Latest / Becker’s Healthcare Digital Health + Health IT / Steven Ramirez, Chief Information Security Officer at Renown Health

Transcript

Steven Ramirez, Chief Information Security Officer at Renown Health · Becker’s Healthcare Digital Health + Health IT

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  This is Laura Dierda with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
• 0:42
  Steven Ramirez, chief information security and technology officer
• 0:46
  at Renown Health. Steven, it's a pleasure to
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  have you on the podcast today.
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  Good morning, Laura. Great to be with you.
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  Now I'm excited to have you here because
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  I know you've got a really wide, background
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  in information technology, security, and a lot of
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  things that you're doing at renowned are are
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  really cutting edge in terms of how you're
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  thinking about AI technology
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  and keeping things,
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  secure as well as transforming the health care
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  and health care delivery system. And
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  so I'm looking forward to learning more about
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  what you're doing now and and how you're
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  thinking about the future. But before we dive
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  into that, can you tell us a little
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  bit more about Renown and what makes it
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  unique? Yeah. Definitely. So, again, good morning. I'm
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  excited to be with you and, you know,
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  share the journey that, we're partaking here at
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  Renown. So,
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  something really cool and something that we really
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  kicked off end of last year going into
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  this year was our CEO made a big
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  focus on, you know, rebranding our mission, vision,
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  and value statement. So what's unique about Renown
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  is that we were actually the first hospital
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  in Nevada,
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  which was founded in 1864.
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  Since then, you know, we've been serving, you
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  know, the great community,
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  of Northern Nevada, California,
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  in that outreaching area. So we serve over
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  a million people, and cover a hundred square,
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  mile reach, just from what our services, you
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  know, reach out to. We're the only regional
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  level two trauma center. We have an affiliation
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  with UNR. So really, you know, embracing that
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  academic medicine and really looking to grow that
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  partnership,
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  from the clinical research side to really just,
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  you know, help us grow our mission to
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  serve the community.
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  We've recently rolled out transplant, you know, and
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  other specialties,
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  so that people can just really have the
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  care they need at home. So we're really
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  excited,
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  to what you touched on, to really see
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  how tech can help enable that, across the
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  organization. So, you know, we've done a lot
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  of lot of cool things and we're really
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  kicking off year one of our, strategic plan.
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  So, you know, working closely with our CIO,
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  and other executive leaders to really, you know,
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  execute on that over the coming years.
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  That's really great to hear. And, you know,
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  cool to have that opportunity to be right
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  on the forefront of this type of,
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  digital transformation.
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  Now when you look at the last year
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  or so, can you tell us a little
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  bit about what you're most proud of? What
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  project initiative
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  or or really the things that,
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  had the most impact on the health system
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  overall?
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  Yeah. So I've been at Renown, just a
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  little over three years now. So when we
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  came in,
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  it was really doing a big effort to,
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  you know, just look at our technical landscape.
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  I think we were spending a lot of
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  money in areas that needed to have some
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  refocus on. So I know under the direction
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  of our CIO,
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  and, you know, executive team, Really, we did
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  a phased approach to stabilization.
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  So really what was working well, what wasn't,
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  you know, areas that we needed to focus
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  on, you know, cybersecurity being a big focus
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  of that as well as tech debt.
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  I know a lot of health care organizations
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  are really looking at how, you know, they
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  can balance the cost to, you know,
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  the digital transformation,
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  in a meaningful way to have what we
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  need to support, you know, the clinical growth
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  in a lot of these cool tech, you
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  know. AI is definitely a big buzzword on,
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  you know, areas on that that, you know,
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  we'll share more. So, you know, the stabilization,
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  modernization,
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  and then the optimization. So we really tried
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  to
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  adhere to those three pillars. So really the
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  first few years was really looking at, you
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  know, how can we stabilize things, you know.
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  Do we have the right people process technology?
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  And then where do we really need to
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  strategically focus and modernize our infrastructure,
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  as well as cybersecurity stack? And then obviously,
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  optimization.
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  Like, once we get that, it's, you know,
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  that ongoing life cycle management. So
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  as far as what I'm most proud of
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  is that, you know, through that journey, you
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  know, I originally started as our chief information
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  security officer and then that evolved into being
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  the CISO. So, the chief information security and
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  technology officer. So,
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  my CIO tasked me to go through and
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  really, you know, take a deep dive with
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  the team to look at everything holistically.
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  So, you know, really proud of, you know,
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  where we've come,
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  over the past three years, you know, as
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  an organization
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  culturally.
