Becker's Hospital Review touched down in Orlando last week to ask three questions of hospital, technology and advisory firm leaders. Here, respondents share their response to question No. 3: Who are the hospitals in competition with for talent?
Read compilations for questions No. 1 and No. 2.
Jose Barreau, MD. CEO and Co-founder, Halo Communications: Hospitals would be very smart to look at it like that. The quality of your care still has a lot do with your physician. Let's face it. You can have the best facilities and ancillary stuff, but if you have a bad doctor, it's not going to be great for you.You're better off having a great doctor and the care underneath is not as good. At least the decision making on a high level will be good. Nurses, too. Hospitals need to compete for nursing and physician talent. It's visible. Some organizations have a higher level of talent and it shows.
Keith Bigelow. General Manager and Senior Vice President of Analytics and AI, GE Healthcare: Ironically, I think hospitals are increasingly in competition for talent with Amazon, Google, Apple, Facebook and Microsoft, because they are offering a massive amount of access to data, offering really compelling financial opportunities, and opportunity for hospital employees to finally do something at a global scale.
Eric Chetwynd. General Manager of Healthcare Solutions, Everbridge: There was one I alluded to — nursing. There is a nursing staffing shortage, but the challenge is you need a lot of nurses in healthcare. From what we've seen, there are a lot of questions about how [hospitals] are going to protect them. It goes beyond compensation these days — progressive organizations are starting to think about what else they can offer to attract nurses to their organization, especially in competitive markets. That might come down to staff safety or new benefit programs. And looking for different ways to attract those primary care physicians to your health system is another common, but continuing, challenge.
Rhonda Collins, DNP, RN. CNO, Vocera: The issue for hospitals right now is the burnout issue, the overworked and stress and fatigue issue; it takes two to do one job. We're also coming into another nursing shortage, like in the early 2000s. Every time I talk to a CNO their biggest challenge is staffing. Recruitment is one thing, but retention is quite another. We are doing international recruitment again. The second part of that is retention. You have this chronic revolving door, so some of the conversation I see now is about being more creative about how you retain your nurses.
All the data is telling us that millennial nurses are more interested in engagement. They want to be engaged in the process. They want to be engaged in decisions about the tools that they use. They want to feel like part of the family. [Millennials] really want to be part of the mission and vision and feel like they've contributed to that. The challenging thing for hospitals is you never get to shut the doors and just focus on that. You're always open.
Patrick Combes. Technology Leader, Healthcare & Life Sciences, Amazon Web Services: [Hospitals only compete] with each other. Honestly. I think as far as hiring is concerned we don't ever adopt the business of our customers. There's not going to be an Amazon hospital. We don't need physicians to staff a nonexistent hospital.
Pete Durlach. Senior Vice President, Healthcare Strategy and New Business Development, Nuance Communications: Any and all technology players that offer a genuine, mission-driven opportunity to drive advancement to healthcare quality and/or patient care. Whether it be big tech, non-traditional providers, employer-based medical clinics, or the emerging spaces around preventive and alternative medicine, there are many opportunities that align the same mission-driven incentives of working at a hospital.
Garri Garrison, RN. Vice President of Performance Management, 3M Health Information Systems: It's really across the board, but I don't think it's new. Your payers pull good people; your analytics firms; your consulting firms; your rev cycle firms; your IT corporations right now need healthcare knowledge, so now you even have Microsoft, Apple, Amazon and Google competing for talent. They are going to hire expertise immediately and say we are going to be a healthcare firm by next week. I've been at this a long time and it doesn't come that easy. It really doesn't. Living in the regulatory world vs living in the provider world, they do not equate. There is a lot of knowledge that you don't have as the provider, and once you move out of that and start getting into IT or healthcare consulting, there are large knowledge gaps.
