Risk Never Sleeps Podcast

Episode #104: Virtualized Endpoints—A New Era in Healthcare Cybersecurity

Guest: James Millington, VP of Product Marketing & Industry Solutions, IGEL Technology
Host: Ed Gaudet, CEO & Founder, Censinet
Date: October 31, 2024

Episode Overview

In this wide-ranging and highly engaging episode, host Ed Gaudet welcomes his longtime friend and industry peer, James Millington of IGEL Technology. The conversation centers on the evolving world of healthcare endpoint security, the adoption of virtualized endpoints, and their impact on protecting patient safety in an increasingly digital world. The episode’s tone is energetic, candid, and sprinkled with personal anecdotes, music banter, and career insights—offering listeners a unique blend of technical expertise and human stories.

Key Discussion Points & Insights

1. James Millington’s Background and IGEL’s Role in Healthcare (01:08–04:09)

• James’s Journey:

  • Started at Citrix in 2000, focused on product management and integration with EHRs (Epic, Cerner).
  • Went on to Imprivata, engaging deeply in provider workflows and security solutions.
  • Later, worked at VMware leading healthcare solution marketing.
  • Always involved in healthcare, always from the vendor side.

• About IGEL:

  • German-founded company with strong U.S. healthcare presence.
  • Transitioned two years ago from thin client hardware to a dedicated secure endpoint operating system.
  • "The IGEL OS has never been compromised in a cyber attack." (06:00, James Millington)
  • Company name means “hedgehog” in German—a fun fact that kicks off the episode’s informal rapport.

2. The Challenge of Endpoint Security in Healthcare (04:17–11:13)

• State of Attacks & Rationale for Virtualization:

  • Many successful cyberattacks in healthcare are preventable.
  • Healthcare has long used virtualized applications, yet many still run Windows at the endpoint.
  • "If you’re not running your Windows applications at the endpoint ... then you really don’t need to run Windows at the endpoint because it’s costly, it’s complex, and it’s vulnerable." (04:43, James Millington)
  • Thin clients, and now IGEL’s secure OS, remove endpoint data risks.

• Residual Inertia in IT:

  • Resistance to changing from Windows endpoints due to familiarity and established practice.
  • Encourages leadership to reconsider in light of peer experiences within organizations like CHIME.

• Cost and Complexity:

  • Up to 40% of the endpoint budget is spent on endpoint security software and its management.
  • "There is a ton of overlapping software solutions that are put at the endpoint. That takes a lot of your budget and it takes a lot of the resources on the endpoint to actually run that." (09:29, James)

• CrowdStrike Outage Anecdote:

  • James recounts a recent severe industry-wide outage. A major healthcare org with 1,000 IGEL endpoints saw no impact during the CrowdStrike incident, while healthcare providers nationwide experienced disruptions.
  • "Not one of those [IGEL] was impacted… No downtime. ER was full all morning. No impact on patients." (12:20, James)

3. Humanizing the Technology: Workflow and Provider Perspectives (07:17–08:40)

• Providers Want Reliability:

  • "The providers themselves ... they just want... this stuff just needs to work." (07:26, James)
  • IT often resists due to established routines, not evidence.

• Clinical Continuity:

  • Virtualized, stateless endpoints offer patient data protection, operational resilience, and rapid recovery.

4. Sustainability and Total Cost of Ownership (TCO) (09:10–11:13)

• IGEL’s solution also promotes device longevity and sustainability.
• By cutting down the endpoint software stack, organizations can reallocate budget to other necessary cybersecurity protections.

