This is Laura Dierda with the Becker's Healthcare
Podcast. I'm thrilled today to be joined by
Joshua Wilda, associate vice president for information systems
and chief information digital officer at the University
of Iowa Healthcare. Joshua, it's a pleasure to
have you on the podcast today. Thank you,
Laura. I'm excited to be here today,
especially representing University of Iowa Health Care.
Absolutely. Now, you know, I love University of
Iowa. I haven't grown up right near there,
a a big Hawkeye fan. And so just
we'll be excited to learn more about some
of the things you're doing and,
what you're thinking about for the future. But
before we dive in, can you tell us
a little bit more about yourself, your background?
I know you recently,
joined the University of Iowa, and so love
to hear a little bit more about,
you know, some of the things that you've
done throughout your career and what you're bringing
to the new, new place.
Yeah. For sure. So,
I've been in health care IT for about
twenty years now in various different roles. I
actually started
as an Epic implementer working at Epic,
which gave me a really good opportunity to
understand the relationship
between,
patient provider and technology,
with how forward folk forward facing and forward,
thinking that they are as an organization.
After that, I got that opportunity to go
work for
a health system in the Michigan market, University
of Michigan Health West, where I really had
that opportunity to combine talents of how do
we connect patients and providers,
how do we use technology as that vehicle
to allow the whole organization
to work at the top of their license.
I talk a lot about about that,
and really get myself to to hone in
on my own leadership style, leadership abilities.
Five years ago,
University of Michigan Health West joined
into the University of Michigan Health Regional Network
where I got to be able the the
opportunity to to lead a much larger team
across a network of community health organizations
and get the opportunity to really partner with
academic medical centers. You see this now happening
these days where academic medical centers and community
health medicine
are really combining forces and bringing more power
to what they can do. And then, you
know, I had the opportunity to expand in
my own career.
The mission that happens at Iowa, the fact
that Iowa is is, the
the only academic medical center here. We're a
quaternary
organization for the state, and we truly serve
the Iowan community.
And I love the mission and passion around,
again, how can we extend technology,
especially now, you know, Laura, you've probably seen
and heard about rural health.
We'll talk probably a little bit about that.
And Iowa is right for how can we
use technology to connect patients,
to for them to stay in their communities,
but still get the health care that they
lead. So, my career has gone full circle
up and down,
allowing me to use a lot of my
own past experiences to now bring a breadth
of expertise in digital health,
in digital transformation, in project management, in leadership
to the already great foundation that was here
at UIHC
and be able to to really push us
forward. As you, can imagine our mission and
vision, changing medicine, changing lives. How can you
not get behind that?
And so that's it's very exciting to be
a part of it now.
Absolutely. No. That's amazing. And what a a
great way to come into the health care
space to understand the technology side, really, being
able to then move into the provider side,
and see some of the big challenges as
well as come up with solutions and develop
network and relationships that can make a big
difference. So, you know, I'm curious when you
think about where we're at today, what are
some of the opportunities and headwinds that you
have your eye on right now? What are
you, thinking most about?
Yeah. Laura, I think for for me and
and I'll see talk specifically here at University
of Iowa.
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. This is
a perfect opportunity and perfect
ecosystem
for that.
You know, many out there I I'm from
Wisconsin. I'm a Midwesterner, so I understand
communities in the Midwest, but some might say,
you know, Iowa, they don't use IT. They
don't use technology.
You know, I beg to differ coming from
the Midwest of, you know, farmers and those
that are in these industries.
They actually rely heavy on technology.
And how can we then bridge that gap
to give them that care that they need
so you can still focus on on their
families and where they're going and where they
are, but get the care. So patient experience,
I think, is something that we can lead,
definitely the state in, but also expand on
nationally.
The other thing that is hyper focused is,
for me,
is connecting the dots between
the health care, the research, and the academic
side of our tripartite mission.
Often I see in some other,
organizations
that while they're part of the mission, they're
not coalescing together.
