In this installment of C-suite Conversations, Chris Howard, President and CEO of Sharp HealthCare, reflects on leading San Diego’s largest healthcare system through a period of rapid transformation. Chris discusses the vital role of technology in advancing care, the impact of national policy shifts, and how Sharp is navigating the opportunities and risks of artificial intelligence, all while keeping people at the center of healthcare delivery.

Sharp HealthCare is a not-for-profit healthcare system based in San Diego, California, with four acute care hospitals, four specialty hospitals, three medical groups, and a health plan. Sharp has 2,800 affiliated physicians and more than 20,000 employees.  

Q & A With Chris Howard

Judy Kirby: Chris, I appreciate you taking the time to talk with me today. What I want to talk about is how technology is driving healthcare, and where healthcare is going over the next few years. But first, can you talk a little about what has led to your CEO position with Sharp HealthCare?  

From a small community hospital to Baptist Medical Center in Oklahoma City, which is now called Integris Health, to SSM Health Care of Oklahoma, to SSM Health Care of St. Louis, and then to SSM at the corporate level — all of those experiences gave me the breadth of skills and expertise that happened to be what Sharp HealthCare was looking for at the time I was hired.  

Judy: In today’s landscape, what keeps you up at night?  

Chris: Top of mind today is legislation recently signed into law in Washington, D.C., which will dramatically impact Medicaid funding in the years to follow. There’s no doubt, based on what the bill includes, that what had been feared and has, in fact, come true. There will be almost a trillion dollars taken out of the federal Medicaid fund, which will impair healthcare across this country, especially for hospitals. Many individuals will lose their Medicaid coverage or will have to navigate circumstances to maintain eligibility, which will constantly put them at risk of losing their coverage. That’s not a political opinion in any way, shape, or form; it’s simply a statement of reality. Some people will not meet the new requirements to maintain coverage, and they will no longer be insured. We know from history and data that individuals without health insurance do not access healthcare as easily as those who do have insurance coverage, and thus, community health will suffer.  

In addition, here in San Diego, from a binational community perspective, we have many individuals who are already choosing not to access healthcare for fear of being deported or putting family members at risk of being deported. So, we have this large swath of individuals who are not accessing healthcare. And we know from history that they will eventually have to seek medical attention, but they will be much sicker and have no insurance coverage, which will result in a greater financial burden for hospitals and medical clinics to provide essentially free care. As the largest Medicaid provider in San Diego County, it has daunting consequences for a system like Sharp.  

Judy: I have recently read about the executive pay cuts in healthcare. Are you able to talk about that and what you’ve done? How did you handle it?  

Chris: Yes, I can talk about it. I met with the executive leadership team, and we discussed the workforce reductions we needed to make to improve our overall operating status over the next year or two as an organization. We knew a number of valuable team members, including 30- and 40-year team members at Sharp, would no longer be with the organization. There was no way that the executive leadership team could not participate in that.  

So, we reduced the number of members on our executive team by two, and all executives agreed to receive less pay this year, with no standard increases for next year. What’s more, I felt I should make an additional contribution and informed the board that I would be doing so. It was not a difficult decision at the end of the day, Judy. Because, ultimately, I’m the individual responsible for the organization’s overall health and well-being.   

Judy: Will that make it harder to get the best new physicians, nurses, and other people to come to Sharp, or might it make it easier because people see a fiscally responsible organization that does the right thing?  

Chris: I’m not sure. I’ve heard positive comments based on the actions at the executive level, but that should not be the headline here. The executives of the organization are the most highly compensated individuals of an organization. They have the ability to absorb some sacrifice, in some cases, far more than others. I think it sends a clear message that the leadership team wants to be part of the solution. We’re all in it together. 

Judy: So you’ve probably heard the comment that healthcare organizations are really technology companies that deliver healthcare. From your perspective, how accurate is that comment? 

Chris: I don’t agree, and I say that with complete respect for the technology that enables us to provide the high-quality healthcare we have here. However, I know from 37 years of healthcare experience that it is our highly educated and trained individuals, such as our nurses, technicians, and physicians, who are putting their hands on patients and providing healthcare. That is where healthcare takes place. Everything else helps ensure that they can do their jobs as effectively and optimally as possible. 

