Rick Schooler, vice president and CIO of Orlando Health, a seven-hospital health system with a 355-member IT staff, is the 2011 John E. Gall CIO of the Year – an award given by both CHIME and HIMSS. It’s a designation that Schooler finds particularly gratifying.

“I personally view the Gaul award as the single most significant endorsement that a CIO can have from the industry,” he said.

It’s understandable that Schooler, who, as a CHIME foundation board member, helped to select others for the award, would be grateful for the honor. The award is named for John E. Gall, Jr., who pioneered the implementation of healthcare information systems at El Camino Hospital in the 1960's. The award recognizes health IT leadership, and leadership is something top-of-mind for Schooler.

“There really has never been a better time to be a CIO – to be a competent CIO,” he said. “That does not only mean a competent technology person. That means, first and foremost, you’re a healthcare leader. You understand the business. You know where things are going. You get it. And, you’re able to bring the right people together to make decisions and make plans and investments that are truly tangible – that enable strategy.”

Schooler has plenty of opportunity to practice his leadership skills. As Orlando Health CIO, he not only oversees healthcare IT, but also telecommunications, clinical informatics, biomedical engineering, supply chain, retail pharmacy, and a group purchasing organization. Schooler earned a bachelor’s degree in computer science from Purdue University and an MBA from the University of Indianapolis. The healthcare IT world has changed radically since Schooler served as director of systems integration at Methodist Hospital in Indiana from in the early 1990s, and even more since his stint as CIO for Central Georgia Health System before he joined Orlando Health.

Schooler knows the demands and expectations are growing rapidly. For a CIO to effectively retain his or her role and to flourish in that role requires more skills than ever before.

“Whether it’s personal traits, whether it’s knowledge base as an individual. Whether it’s our knowledge of the industry, technology. Whether it’s our relationships that we build, the way we network,” he said. “You put it all in a bag. It’s all got to be there.”

What do you view as your primary mission as CIO?

My primary mission is reflected in our annual IS report. Our mission statement and our vision statement is right upfront. That mission statement essentially is to enable our Patient First Clinically Integrated Model of Care. It really is that. There’s really no reason for us to be here unless were enabling our Patient First Clinically Integrated Model of Care strategy. If you’ve read the Mayo Clinic book on lessons on leadership, it talks about their patient-first strategy, and we picked up on that three or four years ago and we said we’ve got to transform our culture. We’ve got to change our organization to survive in the future. We’re going to pursue clinical integration. We’re going to pursue accountable care – whatever word you want to put on all the different things that are going to happen – we’re all going to have to do this to survive. What is it that’s really going to differentiate us from others in our marketplace who would be competitors, as well as what would set us apart nationally as best-in-the-nation medicine. We are convinced that it’s Patient First, and that means everything we do has to be rethought, It has to be reconsidered first and foremost through the experience and the expectation of our patient. When you start thinking that way in delivering healthcare, you begin to quickly identify a lot of things that need to change.

What is your proudest achievement?

Even before I was a CIO – even when I was a kid growing up, playing sports and being in different leadership roles through high school and college and after – it’s two factors, but it’s the same thing: I really get jazzed when I see my team members achieve their potential, whether it’s individually or whether it’s collectively – especially when somebody with whom I’ve been able to work becomes a CIO or becomes a leader. Or a team that really does something just phenomenal. It’s just like, “Wow, I cannot believe we did that.” It’s just such a good feeling as individual for me to know that however it happened, my leadership was effective enough to get this individual or this team to achieve their potential. I don’t know what else you can ask for as a leader.

What has been the biggest challenge you’ve had to face as CIO?

I heard a term the other day – a two-word comment that actually sums it up. The term was “tyranny of the urgent.” What that means is convincing other executives not to give in to the “tyranny of the urgent” at the cost of sacrificing strategic or consensus-driven actions that are well governed and well thought upon. Yet the tyranny of the urgent causes us to sacrifice what we ought to do and what we know we should do for what we believe in the moment we must do. That transcends every level of any organization. It can be a specific technology decision. It can be a specific decision made by the business. It can be a “We’ve got to get this done right now, otherwise…” And, so we often find ourselves – and I’ve seen this in my career working at three health systems over 21 years – sacrificing what should be done for the tyranny of the urgent. It’s never-ending. It’s constant. It is incessant. It does not stop. Every day there’s somebody that says, “My hair’s on fire,” or “I’ve got to have it right now.” When you drill down into a lot of that, you know what? You find out that it really wasn’t that big of a deal. It’s been my biggest challenge, bar none – that is having to sacrifice what we should do for what we believe in the moment we have to do.

Has meaningful use changed your job?

The significant change has been essentially in terms of timeframe. We’ve known for many years that we must implement these kinds of technology and we must use them in what has been coined “a meaningful way.” So it really wasn’t something that sidetracked us. We were pretty much ready to move on this. But the way in which things have to be reported and the timing that just made us re-orient ourselves to go ahead and do some things now that we had planned to do later. But because we want to get all the money we can and we want to be compliant with all stages and all phases, that’s caused us to be a little more expeditious in our planning.

Where will healthcare IT be five or 10 years from now?

We are going to be responsible to manage a bigger population of people with more risk in terms of our ability to keep them healthy. We’re going to be held accountable to managing readmissions, to reducing harm. Our board has given us specific goals around readmissions and mortality and harm. I think organizations are going to be paying much more attention to the quality of care because value-based purchasing is going to be real. We are going to be reimbursed less if our quality doesn’t improve, and, quite frankly, it may be less even if it does improve. We believe that here in Florida because we received a $45 million haircut from the State of Florida on Medicaid in one fell swoop back in July with no real understanding of how bad the problem’s going to be. It was a big haircut. You know, you’d better be a leader. You better be a team of leaders if you’re going to survive both kinds of things happening: continuing to provide the quality you’re going to have to provide to survive in the future – your alignment with other organizations as we all pursue what we are all defining as we go as accountable care – and to be able to deal with what is now CMS, but in the near future is going to be a bundled payment across the continuum. The organizations that are on it now, that are doing it right, are going to be fine down the road because they’ve got the ability to see their way through it, and be able to fund it. The organizations that are not going to be able to fund this, or they can’t see their way through it, are going to have to consolidate. They’re going to have to get on somebody else’s wagon. I just don’t see any way for somebody to make this, five or seven years from now, on their own as a stand-alone hospital unless you’ve really got your act together – and that means IT. IT has become one of the key enablers.

What are you reading?

Complexity: The Emerging Science at the Edge of Order and Chaos, by Melanie Mitchell Waldrop, a professor of computer science at Portland State University. It’s almost like a textbook. It’s about the complexity that exists in nature and everything around us. So, it talks about the complexity of DNA, about how networks really work and what are networks in life, as well as computer networks. It talks about different aspects of life in terms of theories and strategies, and it really does a good job of making you think about how to survive and how to manage and how to thrive in complex environments.

Rick Schooler, vice president and CIO of Orlando Health is the 2011 John E. Gall CIO of the Year.