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  I mean, really coming up with our IT
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  tactical and strategic plan to align really where
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  our CIO wanted us to go as well
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  as our executive team to, you know, better
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  support the business. So I think a lot
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  of the success to that was our governance
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  strategy. So, again, when you're looking at a
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  lot of, you know, investment opportunities, you need
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  to really first hone in on your, you
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  know, governance.
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  So we set up a GRC, our governance
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  risk and compliance
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  committee, which is co chaired by me and
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  my compliance officer and then have all of
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  those key stakeholders across the organization. So we're
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  able to look at all risk throughout the
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  organization, which, you know, very, very important,
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  and, you know, really tied into my CISO
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  role. But also,
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  you know, in working with our CIO, they
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  he set up, you know, with his other
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  partners on our president's council and SBAR process
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  to really govern any net new technology and
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  projects coming into our organization.
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  So that really, you know, tied into third
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  party risk management as well. So that, you
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  know, we had different checks and balances for,
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  you know, new tech we were gonna look
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  at that would then, you know, work through
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  our application rationalization,
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  you know, going through our intake with our
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  TMO, PMO office. So really making sure we
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  had all the the right eyes on any
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  net new technology,
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  projects, etcetera,
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  that to really ensure that success and making
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  sure that, you know, we're able to,
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  properly,
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  you know, roll that out across the organization.
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  So that governance strategy, you know, is,
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  super critical to that,
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  but also
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  implementing and adhering to various
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  frameworks. So, you know, really a subset of
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  overall governance,
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  that we're a NIST
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  shop, NIST CSF. We just recently did our
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  NIST
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  CSF two point o.
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  Obviously, do our HIPAA, and we're also,
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  really starting to take a deeper dive into
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  the I triple E,
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  twenty nine thirty three for AI governance.
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  So, again, that's where,
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  why governance is so important because there's a
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  lot of,
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  my CIO will, you know, famously say shiny
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  bright objects out there. So really making sure
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  that, you know, we're we as an organization
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  make sure that if there is a technology
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  that makes sense to really supplement
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  what we're doing, we're able to properly secure
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  it or roll it out and support it,
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  and then the business actually gets true value
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  out of that. So,
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  I think we've done a good job of,
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  you know, using that from a governance and
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  intake process to really make sure that we're
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  getting the most bang for our buck for
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  any proposed technology.
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  That's really helpful to know. And I appreciate
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  the deep dive into your governance strategy because
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  I know that's something that health systems
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  in general are are trying to stand up
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  and figure out, especially as technology is rapidly
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  evolving and and truly
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  wanting to make sure that things are secure,
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  but also not being left behind
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  in the AI space and more. So, you
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  know, this has been a a really helpful,
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  understanding of what that process looks like for
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  you. And I'm curious, as you mentioned, you
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  know, elevating into the
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  CStow role, I I know the team is
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  being built up around you. What does that
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  look like? How are you hoping to continue
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  to evolve the team that you work with,
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  your leadership team as well, to make sure
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  that, you know, it's, prepared and ready to
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  deliver on the transformation that's occurring?
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  So yeah. No. That great question. So, again,
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  my role, again, evolved just, you know, with
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  the natural synergies between,
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  cybersecurity
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  and the technology space. So, again,
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  we just had so much tech debt and
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  a lot of just modernization
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  efforts that we needed to go that it
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  just made sense to combine,
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  the technology
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  group as well as security team. We had
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  a lot of managed services,
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  out there. So really looking at, you know,
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  where we are today and where we wanted
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  to go,
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  with a security focus really made that helpful.
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  And security really helped drive some modernization efforts
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  on the infrastructure side. So, you know, really
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  from the identity,
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  two factor authentication,
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  you know, driving more single sign on, and
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  then looking at a lot more of these
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  zero trust based tools to really enable, like,
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  a
• 9:09
  on the go workforce.
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  So,
• 9:11
  you know, typical VPN and solutions like that
• 9:14
  are a little clunky for our end users.
• 9:16
  So again, you know, looking at that holistically
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  and seeing how we can better support our
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  end users and making a big focus on,
• 9:24
  you know, the end user experience. You know,
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  we're just really scratching the surface on that.
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  So obviously, that that made a lot of
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  sense. But again, as we're growing and kicking
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  off our strategic plan and working with our
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  CIO, it really made sense to help branch
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  off my current role. So we're in the
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  process of bringing on a new VP of,
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  infrastructure,
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  data center network,
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  to really help really,
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  take us on that journey over the next
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  few years as part of our strategic plan
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  because it's a little too much for one
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  person. So a lot of what we're gonna
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  focus on in kind of this IT reorg
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  is gonna be, like, front end technology
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  versus back end technology,
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  and then really having those more focus points
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  so we can better align and support the
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  business on a lot of our modernization
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  and and tech debt efforts across the organization.