5. Personal Stories, Passion Projects, and Career Advice (13:25–39:11)

Transition to Personal Insights

• The episode moves seamlessly from technical content to personal anecdotes.
• James’s Passion: Scuba diving, liveaboard travel, and the broadening effect of sharing hobbies with friends and family.
  • "Very peaceful... very in the moment, very present, very mindfulness." (16:53, James)

Proudest Moments & Lessons from Healthcare IT (17:14–20:00)

• James shares moving stories about healthcare IT enabling meaningful patient experiences, including a tale about children connecting with estranged parents thanks to in-room technology.
• "It wasn’t anything I did but ... maybe I played a little part in a really good thing." (19:09, James)

The Unique Demands of Healthcare as a Sector (20:00–21:47)

• Healthcare technology requires total commitment and a willingness to learn afresh.
• "If it’s transactional, you’ll never succeed in healthcare. And so that shared mission is real." (20:37, Ed)

The Nature of Risk and Career Lessons (22:04–24:22)

• Most “risky” moves are mitigated by knowledge and preparation (James relates this to shark diving).
• Hardest career lesson: always double-check data!

Fun and Camaraderie: Tales from the House Band (24:25–36:38)

• Recollections of performing in a company band—photos, surprise screen shares, and stories of ‘auditioning’ Ed for stage performances.
• "If something sounds a little too good to be true, it probably is." (24:19, Ed & James)

Desert Island Albums & Karaoke (28:06–33:56)

• Lively discussion of musical favorites (Prince, Led Zeppelin, house music), culminating in an impromptu duet of "Champagne Supernova."
  • "How many special people change? How many lives are living strange? Where were you while we were getting high?" (31:06, James—singing)

6. Advice for Entering Healthcare & Cybersecurity (34:06–39:07)

• Career Advice:

  • "Find something that makes you stand out... Find that thing that’s unique about you that you love ... embrace your weird." (34:56–35:39, James)
  • Authenticity and passion are key differentiators.
  • Personal projects and non-traditional skills can open unexpected doors.

• Empowering Others:

  • The story of hiring based on a candidate’s passion-project blog, and the culture-building effect of creative, non-work pursuits (like company bands).

Notable Quotes & Memorable Moments

• "The IGEL OS has never been compromised in a cyber attack."
  —James Millington (06:00)
• "If you’re not running your Windows applications at the endpoint ... then you really don’t need to run Windows at the endpoint."
  —James Millington (04:43)
• "Not one of those [IGEL] was impacted… No downtime. ER was full all morning. No impact on patients."
  —James Millington (12:20)
• "If it’s transactional, you’ll never succeed in healthcare. And so that shared mission is real."
  —Ed Gaudet (20:37)
• "Find that thing that’s unique about you that you love, that can be a quirk, that can be something that is a reason that people are going to employ you and notice you ... embrace your weird."
  —James Millington (34:56–35:42)
• "How many special people change? How many lives are living strange? Where were you while we were getting high?"
  —James Millington (31:06, singing "Champagne Supernova" with Ed)

Timestamps for Key Segments

• 00:00 – Opening/intros, guest background
• 01:08–04:09 – James’s healthcare journey & IGEL’s evolution
• 04:17–11:13 – Cybersecurity landscape, endpoint virtualization, TCO
• 12:20 – CrowdStrike outage anecdote
• 13:25–17:14 – Personal aspirations, scuba diving
• 19:09 – Emotional story about IT’s impact on patients
• 20:00–21:47 – What makes healthcare IT unique
• 22:04 & 24:19 – Risk-taking and career lessons
• 24:25–36:38 – Band memories & music chat
• 31:06 – Champagne Supernova duet
• 34:06–39:07 – Advice to new professionals, authenticity

Tone & Style Highlights

• The episode is informal, energetic, and marked by deep familiarity between host and guest.
• Technical explanation alternates seamlessly with humor, nostalgia, and genuine emotion.
• Listeners gain both practical insights and a sense of the camaraderie, purpose, and “human element” that makes healthcare cybersecurity a uniquely rewarding—and fun—mission.

Conclusion

This episode offers a compelling look at the critical and often-overlooked role of endpoint security in healthcare, making the case for virtualized solutions like IGEL’s. Through engaging storytelling and candid career advice, Ed and James inspire listeners to rethink risk, embrace personal uniqueness, and consider the real-world impact their work can have on patient lives. The conversation is not just about technology—it’s about culture, passion, and purpose.