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 Today on Keynote

sometimes in it they think, well, I can only do it. Well, no, if you're doing it in healthcare, you're doing healthcare and you're fortunate enough to do it with a technology foundation.

I love that part of it. . 

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.

Now, let's jump right into the episode.

  (Main) . Alright, it's keynote and today we're joined by Susan Banez from Southeast Georgia Health System, CIO, the first ever CIO of Southeast Georgia Health System. Susan, welcome to the show. Thanks, bill. Glad to be here.

Thanks for taking the time to talk to me. I'm looking forward to the conversation. It has to start with. I've had people who stepped into roles that people had before and turnarounds and those kind of things, but first ever, what does the work look like?

How do you establish yourself? How do you establish the role, the priorities? What does that look like?

Yeah, it's really been an exciting time and I really have to give credit to the CEO that was leading the organization who really had the vision. Understood technology and the importance of it in bringing the CIO role to Southeast Georgia.

Prior to that, the highest ranking it official was a director and probably historically, that was okay, but as they got new officer group and really positioned the organization to move into the next chapter. Of its journey. It really was his vision to bring in a CIO, which was really exciting.

I, in my career, have not worked at an organization where I was the first CIO or they hadn't had a CIO.

actually there's things that are, that would be exciting to me about that and things that would be terrifying. I think the things that would be exciting is it's a little bit greenfield.

It's like, all right, let's. Talk about governance. Let's bring people along. Let's understand how technology, like you can collaboratively build it with the organization. Things that would terrify me is there's probably a whole bunch of stuff that didn't exist. Like you, you had to, had to spin it up from nothing.

You're right. So I did bring a playbook with me based on my experience at other organizations that I had built out teams and built out governance and built out processes and things like that. Career ladders and, all the blocking and tackling stuff. But stepping into this role as the first CIO even had to take a step back from that.

So you really had to start at. The grassroots level, what was a CIO and why do they need one, and what was the difference that it was gonna make? And, how many people do you need in an IT department? All of those things. Before you could even start talking about what we are very accustomed to discussing, is it strategy and, what our roadmap looks like and what governance looks like.

There were just things that they didn't know, what they didn't know, and so. Realizing that as I joined the organization and very quickly into my a hundred day assessment, it really was a, hold on, we gotta step back a little bit further and really start the organization on this journey. So just realizing that and pivoting a little bit so you could take them along into, the beginning chapter, one of the book before we could go through the rest of it.

And that part the organization there is a lot of great people that have been here for a very long time, and maybe they haven't worked at other organizations, so they truly did not know what they didn't know.

I've looked at your LinkedIn profile right now, and you have experienced across several kinds of health systems.

Has that helped you both from a, large and small standpoint and also from a regional sort of diversity of having been at different types of communities? I

think it really has, I think a, it helped me build my playbook so that I had, pretty much a playbook, if you will, when I came in the door here.

But it also gave me a lot of different perspectives from different parts of the country, different types of organizations for-profit, not-for-profit. I. Large, small, it really gave me a perspective of it's not just this way at hospital A or health system A, and so it's got to be this way at HO Health System B.

It was really, this, I can take this from this large organization and this from this small organization and really adapt it and customize it to what this health system needed.

People ask me all the time, how do you get to be the CIO of a health system?

You were willing to move around. Texas. Colorado, Georgia. You were willing to, it looks like, did you relocate for all those jobs to

I did every time. Yeah. That's an interesting point. And I talked to a lot of young leaders that are looking to move into a CIO or high IT leadership position, and that's something you have to decide early on.

Are you willing to relocate? Are you willing to move to take a step up and then take a step up and take a step up to ultimately reach the position that you want? And that's a tough decision because there's a lot of factors I. I was fortunate where I had support from my family and, just a lot of luck and blessings where it was like, okay, I'm gonna take this leap of faith because this is a continuing step along the path.

And I didn't get started until late. I didn't start out as a traditional college student. I started out as an adult college student with. Young children. So, I got started late in the game and so I had a lot of ground to make up as far as moving around to get to my ultimate goal. But I talked to early careerists about that, no early will you move, will you not move?

And what would you be willing to do if you were gonna stay, put in a location? If you were geographically bound what are you willing to do? How do you get to where you wanna go without moving? Because there's. In my opinion, in most cases, you do have to move on or move out to move up.

If anyone's followed my career path I've moved all over the country for the next thing and now family allowed me to do that. There was a lot of things that allowed me to do that, as you rightfully pointed out there's a lot of reasons not to move and there's a lot of reasons, but it has to be intentional.

