Episode #201. The Day the System Goes Dark: Are You Ready? with Andrea Steele, the Associate Vice President of Information Technology and Business Intelligence for the Health Care District of Palm Beach County

Summary

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Podcast Summary: Risk Never Sleeps – Episode #201

“The Day the System Goes Dark: Are You Ready?” with Andrea Steele
Host: Ed Gaudet
Guest: Andrea Steele, Associate VP of IT & Business Intelligence, Health Care District of Palm Beach County
Date: March 30, 2026
Recorded Live at: ViVE, Los Angeles

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Episode Overview

In this insightful episode, Ed Gaudet welcomes back Andrea Steele, a seasoned healthcare IT and cybersecurity leader, to discuss preparedness for major system outages—the day “the system goes dark.” Fresh off a panel at ViVE discussing cybersecurity and AI, Andrea shares practical strategies for building resilience, the importance of disaster recovery and business continuity testing, navigating the fast-evolving AI landscape in healthcare, and lessons from her career in healthcare IT leadership. The conversation is candid, informative, and peppered with personal stories and practical advice for current and aspiring healthcare technologists.

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Key Discussion Points & Insights

1. Panel Takeaways: Cybersecurity, AI, and Resilience

[04:15]

• Resilience & Continuity Testing:
  Andrea stresses the importance of actually testing business continuity and disaster recovery plans:

  “It’s not really if we’re going to go down, but when we’re going to go down. So what are we doing to proactively make sure that we’re ready for that?” (Andrea Steele, 04:15)

• Consolidating Functions:
  Ed and Andrea discuss the need to move continuity and recovery efforts out of operational silos and bring in more buy-in from clinical and operations teams, even though it disrupts their routines.
• Getting Operations On-Board:
  Andrea notes the challenge but necessity of engaging operations for regular downtime drills, ideally outside patient care hours.

  “Having those tough conversations to get them on board… even if it impacts their time and their patient care.” (Andrea Steele, 04:40)

2. Andrea’s Career Journey and Leadership Perspective

[05:22]

• Andrea is on the lookout for her next leadership chapter—possibly a CISO or CIO role. She prefers the CISO role for its focus:

  “The CIO role can get just like a little scattered. So I like that you can focus quite a bit more with the CISO role.” (Andrea Steele, 05:35)

3. AI’s Impact in Healthcare IT

[05:51], [06:16]

• Both guests discuss emerging risks and opportunities in the use of AI, particularly concerning SaaS contract repositories:

  “If you’re going to purchase a new software to house all of your contracts, what is that actual SaaS based company doing to protect the data that is stored in it?” (Andrea Steele, 06:16)

• Shadow AI:
  Andrea recommends leaders “get out there and talk to the people and understand what they’re doing”—since shadow AI adoption is happening outside IT’s line of sight.

  “Having good relationships with people and … getting them to talk to you… is probably going to be the fastest way for you to figure out what shadow AI is out there, what people are wanting, and how do we get to yes. Safely.” (Andrea Steele, 06:53)
  Ed echoes: “Get to yes. Safely. I love that.” (07:26)

4. Personal Stories: From Laundry Duty to Healthcare IT

[07:33]

• Andrea’s introduction to healthcare came early, washing laundry for her mother’s physical therapy office:

  “I started doing laundry for the physical therapy office when I was 12.” (Andrea Steele, 07:33)

• She’s motivated by the mission-driven nature of healthcare and the challenge of driving change in a traditionally slow-moving sector.

  “By the time I finished my MBA, I actually felt like, what can I actually do to change healthcare? It’s years and years in the making and it’s very archaic and slow to change.” (Andrea Steele, 08:10)

5. The Challenge of Change and Resistance in Healthcare

[08:31]

• Healthcare’s notorious resistance to change is dissected, with Andrea partly blaming insurance companies for complexity and inertia:

  “Can I blame the insurance company?” (Andrea Steele, 09:36)

• Ed points to complexity: “The workflows, the transactions are complex and … it’s just part of the overarching problem.” (Ed Gaudet, 09:49)

6. Adventures, Risk, and Staying Curious

[10:09]

• Andrea shares her love of skiing, adventure, and willingness to try new things—qualities she also champions in professional life. She’s heli-skied once and wants to try “skijoring”:

  “Where a horse pulls you on your skis. Kind of like skiing, but you can go over jumps.” (Andrea Steele, 11:04)

• The value of risk-taking and curiosity are recurring themes.

  “Stay curious.” (Andrea Steele, 12:48)

7. Advice for Next-Gen Healthcare Professionals

[12:00]

• Andrea encourages newcomers to the field to start anywhere, even if it doesn’t seem directly related; passion, curiosity, and willingness to learn are key.

