University of Utah Health Achieves HIMSS EMRAM 7; CIO Credits an Agile, Clinician-Focused IT Strategy

Donna Roach shares how digital governance, agile methodology, and clinician alignment are reshaping IT strategy.

University of Utah Health is leveraging governance discipline and agile principles to build a digitally empowered organization, according to Chief Information Officer Donna Roach. Speaking about the health system’s journey toward achieving HIMSS EMRAM Stage 7, Roach described a focused, clinician-oriented approach to platform optimization, capacity management, and change enablement—positioning the IT organization as a strategic partner across the enterprise.

Situated in Salt Lake City, University of Utah Health encompasses five hospitals, 20 clinics, and a significant telehealth presence across a five-state Mountain West region. With $3.5 billion in annual revenue and designation as the region’s only academic medical center, the organization faces both complexity and opportunity in transforming care through technology.



“We’ve been an Epic site for many years,” Roach said, “but since 2016 we’ve really been optimizing that platform, staying on a single instance and working closely with Epic as a development partner.” She pointed to the health system’s early adoption of Epic’s Gallery content management system as an example of how vendor collaboration can yield direct clinical benefits. “Physicians were telling us, ‘Hey, things that never showed up before are now showing up in the media tab.’ That’s exactly the kind of feedback we want to hear.”

Digital Roadmap Anchored by Governance

Roach entered the organization at a pivotal moment, just as the COVID-19 pandemic began shifting priorities across healthcare. One of her early charges was to define and communicate a comprehensive digital strategy. Rather than defaulting to virtual care alone, Roach pushed for a broader vision—one that would require system-wide alignment and governance.



Working with leadership, she established a Digital Enablement Committee and created a roadmap spanning six focus areas, including access to care, innovation, personalization, architecture, and virtual services. Initiatives are assessed for urgency and sorted into “immediate,” “intermediate,” or “long-term” categories. This structure allows for flexibility in prioritization without compromising the system’s strategic direction.

“There was a point recently when a group requested that an intermediate initiative be moved up in priority,” Roach said. “We agreed, but in doing so, we also moved another project back to maintain balance and capacity.”

This balancing act is central to how University of Utah Health approaches governance. A strong link between strategic goals and execution enables the IT team to maintain focus while also responding to changing operational needs. Projects identified as immediate are communicated to tactical governance bodies such as the Application Advisory Council, Infrastructure Governance, and Data Governance teams.

Agile Execution Meets Organizational Reality

To better adapt to rapidly changing technology landscapes, Roach has introduced scaled agile practices into the IT organization. While vendors often maintain longer, more traditional project cycles, her team is learning to prioritize work in more frequent increments, typically six to nine months in duration.

“We’ve shifted away from pure waterfall,” Roach explained, “because too much changes in an 18-month cycle. Agile gives us the discipline to focus on 80% of the work, deliver it, and then move into optimization.”

The shift also allows for greater transparency and predictability. Iteration planning sessions help set expectations internally while giving vendor partners a clearer view into the organization’s priorities. “We’re working with our vendors to get them aligned with how we now plan and execute,” she said.

That shift has helped reduce noise and fragmented requests,