As workforce shortages deepen, digital expectations rise and rural patients demand better access, University of Iowa Health Care in Iowa City is reshaping its technology strategy to bridge gaps across clinical care, research and education.
The system’s mission — “changing medicine, changing lives” — has become closely tied to how quickly it can adopt and operationalize digital tools at scale. For Joshua Wilda, chief information and digital officer, the next era of health system leadership requires new models of connection: connecting patients to care, research to practice, and communities to shared digital infrastructure.
Mr. Wilda has spent more than two decades in healthcare IT, beginning his career at Epic before moving into provider organizations. His early experience helped shape how he views technology’s role in supporting the relationship between patient and provider. Technology can complicate care or frustrate patients; but it doesn’t have to. Mr. Wilda previously spent time leading technology at the University of Michigan Health West, where he used technology as a vehicle for the whole organization to work at the top of their licenses.
At Iowa, that philosophy translates into a central priority: strengthening the organization’s connection to patients between visits. Rural healthcare, often perceived as technologically behind, is actually filled with tech-dependent communities — a reality Mr. Wilda sees as an opportunity.
“One of the major things that I’m still hyper focused on is patient experience and how do we connect our patients to us when they’re not here,” he said during an interview with the “Becker’s Healthcare Podcast.” “This is a perfect opportunity and perfect ecosystem for that.”
When the entire ecosystem is working together–the research, education and healthcare supporting each other and driving the success of the organization as a whole–the academic health system can better serve the community. It takes complex technology infrastructure to support all aspects of the ecosystem to become fully integrated, and that’s not cheap.
Financial pressure is intensifying the need for disciplined digital investment. Mr. Wilda and his team are evaluating new tools more rigorously than in the past to reduce duplicative solutions and ensure innovation efforts align with real organizational needs.
“Technology can be an enabler, but technology has a cost behind it,” he said. “How do those costs affect the cost of healthcare? How do we drive down those costs?”
The technology comes at a cost, and just becoming more efficient or reducing headcount doesn’t mean the system is spending less overall to get the job done.
Inpatient care model redesign
Inside the hospital, Iowa is advancing new inpatient care models supported by AI, sensors and tele-nursing. The goal is to enhance patient-provider intimacy even when technology is intermediating the interaction.
“How can we use our four walls and bricks and mortar with sensors, with AI, with tele-nursing, and some other things that we’re doing to really encapsulate that patient care and deliver more of that patient-provider intimacy, but through our technology,” he said.
Wayfinding is another area where digital tools can meaningfully improve patient experience. Navigation is the often initial barrier patients must overcome in their healthcare journey and sets the tone for the rest of their care.
“The first thing they have to figure out is how do I get to where I need to be? Where do I need to park?” he said. “So digital wayfinding and that experience of helping folks relieve some of the pressures of what it takes to engage with healthcare, so they can focus on the relationship, what they need to do to be better, what they need to do to heal.”
Partnerships
AI adoption is underway across clinical, operational and administrative domains. Yet Mr. Wilda expects its most transformative impact to be raising the capabilities of the entire workforce, not just clinicians.
“We’re also looking holistically. How do we raise all boats using AI and raise all of our capabilities as health care professionals,” he said.
One of the most strategic levers Iowa is pulling is partnership — especially through its Epic Community Connect program, which extends technology infrastructure to critical access hospitals across the state. These collaborations create shared scale without imposing control, giving smaller hospitals access to tools they could not afford alone.
“How do we pool our resources together, not from a command-and-control standpoint, but from leveraging all of our experiences,” he said. “Now how can we do that in such a way that we get economies of scale, especially from a technology standpoint?”
Those efforts are already strengthening community hospitals’ digital capabilities.
“The secret sauce is actually then those critical access hospitals that we’re extending to, especially in Iowa, how they’ve come together,” he said. “They’ve talked as a community now on how they leverage the tools.”
But there are also risks.
Cybersecurity adds growing urgency to every strategic decision. With digital touchpoints expanding across rural communities and enterprise systems, the organization views cyber risk not as an IT responsibility but as a systemwide threat.
“I do feel that’s our biggest risk these days,” Mr. Wilda said. “Although you’re starting to see some of the cloud technologies start to get a knock on resiliency, I think cybersecurity is one of the most impactful things that can happen at any given moment.”
The future
Looking ahead, the University of Iowa Health expects to grow by expanding digital reach, optimizing operations and deploying AI and automation to support workforce-constrained environments. Mr. Wilda emphasized that the goal is not technology for its own sake, but technology that strengthens relationships and simplifies care.
“Growth is truly going to be how do we control costs but bring those innovations to the table,” he said. “AI and automation is definitely going to allow us to be more efficient. But it is going to be that hyper focus on making sure the technologies enhance the patient provider intimacy and not just decrease it.”