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  So,
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  definitely can use the help on that and,
• 10:18
  you know, have an additional partner to really
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  ensure the success of what we need to
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  do, you know, sticking to that stabilization, modernization,
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  and optimization to really help
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  set ourselves up for the future on technologies
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  like AI,
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  etcetera. So
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  No. It's helpful to know. Thank you so
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  much, Steven, for digging a little bit deeper
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  there. Now when you look into the future,
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  the next twelve months or so, where do
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  you see the big growth opportunities,
• 10:45
  for renowned and your team in general?
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  So, you know, just starting on the the
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  cybersecurity side, I think we've done a a
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  great job, and I touched on that, you
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  know, a little bit before that, the cybersecurity
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  side helped drive some modernization
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  efforts on
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  the technology side. So, you know, I'm really
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  proud of the cybersecurity program,
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  that we built, the team that I have,
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  and really where we're going. We're just kicking
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  off our,
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  three year road map. So,
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  successfully completed phase one of that and now
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  really getting into more of the, you know,
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  fun maturity efforts associated with that. So we
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  really started with, you know, articulating
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  risk with the organization, and I think that
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  helped drive the understanding and importance,
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  and which in turn drove
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  the investment. So we got a very big
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  investment over the next three years. So now
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  it's about delivering.
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  And we took a very, you know, simplistic
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  approach to, you know, we know ransomware is
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  a problem. We know phishing is a problem.
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  So what is the core fundamental reason on
• 11:43
  why organizations are at risk to that? And
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  then how do we address that from people
• 11:48
  process and technology standpoint? So we put together
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  a road map and, SBAR,
• 11:54
  that we then went up through our various,
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  you know, governance process. Our CIO took that
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  up to the board and executive
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  team to really get the buy off on
• 12:03
  that. And, you know, that's really encompassing a
• 12:05
  lot of what we're doing.
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  And, you know, really excited to really be
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  focusing on identity, you know, really scratching the
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  surface on that in our first initial plan
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  that, you know, what makes up identity, getting
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  those core fundamentals together that really set us
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  up to then start to do these enhanced
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  security
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  practices of, like, zero trust,
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  and,
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  enhanced DLP,
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  and other components to that as well as
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  deception technology, different automations, and pieces like that.
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  If you don't have the core framework,
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  and foundation in place, it's really hard to,
• 12:40
  you know, be successful and do some of
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  those,
• 12:43
  level up activities, you know, I'd like to
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  call it. So really looking forward to doing
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  a lot of that. And I think that
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  all goes back to, you know, the ability
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  to
• 12:51
  articulate risk. We have a great security culture
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  across the organization that our team is very
• 12:56
  risk adverse. So I have, you know that
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  makes my job very easy, and we're able
• 13:01
  to execute a lot quicker kind of having
• 13:03
  that dual role,
• 13:05
  of the c you know, CISO and CTO
• 13:07
  role. And I know we're gonna continue to
• 13:09
  build off of that momentum
• 13:11
  across across the board,
• 13:14
  and are really excited to see that. And
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  also to,
• 13:18
  see how we, you know, again, use our
• 13:20
  frameworks like IEEE twenty nine thirty three for,
• 13:23
  you know, AI, bed device security,
• 13:27
  and really just to make sure that we're
• 13:28
  being risk agnostic
• 13:30
  to a lot of these things, doing the
• 13:32
  fundamentals very well. We have the organizational culture.
• 13:35
  And then, you know, with a lot of
• 13:36
  the geopolitical things going on, the importance of
• 13:38
  self governance that Renown and our executives are
• 13:42
  you know, we're full steam ahead on, you
• 13:44
  know, doing the right thing from a a
• 13:46
  cybersecurity and technology standpoint regardless of what's going
• 13:49
  on because, you know, our goal is to,
• 13:51
  you know, be successful, adhere to our mission,
• 13:54
  and really support our end users as we
• 13:56
  move forward. So,
• 13:57
  cybersecurity is a big focal point to that.
