450- Healthcare AI Needs a Reality Check w/Mikkel Finsen

450-Mikkel Finsen

Host: Mike Kelley

Guest: Mikkel Finsen

Mike Kelley: Well. Welcome back to You've Been Heard, the show where we pull

back the curtain for current IT leaders and rising stars aiming for their own

seat at the table. We've tossed out the corporate scripts for real, unvarnished

talk about what it actually takes to lead. Mikkel a huge welcome. We're thrilled

you decided to join us today and trade stories with us over at

youvebeenheard.com. Sitting in the guest chair today is Mikkel Finsen, a

technology leader who blends European executive roots with modern digital

transformation and cybersecurity expertise. What makes Mikkle's perspective so

refreshing is his global, no nonsense approach to scaling operations, proving

that strong technical architecture only matters if it directly translates into

real world business resilience and empowered people. Mikkel, we got plenty of

room or plenty of ground to cover, but the mic is yours first, mind introducing

yourself and sharing what your ride to the leadership chair looked like?

Mikkel Finsen: Thank you Mike. It's a pleasure to be here. so yes, I'm Mikkel

Finsen. I am born and bred in Denmark, a few thousand miles away from the east

coast of the US. but, my journey started, obviously many years ago. I started

out in interior design, designing offices and warehouses. So it was not exactly

the traditional it path. and somewhere along those lines, I decided I was going

to try something else before I committed fully to a future interior design in

Denmark. And I took a year off and went to Ireland of all places, and meet the

Irish people. And, back then we called the Celtic Tiger, which is basically the

boom and the technology boom that happened in Ireland in the mid nineties and

late 90s. and I took on my first IT support role with IBM and I was there in

tech support. I knew nothing about computers at that point. so I had a deep dive

into tech tech support and ended up doing tech support for IBM across,

Scandinavia to start with, and then the US market. And then, after thirteen

months in tech support in IBM, you burn out doing tech support after a while.

But I get a job with KPMG in Ireland. And, that was a significant, change in IT

support in moving into a corporate infrastructure corporate network where we now

support users and face to face. but it was really start to my technology

journey. And then I started at the help desk and I gradually worked my way up in

the organization. I was there in KPMG in total for a little over two decades,

spending my first, twelve ish years at KPMG in Ireland and then moved to the US.