  “Even if it’s starting out working in the hospital cafeteria while you… work on your medical assistant degree… have a willingness to learn. There are people out there who are willing to hire eager folks.” (Andrea Steele, 12:00)

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Notable Quotes & Memorable Moments

• “It’s not really if we’re going to go down, but when we’re going to go down.” – Andrea Steele [04:15]
• “Get to yes. Safely.” – Andrea Steele [06:53]
• “I started doing laundry for the physical therapy office when I was 12.” – Andrea Steele [07:33]
• “Why are people so reluctant to change in healthcare?” – Ed Gaudet [09:17]
• “Stay curious.” – Andrea Steele [12:48]

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Important Timestamps

• [04:15] – Resilience and the inevitability of system downtime
• [06:16] – AI/contract repository security concerns
• [06:53] – Advice about ‘shadow AI’ and building trust
• [07:33] – Andrea’s origin story in healthcare
• [09:36] – On change resistance and blaming insurance companies
• [10:09] – Adventures, risk-taking, and embracing novelty
• [12:00] – Career advice for newcomers

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Tone and Style

The episode is conversational and candid, mixing professional insights with humor and personal stories. Both Ed and Andrea keep the tone approachable, practical, and optimistic—even when confronting industry challenges.

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In Summary

This episode is a must-listen for healthcare IT professionals seeking practical wisdom about building resilience in the face of outages, navigating the risks of rapid AI adoption, and moving beyond ingrained resistance to change in healthcare. Andrea Steele’s journey—driven by curiosity, mission, and a spirit of adventure—offers strong inspiration for leaders at every level.

Enduring Message:
Stay curious, stay prepared, and always get to ‘yes’—safely. Because in healthcare, risk never sleeps.

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Transcript

[A]

Foreign.

[B]

Welcome to Risk Never Sleeps, where we meet and get to know the people delivering patient care and protecting patient safety. I'm your host, Ed Gaudet.

[A]

Welcome to the Risk Never Sleeps podcast in which we learn about the people that are on the front lines protecting patient safety and delivering patient care. And boy, do we have a guest today. Live from Vive in Los Angeles, Andrea Steele, an old time friend. Customer. Right. Guest on the podcast. How many years ago? A year ago. Two years ago.

[C]

Probably a year and a half.

[A]

Year and a half ago. And you're here at Vive. We had dinner last night. It's good to see you. Good to see you. Now, I know this is a little impromptu, but we'll keep it fresh and alive. And you're on a bit of a journey right now. Absolutely.

[C]

I just came off the stage talking about cybersecurity and AI, so I'm also on a bit of a high right this moment.

[A]

Yeah. So talk to me about that.

[C]

Oh, it was awesome. I got to be interviewed alongside a couple colleagues. Jason, he did a great job. There were a ton of people out in the audience that I could barely see after the blinding light, but it was a lot of fun.

[A]

Yeah, it's a little intimidating how when you look out there and you shall speed well, Tim.

[C]

And wondering what they're thinking.

[A]

Yeah, yeah, yeah. And do I sound good? Was it a panel?

[C]

It was.

[A]

How many folks were on it?

[C]

Three panelists and then the interviewer.

[A]

Yeah. Who are some of the other folks that joined you?

[C]

Oh, my gosh. Totally blank.

[A]

That's okay. But just, you know, companies or industry or.

[C]

Baptist health.

[A]

Oh, yeah.

[C]

So Jacksonville.

[A]

Okay.

[C]

And another gentleman from Georgia.

[A]

Oh, was it James Case from Baptist? Oh, yeah, James. All good. He was supposed to come to dinner last night, but he was late. He was delayed.

[C]

I know. He told me all about it. He got rerouted through. Instead of Atlanta, he had to go to Chicago.

[A]

That's right. Yeah.

[C]

Yeah.

[A]

I got in midnight or something crazy.

[C]

But he did great.

[A]

Did he? Yeah. We're getting killed in Boston right now. A couple feet of snow. Two, three. Right. Connecticut, too, I think. Yeah.

[C]

I've got four feet up in Green Valley Lake here in California.

[A]

Whoa. So you're from California?

[C]

Yes.

[A]

Where? Green.

[C]

Green Valley Lake, which is on the way to Big Bear.

[A]

Oh, Big Bear. Oh, do you ski?

[C]

Yes.

[A]

Oh, it's so beautiful. Like when I drove in from the airport and the mountains were just covered with white, and yet that juxtaposition of the palm trees and the. Just so wonderful. Do you Grow up here?

[C]

No, I grew up in Oregon.

[A]

Oh, okay. That's still nice up there. When you're not working, what do you like to do? What are you passionate about? What are some of your hobbies? So what do you like to do when you're not working? Ski.

[C]

Yes. Lots of skiing. And I've been teaching my boys since they were probably three.