• 14:00
  And then, you know, obviously, having the technology,
• 14:03
  to really go where we need to to
• 14:05
  support a lot of these cool new clinical
• 14:07
  innovations across across the, board on that. So,
• 14:11
  we're really getting to the
• 14:13
  to the point, you know, from a cybersecurity
• 14:15
  perspective that, you know, I told my team
• 14:18
  that we don't wanna tell people our house
• 14:20
  is on fire. That's really have a strategy
• 14:22
  to put it out. So I like to
• 14:24
  say, like, our smoke detectors are alerting. So
• 14:27
  that's what a lot of cybersecurity shops, you
• 14:29
  know, will go through and we know something
• 14:30
  bad's happening.
• 14:32
  But how can we be more
• 14:34
  tactical at, you know, automating and getting things
• 14:37
  done like fire suppression, for example? Why can't
• 14:39
  we have we know something's going on, so
• 14:41
  let's put it out as quickly as possible
• 14:43
  and isolate it. And then have that incident
• 14:45
  response. It's like the firefighters showing up to
• 14:48
  that. And then, you know, if there's any
• 14:50
  kind of restoration efforts, do we have Servpro?
• 14:52
  How quickly can they be there and help
• 14:54
  us clean up components of that? So really
• 14:56
  hoping tell that story to the business and
• 14:58
  making sure again that we're able to not
• 15:00
  only know something's going on, but being able
• 15:02
  to react quickly. But that also translates into,
• 15:05
  you know, what a lot of what we've
• 15:06
  been talking about the importance of that close
• 15:09
  relationship with the technology
• 15:11
  enablement,
• 15:12
  to have, you know,
• 15:14
  a resilient
• 15:15
  infrastructure. So no single points of failure. We
• 15:17
  know, you know, inevitably technology fails and or
• 15:21
  you know, in the unfortunate event we have
• 15:23
  any kind of cybersecurity
• 15:25
  event that how quickly can we, you know,
• 15:27
  come back. So that's really been a big
• 15:29
  focus on, you know, how we architect
• 15:31
  and are building out,
• 15:33
  and investing in a lot of our core
• 15:35
  infrastructure for that modernization effort to really make
• 15:38
  sure that, you know, we're we're planning for
• 15:41
  any kind of risk that comes, you know,
• 15:43
  at us and really embedding that into our,
• 15:46
  go forward strategy.
• 15:51
  I appreciate,
• 15:52
  your insight here. And definitely, you know, it
• 15:54
  seems like a lot of opportunity to bring
• 15:57
  in new technologies, make sure they're safe. You
• 15:59
  have a a great playbook,
• 16:01
  in looking at those things and and then
• 16:03
  executing on them. You touched on this a
• 16:05
  little bit as some of the challenges,
• 16:07
  happening in geopolitical landscape as well as, you
• 16:10
  know, for for technology evolution. Could you dig
• 16:13
  a little bit deeper in there? What are
• 16:14
  are the biggest challenges, I guess, as you're
• 16:16
  looking ahead? What do you anticipate and and
• 16:19
  how are you preparing?
• 16:20
  Well, definitely, you know, geopolitical.
• 16:23
  So, you know, starting with the cybersecurity
• 16:26
  side of the house that, you know, there's
• 16:28
  a lot of effort on, you know, ending
• 16:30
  the conflict between Russia and Ukraine.
• 16:34
  So I actually saw some information yesterday on,
• 16:37
  you know, different threat intelligence that some of
• 16:39
  the threat actors are now using
• 16:41
  countries that are more western friendly like the
• 16:44
  Germany's and and others to really start to,
• 16:48
  spawn their attacks from there. So, like, our
• 16:50
  whole geofencing
• 16:51
  and, external blocking strategies have to really be
• 16:55
  a little bit more,
• 16:56
  strategic on,
• 16:58
  you know, people taking advantage of the the
• 17:01
  old ways to,
• 17:02
  you know, make sure that we're doing right
• 17:04
  by the organization and staying up on those,
• 17:06
  conflicts.
• 17:07
  As well as, you know,
• 17:09
  the HIPAA security rule, which is, you know,
• 17:11
  out there for, you know, comment, etcetera.
• 17:14
  With the new administration, what will that look
• 17:16
  like?
• 17:17
  As well as, you know, some funding changes
• 17:19
  that are are out there on Capitol Hill.
• 17:21
  So that's, you know, really why I touched
• 17:23
  on, you know, self governance that, you know,
• 17:25
  we have these industry frameworks that we're gonna
• 17:27
  adhere to regardless of that to really protect
• 17:31
  the mission and,
• 17:33
  really stick to the fundamentals on what we
• 17:35
  need to do,
• 17:36
  moving forward. So I think those will be
• 17:38
  some of the the biggest challenges as well
• 17:40
  as, you know, our continued dependence on third
• 17:43
  party partners,
• 17:45
  and fourth party partners.