But was always of the belief that, take the opportunities you're given and when

you work through, your youth and then some jobs in KPMG were exciting. Some were

probably not. But I took the opportunities I was given to me and I jumped on

projects. I jumped on, new technologies or new initiatives and, gradually worked

my way up to become, should I say, the right hand man of the CIO or the director

there at that time? and learned a tremendous amount of stuff about project

management, business management, but also technologies. And I was surrounded by

people who knew technologies a lot better than I did. I could support it. I

could speak with end users, I could help them understand the technology

challenges we're facing. But the real heroes in my world were the people I work

with at KPMG and in the operations teams and support teams who really knew the

technologies. And I learned a lot from them. and also how to manage people with

technologies. And then I was gradually promoted to helpdesk manager to business

operations manager and then as a director. And then magically, I was asked to

join the global team in the US and moved across to the US in twenty eleven and,

took on a global director role there as part of the KPMG global and had a

wonderful ten years there as well, where I really learned a lot more about, not

no longer being hands on, but, trying to manage resources and managing projects

and services and also level set end user expectations. But working in Europe and

working in us is very different when it comes to both culture and just work

environment. So, the first year at KPMG, US or the US was certainly should I

say, culture shock because there are certain things you could do in Ireland you

couldn't do in the US or certain ways of interacting with people that works in

Europe but doesn't work in the US. So I spent a few years learning that change,

but it was certainly still valuable, learnings both from a political

environment, where you have these people, running around with sores on their

elbows and trying to cut each other down, get ahead of the curve. And then you

have others, maybe like me, a little bit more subdued, sitting back and making

sure things are working and trying to provide the best service we can. and then

at a certain point in my career, after more than two decades with KPMG, I had to

decide, what does my future look like? I was still relatively young, but I, had

also, unfortunately Encountered a serious medical issue. So that required me to

just look a little bit differently at life. And then while I loved my colleagues

and work at KPMG, I also realised that it was, putting a strain on my health, I

decided to, look and see what's outside of KPMG. It is very daunting when you

have spent two decades in an organisation to start interviewing again, start

looking for jobs. Oh do I have all the requirements? Do I have all the

certificates? Do I have the experience needed? but I, came across this

opportunity at Open Door where I am now, where the CEO was a wonderful woman and

she was trying to, build an enterprise ready IT organization. it was a

significant step down in regards to managing people. I went from managing,

twenty people in the US and I don't know how many people in, India. And now I

was joining a team of five, including me, But it was not necessarily the size of

the organization that matters. It was more the challenges and opportunities

ahead that I kind of like predicted. and we had the opportunity to really

rebuild the entire IT organization from scratch, including building the

infrastructure, building the security, building the service management attitude

towards it and how we provide services at, within the organization, helping the

organization grow and use the technologies better. so that really appealed to

me. And I was grateful that I, got the opportunity to join open door and, and

I've been here ever since. Of course. and over the years, I've developed a close

relationship with the senior leadership within the organization. And we've now

built a team of, twenty ish, IT professionals that are providing services to

about a thousand people across the area where we, operate. but it's been a

fantastic journey in the sense of, all the challenges, especially coming from

corporate America and into healthcare, into nonprofit healthcare. But we now

have to use the money more carefully and really decide if you buy something, it

has to be something you can really leverage for the next three, five, seven

years. So it wasn't just, build, and deployed. now we had to be more cautious.

So that changed my learnings a lot. And then coming into healthcare with a lot

of new acronyms and a lot of new priorities, the mission statement suddenly

became even more important. so it was very difficult to not difficult. It's not

the right word. It was challenging to adapt from corporate America to, not for

profit health care. But I will also say the first five years of my existence

here was focusing primarily on technologies, which is the same whether you're in

corporate or a not for profit, you're still managing technologies, you're still

managing people with technical experiences and skills. so that is the same. It's

just how do we apply it to the business and the business mission and objectives.

Mike Kelley: So I've heard three topics that I'd really love to dive in a little

bit more on. One, just because you've got a unique perspective. I haven't had a

chance to talk to somebody who's come across the pond, so to speak. and I'd love

to understand a little bit more of those differences that you were talking about

in the culture of the things that you could do in Europe that couldn't do in

America and, or just the, cultural differences. So if you don't mind starting

there and then we'll kind of dive a little deeper into the nonprofit and the for

profit and then quadrupling the size of your team over the period of time that

you've been at, open door. but tell me a little bit more about the cultural

differences between the different countries.

Mikkel Finsen: At least, I can only speak from, Ireland versus, cbmc global and

global might not be the same as KPMG US, but certainly in Ireland. I had the

sense and feeling of being a lot more in a group where we trusted each other,

where we worked closely, we went out for pints on Wednesday, Thursday and

Fridays and sometimes Tuesdays. And we trusted each other. We had very direct

and honest conversations. You learn to use a lot of interesting words. And when

you work in Ireland, but it's just part of the culture. And it's a wonderful

atmosphere to be in. And we achieved something. And when we said, we're going to

have it done by September. Lo and behold, we would get it deployed by September.

And that meant, working on weekends. And we pulled together and I think

everybody were committed to the same direction and the same outcomes. And coming

over to the US, I just felt many times you had to be more careful with how you

express yourself. because, and I don't know if it's sensitivity thing, whatever

it is, but, it sounds really harsh, but a lot more fake at times in the sense of

you had to be a lot more overly positive. You couldn't be direct. You couldn't,

necessarily say things didn't work the way it should be or we haven't done a

good enough job. It was we always had to be careful with how you got perceived

and how people looked at you and what came out of your mouth at times. even if

you were frustrated, you had to be really mindful of those things. but then on

the flip side, the activities you saw at these large organizations like KPMG,

all that is wonderful. but it's just different personalities. and I just never

felt that you never developed that close relationship with the team. At least,

with the team I worked with in the US, as I saw in Ireland. So I'm still in

touch with colleagues in Ireland. People are, within six months of leaving KPMG,

it was like I'd never been there before. Nobody contacted you. And I just even

though you spent ten years together on, herring projects like Hang on. Well, was

this all just fake then, you know, and then you start wondering why invest so

much personally in an organization or in a team? If all you're in there just

for, achieving your own personal goals and figure out how can I get ahead

instead of the other ones? And so that was just my biggest takeaway from those

organizations. Now I'm back in an environment where we have a strong team, we

have a good relationship with everybody. we try to socialize, we try to, get to

know each other. and I think it's definitely more to what I used to be. I still

have to be careful with some of my bad behaviors I might have learned in an

Irish setting, but that's just something part of growing up too.

