Risk Never Sleeps Podcast – Episode #142

"Code Meets Clinic: Hacking Healthcare with Humanity"

Guest: Dr. Joseph Izzo, Emergency Physician, Kaiser Permanente and CMIO, San Joaquin General Hospital
Host: Ed Gaudet
Date: September 18, 2025

Episode Overview

In this episode, Ed Gaudet sits down with Dr. Joseph “Joe” Izzo, an emergency physician and Chief Medical Information Officer (CMIO) at San Joaquin General Hospital. Their conversation explores the intersection of clinical practice and health IT, the evolving role of the CMIO, the promises and potholes of AI and data innovation, and how to responsibly protect both patient data and patient care. The episode blends practical insights with humor and humanity—peppered with anecdotes about cross-country moves, pizza, dogs, and the importance of keeping musical hobbies alive.

Key Discussion Points and Insights

1. Dr. Izzo's Background and the CMIO Role ([00:54]–[03:35])

• Dr. Izzo describes his dual career path: starting with C programming, moving into emergency medicine, and then bridging both worlds as a clinical informaticist.
• Quote:
  “I’ve always sort of straddled those two areas, but makes us good to be liaisons between the two sides. … We mostly work with EMR optimization, so certainly now with AI, we’re focused on that as well and other areas that pertain to data.”
  —Dr. Joe Izzo [01:28]
• He discusses the ongoing need for “liaisons” who can mediate between IT staff and clinicians.

2. The Core Mission: Patient-Centered Technology ([03:35]–[04:17])

• Both speakers emphasize that, whether in cybersecurity or tech innovation, the focus is always patient safety and outcomes.
• Quote:
  “I think the core of everything is still the patient. Even if it’s cybersecurity or data innovation, you’re doing it predominantly for the patient.”
  —Dr. Izzo [03:42]

3. Organizational Initiatives and Emerging Risks ([04:18]–[05:43])

• Dr. Izzo highlights his focus on building an empowered team with dual expertise.
• Top priorities:
  • Pushing innovation, especially around AI pilots.
  • Preparing staff to confidently perform forensics and audit data access.
  • Leveraging population health data for improved outcomes.
• Quote:
  “We’re able to leverage population-level health … whether that’s access to care, better recovery, earlier discharge. And I think that’s untapped. I mean, there’s so much more coming into that space.”
  —Dr. Izzo [05:17]

4. AI Governance: Building Policies and Sandboxes ([05:43]–[08:51])

• Dr. Izzo describes the rapid formation of an AI governance committee, prompted by the need to consider AI-based scribe technology.
• Their approach included all stakeholders: executive, clinical, risk, and medical records teams.
• They established policy quickly, enabling responsible AI adoption for various workflows (computer-assisted coding, patient outreach, etc.).
• Quote:
  “Having something in place to understand how to approach that made us able to go … not just with scribes, but some other rollouts like computer-assisted coding, patient outreach … That seems to be what works best.”
  —Dr. Izzo [07:23]
• On sandboxes: They use synthetic data and APIs in an offline sandbox for resident training and experimentation, keeping real patient data safe.

5. The Importance of Responsible AI Adoption ([08:51]–[09:49])

• Challenge: Increasing accessibility of AI tools (e.g., inexpensive or free scribe software) amplifies risk if not properly governed.
• Quote:
  “It’s a big responsibility to be using these tools and the vendors are very smart in making sure they distribute onus, you know.”
  —Dr. Izzo [09:29]
• Theme: The need for governance is urgent—for safety and trust.

6. Physician Involvement in Technology Decisions ([09:49]–[10:03])

• Attending tech conferences as a team ensures varied clinical perspectives influence decisions, avoiding “fruitless avenues.”

7. Career Reflections and Advice to Younger Self ([10:03]–[11:18])

• Dr. Izzo encourages clinicians with tech interests not to feel discouraged, noting the emergence of new specialties and niches like clinical informatics.
• Quote:
  “If this is your interest … you’re still doing something that affects positively patient care, and maybe even more so if it’s at the system level.”
  —Dr. Izzo [11:04]

8. Risk-Taking: Personal Stories ([11:34]–[12:27])

• Dr. Izzo shares his biggest personal risk: leaving lifelong East Coast roots for California, with only a week to start his first attending job.