People provide healthcare, not machines. Ironically, Sharp is the largest network of excellence in robotic surgery in San Diego, with over 20 robots being utilized to provide exceptional surgical procedures for our patients. But there’s a physician behind each of those robots doing the procedure, and the robot enhances the physician’s ability to create better outcomes. It’s the nurses at the bedside of patients, whether they’re in a clinic, a hospital, one of our hospice homes, or elsewhere. People are at the heart of our organization, as it should be.  

Technology, though, has advanced to such a level that we can now do much more than we ever could before, make better decisions, and work more effectively and accurately. Information technology is the backbone of the infrastructure that enables clinicians of all types to deliver exceptional healthcare, and it is absolutely critical to our success. 

Judy: As a CEO, how do you view technology’s role in driving Sharp HealthCare’s future?  

Chris: I think it’s at the top of the list. The advancements in information technology have enabled organizations like ours and many others across the country to be significantly more innovative and effective than we could ever have been without them — and, frankly, to survive. Since we’ve implemented things like Workday and Epic across our system, we’re much more cohesive. We’re able to do things with this technology that are more advanced than we could do before, and that’s a good thing.   

With the use of artificial intelligence in clinical diagnostics, particularly in areas like radiology, we are already able to diagnose masses or abnormalities at a significantly faster rate. Today, that is possible. Tomorrow, it will be a basic necessity. I think having this technology will accelerate the advancement of healthcare as an industry and provide more definitive answers to clinical questions that have eluded us for many, many years. Being able to do our work in real time, much faster, more effectively, and with better outcomes — I think that’s a great day for healthcare overall.  

Judy: AI poses big questions about guardrails. How are you addressing governance and guardrails with Sharp as you move ahead?  

Chris: Governance was the very first thing we addressed as an organization because we were extremely concerned, I especially, that we didn’t know what we didn’t know about AI. And that remains the case to some extent. We established a multidisciplinary AI Ethics and Oversight Committee Governance, comprising leadership from across the organization, to answer the tough questions about how we utilize AI. How do we control AI? How do we know what’s coming with AI? And most importantly, what are the pitfalls or dangers of AI? Because AI is a miraculous new technology, without a doubt, and we are already seeing its benefits. However, if left uncontrolled — or perhaps a better way to say it is unregulated — in a healthcare system, it can place the organization at great risk.  

For example, we realized early on that team members across the entire organization were using ChatGPT and asking ChatGPT about our organization. That meant information about our organization was now contained somewhere within ChatGPT, in the public domain. We wanted to put protections in place to ensure that our data was not shared inappropriately. So, our great Information Technology Division created Sharp AI, which is essentially a structured, protected, and controlled version of ChatGPT. The decision was made by our AI Ethics and Oversight Committee Governance to disable the use of regular ChatGPT on any Sharp platform.   

Judy: You mentioned the use of AI for radiology at Sharp. Where else are you using it?  

Chris: We are using it in our medical offices, essentially with automated ambient dictation and recording of notes from our physicians and clinicians. Back when the electronic medical record (EMR) was introduced to healthcare, it was going to transform the healthcare experience. However, it also created an additional burden in the patient care setting because our physicians were typing on a keyboard, sometimes not even facing the patient, to ensure that all the information was entered into the EMR. Now, our clinicians can set their mobile device on a table and have a real conversation with the patient, while the AI-enabled technology transcribes the entire conversation in real time. In some cases, it does so in greater detail than our clinicians might have done themselves, especially when trying to recall everything they discussed with a patient during the visit earlier.  

That has been a game changer for our clinicians who literally tell us, “Finally! With this technology, I can engage my patients the way I used to and not worry about whether I am going to remember everything the patient tells me in perfect detail.”   

Judy: What else?  

Chris: In research, our Innovation Institute is partnering with companies to utilize AI technology and data to achieve greater efficiency and efficacy to the end point of a clinical trial or to reach a diagnosis in less time. We’re also utilizing it in the revenue cycle to increase speed and efficiency. This involves extracting information from the medical record, properly coding for an episode of care, billing for that episode, and resolving any potential issues that could delay payment in advance.   