Mike Kelley: Yeah, and I was actually going to ask how much that influenced the

way you're building the team now that you're empowering them and, the design of

what you've grown since you've joined the new organization?

Mikkel Finsen: I tried to, empower my staff to do what they're hired to do. but

I certainly still have certain ambitions and plans, that I want to achieve. And

then I try to kind of push that, in that direction. And I let them decide, how

do we deploy things, best practices or how do we configure the network? But I

still have my opinions and we will have honest conversations. And yes,

sometimes, people think it's personal, but nothing is personal. So it's just a

matter of just hearing and sharing the issues we see. And so we can learn and

get better. that's the whole aim of it. It's not to, put anybody down. And if

that's the way it's perceived, then that's certainly not my intention. and

that's the thing I still need to learn and get better at.

Mike Kelley: Yeah. I struggle with that myself sometimes. Just not, going

forward with the vision that we have and seeing that and trying to impart that

and some of those differences and sometimes just being honest. But I found that

I much prefer to be honest. And the saying that I've come up with or twisted,

the truth is always the best. The trick is in the delivery. Yep.

Mikkel Finsen: Proof is in the pudding.

Mike Kelley: Honesty is always the best policy. The trick is in the delivery.

That's what I was trying to articulate. So the challenges of moving from

corporate America into the nonprofit world and then being there, I assume with

the IT team quadrupling in size, that the general workforce also went through a

huge growth over the last seven years that you've been there. How much has the

workforce in general grown compared to the IT team?

Mikkel Finsen: The IT team grew significantly, whereas the general organization

did not, because we still had seven clinics and a few school based clinics as

well. And staff headcount in those areas really stayed, not static. we still

grew. We got on to more providers and to see more patients. But it did grow

significantly compared to any other organization during the first four years of

me being here. But that was part of the plan that I discussed with the CEO when

I joined was that we needed to build a team worthy to support the organization.

And so we didn't have technical outages. We didn't have, slow response times, so

we could actually support the organization and help them use the technologies to

deliver patient care. so that was always the agreement. And that investment was

made over a roughly four years that we had agreed to move from five up to twelve

or thirteen, I believe it was. And what then happened is we actually acquired

another organizations within the same area. We are focusing primarily on

behavioral health. So we were about five fifty. They came in with about three

hundred and fifty four hundred people. So, staffing wise, we almost doubled. And

because of that, we also brought in a few more IT staff to help support the

extra growth in staff, instead of having a measly twenty sites across the area,

we now have forty five ish sites. So we now have a lot more people and equipment

to support as well. So that was the business case for increasing it.

Mike Kelley: Okay. That makes sense. And then I'm sure that there's other

metrics that the the organization has been using to judge growth the velocity.

The. Yes, it's a nonprofit, but you're still working through and profits or

revenue versus cost.

Mikkel Finsen: Yeah. So our main driver is obviously patient visits. So the more

patients we see and the better for us in regards to revenue, we are what they

call a federally qualified health center. So we do get, some payments from the

federal, for each visits we have. but it's still important for us to make sure

our providers are fully utilized Monday to Saturday, see as many patients as we

can obviously give them, the odd, a few minutes for lunch and administrative

work. But, we do want them to see as many patients as possible. And that drives

our revenue up or at least our operations budget up. and put. On the flip side,

we need to also make sure we kind of match and don't exceed, operational costs,

so we always look at, where we can get, preferential pricing from vendors.

Microsoft, I will say has been phenomenal when it comes to supporting

nonprofits. and we've certainly availed a lot from them. but those are the

relationships we're building now with vendors is to not, we're not trying to get

in on it cheap here. We certainly want the technologies that support and deliver

the outcomes we want, but we still want to make sure we do it for a reasonable

price. we're not KPMG. We can't afford to buy a Rolls Royce for every

application we buy. So, we look more critically at the applications and the

needs we have and say, do we really need this? Do we need all these, ten bells

and whistles or can we get away with five of them? And then we get price

accordingly. But nowadays you see vendors. increase their prices year on year.

