A hallmark of well-executed technology deployment is the absence of fanfare. No alarms blare, few users hiccup and stakeholders acknowledge a job well done. The coronavirus pandemic tested technology's ability to run quietly in the background, as new, distributed constraints cropped up.
"When IT is invisible, it's really working," said Brian Lancaster, CIO of Nebraska Medicine and the University of Nebraska Medical Center (UNMC). Many industry peers are not invisible right now, he told CIO Dive.
Lancaster is the CIO of two organizations operating in concert. Nebraska Medicine is the healthcare business, a clinical enterprise where nurses, doctors and pharmacists operate. UNMC is a teaching and research facility with faculty and students across six colleges.
As part of the connected operations, a physician could offer direct care at Nebraska Medicine and serve as researcher and faculty member at UNMC. Staff members use Microsoft for email, productivity and collaboration platforms, which became more important with the pandemic.
The organizations' use of healthcare software system Epic exemplifies the complex environment. Epic is used in a clinical setting, where all care is documented. The system is also used in an educational venue for simulation and in medical research. Siloed use cases are entirely broken down.
The tech works "flawlessly," said Lancaster. The clinical information, education and research systems share network, data and telecom infrastructure.
Maintaining seamless operations and easily pivoting to remote work was the result of a digital transformation journey which began four years ago when Nebraska Medicine and UNMC began discussing cloud- and mobile-first efforts.
"You really need to use technology as a strategy," and see what revenue and benefits you can create as a byproduct, Lancaster said. It requires a shift from cost containment and risk mitigation, to technology initiatives that introduce more markets or support the business level.
Digital transformation: a timeline
When he joined in 2015, the organization was widely deployed with Epic, ran laptops without a lifecycle management plan and lacked strategy on the infrastructure and system side, Lancaster said. It was just trying to keep Epic running.
The puzzle was how to invest quickly and holistically in software as a service. Legacy deployments of McKesson and Epic are not cloud-enabled. And the goal was to create a similar user experience for researchers, clinicians and students. It was a push for IT as a service.
The digital transformation efforts of Nebraska Medicine and UNMC allowed the organization to quickly pivot when the pandemic hit. Its technology updates included:
A 2016 data center move with a push toward server virtualization.
Network virtualization between 2016 and early 2018 allowed for agility and network microsegmentation. Workloads can move between data centers without IT having to create a new IP address, Lancaster said.
In 2018, software-defined data center adoption and the deployment of network insight tools.
In July 2019, the organization rolled out VMware's Workspace One to end users, which allowed for virtual desktop, management of mobile and web apps alongside legacy applications. It created a device-agnostic hub for end users.
Workspace One was integral for allowing UNMC and Nebraska Medicine when the order arrived on March 16 declaring no more in person classes and sparked the quick adoption of telehealth.
The organization worked from July to October last year on change management to get every student, faculty member, clinician and other staff members installed and enrolled. It allowed them to use a single web portal to access the organization's resources and applications.
If an organization cut out training and adoption components of technology deployments, "I wouldn't wish that on anyone."
CIO of Nebraska Medicine and the University of Nebraska Medical Center (UNMC)
Without the preparation, UNMC and Nebraska Medicine would have had to deploy remote tools to facilitate working, education and research to almost 17,000 people, including students, faculty, staff and medical professionals.
For the adoption work, IT held more than 90 sessions, either one-on-one or at the department level. Some of his peers were trying to do this all in five days, Lancaster said. He couldn't imagine making the transition "without more hand holding."
"Healthcare is not the same as other industries in terms of the technical aptitude of the user base," Lancaster said. While people can struggle with laptop basics, the technology is more nuanced in healthcare.
If an organization cut out training and adoption components of technology deployments, "I wouldn't wish that on anyone," he said.
Another CIO's example
The pandemic highlighted preparation: Companies with digital transformation efforts already in place and a tech-centric culture were able to quickly pivot. It's not that they had explicitly planned for a pandemic — organizations had planned for a connected future.
"I would say we didn't explicitly plan for a pandemic. I would say we had planned for a mobile and global workforce."
SVP and CIO of Ellucian
Higher education technology software and services company Ellucian began pivoting toward a cloud-based product suite six or seven years ago, Lee Congdon, told CIO Dive. "This was an extremely smooth transition for us."
"I would say we didn't explicitly plan for a pandemic," he said. "I would say we had planned for a mobile and global workforce."
The company's work to standardize and encourage the use of collaboration tools with easy and secure access, only became more relevant as the workforce distributed.
But some of Ellucian's higher education customers struggled to immediately deliver the rest of the term online.
Ellucian's cloud pivot allows it to help "customers understand what's involved in running an organization that's based in the cloud and the benefits of that," Congdon said.