As CIOs continue to manage through perhaps the biggest health crises of our time, one of the biggest challenges is keeping an eye toward the future. “People are tired,” said Donna Roach, who stepped into the role just six months into the pandemic. “But you still have to carve out time to work on your strategy and where you need to be.” If leaders wait until things are more stabilized, it’ll be too late.
It’s a tough stance to take, particularly when it means asking busy clinicians for 30 minutes of precious time when they’ve already given so much. To Roach, however, it’s part of the job. And it’s one of the reasons why she has made relationship building a priority throughout her career.
Recently, Roach spoke with Kate Gamble, Managing Editor at healthsystemCIO, about her key priorities as CIO at University of Utah Health — many of which center on accelerating digital transformation. She also talked about the approach she took to get to know her team despite the limitations of Covid; what appealed to her most about the organization; and the one area in which healthcare has a lot of catching up to do.
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- The first step in developing a digital health strategy is to assess the environment. “We spent a lot of time just trying to understand what that means from a strategy side and how we want to engage on it.”
- One of the best practices University of Utah Health follows is to utilize an agile approach, “with quicker development cycles and less reliance on vendors.”
- Like any initiative, a digital strategy must be supported by a strong framework and architecture. Without those in place, “it’s going to fail.”
- Communication is a key aspect in getting all stakeholders on the same page and creating a unified approach to fulfilling the organizational roadmap, rather than having people “working in pockets.”
- The key to getting to know staff and colleagues in Zoom and Teams environment? “Don’t see it as a barrier,” said Roach. And “be purposeful about communication.”
Q&A with Donna Roach, CIO, University of Utah Health, Part 1
Gamble: Hi Donna, thank you for joining us. I’d love to talk about what you’re doing at University of Utah Health, especially in terms of digital health. It’s so interesting to see how it has developed.
Donna: I agree. It’s funny, I was told probably on day one, ‘We have a digital strategy that needs to be developed,’ and I said, ‘okay, no problem.’ It was going to be my project to run, along with the CMIO and other key stakeholders. So, they had already been going down that path.
When I asked, ‘what do you think digital means?’ they said, ‘It’s virtual care and telehealth.’ I said, ‘Okay, but you realize it’s much more than that. It’s a whole gamut of stuff.’ They said, ‘Yes, that’s why we want you to develop a strategy and a governing body.’ So that was good, because it assured me that we were on the same page that digital is more virtual care and telehealth.
Terminology becomes very interesting, and people can definitely get caught up with it. But really, everything in IT is digital; it’s just a name.
Representation across the organization
Gamble: I’m sure it made a difference that the organization had already started thinking about it. What were your initial steps to get the digital strategy off the ground?
Roach: The first part is assessing the environment. In an academic setting, it’s a little bit slower and a little more purposeful than what you would see in most organizations. And so, we spent a lot of time just trying to understand, from a strategic side, what this means and how we want to engage on it.
It was actually great timing because we created a governance structure around it. We put together a digital enablement committee made up of a number of people throughout the organization. We wanted to look toward best practices and ask, ‘what have others done who have accelerated their digital platform or digital strategy?’
One thing we noted was having good representation across the organization. And so, we have department chairs on our committee. We have marketing/communications. We have hospital operations. There’s a lot of great representation. I have a counterpart on the university side — the CIO — who sits on this committee. That really lends itself to the strategy; we become strategic developers of where the roadmap needs to be.
Creating an agile process
The other thing we’re trying to introduce is agility. We know that the best practice is to create more of an agile approach to this, with quicker development cycles and less reliance on various vendors. Of course, you still have to bring in vendors or outside partners in; this is more about how you create an agile process with product teams and product structure. We’re introducing that into the organization.
That’s been interesting because their familiarity with the agile framework isn’t as high as I’ve seen at other healthcare organizations. And so, we’ve had to take a step back and talk about why we do this. What’s the importance? Why do you want to do this type of work and development versus the traditional IT model of operate, build and run?