We just got, the threats that some of our products might increase with up to

forty percent. it's just ridiculous. It's like, daylight robbery. so and that

brings us then to the next point is now we have to make sure we spend the money,

wisely and then we have to go and say, okay, well, is there another product that

can help us achieve the same things for less? so that's what we're up against

every year. When we look at our budget, we try to stay not flat, but we

certainly try to stay relatively flat on our operational budget again, to

support the patient visits and the goals of the organization. and on the capital

side, we've certainly gone down year on year, since I joined because we have

invested a lot. what we do now is refreshes and stuff like that.

Mike Kelley: So when you first joined the organization, what were the largest

projects that you initially felt needed to be tackled first?

Mikkel Finsen: The first piece was the service management aspect. we didn't have

a ticketing system. so we needed somewhere where we can start log and track

tickets because people were emailing, calling us and stuff didn't get done. We

didn't know what was actually happening. And we didn't have an inventory of all

the servers and applications that we had. and we had a lot of old equipment that

we, ran in the organization because of hand me downs and just because nobody had

invested in it. so those things were definitely important. I did join, in twenty

nineteen. And then, the first thing that really hit us was the mobility of

computers. And when Covid hit in February or March of Twenty twenty. So at that

point, the next big challenge was to convert a large percentage of our staff

from desktop computers to laptop computers so they could work remotely. And that

took a lot of finagling to get done. but that was certainly one of the bigger

challenges for us. besides getting the inventory, besides getting its, ticketing

system up and running and start looking at refreshes, but that accelerated a

fair few things. and then, just while we were at it in Covid as well, we might

as well just get the ransomware attack out of the way. So we did that in August

of twenty twenty as well. So, within the first twelve months of me joining

healthcare, I've certainly been rattled a few times with both Covid and

somewhere, but it's also at that time, you see who your star players were and

how that really brought the team very close together. so those were the

challenges.

Mike Kelley: So just out of curiosity, when Covid was going on, while you guys

were facing that, everybody went mobile and dispersed some. Did your team stay

in the office or did you guys disperse also, and you were able to get that close

knit team while being physically separated?

Mikkel Finsen: For the first few months, we were dispersed and we did put up a

quick, hybrid setup where people would be in the office and we would sit in

different locations of the building. but I will admit that as soon as, the

ransomware hit, it was like all hands on deck. we had to forget about these,

distances. We had to set up a war room. We had to go through, get all the

systems listed out and start, recovering from the ransomware. At that point, we

were just in the office every day. and that's, how we've been ever since. Pretty

much we have started to introduce some hybrid. But that's just because people

are looking for it. But we were pretty much in the office all the time. And I

actually got a letter from the company that I needed to keep in the car in case

I got stopped during Covid and say I'm allowed to drive, which was quite so

real, but it was interesting.

Mike Kelley: Yeah, I used to carry one of those letters with me too, just in

case.

Mikkel Finsen: The commute was awesome during Covid. I have to say, it was

excellent.

Mike Kelley: Yeah. Nobody on the road? Nope. yeah. Made it so that you get there

quick and easy. okay. So refresh the infrastructure. added in ticketing system

to be able to help see what was going on to recognize so that you could solve

larger problems, recurrent problems, making things more efficient, adding

mobility into all of the employees and helping them out. Then, where'd you head

next? After that? after things started to settle down a little bit and then you

guys got back into regular business. Twenty two, twenty three. what happened a

couple of years ago?

Mikkel Finsen: Well, actually in twenty twenty was when we kicked off a number

of projects as a result of ransomware. So we, rebuilt our entire network with

new network equipment and, decommissioned a number of servers and off site data

centers and started moving a lot of things to the cloud. And, I had a very

productive conversation with the board that, during the, ransomware as well. And

at that point, we also decided to, and they were open to the idea of investing a

lot more in cyber security world. So we now started adding a number of cyber

security tools to our toolkit. And so twenty twenty and twenty twenty one were

very busy when it comes to technologies and deploying services and moving to the

cloud and consolidating. So that was really, the focus of it at that point.