The research isn't driving the health care, isn't
driving the education within the organization itself. Usually,
it kinda permeates out and then comes back
in another ways. And so I'm focusing on
how do our teams connect those dots even
more so that we can bring some of
that research to the bedside as quick as
possible for our patients in in care from
that standpoint.
I hate to always talk about this. I
think every CIO, CIO, CIDO does
cybersecurity.
You know, those two missions of how do
we extend ourselves
not only in, the community that we're in,
but to the rest of the state, then
there's big risk there too from a cybersecurity
standpoint. I do feel
that's our biggest risk these days. Although you're
starting to see some of the cloud technologies,
starting to get a knock on resiliency,
but I think it's still cybersecurity
is one of the most
impactful things that can happen at any given
moment. And how are we prepared now to
use technologies like cloud
and others to maintain services
while we deal with those high impacting events?
Last but not least, when we talk about
headwinds,
it definitely is
this push and pull of technology can be
an enabler,
but technology has cost behind it. And how
do those costs affect the cost of health
care? How do we drive down those costs?
What's happening at the federal and state levels
around our reimbursement?
You know? And it is interesting that I
have these conversations of, hey. You know, we're
reducing your reimbursement, but use technology to make
yourself more efficient.
Well, that comes with cost.
That comes with the understanding of how do
we become intentional with how we're using technologies.
Rural health care, I mentioned that with some
of the federal funding that's coming our way
here in short order. The conversation is, yes,
we wanna use that to stand it up,
but it also needs to be sustainable and
make the impact of the mission and care
there so it is sustainable cost. So Dan
Dan that that that dance of innovation,
cybersecurity,
how much you you know, how innovative can
you be when you're always concerned about those
security and resiliency pieces of it, and then
the funding. And how do we continue to
flow that
to allow technology to help drive health care
from a vehicle standpoint? We're still in it
for patients and providers. I never want anyone
to ever think that, especially in our world,
that it's not health care first. I talk
about that we're an organization.
Our leadership style is we're health care professionals
in the IT space. I say that often.
And that's where the goal is of how
do we balance cost,
risk, and innovation
to push forward where health care can go.
I love that. I think that's such a
sums up sums up so well,
some of the different challenges, but then also
opportunities that you have with the technology, with
AI, and, what it really takes in order
to transform the organization, not just bringing technology
in, but
knowing how to implement it and incorporate into
the daily workflows to solve some of these
big problems and really tackle,
you know, the challenges that we're having head
on. So Yeah. When you think about,
yeah, I guess, are there any specific examples
you're looking at in the next year or
two?
Yeah. Some things that we're doing for innovative
wise, we're we're one, it's not innovative. It's
it's actually
assuring that the block and tackling of some
technologies that are table stakes are out there,
like telemedicine and teledelivery.
Those are some things that we're we're looking
at. We're definitely looking at the cyber,
security framework. And, again, using infrastructure
and technology. How can we
bridge the gap in resiliency and really make
sure it's at control cost? So we're talking
about being a cloud smart organization
using cloud technologies not as the primary deliverer,
but to to to stand up our resiliency.
I'm really excited for where the hospital of
the future and I always say that and
I go, it is here and now. 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 and
deliver more of that patient provider intimacy but
through our technology. So we're definitely looking at
products that allow us to expand our services
and telly,
expand our services in patient education.
There are also some things that are fun
things, which is interesting that,
as I came here, it's a very large
institution.
You know, I came from Michigan Medicine, same
thing there. It's something that you you experience
every day here, and you see it are
those patients that are coming here. And for
the most part, they don't wanna be here.
You know, there are some life changing fun
events why you would be at health care.
But when they come here,
you should really be focused on how can
they come in and be well and and
and engage. But the first thing they gotta
figure out is how do I get to
where I need to be? Where do I
need to park? So digital wayfinding and that
experience
of helping folks relieve some of the pressures
of what it takes to engage with health
care,
so they can focus on the relationship, what
they need to do to be better, what
they need to do to heal. That's something
that's fun to to look at, and we're
talking about that as an organization of how
can we give a a great internal experience
when they're here so they can focus on
engaging with us and not focus on how
are they gonna wander around and get to
where they need to be. So those are
some fun things that we're continuing to work
on. And I didn't touch on AI just
because everyone else does.