Judy: We’re hearing from some organizations that technology should now be less about innovation and more about deriving value from the technology they already have.   

Chris: I feel there’s an opportunity to maximize the opportunity on both sides. Our innovation division operates within its own domain. It has its own budget and its own goals and objectives, which include seeking out new technologies that could one day benefit Sharp. It’s not necessarily about today; it’s about five years from now. The number one question we have is, what is possible that we don’t know? What is a challenge that we don’t realize today? What investment abilities might we develop in the future that could prove to be a wise investment, helping us improve our processes, reduce costs, or provide care more effectively?   

So, the innovation division continues its work in real time, but it’s compartmentalized to ensure it doesn’t have blinders to what’s possible in the realm of innovation. And then there’s everything we have today, such as Epic and Workday, and many of the processes, structures, and technologies used day in and day out. There is no doubt that we have an opportunity to optimize the technology we have today. We converted systemwide to Epic last year, and Epic is deploying more AI-enabled technology on a weekly or monthly basis than we’re taking advantage of. There’s a lot of work underway to ensure that we understand the technologies available to us, which ones we should deploy now, and what is already deployed that we can take greater advantage of.  

The lion’s share of our work right now is to optimize what we currently have, but innovation is happening all around us. It’s not an “either/or,” it’s more of a “yes, and.” I think there’s an opportunity to take advantage of the best of both worlds moving forward.   

Judy: Another thing we’re hearing is that there is a significant skills gap in healthcare among the C-suite and director-level executives as they’re coming up. Have you noticed that gap, and how are you addressing it?  

Chris: I have seen it, and in reality, it’s a generational thing. I’m not saying it is older executive leadership versus other levels of leadership, but there’s no doubt that up-and-coming leaders are more involved in the details, and they’re very interested in and engaged with the technology that exists today. So, what I have expressed to our Information Technology group, in particular, at all levels, is to educate us, teach us, interpret for us, because they are the experts in technology, not Chris Howard, the CEO of Sharp. I readily admit that.  

I’m open to learning and interested in doing so, as are the rest of our executive leaders. We want our other leaders across the organization to come forward transparently and tell us what we don’t know and tell us what’s possible, what’s working, and what’s not working. There’s definitely a bidirectional communication process at Sharp where feedback is requested, received, and welcomed. Years ago, somebody said to me, “The good thing at Sharp, Chris, is that we ask for input. And sometimes, the challenging thing at Sharp is that we ask for input.” I think he was right because there is far more input coming in than we can absorb or address on any given day, but it’s always welcome.  

Judy: If you hadn’t moved up into the CEO ranks, what career path do you think you would have taken along the way?  

Chris: Growing up, there were two things that I was most interested in. One was architecture. I always thought designing buildings, structures, or homes would be a fascinating field. The other was meteorology. I loved growing up in the Midwest weather. Most Midwesterners either love or hate the weather, but they’re always paying attention to it. I thought, what a great thing it would be to be a meteorologist on television, because how many jobs can you have where you’re wrong a lot of the time, but you keep your job? That’s no dig on meteorologists. Those folks, of course, do a fantastic job to the best of their ability, but the weather is what it is, and it will always be unpredictable to a degree.   

Judy: What passion or hobby do you enjoy dedicating your time to outside of work?  

Chris: I enjoy golf, although my skill level has definitely plateaued. My wife also plays, so we enjoy golfing together on the weekends. We also like to hike and enjoy the diverse San Diego landscape. Being able to get out and enjoy 75-degree weather for much of the year is a real treat. We also like to cook, and for most of my life, I have smoked food on the multitude of smokers I’ve collected, much to my wife’s chagrin. 

As a seasoned leader in the payor space who is now guiding digital transformation on the provider side, Tim Skeen possesses a rare dual-perspective on the evolving healthcare landscape. In this candid interview, Tim speaks of bridging the long-standing divide between payors and providers, maximizing data interoperability, driving innovation through responsible AI, and solving the IT leadership talent pipeline challenge.

Sentara Health is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 30,000 employees and 12 hospitals in Virginia and Northeastern North Carolina. The Sentara Health Plans division serves more than 1.2 million members in Virginia and Florida.

