4 questions with Rush CIO Dr. Shafiq Rab

Dr. Shafiq Rab, CIO of Rush University Medical Center in Chicago, uses his background in public health to inform his IT vision.

Dr. Rab, who completed his medical degree and internal medicine residency at Karachi, Pakistan-based Dow Medical College, had his interest in public health piqued during one of his first physician jobs. While treating an urban squatters settlement in Pakistan, he worked with non-governmental organizations to address the infant mortality rate, mainly by bringing clean drinking water to its residents.

"That's how I got involved in healthcare," he says. "And I remain committed to healthcare. It is the thing for me — how to serve my people. That's it. I've got nothing else."

Upon moving to the United States, however, Dr. Rab chose to pursue a different facet of healthcare. He took classes and taught himself computing and software skills, from EHR implementation to C++ coding to general app development. For almost 20 years, he has served as a healthcare CIO at institutions like Hackensack (N.J.) University Health Network; Greater Hudson Valley Health System in Middletown, N.Y.; and St. Mary's Hospital in Passaic, N.J.

In January, Dr. Rab brought his public health and IT expertise to Chicago after being named CIO and senior vice president of Rush University Medical Center. Dr. Rab recently spoke with Becker's Hospital Review about how his background will inform his work at Rush.

Note: Responses have been lightly edited for length and clarity.

Question: How does your commitment to public health impact your work as a CIO?

Dr. Shafiq Rab: There are many things that affect our health outside of catastrophic and acute events we typically think about. In the United States, we decreased infectious diseases through reforms that improved water quality and air quality, for example.

Today, there are other issues, known as social determinants of health. With economic and social disparities in the cities, we see new things come up, like housing, safety, mobility and access to care. Without, say, routing of the buses that encourages access to care, or the ability to get your blood pressure checked when you need it, or even having a small education about health risks like smoking, health outcomes tend to be worse. These social determinants of health are causing a heavy burden on our economy, too.

As a CIO, these things are important to understand. They help me see how we need to extend the continuum of care from the acute care facilities into the communities.

Q: What advice would you give to hospitals looking to optimize patient engagement?

SR: First of all — I need advice! I'm not a pundit, I'm still learning. I'm a student. But I can share my experiences that have helped me.

You have to know your community and the area that you are serving. You can go to your patient database and look at which ZIP code people come from, you can do a geospatial map to see which people come from which areas and you can use this information to see whether they have access to care in their community. That means whether they have a pharmacy or a clinic in their neighborhood, or whether there is transportation for them to access one.

You also have to understand your community. What impacts how they act? If somebody has cancer, for example, why are they not going for their care? It could be that they don't have insurance. You need to understand your community and their ability to access healthcare, because that's how you learn how to provide help to them. At Rush, we are doing predictive and prescriptive analytics. We are providing patients with preventative measures, encouraging them to eat healthy, walk five miles and stop smoking.

Q: In the almost 20 years you've worked as a CIO, how has the health IT landscape changed?

SR: For me, interest in health IT means I get to serve the people in a much better way than I could have done before. I don't have to sell IT anymore, because people know that we need analytics, people know that it can lead to a better experience.

Health IT is a great development for patients and the community, because it expands mobility. Almost all people now have smartphones in their hands, which has required people like us to respond. Now patients all want pertinent information to be provided at the time they need it. We can also use technology to help patients who need directions to the hospital or need directions on how to get their care.

The year of the patient has come, because of technology. We need to celebrate that.

Q: For you, as a CIO, what are some health IT trends you want to learn more about?

SR: One of the things that is keeping me nervous is how the old ways of understanding security are obsolete now, so the biggest thing that I am trying to understand is how to bring behavioral analysis into cybersecurity. This is the way to understand our enemy.

I would also like to understand machine learning, and how it can let us better serve our community. I want to be able to use all the data that we're collecting, so that one day I can ask my computer: 'How many patients of this kind have I seen before? What has worked? What has not worked? What other innovative things can I do to help my patient?' Building that cognitive function [and] that artificial intelligence into it and understanding the machine learning.

The biggest thing that I always talk about is interoperability. The time has come that we should have a standard for interoperability, we should use FHIR [Fast Healthcare Interoperability Resources, a standards framework], so that we have a free flow of data. We have to free the data; that has to happen, because without that, no one institution can survive. We have to have that insight into humanity, so we can serve our country and our nation in a much better way.

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