Every health system has AI pilots. Far fewer have systems that scale past them, and the difference is rarely the model. Nicole Sanders and Christine Williams left large enterprise and platform roles to start Foxtrot Services, a firm built to take AI implementations from prototype into production in regulated, high stakes environments. They work across healthcare, manufacturing, financial services, and supply chain, including the implementation work behind Surgence, the ecosystem connecting providers, distributors, and suppliers on shared supply and demand data. In this conversation they get specific about the call every CIO is weighing right now, whether to wait for the EHR vendor to build the capability or to move without them, and what it actually takes to convert saved hours into money. They also go at the part nobody puts in the case study: what compute and licensing cost at scale, why the architecture underneath determines the bill, and how permissions and governance break when a pilot becomes a system.
Nicole Sanders, Co-Founder and Co-CEO, Foxtrot Services
Christine Williams, Co-Founder and Co-CEO, Foxtrot Services
Megan Antonelli, Chief Executive Officer, HealthIMPACT Live
00:00:00 Intro: Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Jenny Sharpe and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
00:00:30 Megan Antonelli: Your AI program saved ten zero zero zero hours this year. Congratulations! Now where did they go? That question is the whole ball game and most health sims can't answer it. I'm Megan Antonelli, CEO of Health Impact Live and this is Digital Health Talks. My guests today are Nicole Sanders and Christine Williams, co-founders and co-CEOs of Fox Trot Services. They both led inside large enterprise and platform organizations before starting. A firm that does one thing gets AI implementations out of the demo and into production in the kind of regulated, high stake places where getting it wrong is not a slide. It is a patient healthcare, manufacturing, financial services, supply chain. Two CEOs, one company, and a very strong opinion about why pilots die. Hi, Nicole. Christine, welcome to the show. I'm so excited to have you on digital health talks today.
00:01:24 Christine Williams: Thank you so much. It's great to be here. Thanks, Megan. Great to be here.
00:01:27 Megan Antonelli: Yeah. So I, you know, we had a chance to chat. I love what you guys have built and I can't wait to hear about it. But we always start with what is the best room you've ever been in. We convene a lot of rooms. It can be a conference, a job, a, you know, um, a wine room in Tuscany. It doesn't matter whatever the room is. Tell us, tell us your favorite room and then tell us a little bit about how you got to the room you're in today.
00:01:55 Christine Williams: I might want to pick the wine room in Tuscany, but I actually think that the room that I'm in right now, um, has to be the best room. And, um, you know, really it's, it's, um, working inside a company where we've had the opportunity to create our own values. Um, you know, in a, in a place where people can have autonomy and can thrive. Um, you know, in this room, people are encouraged to learn, cultivate new ideas, make mistakes. Um, you know, in our leadership team in this room, there are just as many women as men. And we have this work life balance here where we're supporting people's real lives. Um, you know, we're seeing kids and pets show up on screen. We're seeing, you know, people over the weekend posting on Slack birthday parties and sporting events. Um, so, you know, recognizing that people have full lives outside of, outside of work and working hard are not mutually exclusive. Okay.
00:02:55 Nicole Sanders: Couldn't agree more. Um. The best rooms I've been throughout my career have been filled with respect. Active listening, hard work, and shared mission and vision. And so I think what's really cool is we've brought the best of all of that to create the culture here at Foxtrot, which is incredible.
00:03:14 Megan Antonelli: I love that. I mean, and it's so great to have two female founders on the show and in an environment. I mean, your backgrounds are both so impressive. Tell us a little bit about kind of where you were and, um, you know, what, what kind of had had you leave those jobs to, to start this up?
00:03:33 Nicole Sanders: I love that question. Thanks, Megan. We've known each other for over a decade, dating back to when I was at Lockheed and Christine was running a consulting shop. And then when I left Lockheed and joined Palantir in twenty twenty, I couldn't believe that that's where Christine had gone and found the people. There's a great people page there, and I was like, is On Slack again, is that the Christine Williams that I know from before. And it was. And so that was incredible. A very happy accident. And one day while we were there, we went for a walk, grabbed a coffee. And I remember very vividly we were looking over the C and O canal in Georgetown, having our coffee, having a chat. And what we chatted about was how incredible the talent was. We were surrounded by this incredible talent at Palantir. And the only challenge with that was why there wasn't enough of it to support all the growth we were experiencing. And so the kind of question we posed was, why wasn't there a company that we could count on to provide us that incredible forward deployed engineering talent? And then we put a pin in that and went back to work, of course. Um, but years later, we both moved on, Christine, to a major systems integrator. I was actually at a health tech startup and we got together for dinner and literally on a notepad, drew out the company concepts and basically said to each other, now or never. Um, that was November twenty three and we launched in December.