Then, we altered the start discussing with HR about, setting up a new HR system

for them. and we migrated, to that as well as part of twenty twenty one twenty

two. and then we looked at, intranet to be better at communicating with the

organization on, promoting internally all the good stuff that is being done by

it, by HR, by finance, by the clinicals and then centralizing a lot of that in

one location. And then, a couple years ago, we started the whole finance

optimization where we work closely with finance and implementing a new ERP

system. So we've done pretty much the whole thing now, except we have not

replaced our EHR system. And which is eighty percent of our business. So that's

something that is not done lightly. So we're leaving that for now. But I think

the beauty of me coming in at this time, I did to where I am now is, all the

stuff we have been involved with, it is now the trusted advisor of the

organization. I have a seat at the board. I meet with the CEO on a weekly basis

and, we talk about everything, to do with it and how we're performing and not

performing and share our progress with the board and they actively listen and

ask questions and sometimes challenging questions, which is good. and I think

that's really been the focus for the last, couple of years is to get better at

interacting with the senior leadership and listening more to the business and

trying to say, okay, we've done all this now, now how can we help drive more

efficiencies into the operations, and what technologies can we help you guys

with? but one challenge that has been is, moving from corporate to, nonprofit

health care's corporate. Everybody knows how to use computer. Everybody uses it

every day. It is part of their world, part of their, existence. Once we move

into healthcare, eighty percent of our organization are patient facing. They

couldn't care less about outlook. They focus on seeing the patient. They focus

on getting patients healthy and getting them treatments. So their application,

which is the EHR, is their critical component. So in corporate America, if

outlook went down, we couldn't do anything. If our EHR goes down then we're

screwed because now we can't see patient records. we can treat patients. But it

just becomes more challenging. So we now have to shift focus on understanding

what technologies are important. and that was a bit of a shift in the beginning,

but we've learned that now, so that's for sure.

Mike Kelley: No, it's a good thing. I mean, one of the common threads that I

hear from our peers is understanding the operation or understanding the

business; it's really critical that we can talk to them about the business. And

we look at what we're doing as how it impacts and helps or detracts from the

business, and trying to make sure that it doesn't detract from the business. but

one of the things that you mentioned that I'm curious about, as you came on

board, it seemed like you had the CEO's trust from the beginning. But then, with

all of those events that happened in twenty and twenty one, you really earned it

too. So I'm kind of curious about that and how much you think being tempered by

the fire, really helped give you the seat or were you entrusted with that seat

and then being tempered by the fires helped really show to the rest of the board

and the C-suite, the value that you were bringing to the team and the team that

you were building. I thought about that.

Mikkel Finsen: Yeah. I certainly think the, number of forest fires we

experienced in twenty twenty certainly made us earn our stripes and show value

and show that we were the right team and the right individuals for the task. I

think a lot of the things that happened in twenty twenty fast tracked the plans

I had already shared with the board in October of twenty nineteen. When I

joined, I'd say these are some of the findings that I think we need to address.

And unfortunately, some of these things materialize sooner than I had hoped for.

So we had to work in a warp speed almost at times. But I think that hopefully

showed or I know it showed the board and the CEO that we do have, selfishly that

I am the right person to lead the team to get things done. and we have a great

group of people here to deliver on those things to and support the organization.

So, but I said it got fast tracked, significantly because of the events that

were outside of our control to start with.

Mike Kelley: So let's jump forward a little bit. And we'll jump back to like

twenty three and some of the influences that happened there, but like currently,

you're talking about the HR and looking at that, what other projects or major,

things are on your roadmap in the next couple of years? what is your focus been

since all of the initial upheavals have kind of tapered?