You have to say, what am I willing to potentially sacrifice in order to attain what you want to attain? I wanna talk to you about Southeast Georgia. So Georgia makes me giggle a little bit. There's no doubt. I like, we know where you're at. You're in southeast Georgia there, there's a northeast Georgia, there's a Southwest.

Is there a Northwest Georgia? I don't,

I think there's a Northeast Georgia or Northern Georgia. So there's some other. Systems that are pretty geographically pinpointed with their name.

So Southeast. Tell us a little bit about the communities you serve

I would assume so you're southeast, southwest, got hit pretty hard by those hurricanes last year. Southeast too. Oh, you did as well.

We did not like the Carolinas, but we did. And when I moved here I was assured that hurricanes don't ever hit here. They jump along the coast and they skip over that cove and don't worry about that.

And I come from Texas, so I'm used to hurricanes. But we did get hit with that one and it was a, I think, a surprise. It was a last minute turn as hurricanes can sometimes do. But we serve a five county area. And we are 45 minutes from Jacksonville and 45 minutes from Savannah, and we are right on the coast, St.

Simon's Island, Brunswick, those areas. That's our home base. We have two campuses, one in Brunswick, Georgia, which is our larger campus, and one in Camden or St. Mary's, which is our smaller campus and about 60 physician offices, primary care and specialty.

would you classify it as rural?

Seasonal. How would you classify the primary population? Or are those areas just growing year round?

I think they're in somewhat of a destination or seasonal trend to it, because it's a big golf community, a big beach community. So we do have definitely an influx of tourism.

And so I think that does drive, some of the care level, or volume of care that we have in the health system. So it is somewhat seasonal. Our population this summer is definitely larger. They're second homeowners. In the areas sea Island, St. Simon's, Jekyll, but not to the extent that you see in places like Vail, Colorado, but there is a lot of second homeowners in the area.

you ca You came from Colorado. So that's, it is an interesting dynamic. I'm down in west Florida and. It's beautiful. And I asked one of the CIOs down there, what's one of the biggest challenges, and they said, recruiting physicians. I'm like, you gotta be kidding me.

This is like one of the most beautiful places in the world. He goes, yeah, but he goes they're extremely busy from like October to May, but then it's a ghost town from May to October again. And that creates some interesting dynamics in terms of attracting and retaining, clinicians down in those places.

think one of our biggest challenges here in this area is staffing, because we're a smaller community in between Jacksonville and Savannah, we are challenged with bringing talent into the area. We're the largest employer in the area. There's a lot of military flex seas here.

There's a lot of competition, and then there's the big cities. Or bigger cities that can draw the talent. One, I think we'll get to it in a little bit, but one of the things that I've done since I've been here is adopt truly a hybrid or remote workforce strategy. We haven't rolled it out completely across the organization, but I think in many cases we will.

And so we're piloting it in it. Everybody did it during Covid. It was cool during covid. But in our geographic location and with staffing challenges across the country for IT professionals, we had to look at a strategy that would let us bring in some top talent.

an organization of your size, what does digital transformation look like?

What does innovation look like? Are you mostly focused on blocking and tackling?

It's actually a combination. That's a great point. So while a lot of organizations have the good fortune of being able to just strictly focus on digital transformation, we're having to run parallel tracks of eliminating technical debt and getting a lot of that foundational piece put in place at the same time.

Keeping up with what we have to keep up with from a digital transformation perspective. So for the next, I would say for probably the first five years of my tenure here, we will be running those parallel and dual tracks. So we have to do both.

You brought up tech debt and you're the first CIO and I think somebody might hear that and say, oh, well they didn't have a big technology push before, but there's probably technology

across the entire organization when you got there and without a CIO per se, maybe a director or whatever a lot of times those initiatives don't align into a cohesive strategy. How challenging is it to address tech debt as you come in as the first CIO.

It's really challenging, especially in the financial situation that we're all facing as health systems and then throw in some of the political changes that are going on.

It's a challenge because eliminating tech debt is expensive, resource intensive, but necessary. So you're right. There was not an IT strategic plan, so to speak. Before I got here, there was an organizational strategic plan, but the IT department wasn't really connected, in my opinion, to that strategic plan.

We got secondhand information about, hey, we're gonna be doing this, and oh, by the way, this went live yesterday and there was a lot of reactive posture from an IT perspective, which one of the benefits I think of having a CIO is you have that seat at the table and you can have input into that strategic plan and then you can share that communication and build your IT strategic plan off of that.