Q & A With Tim Skeen

Judy Kirby: Tim, most of your career has been on the payor side of the healthcare industry. Now, for the last five years, you’ve been the EVP and Enterprise CIO at Sentara Health. What intrigued you about a CIO position on the provider side?

I had always been challenged by providers pushing back on us payors. They distrusted us. So, I was interested in understanding how providers think, how they run their business, and what their challenges are, so we could fix that disconnect.

Coming from the for-profit world, where I had spent my whole career, to a not-for-profit was intriguing because you have a mission for the best outcome for the consumer, but also the community more broadly. Sentara is a healthcare provider, but half of our revenue comes from a 1.2 million-member health insurance plan, so being able to help the consumer on both sides of the healthcare continuum was really exciting and interesting to me.

Judy: What have you been able to bring from your experience on the payor side to help fix what is broken in the relationship between providers and payors?

Tim: The fact is that the five or six largest payors in the country are for-profit businesses. They’re trying to drive profits for the shareholders, and so, by nature, they want to win at everything they do. So, collaboration is never really 50-50. They want an edge. They don’t accept that a win-win can happen in a 50-50 partnership. This needs to be about improving the entire ecosystem. All boats rise together.

The flow of data in either direction and the ability to act on that data is the next challenge, and we can see the importance of that just by what Epic’s doing with their Epic payor platform.

After a full year of evaluation, we just signed a contract for a solution that will be linked into both our payor platforms as well as our Epic provider side platform, to start solving a lot of these problems, get data flowing, and allow transparency that is win-win for the provider and payor, and beneficial to the consumer.

Judy: Will that work for both your health plan as well as the other insurance companies you work with?

Tim: It will. We already have a lot of real-time data flow occurring with two of our largest payors, Elevance and Humana, through Epic’s payor platform. On the payor side, we are using population health vendors to connect to all the different disparate provider systems.

Judy: What will that do for the patient?

Tim: It’s a combination of things for patients. One is not having to repeat themselves on their health history, not having to fill out data that’s already populated. It’s about getting the best outcome for a quality gap, a risk, or care gap that they need to solve. Then, leveraging that data to apply various AI agents and bots to have a self-service and a digital interaction that sends them reminders in the channels they want to interact in. With more data, health insurance plans and providers can offer personalized services and communications.

Judy: How do you deal with the issue of prior authorizations? That’s an issue we hear a lot about.

Tim: Prior authorization is always a challenge. It’s a stick and carrot thing, right? You could argue that if you get into a pure population health, fully at-risk situation between payors and providers, prior authorizations go away. Because when I’m a provider and I’m at full-risk with the payor, I’m going to authorize services appropriate to the right cost of care. If I authorize an expensive procedure like an MRI when I really could have done a less expensive intervention, I don’t provide as much thought because the payor is bearing that burden. But if you’re looking for the best outcome, the right amount of diagnostics, the right amount of services, with the best clinical outcome on both sides at the right cost of care, it does change things.

The other thing they are doing on the payor side is refining their PALs (prior authorization lists) to make that less burdensome and more automated. A lot of AI technology coming out makes sure that an authorization request that someone submits is as robust as it can be. The connection to our clinical data gives the payor the data they need to authorize the service without a lot of administrative back and forth.

Judy: One of the things we hear a lot about from CIOs is concern about the division of technology within the organization. Some have AI and cyber, some have analytics and/or informatics, some are called a CIO, some are called a CDIO. What are your thoughts on where this all needs to live, and the differences between a CDIO and a CIO?

Tim: Three years ago, a consultant recommended that I be called a CDIO, not a CIO. But I was not going to do anything differently, and I already have a chief digital officer under me. I don’t really give a lot of credence to the title. I think the resource itself, what they’re capable of, what their skills are, and what the organization is best suited for, are more important. There are different environments where it may be a fit to federate some of those responsibilities. For me, given the 28 years of experience across all the different aspects of healthcare, it was important for me to have responsibility for all of those areas.