00:05:03 Speaker 5: Oh, wow.
00:05:04 Megan Antonelli: Yeah. That's amazing. You know, and I think, um, given your careers and where you were and kind of ending up at Palantir together, I mean, and also the timing of all of this, right? I mean, it couldn't be, um, sort of a better time to kind of be in this space. What were your, what were your backgrounds in, in college? What got you to, to those roles?
00:05:26 Christine Williams: That's a great question. It was a little bit of a journey. I started out, um, in after college, I worked for the US government, um, and focused on infrastructure and urban planning, which is what I'd gotten my master's degree in. And, um, I worked for a couple of small sort of data integration tech startups before I went into consulting. Um, so, you know, sort of pivoted my career from more consulting and international affairs over to tech and never looked back.
00:06:03 Nicole Sanders: Yeah. I was an engineer in college and, you know, went right into the engineering program at Lockheed. But at Lockheed, I would say through, you know, two decades there, um, I was in a variety of roles in business development, program management strategy and engineering and really robust leadership development and training there. And I attribute a lot of the foundational leadership skills that it took to, to be a successful founder. As to the time I spent at Lockheed learning those fundamentals, coupled with three years of really accelerated growth for myself at Palantir, where everything just moved so quickly and all of a sudden all the things you thought weren't possible before when you're in a traditional organization were possible because you are in this non-traditional defense contracting and commercial organization and the ability to move fast and still be secure and super mission focused. For me, just the mixing bowl of all those experiences was, I think, made made it possible to be a good CEO and founder with the foundations necessary to run a business, but speed necessary to run a startup.
00:07:16 Megan Antonelli: Right in a, in a such fast paced change time of, you know, sort of implementation and working with clients. And now you started and kind of had that background in financial services and, and manufacturing supply chain, obviously government with, you know, roots in the government. What has gotten you into healthcare and to sort of focus on the healthcare market?
00:07:41 Christine Williams: Yeah. I mean, I think, you know, as we look at healthcare and look at some of our clients, what they've, what they've brought to us, there's so much valuable data and expertise inside healthcare. But the systems and workflows are in just such desperate need of modernization. Um, you know, one, one area that we do a lot of work in is in supply chain and we're sort of struck by how difficult and complex that is, how badly it needs an overhaul and how disparate and disconnected the systems are. Um, and I think what surprised us is how deep that complexity goes. So it's not just like replacing some old technology, it's really about replacing all across the enterprise and how to modernize that. Because you're dealing with decades of technical debt, you're dealing with disconnected systems, you're dealing with regulations, and, you know, the high stakes of the environment. So, you know, people write off supply chain as a back office function, but it really can directly affect how, you know, whether clinicians have what they need, whether the procedures are happening on time, how much time the nurses are spending with patients. So, you know, it's such an underpinning of everything in terms of how the industry is run.
00:08:53 Nicole Sanders: I think what caught me by surprise wasn't necessarily anything about the complexity or the regulation. We all know that healthcare is a highly regulated market as it should be, but how much courage and bravery it takes for an organization to really take on healthcare innovation at scale. Um, the organizations doing this are swimming upstream again against what Christine talked about, the decades of tech debt and the strict regulations. You can't just bring in AI and have a magic wand and modernize overnight, but you still need to take advantage of this technology and the pace at which it's moving. So you're on this dichotomy of how do I maintain the robustness of my systems and adherence to these regulations, but still innovate and move fast and having to do both of those at the same time? I think it takes organizations who are really willing to focus on that mission and just knock down obstacles as they come at them. Because once you knock one down, there's just another one waiting for you and you just have to keep going. So really impressed watching our customers who do that day in and day out, get through it, get through the next thing, and just keep focused on that mission and that vision. Um, because these problems and challenges have been worked on for a long time and they won't be solved overnight. And so that perseverance is something I've really come to respect in our customers.