9. Life Beyond Medicine: Culture, Music, and Roots ([12:33]–[17:38])

• Dr. Izzo and Ed compare East Coast vs. West Coast lifestyles, especially the food and the night life.
• Dr. Izzo’s music background: played bass (including baroque styles!) and was in a med school band covering Green Day and others.
• Desert island albums include American Idiot and Dookie by Green Day, a Taylor Swift album, and a Star Wars soundtrack.

10. California Living & Personal Interests ([17:38]–[19:42])

• Highlights of Dr. Izzo’s life in California: frequent outdoor activities, hiking, traveling with two adopted hound-mix dogs (rescued and reunited siblings from Hawaii), and favorite local spots.

11. Advice for Non-Clinicians Entering Healthcare and Cybersecurity ([20:06]–[21:10])

• Dr. Izzo encourages maintaining unique interests, citing how many students come from atypical backgrounds and that diversity ultimately benefits care and administration.
• Quote:
  “Don’t lose that niche interest … It probably will make you at the end of the day a better clinician—or conversely, a better administrator, if that’s the path you choose.”
  —Dr. Izzo [20:58]

12. Closing Thoughts: The Joy of the Journey ([21:10]–[22:54])

• Life and career in healthcare and tech are unpredictable journeys; embracing nontraditional paths can lead to rewarding outcomes.
• Ed shares his own story, from technical writing to product innovation, with a poetic detour recognized by JAMA.
• Both praise safe automation and teamwork in healthcare technology as the core of innovation.

Notable Quotes and Memorable Moments

• “The core of everything is still the patient. Even if it’s cybersecurity or data innovation, you’re doing it predominantly for the patient.”
  —Dr. Joe Izzo [03:42]

• “We want tools, we just want them in a way that we feel safe.”
  —Dr. Joe Izzo [09:41]

• “Don’t lose that niche interest that you have because it probably will make you at the end of the day a better clinician or … administrator.”
  —Dr. Joe Izzo [20:58]

• Musical aside:
  “I had a band in medical school … rock, like Red Hot Chili Peppers, Green Day …”
  —Dr. Joe Izzo [15:34]

• Risk and resilience:
  “It was a Toyota with a U Haul … That somehow made it to California with less than a week before my first attending shift, which … is quite daunting.”
  —Dr. Joe Izzo [12:09]

• New specialties, new paths:
  “Many specialties became cemented—you know what I mean? … Just like clinical informatics as a formal pathway for a physician.”
  —Dr. Joe Izzo [10:57]

Timestamps for Key Segments

• [00:54] Dr. Izzo’s intro & dual career roots
• [03:35] The role of the CMIO and teamwork across departments
• [04:26] Tech initiatives, AI, and data innovation at San Joaquin General
• [05:54] Formation of AI governance committee
• [07:46] Physician engagement in tech, conferences, and workflow feedback
• [08:06] Sandboxes for responsible AI experimentation
• [09:12] AI tool risks, onus, and the urgency of governance
• [10:32] Advice to younger self and embracing “niche” interests
• [11:42] Riskiest life decision: moving cross-country for medicine
• [12:41] Life comparisons: NJ vs CA, pizza, and lifestyle
• [15:03] Dr. Izzo’s music passions
• [18:15] Life in California: dogs and outdoor activities
• [20:23] Advice to non-clinicians breaking into cybersecurity/healthcare
• [21:48] Ed’s surprise poetry publication in JAMA
• [22:32] Informatics and the joy of “safe automation”

Final Takeaways

• Bridging the gap between clinical care and IT is both challenging and crucial for patient safety—requiring strong governance, trust in leadership, and a culture of innovation.
• Responsible AI adoption starts with policies, cross-functional committees, and “sandbox” environments for safe exploration.
• Careers in healthcare and IT increasingly reward nontraditional backgrounds and passions—whether that’s coding, music, or migrating from the East Coast for a fresh start.
• Above all, the patient remains at the center of every technological and organizational decision.