Alan Hughes. President, NTT Data: The venture capital world, the startup world, is sucking talent. If you think about all the physicians who are in business and not practicing medicine, I wonder if we wouldn't have the chronic shortage of physicians that we have if they had stuck to practicing medicine. But their view as physicians is invaluable as you are trying to solution in that world. Their biggest competition is all the startups and ancillary systems and individuals that are trying to solve the healthcare equation.
Greg Kuhen. Senior Director, Research, Advisory Board: If we are focusing on tech, then I'd say very much other industries and vendors. When I speak to a CIO who hopes to hire a data scientist and machine learning expert, they see themselves competing with Optum, Amazon, IBM and companies that will offer far more in salaries and in access to tech than health systems can deliver.
Tushar Mehrotra. Senior Vice President, Analytics, Optum: Especially if you are a regional health system, being able to attract a data scientist from the Northeast is going to be a real issue for you. You are continually running into high-tech firms — especially in retail and financial services — paying more for these skill sets than a regional health system can.
Dan Michelson. CEO, Strata Decision Technology: Healthcare is 20 percent of the economy. It's competing with the other 80 percent of the economy. Anybody and everybody could be working in healthcare in some way — in education, in an advertising firm, as an analyst — all these different roles play a part. Being a doctor is not the only important role. Healthcare is the largest employer in every state. Hospitals are constantly in competition. The tech companies that get the headlines are not hiring 40,000 to 50,000 people. Healthcare, every quarter, is really recruiting on that scale. The problem that they are trying to solve, framing the issue from a socioeconomic perspective, is in healthcare, a $3.6 trillion industry where problems are everywhere, we need a lot of smart people who are really motivated and who really want to make a difference.
Bob Monteverdi, MD. Global Healthcare Solutions Leader, Lenovo Health: Because of my background in the provider space, I think of physicians right away when you ask that question. It's the physician burnout, the physician dissatisfaction. Not everybody goes to medical school and wants to become a doctor anymore. They're trying to find something else they can do with that education. Hospitals are in competition with everybody in this ecosystem for those providers. The most common question I've heard over the last 25 years, and even more so in recent years, when you are talking with a doctor is, 'Bob, how did you get out?'
Karen Murphy, PhD, RN. Executive Vice President, Chief Innovation Officer and Founding Director of the Steele Institute for Health Innovation at Geisinger: We need to think of innovative approaches to work with data scientists. It used to be that you traditionally hired somebody and they were sitting in your organization. I think for data scientists, we have to be open to leveraging the talent in Boston, Silicon Valley — really internationally — to get the most out of our data. Because data scientists are in such great demand and competition is so great, their availability of options is wide open. We have to be really flexible and learn how we create virtual teams to leverage the data that's so critically important to us. When we talk about Danville, we have 20 years of the EHR data. We have a very, very stable population, which is very appealing to a data scientist because you can turn that data into information. So to say to a data scientist that's in Silicon Valley or in Boston, "You can work on this data, you just don't have to live here." Then let's go beyond the virtual teams and consider how we make this a rewarding experience, so the data scientist can really benefit and understand the implications of working in a rural healthcare system while sitting at a computer in Boston. I think to be able to leverage that is really important.
Andy Nieto. Global Healthcare Solutions Manager, Lenovo Health: Honestly, I think the question is backwards. Our documentation requirements for physicians have created such a physician burden that it is destroying the availability of talent. The burnout rate is so high. Think about the level of expectation for coding and documentation for a patient with a sore throat. You walk in, it's flu season. I can see you have every symptom the second you walk through the door, but I have to check every box so I get to bill a 99214 for this visit. The system itself destroys the talent pool.
Carey Officer. Operational Vice President, Nemours Care Connect, Center for Health Deliver Innovation, Nemours Children's Health System: When you think of the traditional clinical job in the health system, it's much more widespread now. Think about all the different organizations getting into it. Even the tech companies are hiring physicians to provide that integration so they're not just a tech person trying to understand that clinical side.