00:10:21 Megan Antonelli: Yeah. No, it is it's amazing. And I think, you know, a lot of during the pandemic, a lot of it became very visible, right? It sort of like the, the resilience and the grit and the work that is required to for all of these. And it was, you know, very focused on the caregiver. But it most of them, whether it's the physicians, the nurses or everyone working in administration. And, you know, your point about supply chain? It's funny, I think back, I mean, actually the first tech event we did was in supply chain because barcodes and all that, you know, RFID tech and, and that that space, it was easy to digitize. And therefore, you know, it was easy to kind of take those technologies from other places that were doing it and realize the savings. And now it is coming back in terms of how much that affects and impacts operations within an organization. Right. So, so many. And there are so many levers to which healthcare has to work on. We always talk about with the CIOs, sort of the they're changing the tires while the car is running and the car is running, and it's really fast and it's very important. It's a lot of risk involved. Right? So to that, you know, going back to kind of EHRs and the implementation and, and obviously epic being, you know, sort of the one that most health systems have have in place. But and they have a ton of tech and things that they're going to release. But when we talk to the CIOs, they talk a lot about, you know, waiting to, to implement or do they should they go to the foundation model? Should they go to vendors outside of their HR? Should they wait for that? What, what are you seeing from your side of things in terms of that cost of waiting versus implementing and moving forward to take, take advantage of the tech that's available or waiting for some of the more? Maybe not, you know, the legacy partners that they do have.
00:12:12 Nicole Sanders: Yeah. Great question. I'm certainly not an expert in EHR, but we see a lot of modernizing complex systems in situ. So when there is a legacy system and you need to modernize and you need to move fast, but you still need to make sure you retain that robustness, like I said, and my view is absolutely the EHR systems have to be modernized, but it doesn't need to be the critical path to overall and total modernization. So I like to think of things as you don't have to. It's not an or it's an. And so figuring out how to do both of these at the same time, I think is critically important. There's definitely times and places where you need to have an EHR. Something is deeply embedded in a clinical workflow. You're not just going to kind of vibe code through AI and get that right. There's places and times where you can do that, and there's places and times where you can't. So what we see in a lot of the modern technologies that are engineers deploy is the technologies can sit above the side alongside these legacy systems, and they can start to deliver value immediately while you're modernizing something that might take longer. So I think the question is, isn't do we replace it or innovate? It's how do we replace it and innovate at the same time and do both? Keep modernizing the core and use modern data and AI tools and architectures to make those systems that you have today more useful than ever?
00:13:35 Megan Antonelli: Mhm. Yeah, absolutely. And I, I and, and, and you mentioned the tech debt side of it, right? So getting the value out of the vendors and partners that you currently have. So and, and with supply chain a little bit, I know you guys work with surgeons. I think they're going to join us at Health impact in, in October. Um, tell us a little bit about, you know, their work and, and how that, that supply chain piece is working within the clinical record and the, you know, sort of the value of, of that operations and the shared view there.
00:14:08 Christine Williams: Yeah, I know, thanks for asking. They're surgeons is really doing incredible work. Um, so they are, they are driving connectivity and supply chain transparency between the providers, the distributors and the suppliers. And it's a very, very difficult challenge because letting go of kind of specific workflows and habits developed over decades was a real challenge. Um, working with all of their customers to sort of help coach them on what that looks like and what the benefits are to, to supply chain transparency has been part of their whole ethos. Um, you know, each organization has its own variation of workflow all leading to similar outcomes. So, so coaching different users on how to align on a shared platform, shared naming conventions, standardized processes has been a really, really fascinating part of what surgeons has been able to do. And, um, yeah, we're really proud to be working alongside them. They really are kind of changing the way healthcare is looking at supply chain.
00:15:06 Speaker 5: Mhm.
00:15:07 Megan Antonelli: Yeah. And then, I mean, tell us a little bit about, in terms of your backgrounds and what you've seen in the on the manufacturing side that can kind of be applied to, to healthcare? Are there lessons learned, applications, things that you've been able to sort of say to healthcare? The healthcare clients like, do this, don't do this, you know, from that side of things.
00:15:28 Christine Williams: Yeah. I mean, I think one of the things that we've, um, you know, learned from manufacturing and, and, and talk about a lot is how point solutions aren't really solutions. So if you focus on just solving one problem in isolation, there's a good likelihood that you've moved the constraint to somewhere else. And so what we really work on and work with our customers on is thinking holistically across the entire enterprise. So you can have, you know, the best warehouse management system in the world, but if it's not connected, then to the staffing, inventory scheduling, you're leaving that ROI on the table. Um, and healthcare, you know, really has the same issue. So if you're going to optimize just one workflow, that's not going to have the long term ROI or impact that you need. So we really focusing on designing how the whole system works together.
00:16:19 Speaker 5: Mhm.