[A]

Ah, downhill.

[C]

Yes.

[A]

Okay. What kind of skis you have?

[C]

Oh, my gosh, they're Atomics.

[A]

Oh, nice. Yeah. So you're good. I bet. Black diamonds. You do Glades? Yeah, nice.

[C]

I do. I grew up actually across from a gentleman who was in the Olympics. So I got to go up to his cabin on manhood, periodically ski with his kids so that he could train.

[A]

Wow. And you said boys or.

[C]

I have two boys.

[A]

Two boys. Eight and eight and ten. Ten. Oh, great. Ages. Oh, you want to just keep them those ages? I do, yeah. But boys will be good. I had three girls and they were. They put me through hell, I mean. Oh, just kidding. We'll have to cut that out. No, they were good kids. It's interesting when you have multiple children, the different personalities, right?

[C]

Definitely.

[B]

Yeah.

[A]

And they're so different.

[C]

Absolutely.

[A]

And yet you're the person guiding them. And so you think they'd come out and develop the same way, but they don't.

[C]

Not at all. My older one is very creative, and my younger one is. He's like, amazing at everything that he puts his mind to.

[A]

Yeah, pretty.

[C]

Pretty awesome.

[A]

Yeah. So what was one of the takeaways from the panel that you kind of maybe stopped to make you think a little more? What? Some of the things that people said

[C]

mostly around resilience, making sure that we're actually testing our business continuity and disaster recovery plans, not because it's not really if we're going to go down, when we're going to go down. So what are we doing to proactively make sure that we're ready for that?

[A]

Do you think now that we know that, that we'll start to consolidate some of those functions and not keep them in separate silos?

[C]

Absolutely. And it's really also making sure that you have the operations buy in to be doing that testing more often, too. So having those tough conversations to get them on board for making sure that we prepare, even though, you know, it impacts their time and their patient care, because they have to, you know, go on sort of a pretend go downtime. But can we be doing that between the hours of, say, 1 and 5am yeah.

[A]

How long are you here for?

[C]

All week.

[A]

All week. What are you looking to take out of this show, this event?

[C]

Probably just increased knowledge, meeting people, having these types of conversations and whatever's next for me.

[A]

Yeah. You're on your next chapter, right? New journey. What are you looking for?

[C]

I am looking for another either CISO or CIO role.

[A]

Leadership role. Yeah. Yeah. What do you like about the CISO role?

[C]

I like that it is a little more focused than the CIO role. The CIO role can get just like a little scattered. So I like that you can focus quite a bit more with the CSO role.

[A]

Have you been learning about AI on this trip?

[C]

I have, yes.

[A]

I hope so.

[C]

And we were talking about it actually last night at dinner about using chatbots to review contracts. And then we were also just talking on stage about what are say, for example, the contract repository companies doing to protect their contracts since that's kind of the keys to the kingdom, right?

[A]

Yeah.

[C]

So if you're going to purchase a new software to house all of your contracts, what is that actual SaaS based company doing to protect the data that is stored in it?

[A]

Yeah. And really surfacing some of those terms that can cause risk to your business, like exclusivity clauses, AKA change healthcare. Right?

[C]

Yeah.

[A]

Really getting your arms around the systemic risk based on consolidation of vendors and products and things of that nature.

[C]

Yeah.

[A]

What advice do you have for CISOs or CIOs right now that are on their AI journey?

[C]

I think it's really get out there and talk to the people and understand what they're doing. Because there is a lot of shadow AI out there. And the only way, not the only way, there are tools coming down the pipeline to look for that. But really like having good relationships with people and understanding what they are doing and getting them to talk to you about it is probably going to be the fastest way for you to figure out what shadow AI is out there, what people are wanting and how do we get to yes. Safely.

[A]

Yeah. Get to yes. Safely. I love that. Yeah. All right, some personal questions. How'd you get into healthcare?

[C]

So my mom was a manager for a physical therapy office and I started doing laundry for the physical therapy office when I was 12.

[A]

Wow.

[C]

So she would bring it home, I would wash it, fold it and she would take it back the next day.

[A]

Yeah.

[C]

And my sister is also an aprn. She works in the federally qualified healthcare world. So I think it's just, you know, three quarters of my family.

[A]

What do you love about healthcare?

[C]

I love the mission. I love the fact that everyone, we all have to use healthcare.

[A]

Yeah.

[C]

So what can we do to make it better? That's why I got my MBA in healthcare administration. And it's funny because by the time I finished my mba, I actually felt like, what can I actually do to change healthcare? It's years and years in the making and it's very archaic and slow to change. Slow to change.

[A]

Yeah.