But it is in there in our conversations
around how do we get how do we
utilize it everywhere in our organization for everyone
to work at the top of their license,
in facilities, in HR, in supply chain. You
know, it's not just about those clinical,
AI tools for ambient voice. Those are very
important. Clinical decision for AI, that's very important.
But we're also looking holistically of how do
we raise all boats
using AI and raise all of our capabilities
as
health care professionals. So those are some some
of the exciting things that we're working on
in short order.
I love that. I I think that's, so
cool that your capability,
to do all of those things and the
precipice of really,
strong transformation there at Iowa. Now I think
we've talked a little bit about growth and
some of the ways that you see these
changes occurring, but I am curious. What does
it look like, that balance when you think
about adding value to the organization? I think
especially with technology and AI, you know, it
is expensive as we've talked about in a
big event. So how do you know, that
some of the things you're doing are are
actually adding that value and really what do
you do to measure that? What are some
of the metrics and things you take into
consideration as you're piloting and testing and then
rolling out?
Yeah. I always love the conversation around, is
IT an expense center or a value center?
You know, we're expense center when you're looking
at budgets and you're going, hey. We're in
high health care, and why are you one
of the largest
budgets?
But it is about value, and it is
about what are we bringing to the table
and pushing to the forefront here at Iowa.
One of our goals is to be ahead
of the business, but doing it in an
intentional sort of way. We all know that,
that money is tight or it is small
margins around,
health care, and our focus is intentionality.
Our focus is how do we reinvest in
ourselves
by really focusing on,
eliminating
legacy technologies, overlapping technologies,
and then
driving new innovations in intentional ways. I've been
a part of other organizations where they do
a lot of pilots all over the place.
And they really don't know what they're trying
to solve for. It might be the new
cool big thing
to do and that's out there, but they
really haven't engaged with the organization of what
true problems are we trying to solve? What
problems that if we solve them are gonna
be the most impactful?
And like you said, Laura, what are those
metrics to show that?
We're bringing that discipline
to our institution and having those conversations around
technologies.
Perfect example that I give you is when
I talk about tele nursing.
You know, there's point solutions that are out
there for that. But can we get more
value out of that being a a platform
based technology?
So we can maximize our resources,
teach them a platform, and expand on that
platform.
Also, our end users are now not, dealing
with different systems.
They're now more focused on how the technology
is driving care instead of being a wedge.
So when providing that value, it is about
what's the what are we trying to solve
and getting to the root of that? What
are we trying to to deliver as far
as our experience in getting to that? Talk
about those measurements of what it means to
bring that value.
And then with that intentionality,
and this is something that, you know, I'm
learning
as I have grown into the larger scale
organizations.
How can we move in an agile sort
of way so there's speed to delivery
in that innovation, in that intentionality?
So we're working on how are we assessing
those things in short order, how are we
bringing them to bear in front of our
organization,
as well
as being using our telescope in strategic planning
going, what is the next two to three
years look like, and how can we
maybe deprecate some old technologies
so we can invest in the future and
be in an investment front fund of ourselves?
Absolutely. I love that. And, you know, that
that's such a a great philosophy to have.
And when you think about becoming an investment
fund into yourself, when you become how you,
think about, you know, where the value is
and how you're contributing,
overall,
it'll just become even more critical over the
next couple of years because I know so
many hospitals and systems have tight budgets or
looking at, you know, tight margins,
probably,
in the coming years given just the current
environment, health care landscape, etcetera. So,
I I think when you actually take that
mindset and put it into practice, what does
that look like? Are there any other, I
guess, investments that you still think are important
to make knowing that it's going to be
challenging in the next couple of years? Yeah.
You know, the the other thing, Laura, that
that I think is helpful is now the
partnerships that you form in the communities that
you're in. Right?