Michael Peluso. Chief Technology Officer, Rectangle Health: You can go work for Google; you can go work for a tech company. As a doctor, as an executive, these companies are definitely pushing for everybody. What I think the hospitals have to strengthen is the community aspect to what they're doing. UPMC is a good example. They own their own insurance company now. So not only are they employing from the physician side, but they are employing from the insurance company side. They own the hospital; they own the medical practices; they own the insurance company. They're as big as a tech company. If they can keep building those types of ecosystems around the community, they will have a better ability to attract more folks and keep people.
Michael Phillips, MD, MBA. Partner and Managing Director, Intermountain Ventures: The hardest part for us is we do have an information business, and we don't have the ability to effectively compete for the best talent in information systems and IT. We are not going to be as competitive with salaries as Silicon Valley and other places. Unless people are dedicated to helping others, it's tough to attract that talent. We don't have the ability to attract the right business talent in many ways because people who are working for us — that kind of business talent could go out and find a job that pays better with less angst and heartache.
Joe Polaris. Senior Vice President, Product and Technology, R1 RCM: The competition for talent in a labor market like this and with every industry looking at healthcare as place to drive growth — the competition for talent is everywhere. What health systems really need to do is work on roles that are part of the care team — attract and retain care providers. As a health system, why get distracted trying to be best in recruiting other jobs like call centers, bill collectors, coders, billers, etc. Focus on great care teams and have partners in place that handle the rest of that tough talent battle.
Mike Reagin. Senior Vice-President & CIO, Sentara Healthcare: Hospitals largest competition for talent are tech companies and many of these are also our emerging competition.
Bernie Rice. Enterprise Vice President, CIO, Nemours Children's Health System: In the IT world, it's very different. We're competing with banking and insurance, and most of the IT skill sets. Obviously, my clinical and informatics folks are healthcare. But we struggle network engineers and systems admin folks come from all industries. But it's interesting too, that some of these companies like Amazon and Apple continue to hire healthcare talent, but they are not in the clinical setting.
Lisa Romano, MSN, RN. CNO, Vice President Clinical Services, CipherHealth: More of the problem is that nurses — and nurses makes up most of the hospital workforce; they're the most expensive resource by sheer volume — can do so many things with nursing. I mean, case in point, I was a nurse. I never thought I'd be here 30 years later, working for a software company. I also think physicians are very business savvy now; they are much more comfortable with technology. It's a different physician now than years ago. As such, they are more open to going different directions. I'm working with a lot of previously practicing physicians in the technology space.
Things like work-life balance in hospitals never really came up much. It was just like, come in and suffer. Younger people in the workforce now are not tolerating the things we tolerated 20 years ago, and rightly so. Hospitals are competing with a lifestyle that millennials know is possible to have. Hospitals have to put in place some things that they never have before.
Roy Schoenberg, MD, MPH. President and CEO, American Well: Technology companies. At the end of the day, you shouldn't be in a position to choose sides. Things like the collaboration that we have with Apple and Stanford on the Apple Heart Study, that’s a perfect example of where the knowhow of clinicians, tied with our knowhow in telehealth, tied with the incredible knowhow of Apple on consumer behavior and consumer adoption, can allow everybody to do what they do really well and still have the epiphany and incredible gratification and satisfaction that comes with putting all these things together. I don’t think people have to move around, I think you must allow them to tie together the pieces of the puzzle from where they are. Certain health systems do that and certain health systems don’t, and I think that's going to make or break on their ability to retain talent.
Zach Silverzweig. Co-founder, CipherHealth: I think one of the big challenges in healthcare is finding really high-quality technology teams, from your junior to senior staff members. There's a C-suite challenge, but beyond that, if you want to have an in-house application development shop as a small hospital, you're competing against every other place where that person can work. It's really hard to attract high-quality talent. You can fight that — I think a good recruiting organization within a hospital is going to be really looking for those people who are really mission-driven. If you can find a mission-driven IT and engineering team and build it up, then there's a real way for hospitals to compete. The staffing side has to be a really important side of the CIO strategy. If you don't have really strong folks all the way down that chain, you won't get to deliver that same kind of experience that patients are used to in other parts of their lives.