00:16:20 Megan Antonelli: Yeah. Healthcare definitely has because of the sort of siloed nature of it. Right. Where, I mean, it was literally designed that way, right? I mean, the specialty medicine. And, you know, we look at that at that way, the point solution Problem is, is huge. And I do think there's so much potential with the systems that we have now because they can they just there's so much compute power and there's so much ability to kind of bring these ideas together. Now, on the other hand, there's also the security challenges and the patient identity challenges and things like that. I was writing a blog post the other day about, uh, about all of this, about where the technology has come and for, for whatever reason, it brought me back to when I went in to have my son, my second son at, well, I won't say what hospital, but either way, they had seventeen records for me, right? Because I had worked there. Now everybody knows what hospital is. Um, but I had also, you know, they merged and therefore there were, you know, two systems and I had gone to, you know, being in New York, gone to both, both of the hospitals that merged. So and I thought about that so much because that was fifteen years ago now, and that wouldn't be a problem today. Now, it still is a problem in some cases because the systems don't talk to each other. But I do think we've come a long way with how that problem has been addressed. But I'd love to have your perspective, both from the side of looking at different industries and how they've dealt with similar challenges, but what's required to, to ensure that the this foundational system is, is clean enough that when we come in and do these, it's, uh, you know, ready to go.
00:18:09 Nicole Sanders: Yeah. That's the, the beauty of modern data architectures. Um, the ability to not have to choose between speed, scale and security. You can have all of them. And any AI system that's going to work reliably at scale is going to be riding on top of a modern, secure, governed data architecture of some kind. In our firm, we. We have some expertise working in the Palantir Foundry platform as. As one of the best examples of what that data infrastructure layer might look like. And so problems like resolving patient identity over hundreds of thousands of records can now be solved securely because there are ways of controlling access at the most granular level possible within a data set governing that data. So only those agents, whether they're human agents or AI agents who need to see access to that data, can see it. Resolution techniques that can be applied against a trusted data set that's been validated by both humans and machines. So there are all sorts of tools available inside the tech stack to take problems that used to be very manual and intensive and almost too big to solve through brute force. And now apply machine algorithms and AI to them because you have the underlying security and trust in the way the data is organized and secured itself. If you don't have that, that's table stakes for being able to apply AI against these big problems because it has to first and foremost be a trusted asset. And that's just something that, like our forward deployed engineers are experts at making sure first and foremost, security, governance, data lineage, data architectures are shored up before we start releasing, you know, advanced logic on top of it.
00:20:03 Speaker 5: Right?
00:20:04 Megan Antonelli: Yeah. No, and I think it can't be it can't be understated. And I think that there's a, the focus, at least at the beginning of all of this was very much governance, security, you know, access. And I, you know, in the last six to twelve months, I feel like there's been this shift a little bit towards, you know, time saved, hours saved, you know, ambient tech, clinical tech. You know, some of you know, more of those, um, front facing in some cases higher risk technologies, but they do all come down to kind of hours saved. I mean, what I hear when you say that Nicole around, I mean, that's engineering hours saved, right? I mean, that's just time, time spent. You do the work and then you can kind of come in and have the benefits of this other technology, right? You've got to do that front front work to, to deal with the governance. Um, but I think I saw on LinkedIn the other day, Crystal bro, she's with, um, Musk, the medical, uh, southern South Carolina. I think, um, in terms of, she was talking about that too. I mean, in terms of, it's great to get the hours, but how do you as a management turn the, that hours into, you know, actual value, actual money? And a lot of the conversation now is around ROI and savings. So tell us a little bit about where you're working with your customers and clients around, around that piece in terms of the hours saved and how that turns into value for the organization.
00:21:33 Break: You're listening to digital health talks. When we return, we'll continue our discussion on how technology is revolutionizing healthcare delivery. Stay with us to hear more insights on creating sustainable, patient centered digital health solutions.
00:21:51 Christine Williams: Yeah, absolutely. I mean, and just to kind of double tap what Nicole was saying, you know, getting that foundation is so important, right? So making sure that the data lineage that the data ingest is accurate. And our teams spend time doing that because that's where you're able to create those efficiencies downstream where you've actually, you can actually trust the data. So you've applied AI logic, you've applied applications on top of this data, but the data foundation is so strong that you can actually believe and trust in the ROI that you're, that you're developing after having built it. Um, so, you know, we've seen this at surgeons, um, you know, a procurement particular procurement workflow created a, you know, a significant efficiency multiplier and how staff could update fields. So, you know, this really saw incredibly compounding improvements. Um, and so that increased capacity allows the team to be directed towards higher value work. Um, but you know, if somebody saves two hours and simply fills in those two hours with more administrative work, you've improved a task, but you haven't necessarily changed the outcome. So, you know, what's really important is this is now identified across the leadership, and the leadership is able to actually leverage that efficiency that they've created into making greater strategic decisions.