Every market has
competition, some sort of competition or a community
arm, especially in Iowa. There's a lot of
community and critical access hospitals.
And I think another way to bring that
value is how do we pool our resources
together,
not from a command and control standpoint, but
from a leveraging all of our experiences. You
know, we're all competing for talent.
We're all competing for patient focus. We're all
competing for the best quality of care that
we can do. Now how can we do
that in such a way that we get
economies of scale, especially from a technology standpoint?
That's something I'm excited about that's happening in
Iowa.
For those that are are listeners might know
Epic's Community Connect program, allowing
organizations like Iowa who,
have direct connections and contacts to Epic to
extend ourselves out into the community areas.
So those folks can leverage the technologies at
a lower cost sort of way because of
the scale that we're able to provide it.
And then looking to how do we build
upon that,
something I've been so excited about coming into
the Iowa market has been the community connect
program that we have at Iowa. I've been
thoroughly impressed with the partnerships that we have
made
through our community connect program. But the secret
sauce is actually
then those critical access hospitals that we're extending
to, especially in Iowa, how they've come together.
And they've talked as a community now on
how they leverage the tools.
And that's where you're gonna get the investments,
the returns on these.
You know, if we're all going out and
buying the same systems and putting the same
technologies,
there's no economies and scales of that. How
do we leverage our skill sets and our
talents and our scale
to really drive what can happen in a
community and across the state?
So I think that organizations need to hyper
focus on that. Michigan market, there was a
lot of competition, and we would call coopetition.
Here in the state of Iowa, I'm seeing
that it is more of that community focus.
It's less about competition and more how do
we raise all boats.
And that's something that I'm excited for. And
Iowa is a key partner in that conversation,
especially with the scale,
especially what we provide,
with the skill sets, the talents of our
providers,
of our nurses, of our administration,
and definitely our IT shops. So I think
that that's another area that folks should should
look at at is how do you partner
in technologies
versus going out and doing them on your
own.
I love it. I I think that idea
of partnership and being, so ingrained with those
collaborative collaborators,
within the community,
in in the companies that are willing to,
be part of that and part of that
solution and partner with you to know what
you need and build something that makes sense
for the institution is so helpful. I I
think I've heard more than ever over the
last year that, partnerships are critical in the
health care space, more than ever. So it's
it's a team sport, and that's great to
hear.
Before we wrap up, I wanted to ask,
where do you see some of the best
opportunities for growth in the future? Yeah. Good
question.
There's definitely more growth to be had around
how we can extend our services both internal
to our organization
and then thinking about how do they how
do they grow to the community. I think
another area of growth is
our talent,
and how do we invest even more in
our talent, taking advantage of of especially local
talent, but also expanding ourselves. I think that
as the community of IT changes, you know,
the the the now the technology changes into
AI or the ability to be remote,
it really has changed the framework of how
we utilize our talent and deploy them.
So growth and maximizing
our talent to the point of how are
they involved, how are they getting into the
passion of the mission, how are they bringing
new technologies to the forefront
are gonna help us grow. I think the
most part for for me, growth is truly
going to be how do we control costs
but bring those innovations to the table.
AI and automation is definitely going to allow
us to be more efficient.
But it is gonna be that hyper focus
on how do we make sure the technologies
enhance the patient provider intimacy
and not just decrease it. And I think
as we start seeing AI being a layer
on top of some of the technologies that
we've had, you know, that we've had EHR
for years, and now a e AI is
allowing us to interact with big data and
EHRs
in a more efficient way so we can
focus on patient care. I think that is
gonna drive
more of the benefits of what we can
get out of the collective data in EMR
in our infrastructure and technology. So I'm excited
for the growth and possibility
of how can we be more efficient, but
come at it with a all new light
of innovation,
connection,
partnerships, and collaboration.
I love it. Joshua, thank you so much
for joining us on the podcast today. This
is such an inspiring and and fun conversation
to have, and I look forward to connecting
with you in the future.
Thank you for having me, Laura. Always always
love participating in these.