“You Have to Make It Understandable”: CIO Donna Roach on Improving the Care Experience

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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Key Takeaways

• One of the most effective ways to encourage work-life balance is by modeling it. “I’m very careful about sending an email or a text unless it really is a problem, and respecting that people need downtime.”
• When it comes to digital transformation, there’s no one-size-fits-all approach. The strategy should be based on the needs and ability of each individual organization, as well as the culture.
• It’s critical not to neglect long-term plans during a crisis — even one as all-consuming as Covid. “You still have to carve out time to work on your strategy. If you wait until everything is stabilized, it’s too late.”
• A significant area of opportunity for healthcare leaders? Communicating with patients in a way that they understand. “Most people want to be responsible for their health. But if you throw too much at them, they’ll shut down.”

Q&A with CIO Donna Roach, Part 2 [Click here to view Part 1]

Modeling work-life balance

Roach:  I had some great bosses at Ascension and my other organizations that were very respectful of employees’ time. Your weekend is your weekend. I’m only going to call you if there’s a problem. I’m not going to impinge upon your weekend. Your evening with your family is your evening with your family.

I’m really careful now. Early on in my career I would think, ‘I have to answer that email, or ‘I have to work on this at night and send it off.’ Now my thinking is different. I know what it felt like when I would get an email from somebody higher up in the organization feeling like I had to answer it right away. I’m very careful about sending an email or a text, unless it really is a problem, and respecting that people need their down time. People were giving 110 percent during the pandemic. They’re tired.

What’s great about this area is that there are so many outside activities, like hiking and different sports. And in the winter, you have skiing. People can get a break from it all; I think that’s a real positive.

 

Gamble:  So it’s been a good move for you?

Roach:  Yes. So far, so good. I enjoy the people here — the staff and leaders. It’s a great organization.

 

“A learner at heart”

Gamble:  What appealed to you most about the organization?

Roach:  I like academic environments. I am a learner at heart; and this is a learning organization. They’re very big on looking at what the data say — what’s the reference? Can we look toward what’s been published? How can we improve upon that? Academics is smack in the middle of that. Research is smack in the middle of it. And I really enjoy that part of it.

Also, they’ve done a lot of the heavy lifting in terms of the electronic health record. They really looked at the portfolio landscape when choosing core systems. Before I got there, they had implemented Epic and done work to improve it.

It was fun for me to be able to walk into that environment, because it allowed us to really accelerate our digital transformation strategy. If you’re trying to build out your base or foundation, that can really deter you in how you move forward. The fact that they had done a lot of it was great. I have great respect for Jim Turnbull, who was the prior CIO here. He always spoke highly of the University of Utah and so, for me, it just clicked. It felt like the right place to be.

 

Gamble:  Coming into the role, you knew digital transformation was going to be a big priority. Did you have experience in that area?

Roach:  Prior to this I was at BJC Healthcare and Washington University School of Medicine. Both organizations were in the thick of doing this work, and so I learned quite a bit about through their introductions of agile into the organization. It was great to be able to see it happening. Ascension was very much down that path with their design studio structure. I’ve been around it quite a bit and I’ve seen it in an action.

But although you can become quite good at practicing the art, you still have to be able to apply it to the culture that’s here. You can’t take another model and apply it here. You have to spend time building it out based on what will make it work here and how it applies to your culture when it comes to prioritizing and deciding what to accelerate on the timeline.

 

Gamble:  So it’s really important to get the know the culture and understand the level of readiness?

Roach:  Exactly. When I was at Utah HIMSS, someone asked, ‘what do you say to people about what to do in the middle of the pandemic?’ A lot of effort has gone into managing through the pandemic — we’ve pivoted many times to different things we needed to do. Even within IT, there’s been a lot of development. Let’s create the vaccination process. Let’s incorporate that into MyChart. Let’s set up a testing center — a lot of work that requires IT support.

People are tired. But you have to continue to move towards a strategy. If you’re a major league baseball team and you get to the middle of the season and it’s clear you’re not going to make the playoffs, the owners and coach need to look at what to do for next year. They’re concerned about the season, but also looking toward where we need to be once we get through this.

You have to carve out time to work on your strategy and where you need to be in terms of direction and goals. Because if I wait until everything gets stabilized and we feel fine, it’s too late. There’s so much build up and ramp up — you have to be working toward that, even in the midst of this crisis. It’s important for leaders to carve out time and work on it so that we can better develop it and communicate it out. That way, when it comes time to pull the trigger, we’re ready, rather than scrambling at the last minute.

 

Building for flexibility

Gamble:  I imagine that takes time for that type of thinking to permeate through an organization.

Roach:  It does. I feel like I’ve always been a project manager at heart. I like to put things on a timeline. What’s the date we’re shooting for? What activities will help get us there? What’s the critical path? Where do we want to be at the end of 2022 and at the end of 2023? I’m already thinking about that.

I know it’s hard for clinicians who are dealing with ICU capacity and having to turn away patients, but I need to engage them at certain points. I’ll approach them and say, ‘I’m only going to need about a half hour of your time. Let’s talk through this,’ and then come back to them. Sometimes I over-communicate; but I’d rather do that than waiting too long and not initiating and not aiming toward that strategy. Because no matter how I build it out, it can go a lot of different ways. And so I’m building for flexibility in my strategy, rather than a rigid stance of, ‘we have to hit this state in this timeframe.’

 

“You have to have that back-and-forth interaction”

Gamble:  That agile approach hasn’t always been the way things are done in healthcare — and especially in an academic environment.

Roach:  Yes. It’s interesting; I did some rounding recently with our hospitalists and spoke to some patients. And we found that it’s the simple things they want. One patient mentioned, ‘I have a MyChart account, but I don’t know what all the terminology means.’ That tells me that we could be doing so much better at communicating and helping the patient better understand their care, and at a level that they understand. Not everybody is medically trained; not everybody has an undergraduate degree. You have to make things understandable.

Because I truly believe most people want to be responsible for their health and wanted to take it on. But if you throw too much at them or you throw too much lingo at them, they’ll shut down like anybody and it’s intimidating too. It’s especially intimidating when you’re sick and you have all these things thrown at you and you’re like, ‘what did they just say?’ You can give them a tool like MyChart, and you can give them discharge instructions, but you have to make it understandable. And you have to be able to interact. For example, what does this mean? If I missed taking my meds one time, what should I do? You have to be able to have that back-and-forth interaction so that people can be responsible, and people can interact with your system, even if they don’t have the physician or the nurse right in front of them.

 

Consumer always, patient sometimes

Gamble:  Right. We’re all patients too, and so it’s important to see things going in that direction.

Roach:  It’s funny that you brought up the fact that we’re all patients. That’s one of the things we’re trying to establish, but wording is important. Words mean something. When we tried to introduce consumer-centered care, one of the physicians said, ‘I don’t like the word consumer. It sounds like we’re at Costco.’

The best way to think about it is like this: you’re a consumer always, but a patient sometimes. For me, I don’t want to be considered a patient until I’m absolutely in that situation. I want to be considered a consumer of health and care across the organization, and I wanted to be treated that way, rather than as a patient.

and treat me like that rather than treat me kind of in that patient role.

 

Gamble: That makes sense. Well, I want to thank you so much for your time. I always enjoying speaking with you.

Roach:  Thanks Kate. Take care.