So it does align because if it doesn't align, you shouldn't be doing the initiatives that you're doing in it if it doesn't align with the strategic initiatives and plan of the organization.

Yeah. Where do you start with tech now? 'cause you can't eliminate it all at once.

You're not gonna go in and say, Hey look, we need $150 million. We're gonna replace every computer, every biomed device, every server, every switch hub and router. It, so, where do you start and how do you sort of prioritize it as you move forward?

That's a great question. I'm very fortunate to have a very strong director team that it was all new with the exception of one person.

And so what we did was I did my a hundred day assessment and did a SWOT analysis and then as each one of them came in and their areas like network infrastructure and technology apps and informatics. Information security, data analytics, and enterprise project management. They each did their own a hundred day assessment.

So I presented my initial one to the board and to the C-suite, and then they did theirs, and then we put 'em all together and developed a strategic roadmap trying to hit. You're trying to balance the clinician patient experience. You're trying to ensure that we have a highly reliable organization, high availability, and there were some easy things to knock out first.

Easy things. We did a wifi remediation, replaced all the wifi access points. We replaced the core switch, and firewall, and we're replacing our entire virtual infrastructure. With the Nutanix solution this year, those were some of those big things that had to be done. Then you start talking the legacy OS's, and that's a longer roadmap because all of our devices were legacy OS's, so we had to really map that out so that we could do those in a certain period of time.

But it was a three year initial roadmap. And then of course, we've made some shifts along the way. We didn't have really any cloud presence, so we had to look at that. So one of the strategies was to, we can't replace all this legacy hardware, so let's look at where we can move stuff to the cloud.

So we're an Oracle Cerner shop, and we are going live this month moving our Oracle Cerner instance from legacy hardware in our data center on-prem. We're of the last client hosted sites up to OCI. So we'll be, we're going from one of the last client hosted sites to the first OCI hosted site. Since the Oracle Cerner acquisition.

So we're leapfrogging that. And then we have our U-K-G-H-R payroll, in the cloud. And so as we look to those cloud strategies, if you can't replace it or you don't need to replace it or you're thinking of replacing it, does it make sense to look to the cloud?

That's that's fascinating to me that you're the Cerner migration.

First of all, I didn't know Cerner had. Self-hosted sites. I assume, I guess just they had gone, they were one of the first that went to host it and almost all of their clients were hosted. Yes. I think you could probably

count remaining ones on one hand, if not three fingers.

what are the considerations as you move to the cloud? It is a different model altogether. Business continuity, disaster recovery, how do you think differently as you move workloads up to the cloud?

I think you know, it definitely, you wanna be very intentional and very thoughtful about, I consider us multi-cloud. We have an Azure instance for our data analytics.

We'll be OCI hosted for our EMR platform. We're UKG hosted for HR, payroll, et cetera. And so, right now that strategy works to get us to a foundational baseline and then we would consider. Do we wanna go to something like a Rackspace or, would we have our EMR hosted in a Rackspace?

We'll evaluate that as we get a little further into this journey. But as we think about DR and BCP, that's a whole new concept to this organization. By no fault of their own, they haven't had that rigor and structure or process. And so we're developing our DR plan and our BCP plan right now, going through cyber tabletop exercises, doing our application inventory, really looking at application rationalization and working with our operational owners.

What do you need to come up first? What's your order of operation? And even more basic than that, do you have downtime processes and downtime procedures?

it's interesting. One of the questions that comes up in the 2 29 CIO meetings is who owns DR. And business continuity?

'cause there obviously there's a technology component and it's just naturally assume, hey, you've gotta make sure the technology systems keep running, but what if they don't keep running? There's an awful lot of operations that just needs to be involved, and a lot of organizations don't identify like, who owns this.

Have you found that to be a challenge?

It is a challenge because it's, there's not in just my organization, but in many organizations there's an assumption that if it runs on a computer, it's it, and. So, it's obviously an IT issue, but you know, flipping the script on that operations belongs to operations and so they need to know and make sure their teams are clear on what they do in a downtime and what their processes are and who's responsible for it.

In fact, we've had the conversations, which I'm sure many CIOs have. You write your downtime procedures, you tell us when your system needs to be back up IT network infrastructure. We'll be bringing back up the systems and working on, God forbid a cyber attack or whatever, but the operations departments have to keep running, do their processes, and really help us as an organization determine what the order of the recovery is.