Mikkel Finsen: I think we deployed some fantastic technologies and expensive

technologies. but I also think that we quickly learned that some of those

technologies were, something we probably didn't need or would never utilize

fully. so we start scaling back on some of those. And we identified duplicate

technologies we had deployed for endpoint protection, for example. And so we had

two of them instead of one. And then and then we also went all in with our

network. And I should say not that it matters, but we deployed Cisco network

back in twenty twenty and started looking at SD-Wan and all kind of, fantastic

things that could offer, but I'm not sure if we got, the wrong engineers on the

job from our vendor or if we weren't ready for the technology itself, or if this

is just beyond a small nonprofit we have. But we quickly realized that

implementing some of these, modern or very well spoken of technologies like

SD-Wan and, this whole notion of zero trust, it actually overcomplicated our

network and caused a lot of internal network issues that caused our HR to grow

slowly and then start going down and there was just a lot of noise on the

network. So we've actually ripped a lot of that out again and going and now

reassessing what we did, back in twenty two, twenty three for SD-Wan and say,

hang on, we don't really need this. So now we're actually ripping some of that

out again. And going back to sort of say almost a do over of our network and

starting simple again, say, what do we actually need? And then start, deploying

it like that. I think we just grabbed over too much and it caused issues.

Mike Kelley: I'm curious when you say that you're dialing back, are you still

leaving the SD-Wan infrastructure? Are you like taking a step back towards like

Mpls?

Mikkel Finsen: Well, not necessarily Mpls, but, certainly, close to it, but

we're stripping a lot of SD-Wan out of it, just to have a much simpler network

and what we believe is more secure, we will add it on, I'm sure again, in a year

or two, once we are comfortable with the foundation of the network running

smoothly. Again, we're actually shifting from one vendor to another. So we're

using that opportunity to level set that as well. So that's what we're doing.

But while still maintaining security of our network, of course. And so that's

the reason why.

Mike Kelley: Okay. All right. Interesting. I haven't heard of too many people

taking that pause and that step back. We typically move towards the SD-Wan and

just keep going after it.

Mikkel Finsen: And we did try, but I said, I'm not sure if our skill set weren't

ready for it or if it was more of the consultants, the company we hired,

persuaded us to go, full on in and we never really got it configured correctly

because, the premise of, SD-Wan is awesome. And we do want to move to that level

again, but I think we just have to, almost level set our organization again to

say, okay, let's just take a breath and say, okay, everything is working, let's

get it configured correctly and let's make sure we don't have any, issues,

especially because we have forty odd sites and we want to make sure that

communication between the site is running seamlessly and that our EHR is

performing and secure. so that's really our main goal. And it is performing. We

just have these oops issues at the time, which I'm sure everybody does. I just

get a little bit more frustrated when I see.

Mike Kelley: Yeah. and anytime we slow down the organization by making the EHR

or the ERP or whatever primary system we're using for providing services to the

organization, anytime we slow that down, that causes a lot of frustration. And

usually you get to hear a lot of, chirping birds about how things are going.

Mikkel Finsen: Yeah, and as I said before, if, outlook goes down, it's really

just the administrators or the HR admins, leadership and it that are kind of

like, oh I can't send an email, and then it's a Microsoft that had a blip on the

East coast or whatever. but if our EHR goes down, then we'll know about it and

quickly.

Mike Kelley: Yeah. Because they can still provide care, but now their care is

based on immediate observation versus, oh, here's the history and yeah.

Mikkel Finsen: And I think that was one of the biggest learning points for me is

to level set the primary systems that need to be up all the time. and understand

the urgency and the importance of that system, and make sure that our end users

were comfortable that we knew how to support the platform. Listen, if we have a

slowness or an outage and whether it's our, cost or not, and most of the time

it's an ISP that has gone down to a site or Microsoft link broke, for example.

but still they see it as an IT outage. And then that's what we need to avoid.

Mike Kelley: Yeah. And you know what? This little bit of advice that we're

talking about right now applies to anybody in any IT leadership role at any

organization, understand what are the applications that the organization needs

that the business needs for operation, because that's what they care about.

Yeah. They're just trying to get the job done.

Mikkel Finsen: Absolutely. I mean, that's, the same for anybody. You know, there

are certain tools in any organization that are more important than others. And,

and I would say that was the learning from so before, our ransomware attack, we

had actually gone through and mapped out all the applications we had and who

uses them and the priority of those applications or the criticality, I should

say, of those applications. So when we actually started doing the recovery of

ransomware, we knew exactly which applications would go with first and get them

up and running first. And that's, how I think we recovered relatively fast.