“Let’s talk about how we work together”
A lot of it is getting people on board. Sometimes I feel like I’m doing a sales job; I’m going out and meeting with people who own different steps within the strategic plan to say, ‘Here’s our digital enablement structure and governance. You’re going to own the roadmap and charter the project teams. But your strategy could potentially be on the roadmap already, so let’s talk about how we can work together to enable your strategy. That way, when you need IT components, we can help leverage it.’ That’s been really good.
Virtual care and telehealth are key elements of the digital roadmap, and we can show what we need to do and how we can improve upon that. We’re working through some of that. Like any academic setting, we have pockets of people doing things. We’re trying to pull it all together so that it’s a unified approach rather than those pockets.
“Without the architecture, “It’s going to fail”
Gamble: You mentioned working with Steve Hess, the CIO on the University side. I imagine that’s really important in making sure everyone is on the same page from day one.
Donna: Yes. People don’t really think about this, but to enable a strong digital strategy, you have to have a digital architecture underneath it to support it. We may have bits and pieces of it, but we don’t have a full digital framework and architecture. We have to build that out, in addition to the outward-facing strategy. If you try to accelerate too much on the application side without having the architecture underneath it, it’s going to fail.
There are lot of examples of it, both here and at other organizations. We have Epic as our base EHR, and we need to build upon that to support our consumers and patients. How do we do that? It’s not just about turning to Epic and saying, ‘improve it.’ We have to do that. And so, from an architectural standpoint, how do you do that within the delivery of the digital roadmap? That plays big into the offerings and what we can do. How do you enable more of a cloud operating model? How do you enable more of a FHIR-based operating model or API model into that architecture?
Gamble: What are some of the things you’ve had to do with the architecture on the Epic side?
Roach: We’re implementing Beaker, Epic’s lab information system. That’s a key component that will accelerate the interoperability of clinical data. We had Cerner in place before, and we were working closely with our reference lab. Having it on Epic will really help streamline that. But workflows are always changing. And so, how do you generate a specimen lab and reprint it? We’re going through the process of retraining and getting people set up.
We started down this path earlier, but the pandemic has impacted everything along the supply chain. We couldn’t find the labels for the new Zebra printers — you need to have those labels to go live with some of the bar coding for specimens, and so it was a mad scramble to find the labels. Every little piece has been impacted in one way or another.
Gamble: The fact that you started with the organization about six or seven months into Covid probably didn’t make it any easier. But at least people had already had time to make some adjustments, so maybe that was a positive.
Donna: It’s a double-edged sword. When you come in, your level set. You’re all in the same boat. You all have to do Zoom calls and Teams calls. In that sense, I was no different from anybody else. Very few of our meetings have moved to in-person. Most of them are still Teams or Zoom-based, which is kind of nice.
The funny thing has been meeting my staff and getting to know them. I’m a relationship-building person, and so to me, Zoom and Teams can only take you so far. The first time you meet people it’s like, ‘wow, I didn’t know you were that tall.’ You’re almost taken aback by their presence. For some people, that can be quite difficult.
But again, we’re all in the same boat, and so I made a special effort to get to know people. I did a lot of one-on-ones. I had a list of people and just started checking them off. And the people here were great about making time for it. Even if it was just a half-hour call, it helped us get to know each other.
“Don’t see it as a barrier”
I came from Ascension, where we were all dispersed. My peers might be in Florida, Connecticut, Kansas or Detroit. You get used to it. You don’t see it as a barrier. You say, ‘I can make this work.’ I think that as we move toward more of a mobile or hybrid workforce, what I learned at Ascension really does apply.
I don’t see it as a barrier. I think about what we can do, and try to be very purposeful about communication. People who haven’t been in that setting might struggle, but you have to encourage them and show them it can be done.
Gamble: Right. It is an adjustment, though.
Roach: It is. I’ve lived in a lot of different areas, and I’ve learned how to make it work when I come into a new market. One thing is to make sure you have things outside of work. I play tennis and golf, and I always make sure I find my church — things that help my mental health and help balance things out so it’s not just about work.