And I found that conversation alone has been very educational to the organization. It's like, what do you wanna bring back up? And then they just look at you like, what do you mean? It's like. Would you like the, it all come

back up at once

or would you like the imaging system back up first?

Like, well we need 'em both. I'm like, yeah, but we only have these resources to work on 'em. Which one would you like first? And when they getting those kinds of trade offs, they're just like. Well, you know what? Our imaging system can actually run standalone for a period of time. Exactly. Get the EHR up first that we and it's just educational for them to just talk through it and go, oh wow.

It is

and I love having the officers in the room when you're having those conversations with all of their background and expertise, you can see them start to think about that. Okay. If you, your system comes up first, then mine, and we could run standalone, we can take care of our patients.

The nurses know how to go on downtime procedures, all of those things. It's just very eye-opening in several of the, downtime procedures, it was refer to it policy. And I was like no, we need to stop and think what your process is. I can tell you what it is gonna be doing.

And they were like okay. That makes a lot of sense. And they are very thoughtful in putting those together. It's just a completely new conversation.

ai I'm just gonna hit AI real quick because, a system of your size, you're still thinking about ai, I would assume it's still a very prevalent conversation.

Yep. We're looking at of course AI in the clinical space, which makes a lot of sense. Ambient listening taking the burden off the providers and the nurses and I think that's gonna be a really big game changer for the organization. So we're still looking at that. We have plans of, in the next year doing some pilots in that in our fiscal year, FY 26, which starts in May bringing some pilots.

To the organization for that. But I think, and this is in my opinion, I'm probably oversimplifying it, but in an easy place to plug and play some AI is in the revenue cycle.

Yes.

There's tons of opportunity. People are not as antsy about the patient care concerns, and there's a lot of tried and true solutions out there that we can bring in that will bring a lot of value.

I'm curious, so you talk about ambient listing. What does it look like at an organization like yours? I see these organizations run these huge bakeoffs and they have five different partners they're looking at. Do you still do something that elaborate or do you try to shrink it down or work with existing partners where possible?

What's your approach to that?

I'm a platform person, and so I believe if a platform solution meets 80% of the functionality, you should stay platform. Rather than going with a point solution. Unless a point solution doesn't exist or unless there's a special case. Because I. We are an organization of this size, and so I, I don't, I'm not a development shop.

I don't have the opportunity to do a large bake off with a bunch of different vendors. I need to stay with the core solutions that I have from a financial and a resource perspective. It's a small team, a small IT team here, probably about 70 people. And we run about 300 applications in our portfolio, and that's a lot.

Right? So, we try to keep it close to the core where we can. And thankfully the two leading EMRs, epic and Oracle have, they're bringing to the table a lot of great solutions that you can look at implementing without having to, veer away from the core.

you're probably the the first person I've talked to that's looking at the Oracle ambient listening. Solution And I, you're, you said you were piloting it. How's that going so far?

We haven't started it. It's on our roadmap to pilot. Okay. So when we get a chance to, we will, and, we're bringing in a lot of different solutions just to get us up to a foundational level, but ambient listening in AI will be one that we bring in probably in.

FY 26 year. So middle FY 26, and our fiscal year starts in May. So close to the end of the year.

I wanna come back to I'm gonna get back to your Facebook profile here. You have a bunch of professional certifications CHCIO, CDH-E I'm gonna say FACHE as well. What, what, What's the value of those programs? What have you found to be the greatest value of those kinds of development programs?

Well, I love the I love the structure and the standards that those bring. It sets us on a level playing field. If you're an FACHE you've met a baseline of requirement and education and certification which doesn't.

Mean you're gonna be better or worse or stronger or weaker. It just means that you have that foundational level. I find that's an important factor, but then I think the networking, especially as an independent health system, is so valuable. I can call my partners in CHIME, my partners in ACHE, I can reach out to phone a friend, that is so valuable as an independent system.

In my time with HCA, we had, you know, endless list of resources that we could call. That we're part of our organization in an independent health system, it's a little bit different. You make friends, you network, you have your phone a friend and your colleagues that you can reach out to.

And that's so valuable.

what is the next generation thinking about healthcare? How are they coming in? What's it like to interact with students who are looking at. either a career change or at a potential career in healthcare.

Yeah, it's really exciting. I get more energized working with students and early careers than I just can't even express how much I enjoy that I teach at Abilene Christian. I've taught at Trinity University in San Antonio. I think that we as IT leaders have an obligation to give back, and that is a way that.