Mike Kelley: Yeah. that's a foundational step within any disaster recovery plan.

and it's trying to figure out all of those pieces. who's the owner of it? Who's

the user of it? how many people are using it? What's its priority within the

organization? So all right. Twenty three, you're dealing with scaling back the

network. And suddenly this, open AI starts showing up and ChatGPT starts showing

up. what's happening in your world around those topics.

Mikkel Finsen: We're a lot more conservative, when it comes to AI. we are again,

I'm not trying to downplay who we are and what we do, but we are, much more

focused on patient care. At least, I know AI is by many organizations, touted as

being the next big thing, and everybody has to do it and we're going to get rid

of so many employees and stuff like that. And I'm a little bit more cautious in

the sense of, sure, we all want AI, but we also have to understand what AI

actually brings to the organization. and some organizations, they just deploy AI

just because they think they have to. And I think we've had some good

conversations within the organization to say, let's look at AI that will

actually make an impact on patient services and operational effectiveness, and

then start looking at, okay, what can we help with the providers with to stop

reducing provider burnout? Okay, let's look at some ambient AI to sit in the

exam room, help them take notes, get it into the EHR and at least say, now we

can close the notes quicker. you don't need to type it up at eight or nine

o'clock at night and then start it again seven o'clock in the morning. And I

think that has been something that we've prioritized. Now we're starting to look

at others is again, operational efficiency. More on how do we do prior

authorization and and how can we help? How can I help that workflow? And again,

it's very much focused on patient facing activities. And sure, we are looking at

AI for IT operations. We're looking at through ERP, but our main focus is really

around, the patient facing stuff. But we do want to do it, in a controlled way.

So I established an AI governance group back in January. We meet, once every six

or seven weeks to talk about AI initiatives and challenges policies, setting the

guardrails up and making sure we understand how and when to use AI. I fully know

that AI has been used for the last eighteen months or two years by staff using

ChatGPT and those tools. And we are looking at, which of those tools can we

start shutting off and say, don't use this with it within the organization. But

we have to understand and accept that AI is there. And now we just have to

provide the guardrails and the controls around how do we manage what's being

uploaded, what's being shared, and provide staff with the necessary training on

how to use these tools effectively.

Mike Kelley: Yeah, and you guys have the fun of all of the HIPAA protected,

information also. Yeah, you can be very careful about that and make sure that

the people who don't normally use email are aware of the ramifications of

dealing with that and asking those kinds of questions.

Mikkel Finsen: Especially when you we start talking about, predictive, AI where

some of the junior staff, even doctors and nurses are starting to type in

questions to an AI agent saying, I have a patient with these symptoms, you know

what prescription should I give? And then generative AI comes up with an answer.

Sure they can ask all these questions, but they still have to go back and

validate it because we only a misdiagnosis away from a lawsuit. And that's what

we need to be cautious of. Why a lot of people say AI is going to be

revolutionizing within healthcare. Fully agree. And I think it has a lot of

excellent use cases, especially in large hospitals and, labs and, X-rays and all

those. And also within, not for profit, we just have to be a little bit more

conservative when it comes to the deployment of AI, in my opinion, to make sure

we do it in a controlled manner. So we know exactly what AI tool will do. Where

the data is stored, how the data is being processed and what the staff have

access to and how they use that data. So it is a little bit more complicated, I

think, within healthcare. And that's why we're a little bit more conservative.

Mike Kelley: Well that's good. and you're starting off in the right place with

the oversight or the steering committee and the governance committee over that.

and then just working with your data to make sure that that's solid. And then

we've got to educate all of our people how to use it, when to use it, why to use

it, and when to trust it, when not to trust it, because, well, AI told me to is

never the defense or it's not a viable defense. And I'm sure we're still facing

our times of hearing people use that.

Mikkel Finsen: Yeah, absolutely.

Mike Kelley: So through all of the discussions today and all of these things

that we've been talking about, are there any thoughts or any, things that you

want to share with our peers at the same level or with those that are following

behind us? any hard earned lessons that you'd love to save somebody else the

pain of learning?