In my case, I have everything technology-related across our health plan and our healthcare delivery. I have analytics and AI. I also have operational responsibilities, which is another thing you’re seeing more often under the CIO. I had operational responsibilities at Elevance as well. I have the entire clinical access center underneath my organization, 600-plus resources for the call center, omnichannel interaction for self-service, digital outreach, conversational AI, and chatbots. All of those things are well-suited to be under the CIO because you’re controlling the technologies that enable an omnichannel approach to servicing the customer. It’s also reshaping how you’re serving customers. The consumer experience needs to be the primary focus, and that’s what our “One Sentara” north star is about: improving the consumer and care provider experience.

What I would say to any up-and-coming IT executive or CIO is that you have to learn the business. No matter what industry you’re in, understand the value chain, the workflows, and the business processes. How can you reimagine and re-engineer those business processes leveraging technology? Be able to speak and articulate those technology solutions in a way that the business can understand, and in a language that connects to them and their most pressing problems. Then you’ll be the best CIO or CDIO you can be.

Judy: Can you talk about how the federated system is working at Sentara?

Tim: I have control over all those things I just mentioned, but federation in the business areas works very well for creating the interaction model and the matrix around point-to-point interaction. Being able to understand where somebody needs to go. People can go directly to each other. They don’t need to go up the chain, across to me, and then come back down the chain. The trust people have in the matrix and the responsiveness built into the interaction model are what make it all work. Without those, it breaks down.

Judy: What is your organization’s AI strategy? And especially when you’re talking about a federated organization, how is Sentara handling AI governance?

Tim: It’s a great question, and I don’t know what the perfect answer is yet. We saw this coming almost three years ago and took it to the board so we could start getting ahead of it. We’ve established an AI governance structure focused on responsible AI. It has a triad at the top: the chief physician executive, our general counsel, and me. The chief analytics officer and the chief health informatics officer co-lead the governance committee.

You want governance, you want responsible AI, you want to make sure you’re not going to do harm, that you have a human in the loop. But it’s also about establishing the data and AI literacy program. AI has been around for 30-plus years, and different types of AI have different levels of risk. So, when most people say AI, they’re referring to GenAI, and that gets the general counsel nervous.

Literacy and understanding are really important because people are going to be talking about AI all over the place. We have nurses, radiologists, call center people – they’re all approached by vendors and consultants who are all leading with AI. “We’re an AI solution!”

For RPA automation, you don’t have to go through the AI steering and governance. We have been doing RPA for 30 years. So, there are differences. The point of making it federated is twofold. There are entry points all over the 34,000-plus colleagues we have, and you don’t want to centralize innovation and the leveraging of GenAI, because it is all about individual productivity.

So, there is personal productivity, and then there’s broader, larger productivity with ambient technology to help with clinicians’ documentation, so they can spend more time with their patients. There is observational AI that helps with virtual nursing, reducing fall risks, and helping with hand-washing and room turnover. Many of those are GenAI, so governance is an important piece of it.

We’re using a “taker-shaper-maker” model. We’re taking as much AI as is well-founded and proven to work in our existing vendor stack. We’re shaping by investing in a few startups and other vendors, co-developing solutions, and helping to shape their model. And then we’re doing a little bit of making, building some of the models with our own data science. We’re also doing some of our prompt engineering and creating agents with our own Sentara ChatGPT private instance that we created and went live with about six months ago.

Judy: You serve on several boards. How has that helped you as a CIO, and how do you balance your time and any potential conflicts of interest?

Tim: I had done board work for Elevance-invested entities. After I left Elevance, I spent a year in private equity working on deal teams in healthcare tech, and I also did more board work. I found out that exposure to healthcare tech and to the private equity and venture capital world was an incredible way to become knowledgeable and understand what’s emerging. There’s a real upside to serving on boards, where you’re exposed to different people, different types of solutions and technology, and you learn from others. It keeps you sharp because you’re having to keep up-to-date with that environment as well, which is broader than just the aperture I am looking through as the CIO of Sentara.

When I came here, one of the things that was discussed was my desire to continue as part of boards, the argument around that benefit, with a commitment from me to balance my time, and make sure that Sentara was the top priority.

From a compliance standpoint, I disclose those interactions and, in some cases, create a formal plan to make sure we comply and avoid conflicts of interest. If there are conflicts of interest that a plan cannot remediate, then I have to eliminate that conflict. I really appreciate Sentara’s flexibility, because I think there is a benefit to all I am learning, which benefits the organization.