I have found that works for me to do it and I really love it. And I love their usually when they're in my class and they're master's students, they're not sure what they wanna do. Now I've had some physicians that have gone back to get their MHAs, and so it's clear what they're looking to do.

They're looking to build their professional education along with their clinical education. That makes perfect sense to me. But some of them don't know what they wanna do yet. And so really I think the opportunity is to tell them what it looks like in healthcare now and what it looks like in healthcare leadership.

because options, you can do anything. You can do technology, clinical finance, business operation, strategy, you name it, you can do anything. So when they come into the program and they say, I don't really know what I wanna do, then you can talk to them about what is your passion. Do you wanna work in a hospital?

Do you wanna work in a large system? Do you wanna work in a clinician's practice? And really start laying out what all those options are, because sometimes in it they think, well, I can only do it. Well, no, if you're doing it in healthcare, you're doing healthcare 📍 and you're fortunate enough to do it with a technology foundation.

I love that part of it.

Well, we're gonna finish where we started, which is future CIOs. So, if we're sitting here. It was one, one of the number one questions I've gotten over the years is, what does it take to become a healthcare CIO? You've navigated that and you've gotten to that chair, to that role.

What would you tell people who are asking you that question today of what did, what does it take and what do I need to develop in order to be in that role? What is the role today? Maybe misconceptions I have about the role today. I'm giving you a lot of different directions you can go with the question,

yeah, I love that question. I think that what I always ask someone when they say, I want to be a something, why? What's your why? Why do you wanna be that and what's motivating you to do that? And usually they can tell you, I wanna take care of people. I got into healthcare and healthcare it because I wanted to be a clinician, but thats not my gift.

So I got into healthcare the only way I could, which was through technology, and it's a blessing to be in healthcare and I'm very mission driven and I love being in healthcare, but you couldn't put me in front of a patient to take care of a patient because I'm not your girl. But I love being here and doing what I do.

I. So, I think if we talk to them about a CIO, it's not just a techie job anymore. It's important that you have the technical background because you have to understand your industry, but you can learn that. So a CIO, in my opinion now is much more of a business owner, an operational leader, and a strategy person.

And then throw in the financial aspect because a lot of the expense, capital and operational for a health system, we're one of the biggest expense departments and we don't generate revenue. So you have to understand the finances and the impact on it. And then you have to understand vendor management and contract negotiation, all that.

You're not just working in technology anymore. So I think that's great because to me what that means is you don't have to have masters in technology to be able to be a CIO. I think you can get to this role in a variety of ways. I came up through the systems engineering. Path. And then, continued my education and had a lot of lucky breaks in my career and ended up in this role, which was my ultimate goal.

But you don't have to start that way. You can come up through finance or you can come up through project management apps and informatics. There's just a million ways to get here. And so talking to them about. What the role is now and what the ways are that you can get here, I think helps them.

And then you come to the really important questions that you and I were talking about. Will you move, are you willing to take a lower position to ultimately get to where you want? Is the title the only thing you'll take or would you work your way up?

It's interesting undergrad.

I think people really can do anything. And they'll be a CIO. But if they were gonna get a Master's degree, would it be master's in health in one of the health fields? Would it be an MBA? Would it be a master in a technical field? I mean that, for me, that's always been a harder question because people ask me, what master's should I pursue?

I lean towards MBA because you're sitting in those rooms and we talk about numbers a lot. Yeah. We talk about the business and the operation a lot. I'm curious what your thoughts are on that.

I was already in healthcare and knew I wanted to stay in healthcare, so I did my MHA and then my DHA because I was already well into my path.

But you're right, an MBA is a great choice and it doesn't tie you to healthcare. So to me, an MHA or a DHA is a doctorate or a master's. Of business and operations with healthcare emphasis. So I think that's a great choice. If you know you're gonna be in healthcare, an MBA is never a bad idea, but what I have seen, what my experience has been is with an MBA, it's a little generic and so you have to earn your cred in whatever industry you're gonna go into.

If you do an MHA, you've already got that healthcare foundation. And so it's easier to jump into a higher level position because you've got a specialty. An MBA is very generic like a ba.

Yeah, that makes a lot of sense. Susan, I want to thank you for your time and I appreciate I, I know how busy you are.

I appreciate you coming on the show.

Thanks, bill. I appreciate the time. It was great to chat with you.

  📍 📍

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