00:23:10 Speaker 5: Mhm.
00:23:11 Nicole Sanders: Yeah, I think that's right. You know, leaders have to be responsible to decide what to do with the capacity that they've created. There is no magic wand here. AI is wonderful, but it's in a lot of ways not unlike any other technology transformation that an organization, an institution of scale has to go through with change management and adoption and training and metrics and KPIs. Like Christine was talking about, a lot of it is, is making sure you're measuring the outcome that you're driving for. So you're still getting after that outcome, whether it's using AI or another technology transformation. So we see time and time again, the ROI from the AI investments really does require dedicated leadership of people and projects. It's no different than any other technology investment in that way.
00:24:03 Speaker 5: Yeah.
00:24:04 Megan Antonelli: No, and I do think with that exuberance and caution and the risks involved, that there's a certain amount of just expectation and they're making big investments, right? And so there's a lot of expectation that the results are going to be immediate. It's going to be as fast as it as it feels when we, you know, go ask ChatGPT, you know, various questions, you know, but it does take time and change management is, has always been, you know, sort of healthcare, you know, that there's therein lies the bottleneck. I think the other thing we've been hearing a little bit in terms of costs is the costs are they're high, you know, and, and when those bills come back and they go up or they unexpectedly come up and they're bigger than they expect, uh, you know, that then results in whoever was the champion feeling a bit, um, you know, having to defend themselves. What's, you know, where do you sit with that in terms of your role in helping, uh, your customers through that, both from maybe it's the understanding where the bill is going to come from in the first place, but also when that, when that bill does get big.
00:25:11 Christine Williams: Yeah. Great question. We've definitely run into that, um, you know, that kind of unexpected compute bill. Um, so understanding the root cause of compute cost is super important, right? So, you know, if it's relating to a new workflow that relies on increased computing power to drive an outcome that creates greater, you know, greater ROI for the organization, that's, that's great news. Um, but, you know, we've also run into clients that are experiencing high compute costs that aren't related to any specific outcome. So, you know, we specialize in this as a company really performing those audits to continually optimize compute costs.
00:25:49 Nicole Sanders: Yeah, absolutely. Um, so our engineers will perform deep architecture audits. Like really dig deep into the underlying infrastructure again, and also making sure the right AI tools and infrastructure are being applied to the right problems at the right time. It's really a systems thinking approach to deploying AI. Like you said, when you just can go in and query ChatGPT for something on your own, it's very different than applying AI across an enterprise and across a system that needs to be governed. So we've seen customers where our teams have been able to deliver massive compute savings out of the gate. I mean, literally in the first two weeks of the engagement to the order of ninety percent compute savings by digging into the way the data structures are built, pipelines, ontologies, and model choices. Especially now, you don't need to be applying the latest GPT model to do, you know, some synthesis check or some alignment check? You really need to know when you need a model. That can be a little bit more advanced in reasoning and one that can be more basic. And so we can, we've got the ability to help our clients make those smart choices in the architecture without sacrificing the actual system, the whole system performance. Again, kind of coming back to the systems thinking approach.
00:27:06 Speaker 5: Yeah.
00:27:07 Megan Antonelli: Yeah, that's a really important point around the models and kind of those choices. And, and when I think of the healthcare organization and, and kind of where they've been and where they focused You know, having the people who make those decisions in-house are not necessarily staffed. And then, I mean, even thinking about governance and we talk a lot about it, but who's responsible? Is it, you know, is it I mean, building the governance committee? And that's where we've kind of focused a lot. When we think back when we started Health Impact, it was EHR implementation and it really sat with the CIO. You know, and what was unique about our room was that we brought together Cmo's, and we brought together the clinicians, and that was, you know, it was novel, which it shouldn't have been. And now luckily, it's not, you know, patient safety is sitting on the governance committees and healthcare quality, uh, obviously security finance, but everybody else still has another job. You know, there's these governance committees, but other people, but they have the other job. So tell me a little bit about how you work with customers to kind of ensure that that governance comes together and, and sort of helps and works ultimately.
