When Jeff Gautney took over as vice president and CIO of Rush University Medical Center last August, he focused on "rebuilding the basement, the kitchen and the bathrooms — those foundational things that enable you to have that really cool living room," he told Becker's.
While his predecessors spent a lot of time on digital innovation, he has concentrated on infrastructure, cybersecurity and IT processes to more easier implement those cutting-edge tools in the future, he said.
He came to the Chicago-based academic medical center from the health IT consulting world. But Mr. Gautney, who had previously worked for Northwell Health in New Hyde Park, N.Y., and Baylor University Medical Center in Dallas, said the pandemic made him realize how much he missed being in an operations role.
"One of the reasons why I picked Rush in particular was because of the commitment to health equity," he said.
That extends to employees. If a staffer is offered the opportunity to work remotely but can't due to a lack of hardware, affordable internet or a quiet place to work, that's an equity issue, he said.
Mr. Gautney recalled being employed as a mental health worker on a nursing floor when diagnosis-related groups, or DRGs, were announced in the 1980s. Since that time, he has worked through the dot-com bubble, the implementation of EHRs and the Affordable Care Act. He's seen health IT go from being primarily billing-oriented, to an enabler of healthcare delivery, to an extender of care into the home and across geographies.
He's had to learn to adapt, and that's where having a strong foundation comes in. Health systems have to be ready when the next unexpected event happens, whether it's a cyberattack, an infectious-disease outbreak or even a judicial decision like the overturning of Roe v. Wade, he said.
Mr. Gautney said he expects to be involved in Rush's telemedicine efforts in the reproductive healthcare oasis of Illinois.
CIOs focused on business, not just tech
Mr. Gautney said health system technology executives are more business-minded these days.
"The role of the CIO and of IT leaders now has been to be engaged with the business in designing new services, not simply the business coming to it and saying, 'I have this new service. I have this new clinic. I need to be able to process charges for it,' or 'I need to be able to put the EMR into it,'" he said. "Now it's like, let's think together about something new we can do that makes it easy for patients to engage with us, or physicians to use our facilities, or to reach a population that's underserved."
He said cybersecurity takes up about a third of his time and budget. Another third is dedicated to those "foundational things" Mr. Gautney mentioned earlier, while the last third goes toward what he called "digital enablement."
"That could be things like CRM [customer relationship management], digital health and digital front door — those kinds of services where it is extending or enabling something that couldn't be done in the physical world without those IT services, or harnessing the intelligence and the information that we understand about our patients, our employees and our students," he said.
Shift to cloud raises unforeseen challenges
The infrastructure part of Mr. Gautney's job now includes shifting to the cloud, a necessity when so many apps are cloud-based. He said he hopes to do it in a more cohesive way going forward, instituting an enterprisewide cloud strategy. Rush leans heavily on Microsoft Azure but has a growing relationship with Amazon Web Services, he said.
One of Rush's smaller hospitals fell victim to last year's ransomware attack against Ultimate Kronos Group that disrupted several hospital systems' cloud-based payroll platforms.
"Migrating the app to the cloud can be the easiest thing," Mr. Gautney said. "It's everything else around how you administer it, support it, secure it, recover it — that becomes very complicated."
Beyond cybersecurity, he expects the digital transition to be an increasing part of the job for CIOs.
"We've got all this data. We've got all this automation. We've got generations of physicians that have come up expecting there to be an EMR, expecting there to be electronic scheduling," he said. "What do we do with that? How do we leverage that most effectively? That's what is going to dominate our landscape for the next 10 years."