[C]

But I do feel like I'm making a difference. And then every time I have my own healthcare experience or my kids healthcare experience, like the cast that my 8 year old just got on his ankle, it's really, you know, interesting to be the observer. So on the patient side. And what can we do to make

[A]

this better and to experience all the inefficiencies that exist? My gosh. Yeah. It's crazy. You think with all the technology and advancements we've made over the last decade, it would be easier?

[C]

You would think. But I think there's some sort of resistance to change as well within healthcare. So other industries are changing more rapidly. Why aren't we?

[A]

Why aren't we?

[C]

There's resistance.

[A]

Yeah. I've thought about this often about the resistance in healthcare and I just try to pinpoint why are people so reluctant to change in healthcare.

[C]

It's hard.

[A]

Well, change is hard, but change exists in financial services and other industries. Right?

[C]

Yeah.

[A]

Why so slow in healthcare? You think?

[C]

Can I blame the insurance company?

[A]

You can, yeah. Okay, let's blame them. Damn insurance companies. That's probably part of it. The workflows, the transactions are complex and

[C]

it's just part of the overarching problem.

[A]

Yeah.

[C]

Of the state of health care in the United States.

[A]

Yeah. We need to sort of flush and start new, Right? Yeah. Okay. Ski. What's the riskiest thing you've ever done? Do you ever. Helicopter ski. Sky typing. Andrea. Whoa. That's good. How many times?

[C]

Only one.

[A]

Okay.

[C]

But I don't know, is that risky, bungee jumping or did you bungee jump too? Not yet, but it's on my radar of things to do.

[A]

Yeah.

[C]

I think you've ever done.

[A]

Bungee jumping is probably the riskiest thing. I've done a lot of risky things that I can tell you about. Probably repel out of a helicopter.

[C]

Would you jump out of a helicopter on skis?

[A]

I would, yeah. I mean, I wouldn't now, but I would have. When I was younger, I was gonna go to jump school, airborne school, but I.

[C]

Cool.

[A]

Yeah.

[C]

I didn't. I would like to jump out of a helicopter and skis.

[A]

Yeah.

[C]

So that's a bucket list item yeah,

[A]

because that's fresh snow. Like you're. No one else has skied there before you. It's kind of cool.

[C]

Yeah.

[A]

You've been to Utah skiing.

[C]

I have Snowbird.

[A]

Me too.

[C]

Yeah. Ulta and Ulta.

[A]

Me too.

[C]

Nice. You know what? I really want to try skijoring.

[A]

What is that?

[C]

Where a horse pulls you on your skis. Kind of like skiing, but you can go over jumps.

[A]

Oh, my God, that sounds risky. Skidoring.

[C]

Skijoring. I think it's Scandinavian skid.

[A]

You ought to look that up.

[C]

They offer it now in Wyoming.

[A]

So they do. It's just in Wyoming.

[C]

I mean, I found it in Wyoming. To go.

[A]

No other state. No, that's. I gotta check that out. That's crazy. Yeah, no, I would do that. I would do the helicopter thing. What I loved about Alta and Snowbird was going on the first runs with the ski patrol. Have you done that? Oh, that's majestic. Because you check for avalanche, but then you get to see the sunrise over the mountain.

[C]

It sounds amazing.

[A]

Yeah, you should do that if you get a chance ever. All right. What advice would you have to someone coming out of school that wants to get into healthcare or it or both?

[C]

Be willing to take the job that even if you don't think it's going to lead to anything, just get in there and learn. So even if it's starting out working in the hospital cafeteria while you say, work on your medical assistant degree or, you know, if you're coming straight out of nursing school, consider administration in addition to patient care and really get into the data and paying attention to how to make data driven decisions. If you want to specifically get into it. Even if you don't have training, have a willingness to learn. There are people out there who are willing to hire eager folks.

[A]

Curious.

[C]

Yeah.

[A]

Yeah. Stay curious.

[C]

Yeah. Actually, Blaine was talking about that last night. The willingness to hire anybody who is just willing. Hungry to learn.

[A]

Yeah. Really has that gene, that curiosity gene, which many people don't have. Again, another weird oddity.

[C]

Yeah.

[A]

Right. Afraid to change, not curious.

[C]

Agreed. There's fear there, I think.

[A]

Fear? Yeah. People have to get over their own fear. They need to bungee jump. Jump out of helicopters with skis on. All right, Andrea, a pleasure to see you and to talk to you today. This is Ed Gaudette from the Risk Never Sleeps podcast. If you're on the front lines protecting patient safety and delivering patient care, remember to stay vigilant because Risk never sleeps.

[B]

Thanks for listening to Risk Never Sleeps for the show. Notes, resources and more information and how to transform the protection of patient safety. Visit [e-mail] that's C-E N S I N E T dot com. I'm your host, Ed Gaudet. And until next time, stay vigilant, because risk never sleeps.