00:28:20 Nicole Sanders: Yeah, much to the chagrin of many of our clients. In some ways, governance is the first thing out of the gate, right? And so it's, it's interesting because before you kind of talked about the speed at which like the technology, you know, can move. And so sometimes customers and people just in general want to see that dashboard, want to see the cool application, want to see kind of the front end candy. Um, but like one of my colleagues used to say, you have to eat your vegetables before you get dessert. So governance is, you know, eating your vegetables and it is paramount in every project. So often either we've completed a pilot or sometimes we inherit pilots that have been done by the organization or another party. And it is get back to basics, get back into the governance, make sure everything is defined, pull in the people from the organization. This is, is, is like you kind of said, who've you've assembled through health impact. Same thing. Assembling the right group of people inside of an organization to define the governance, applying the governance. The technology is available to do that. And our, you know, our engineers and other engineers know how to do that. It's it's the coming together and the defining of the governance, especially, again, with these modern technologies and modern tools that allow you to integrate data that used to be siloed and being able to define that governance, pay attention to it early and deploy it early, because that's just going to pay you back over the long haul, and it is going to unlock that speed that you want to see. Applications and new technologies and new AI models act on top of your data asset spending. The time to get that governance right up front is going to provide you that accelerated speed in the long run.
00:30:02 Christine Williams: Yeah, we've walked into projects where, you know, they're, they're sort of inheriting an original pilot or they've been working on one. And, and, you know, we want to go in and we, you know, we've we've kind of identified some weak permissions or unclear ownership and, um, you know, or poor controls. And they, and we really go in and sit down with them and, and kind of start back at basics like where, you know, where do we align the key governance and key controls to make sure that everything is going to be functioning in a way that's actually usable by all the different levels of users in the organization? So it's, it's very, it's one, like Nicole said, it's one of the first things that we do when we're working with a customer is just to make sure we get that right.
00:30:45 Speaker 5: Yeah.
00:30:46 Megan Antonelli: Well, and I think it's so important. I mean, we see so much, it goes kind of back to the point solutions. And when you have clinical innovation happening at the front lines, you have a lot of pilots come in. A lot of, you know, these organizations are big, you know, multiple hospitals, part of, you know, and so where those pilots come in and how they, you know, we always say pilot itis, it's like they so many pilots and they all die, you know, what are your thoughts in kind of our closing around, um, this and your work around how healthcare systems can avoid that in a time where digital transformation is so fast and adoption is so fast and they want to stay ahead and stay and compete, but, you know, also don't want to have I mean, I've literally had conversations with people who say they have one thousand programs going right now and one thousand AI implementations happening across organizations. I mean, that seems insane to me. You know, um, so what's your advice there?
00:31:43 Christine Williams: It's definitely the wild West. We, we hear the same thing from our customers. You know, everyone's using AI. We don't know how to control it or we don't know how to, you know, create systems in place where it's done in a safe, productive way. So, you know, I think that, um, I think we do really focus and coach our customers on making sure that foundation is in place. Um, because there is all kinds of room for experimentation and pilot building as long as it's done with the security and with the governed environment. Um, and I think, you know, experiment, experimentation should be encouraged. We encourage that in our company. You know, we encourage people to, you know, make mistakes and push the envelope because that's where innovation comes. But, um, but you really have to take those first initial steps in making sure that you're working in an environment that's going to allow for mistakes to happen, which won't derail or won't impact, um, you know, an organization.
00:32:40 Nicole Sanders: Yeah. And it does come back to cost as well by, by getting the foundation, right. So picking your platform that you're going to build all this on or platforms, but kind of defining what that is, defining the environment that that these applications and tools can be built off of. And having your organization of humans come together around defining some things that are just rules and golden. And, you know, this is there's going to like, it's something as simple as an object type. If all of a sudden you have, you know, an object type that's, you know, a piece of medical equipment, but you've got folks working in twenty different departments, all playing around with applications in AI that relate to a piece of medical equipment. You've now twenty exed your compute consumption, and you've created more tech debt for yourself that only someday someone's going to have to go untangle for you. And then you're not building towards a system that can allow your organization to operate as one. I mean, the whole point of all this is to leverage the ability of these technologies to scale around massive data sets so that we can make better decisions and work better together. And that's if you do too many pilots that are just running in all these different directions, you're achieving the opposite effect. So it does require not just the technical governance, but the human governance of the whole process.
00:34:03 Speaker 5: Right.
