sharing agreement.
24:23
For every dollar or every outcome you create for me, let's share in that benefit. Now, that's where you see a lot of these friends fall off. Does the one baseline guarantees? The one... And nope.
24:34
The ones that said, "Nope, I'll do that risk share with you," you ha-- you might have just found the partner and the right player.In the end, please do not be afraid to ask.
24:43
A risk-sharing methodology is actually here to stay, and we're actually seeing an increase coming through, right?
24:49
Some of my clients I'm working with, we are selecting a very tight-knit group of ten top-of-the-line AI forward-thinking technologies and doing things like rooms of the future.
25:00
Those groups that are selected, we are telling them upfront, this is a risk-sharing methodology, 'cause if your room of the future holds, we have no problem you inviting other health systems to come tour the room of the future, which will be more business for you, right?
25:14
But to build that room of the future, we're on a risk-sharing methodology in there, right? And we have some other friends that have said, "Don't tell me more. I'm in."
25:23
In the end, we're starting to saying, "Well, I want a baseline." I said, "Well, how good do you believe in your piece of technology you have built?" Yeah. I, I love that strategy.
25:33
You know, that, that to me is true partnership, being able to, um, mutually benefit at the end of the day and, and share the, the time and resources it, it takes to get a successful, um, business outcome.
25:46
Well, really, really cool, Lloyd. Uh, the last question, um, I have for you, you know, I'd love for the subscribers to, you know, A, understand a little bit about your, you know, your personal business and your firm.
25:58
So I'd love to hear, you know, number one, the, the problems that, that you're solving, that you're really focused on, and, and why your customers are extremely excited to, uh, partner with you. Absolutely. Absolutely.
26:11
Um, we, we are very simple. We, we focus on the last mile challenge.
26:15
Um, HealthScale Partners, um, it's, it's a boutique shop of very selected CIOs and COOs that have seen this problem on the other side of the river in there.
26:24
And I always challenge everybody to recognize the grass is not necessarily greener on the other side. You have to watch out for a septic leak. That could be the reason why in there.
26:33
[laughs] Now, what we try to do is make sure that the green grass you see is not due to a septic leak, um, it is actually due to proper operations, proper delivery of product, right? And what do I mean by that?
26:45
You go to a conference, or you hear from a peer says, "Oh, you should use this piece of technology." Does that technology work in your environment?
26:52
Does that piece of technology or does that developer of that technology understand how to penetrate your environment?
26:58
Now, what I've enjoyed about doing this work is you find out you have brilliant developers, you have brilliant CEOs that have really put thought and care into their product.
27:08
Where we sometimes we fall short is now moving that into a healthcare environment is a different kind of challenge, right?
27:16
And that challenge comes from operational readiness, that challenge comes from consumer readiness, that challenge comes from the team in the technology side being ready to support that.
27:28
So the value add we're looking to do is not only prepare a technology company to go into an environment, but also prepare the healthcare system to, to do that. Now, everybody knows as I said, AI is here to stay.
27:41
Everybody's looking for the next AI tool in there. And we have-- we know this very well, right? 'Cause we've seen exactly the advent of technology cracked in the early two thousands, everybody had a website.
27:51
Then all of a sudden, everybody had a personal computer.
27:54
There's this gray area of training and preparedness that truly generates value add, and the individuals that take the time to develop the proper continuous improvement, the proper training, the proper preparedness for your team actually double their value over twelve to twenty-four months.
28:12
So that's our message to our groups these days, is take the time to prepare your staff, take the time to prepare the technology to come in, and you would actually see an acceleration in value, right?
28:22
I mentioned, uh, an example of a room of a future. That's a project that is ni-nice and dear to my heart because we have been very selective of the partners that we'll pick to come into such a space.
28:32
We're being very selective of who we work with as a, as a cl-- as a, as a health system who's forward-thinking. And what I tell the health system is, you have to recognize it's not a hundred percent guaranteed.
28:45
You want to find out about things that would not work now versus deploy them to a thousand physicians and then find out they don't work. That is an additional value add.
28:56
So as we do this work, as said, boutique shop, we are more keened on relationship building, making sure that we have the right partners, and the right partners will mean that we'll develop the right results. Amazing.
29:09
No, that's, that, that's great. You know, you could t-truly, truly see that, you know, you're, you're taking a very pragmatic approach to leverage some of these innovative technologies.
29:19
So again, thank you so much for joining, Lloyd. Appreciate it. I think the subscribers are gonna get a, just a ton of value from, you know, some of the, the great points that you laid out there.
29:29
And, um, it-- how, how could they reach you? You know, website or LinkedIn? Um, what's, what's the best way to get in touch with you? A-absolutely.
29:37
We're gonna have my details shared with you, Zach, and you can attach it into a newsletter going out, but email, website, all available. LinkedIn, as always, you can find me on LinkedIn.
29:46
A quick message, I, I do a pretty good job of responding. Um, but we'll definitely make sure we can have it available.
29:51
But, um, just normal healthscalepartners.com is, is, is live and well, and you can drop us a note, and we can build and go from there, but I'll make sure you get all of our details to get ahold of us. Awesome. Awesome.
30:03
Thanks so much, Lloyd. All right. Stop the recording.
CIOsurge Podcast
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