Don Soucy. Executive Vice President, Global Sales, Spok: When I think of who hospitals are in contention with, it's everybody on this floor. We have a CMO, a CNO; we're hiring nurses. We look for clinical talent everywhere. If they have a balance of clinical and tech, well, everyone on this floor needs that expertise to talk to their peers at healthcare organizations. In my opinion, if providers and hospitals don't challenge people who want to be challenged and give them a nimble path to making things happen and being transformative, then they are going to look for those challenges elsewhere.
Randy Tomlin. Chairman and CEO, Mobile Smith Health: There's a lot of waste in healthcare. There are companies getting into it, whether it's Amazon, Google, Berkshire Hathaway, that are getting into the space. They've come after the lead doctor talent and now I think they are going to come after CFOs because if there is waste in the system and you want to know how to fix it, you go get the person who knows cost in the system, and that's CFOs. I think these third parties are going to come after CFOs in a big way. The other people they are going to come after are doctors. They are going to take them out of brick and mortar and put them in virtual groups that can be applied to self-insured companies, and leave the brick and mortar costs behind with hospitals.
To protect that, if I'm a provider, what I would be doing is forget about my brick and mortar, and I would take my assets, which are doctors and nurses, and apply them in the most efficient way possible to the self-insured companies. I wouldn't worry about insurance companies, just go right to and start partnering with these companies. You see Walmart starting to do it, CVS.
Dan Trencher. Senior Vice President, Product and Strategy, Teladoc: It depends a bit on what sort of positioning that health system has and where their talent applies. If it is a health system focused on consumer experience and having a long-term relationship with patients, then other digital and tech companies building that same relationship with patients are competitive for talent. I think we are seeing the same thing happening in the other direction. People with healthcare knowledge are going to get hired by the big tech companies or health plans. Those companies trying to get into the healthcare space are going to look for people with healthcare experience.
Tom Utech. Vice President of Marketing and Strategic Innovation, BD: The one role that's going to reach a critical point is nursing. Nurses traditionally work in hospitals and physician offices, but what I hear more and more from customers is nurses have so many options like clinics that are going up and other types of employment, and it's really creating shortages on acute care side. As more and more of these nontraditional players get into the market, they are going to draw some of that key nursing talent out, which is going to stress the system even more.
Wes Wright. Chief Technology Officer, Imprivata: The answer is: Anybody in IT. We are in competition with everybody who is in technology right now. It wasn't that way 5 to 7 years ago. We somewhat egotistically thought that in order to do IT in healthcare, you needed a healthcare background, yet we weren't hiring people with healthcare backgrounds anyhow. [Hospitals] started the war by hiring from the software companies. Then they went, "Ok if you are going to hire from us, we're going to hire from you." You have Microsoft and Amazon that are snapping up healthcare IT people. At the same time, healthcare is attracting IT people from other industries, Providence St. Joseph Health just hired a former Microsoft employee as CIO, for example. So really, it's a wash.
Megan Callahan, Vice President of Healthcare, Lyft: As the healthcare industry continues to evolve, there is some shifting going on among the top talent. As more avenues open up to build healthcare solutions, more medical professionals are naturally going to pursue these new opportunities. This is an exciting development – as more minds and more energy goes behind solving some of the most pressing industry issues, we are going to end up with better products and outcomes for patients.
Jason Considine, Senior Vice President, Patient Collections and Engagement, Experian Health: All tech IT companies, the Apples and Amazons, and I would put us in that boat too. Hospitals are in competition with us for talent. We have similar needs from an IT and tech perspective. It's interesting Apple, Google and those types of companies have started hiring a lot of physicians.
This article was updated Feb. 25 at 2:40 p.m. CST.