00:34:04 Megan Antonelli: Yeah. No, I, it, it's like, it goes back to what you said in terms of governance, and it's the eating your vegetables part of that that then allows you to have the dessert, which is the savings or the efficiencies, or the better, you know, the better care. You know, if you don't kind of have the governance around the pilot adoption and how we're going to evaluate it from the beginning, you know, you kind of end up, uh, with all of those things you just described. Well, as you know, you know, this is part of our Female Founders series and your two amazing women in charge of this organization. Tell us a little bit about what that's like to run an organization. Speaking of governance, in terms of having two, two CEO founders, um, you know, it seems like you've got similar backgrounds, but somewhat different experiences. So talk a little bit about that and what people can learn from that or what, what they should expect from that. I'm like, I would like three more CEOs.
00:35:00 Christine Williams: Yes, for sure. We, um, it's incredible. It really is. It is quite, uh, you know, phenomenal partnership. Um, we were told many times in the beginning, you cannot be two CEOs. Don't do it. Someone has to pick one and the other is another role. Um, but we fought back and decided to do it anyway. Um, I think we had heard that maybe Netflix had two CEOs and said, well, if they do it, they can do it. We can do it. So, um, so, you know, it really has been incredible. Um, you know, we first of all get such support from each other. Um, being a CEO can be kind of isolating. Um, and having someone besides you who understands exactly where you are exactly has the same information, the same stress, the same kind of excitement is very empowering. Um, we can reinforce each other's intuitions and we can, you know, challenge each other freely if needed. Um, one incredible thing that I don't know if it's coincidental or is just, you know, developed, but we have our bad days on different days. So when one of us is frustrated or stressed out, the other one is there to support, um, and, you know, provide the energy and perspective. So it's, it's pretty extraordinary.
00:36:14 Speaker 5: Yeah.
00:36:15 Nicole Sanders: I mean, I'm going to have to answer this too because this is, you know, our favorite question. And maybe the first time we're kind of publicly talking about this. So thanks for asking. So people definitely assume that two CEOs is like confusing or there's conflict or the question we always get is, well, like, how do you divide up the job? Like who does what? And it mystifies people that the answer is no. We share the job. We really, really do. Um, so for us, it's been incredible. Uh, we see things differently. And I think that's a huge part of why it works. Like Christine said, we challenge each other and we push each other to be better and we make better decisions because neither of us is is just echoing back to the other what what we think they want to hear. And we have this almost ridiculous level of alignment around values and vision and what's right for the business. And I think that's why it really can work, because if we do happen to disagree on a decision or a direction for the company, there's never a question about underlying motive. It's always because from where I see it, this is what I think is the best for the company. Or from where Christine sees it, she thinks it's what's best for the company. And so we have a lot of respect for each other. We work through any differences that we have, and I can guarantee you, we come to a better answer than either of us would have gotten to alone. In fact, there are times where we're making decisions for the company. I can't imagine having to have a conversation with myself about how to how to proceed down this path. So the collective judgment, strategy and vision that we share, I think, is a big reason we've been able to grow so fast at Foxtrot. And the other thing I'll say is neither of us think that we do or need to know everything. And, you know, I've observed a lot of leaders in the past where it felt like they like their job was to be all knowing. Um, and heaven forbid, if they didn't get there like, like little notes before going into like the big the big briefing, like they had to know everything and answer everything. We just don't operate that way. We lean on each other. We lean on our teams, our mentors, coaches. We ask for help all the time. And I think we're better leaders because of it.
00:38:16 Christine Williams: Yeah, no, I agree. And and just one other point on that is I think that, you know, being co-leaders or being co-CEOs allows us to, you know, serve as a model to the other leaders in our company, you know, so they can see us respect, be respectful, respectfully disagree. They can see us listening to each other. Um, you know, when we do disagree, it's in a healthy and productive way. So, you know, I think that being able to kind of spread these values to our leadership team just continues to, to kind of share this culture that we feel across the organization.
00:38:49 Speaker 5: And don't forget.
00:38:51 Nicole Sanders: We're both moms.
00:38:52 Speaker 5: We're both moms.
00:38:53 Nicole Sanders: And so there's a lot of shared empathy around what it means to balance that because not only are we both moms, we're both moms with kids who are still at home and very active parenting lives, as well as our work lives.