Mikkel Finsen: This is where my, background might differ slightly from others

is, I shared my plans with my leadership with my manager and have very open and

transparent conversations about, where we did good and where we did bad. and

then if we do bad, how do we get better? and make sure I have the buy in from my

leadership to or for my stakeholders for the various projects and initiatives we

do. Sure. Some of the technical stuff is something that I think we're hired to

do like installing network and maintain that. But what I'm talking about is more

around projects that has a deeper impact on the business, like the ERP project

and or the HR project. Listen, I was spearheading the meetings, the demos, the

RFP process with multiple vendors. But at the end of the day, it was HR or

finance final decision on which product they want to go with. They play a very

important role in getting the requirements right, getting the demos right,

getting the questions right, and then picking a system that they believe is the

best suited for their operations. And then we will help implement it and help

managing that part of the process as well. And then the user adoption is always

a challenge, but that's really how I would recommend most people, deal with,

making sure that the business and the stakeholders are involved in as many

decisions as possible so we can help grow the organization.

Mike Kelley: Well, and it's awesome advice because the more that we involve the

leaders of these different groups that we're trying to help with technology, the

better informed they are, then they bring more of their people into the

discussion. And those people get a chance to have a say in which product we're

choosing and implementing for them. and that it's on target for what they're

trying to accomplish and how it affects their day to day. So you get that buy in

at the beginning instead of trying to train it in after the fact, because trying

to train. By in. I have yet to hear anybody run a course on how to train by in.

Mikkel Finsen: Yeah, I'm not sure it's something you can train on. It's more of

how you tell stories, how you interact with your peers and your leaders.

Mike Kelley: Yeah. I promised you a question at the beginning of this. And so

now I think it's about time to find out. Make a prediction. What do you think

that we might be talking about as it leaders in eighteen months, that we're not

talking about today? what's your prediction?

Mikkel Finsen: I do think AI is going to be talked about again in twelve to

eighteen months. I don't think it's going to be heavily deployed as some gurus

say it will be. And I think it's something we need to take stock of in twelve or

eighteen months time and really assess where are we with the whole AI

conversation, the whole AI data centers, the whole AI governance, the whole,

data management within AI, I think we've given it too much free reign. And I

think we need to figure out a way of getting some control of, AI and how it's

actually deployed. everybody can sit on their lounge chair in a garden and just

do nothing while AI is working. we still have to learn, we still have to skill

up our staff. And we still have to make sure that the AI tools actually work the

way we want them to work. And you can have twenty year old kids writing AI

agents, but at the same time, someone needs to understand the end to end process

in order for it to make sure that the data that comes out of the AI is actually

validated somehow. and so that's where I think in twelve months time, we're

going to have to have a, not a reset, but certainly a reality check on where we

are with AI and how it's operating within the governments, within healthcare,

within businesses in general.

Mike Kelley: Yeah. I tend to agree on that one. any final parting thoughts?

Anything you want to leave your peers with or you got any side projects or

personal projects that you want to promote?

Mikkel Finsen: Work life balance often changes when you move into a

non-for-profit. Right now I'm able to help my team at least try to work nine to

five. Spend time with their families and friends over the weekends. We try to

avoid having projects running over the weekends or nights. It will happen with

certain, changes and stuff like that, but by and large, we try to do everything

nine to five. Whereas in corporate America, often you could easily work, sixty

or seventy or eighty hours a week, and get calls on Saturdays and Sundays from

around the world, which destroys your work life balance and which I think is

important.

Mike Kelley: I fully agree on that, that work life balance. As a young man, I

went to one extreme and now as I'm getting a little on or long in the tooth, as

I like to say, I definitely think that it's one of the most important things

that we can protect for ourselves and for our teams is that work life balance.

Mikkel Finsen: Yeah. And I think it's important to show the younger generations

as well as you can still achieve a lot of things within the normal time span and

just plan differently and plan it out based on the workloads we have. And then I

think that would help them a lot.

Mike Kelley: Yeah. That's a challenge though. Learning how to plan all of that

out and to achieve those goals. But like you were talking about with your team

in Ireland, meeting those goals is, paramount.

Mikkel Finsen: Yeah, it absolutely is.

Mike Kelley: Mikkel, thank you very much for your time and your experience. We

truly appreciate that and hope to see you and more, of the listeners at

youvebeenheard.com community, please stop by, join us, listen in or join in on

the conversation. Help us talk about these kinds of topics and the best ways to

handle them. There's so much that we can teach each other without having to

compete with each other, which is nice.