'It's not just an Epic workflow anymore': Rush's CIO challenges team to think big

Chicago-based Rush System of Health recently completed the implementation of a new customer 360 architecture to bring together information and data from across the health system about patients, community members, students and more.


That information had previously been held in different databases but now has come together to create a whole view of individuals and their family networks.

"[We put] in this infrastructure to connect all of that and to give us a much more holistic view of who our customers are, what their preferences are and what their experiences have been so that at point of contact, we're able to bring all of that knowledge to bear and suggest what the next best action could be," said Jeff Gautney, senior vice president and CIO of Rush, during an episode of the "Becker's Healthcare Podcast." "That could all be very subtle."

One example Mr. Gautney shared is a common occurrence: a patient calls into the call center for a particular question, and the receptionist sees that patient has three referrals that weren't acted on. The receptionist can mention the missed follow-up and help the patients close their gaps in care during the phone call.

The new data connectivity also challenges team members to think about their ability to support patients differently. Rush uses Epic EHR, and like many health systems, its team members have primary "swim lanes" of accountabilities; they are experts at a module but not generally thinking outside of their expertise, or "swim lane."

"We have to really turn that on its side and say, 'No, let's think about the whole workflow.' Because it's not just an Epic workflow anymore; now there's half a dozen other things that light up," said Mr. Gautney. "You have to think about those tools and think about how they enable the workflow in a different way, and it's been a challenge because we have trained people to be really, really good in their swim lanes, and now we're asking them to think about the whole pool."

Change management in the IT space is often discussed in terms of the "people, process and technology," with "people" listed as the most crucial element to any successful transition. The technology investment and installation is often the easiest part, and processes must be designed to incentivize new goals, but change won't make a difference if team members aren't fully committed to the new direction.

"Sometimes it's a challenging transition, but I think this is one that will bear the greatest fruit for us as we go forward," Mr. Gautney said. "That's the reality, particularly in digital and AI. You really do have to think across those siloes."

Mr. Gautney and his team have inspired change by inviting team members to participate in the planning and design process so they feel invested, not left behind. There is a lot of communication involved in change management, and that isn't always easy.

"We're a hybrid workforce and largely remote. We have folks in our workforce that work in 20 different states, so the old days of pulling people together in a room and whiteboard things out are very different today," he said. "How we engage with people and how we inspire them had to adapt over the last three years significantly. Over-communicating is definitely part of it, then we have some formal training and some assignments for projects that are stretch projects where they may not know everything going on but they learn on the job."

With the fast pace of change in digital technology, CIOs need nimble teams ready to try new things and learn new skills.

"The old 'throwing people into the deep end of the pool,' most of them do learn to swim, but some do sink, so we want to save them because we need everybody in the village, not just some people," he said. "We try to put people into safe spots where they can participate in projects and grow, and that's been so far pretty successful. There's a lot of room to continue to do that; it signifies to the rest of the staff that we have a commitment to continually investing and continually growing the team, and I want us to be thought of as a place where people can come and grow their career, not just do the one thing that they're really well known for over and over again."

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