00:39:08 Megan Antonelli: Yeah, well, that is great. I think that sort of purpose driven and as you said in the beginning, in terms of your founding and, and kind of what you're bringing together, um, in a, in a market, you know, yes, healthcare is, is very deeply empathetic, but you serve multiple markets. So, um, sometimes they can be a little bit colder and more sterile than, than healthcare is so amazing that you've kind of built this, uh, purpose driven environment, um, with work life balance and all of that for your teams, which is awesome. And I'm just so thrilled to see the growth that you guys have had. Um, in terms of another, you know, we like to end on, uh, this actually also comes out of the pandemic. We, uh, felt that as we left and as we went back to events after the pandemic, we wanted to talk about what was good in health care and sort of the silver lining. So our question, our last question is always around, what's the good thing in healthcare that makes you so excited? Because sometimes I have, you know, being a New Yorker, a tendency to talk about negative stuff, um, to, to focus on, you know, what's, what's exciting in healthcare that you're super excited about as you see from your clients or across the industry?
00:40:19 Speaker 5: Yeah.
00:40:19 Christine Williams: I mean, we have incredible clients that are really just pushing innovation in a way that is extraordinary. And I think a lot of people maybe don't appreciate the pace of it. Um, you know, we, we focus on data. So, you know, speaking from, with that kind of hat on, you know, clinicians and researchers are able to connect data now in ways that they weren't able to do in the recent past from, from sort of disparate places. Um, and data that was maybe inaccessible to them before. And, you know, of course they're using AI in ways to analyze data at scale that that is, you know, completely game changing and it just wasn't possible before.
00:40:59 Speaker 5: Yeah.
00:40:59 Nicole Sanders: Totally agree. I think we're seeing new opportunities for, you know, different segments of the community, like clinicians and researchers to start sharing data and collaborating so that they can see patterns earlier, they can ask better questions, they can then accelerate the discovery and ultimately find better ways to treat disease. I think we're going to see the speed of advancements of advanced disease treatment accelerate. Maybe it's the work is being done now, and I think we'll start seeing the benefits of that work, you know, in the coming years. And then the pace at which those things become available to us in the public, because they have to get through all of the regulatory approvals. But once we sort of start the first wave, I think the waves are going to be coming in really quickly. And that work is being done now. And it's incredible that, you know, we're honored to be, in a small way part of that work and and helping our customers do that really, really important work where finally the technology is is catching up to the complexity of the problems that these folks solve.
00:41:59 Megan Antonelli: One hundred percent. Yeah. No, I mean, I think that that is what is really exciting. And it even goes back to a little bit about what you talked about in terms of the possibility of, of doing all of that, you know, eating of the vegetables, the clean up work that has had to take a back seat because of what's available. It's easier now. And so, and also necessary to take to get the benefits from the other side. So they're, you know, they're focused on it. And then once that layer is is better and cleaned up, they can realize those benefits of technology that have been kind of stop and go from from the get go. So other than coming to health impact and meeting the team in October, what's the best way for our audience to get in touch with you?
00:42:44 Nicole Sanders: Absolutely. We're easy to find on LinkedIn and our website is foxtrot dash services dot com. We'd love to see you and hear from you.
00:42:53 Christine Williams: And stay tuned for our books.
00:42:55 Megan Antonelli: Awesome. Can't wait. Very exciting. We'll have to have to get those there. Um, thank you so much, Nicole and Christine, a real pleasure to have you join us. I think the, the cases and the, the sort of experience that you've had in terms of taking your experience and bringing it to healthcare and kind of learning about and, and helping your healthcare customers really build that foundation to, you know, really save and, and kind of get out of pilot itis, if you will, into real value and real cost savings coming out of these technologies to, to impact patients is amazing. Uh, to our listeners, thank you so much for joining us. This is Megan Antonelli with Health Impact Live and digital health Talks. Let's keep fixing healthcare one conversation at a time.
00:43:42 Outro: Thank you for joining us on Digital Health Talks, where we explore the intersection of healthcare and technology with leaders who are transforming patient care. This episode was brought to you by our valued program partners. Heidi, the AI care partner built for every moment of the clinical day. Natera. Advancing. Contactless. Vital signs. Monitoring. Sailpoint. Securing healthcare identity management and access. Governance. Your engagement helps drive the future of healthcare innovation. Subscribe to digital health Talks on your preferred podcast platform. Share these insights with your network and follow us on LinkedIn for exclusive content and updates. Ready to connect with healthcare technology leaders in person? Join us at the next Health Impact event. Visit healthimpact dot com for dates and registration. Until next time. This is digital health talks where changemakers come together to fix healthcare.