• 17:47
  You know, Change Healthcare was the one that,
• 17:49
  you know, really burnt in our minds and
• 17:51
  memories on, you know, what can happen from
• 17:53
  that. So just how we better protect our
• 17:55
  organization on,
• 17:57
  looking at partnerships
• 17:59
  like that and then having backups to a
• 18:01
  lot of that. So I think that's gonna
• 18:02
  be the biggest challenges as well as just,
• 18:04
  you know, cost controls and, you know, making
• 18:07
  sure that we stay the course. Because, again,
• 18:10
  there's a ton of shiny bright objects and
• 18:11
  things that you need, you know, that are
• 18:13
  coming out and, you know, people are pitching
• 18:15
  that, you know, will fix burnout, will fix,
• 18:18
  you know, solve world hunger. But again, there's
• 18:20
  a lot of these pieces that you need
• 18:22
  to have foundationally in place from, you know,
• 18:24
  an infrastructure,
• 18:26
  security, and data,
• 18:28
  perspective, or you're never gonna be successful in
• 18:30
  using some of these more modernized
• 18:32
  technologies
• 18:33
  and kinda similar to what we did with
• 18:35
  security. We have to have those foundational elements
• 18:37
  in place,
• 18:39
  on the technology side, on the data side
• 18:41
  to then, you know, enable some of these
• 18:43
  cooler advanced technologies.
• 18:45
  So
• 18:46
  That's amazing to hear. You know? And certainly,
• 18:48
  fascinating to understand everything you have to keep
• 18:51
  your finger on the pulse on and learn
• 18:53
  about and know about,
• 18:55
  in your role as the, you know, chief
• 18:57
  information security as well as technology officer at
• 19:00
  Renown.
• 19:01
  Just fascinating.
• 19:02
  I'm curious before we wrap up here, what
• 19:04
  is the number one most important thing that
• 19:06
  you're doing right now to set up Renown
• 19:08
  for long term success?
• 19:10
  I think being risk agnostic, you know, which
• 19:13
  I spoke to, sticking to the fundamentals,
• 19:16
  having that organizational
• 19:18
  culture and buy in as well as self
• 19:20
  governance. So from an IT perspective, you know,
• 19:23
  doing what we say and and saying what
• 19:25
  we do, you know, so delivering and being
• 19:27
  good partners to the business.
• 19:29
  So I think those are really fundamental. And
• 19:32
  something that, you know, I'm really excited that
• 19:34
  we're kicking off this year is, you know,
• 19:35
  we always talk about the cybersecurity
• 19:37
  shortage,
• 19:38
  that we have, but we have the great
• 19:40
  opportunity
• 19:40
  with, you know, being partnered with,
• 19:43
  UNR,
• 19:45
  to kick off an internship for a pipeline
• 19:47
  with,
• 19:48
  cybersecurity
• 19:49
  talent that they have there. So,
• 19:51
  this is the first year that we're gonna
• 19:53
  start to have an internship
• 19:55
  program with, their cyber program over there.
• 19:58
  So really gonna see how that can not
• 20:00
  only benefit the up and coming talent,
• 20:03
  out there, but also benefit, you know, our
• 20:05
  team from a lot of what we're trying
• 20:07
  to do. So really building
• 20:09
  for the future on what we can do,
• 20:11
  with cybersecurity
• 20:12
  shortages and knowing that, you know, those kinds
• 20:14
  of risks aren't gonna go away anywhere. And
• 20:17
  again, you know, there's just so much going
• 20:19
  on to just really stay in touch with
• 20:21
  our business and our strategic plan to really
• 20:23
  give us that road map to making sure
• 20:26
  we're delivering,
• 20:27
  and not getting off track, on where we
• 20:29
  need to go as an organization.
• 20:33
  That makes a lot of sense. Steven, thank
• 20:35
  you so much for joining us on the
• 20:36
  podcast today. This has been a fascinating conversation,
• 20:38
  and I look forward to connecting with you
• 20:40
  again soon as well as seeing you at
• 20:42
  our health IT, digital health, and revenue cycle
• 20:44
  event in October. I know you'll be speaking,
• 20:46
  on cybersecurity, and I can imagine just continuing
• 20:49
  to follow this conversation and how the situation
• 20:51
  evolves. And so I'm really looking forward to
• 20:53
  that, and,
• 20:55
  thank you again for your time.
• 20:56
  Thank you.