Judy: A big concern I hear about over and over is the lack of up-and-coming IT leadership in the future. We’re also seeing a lot of outsourcing, and a downward trend of people entering college for computer science. What are your thoughts around the void in the future of leadership?

Tim: Part of the problem on the health systems side, versus the for-profit payor side, has been the huge gap in compensation. Historically, you had a lot of the strongest talent working in the payor space, and I think that’s starting to even out, which is great to see. It’s not just about IT either. On the clinical side, we don’t have enough people going to medical school. We’re going to have a dearth of clinicians, which is problematic as well. That is why allowing resources into our country, or allowing a global economy of those resources, both clinical and technical, is critical.

But in terms of encouraging more young people to go into technology, I wish I could solve that problem. When I mentor people, I tell them that, in addition to their technology chops, being a critical thinker and a problem-solver are more important than how well they are at writing code. That will be what the real job is going forward. Go learn the business and be curious. Understand the whole business value chain. Most people don’t understand how Medicaid works, how Medicare works, payors and providers, the full life of a claim, the payment cycle, and all those things. Learn all of that. And, have a passion and an interest in technology as it relates to solutions and innovating. So, it’s trying to inspire people to do that.

Where else can you inspire people better than the world we’re living in today, right? When somebody walks into our cancer center with cancer and walks out cured, what is more inspirational than that? Everyone is dealing with some health issue in their inner circle of family or friends, or some frustration with the healthcare environment. Why not help improve that?

Judy: How do you achieve that inspiration in a remote or hybrid environment where team members are not seeing the patients or the outcomes first-hand because they’re sitting at a desk somewhere far away?

Tim: That was a problem for IT before COVID and working-from-home because people were sitting in an IT office with other IT folks. So now, being in a hybrid mode, it’s a different way of managing. It’s a challenge that the CHRO and I have to figure out.

Judy: If you hadn’t become an IT leader, what other career do you think you were cut out for?

Tim: What I really wanted to be was an NBA player, but you’ve seen me. I’m 5’9″ at best, so my point guard days ended at high school. For me, it was always about problem-solving and efficiency, which is how I got started in consulting. I have a mind that is always trying to think about the most efficient way to eat my meal, travel from A to Z, or whatever, so it would have to be something around business process re-engineering, or figuring out the best way to change a manufacturing process or production line.

Judy: Outside of work, what is something you love to do when you have the time?

Judy: What’s your favorite country to visit?

Tim: New Zealand

Judy: Mine too!

Jim Dunn is a nationally recognized HR leader with more than three decades of experience guiding culture, talent, and transformation strategies across prominent healthcare and nonprofit organizations. He served as Chief People and Culture Officer at Advocate Health and held HR roles at Parkland Health and the American Cancer Society. Jim currently serves as CEO and President of LD Human Capital Consulting. Jim offers a wealth of perspectives on leadership development, executive onboarding, behavioral assessments, and organizational culture.

Q & A With Jim Dunn

Judy Kirby: Jim, you are a board chair, people and culture executive, six-time CHRO, author, professor, human capital advisor, and executive coach. That is impressive! After positions at an oil company, Emory University, and the American Cancer Society, how did you end up in healthcare?

She removed the turban from her head, and that’s when it hit me that she was a cancer patient. She was there for an appointment with the Look Good Feel Better program and had three different styles of wigs, and she wanted my opinion on which looked better on her. Shocked and deeply touched at the same time, I took a deep breath and engaged with her as she changed into several different styles of wigs.

Look Good Feel Better was and probably still is a global cancer program dedicated to restoring the confidence and self-esteem of cancer patients. She was there to meet with one of the trained volunteer cosmetologists, a female, and simply wanted a male perspective. Hopefully, I was able to help her make a good decision, but it was one of those pivotal moments where I knew I wanted to be closer to engaging and serving those directly involved in patient care.

Judy: Your career has included roles at prestigious medical facilities, including Parkland Health and Hospital, Advocate Health, and the Cleveland Clinic. As you moved from organization to organization, how have you successfully navigated distinct cultures? What did you learn from your onboarding experiences?

Jim: It has been a privilege to work for such world-class healthcare organizations over the last decade. As the adage goes, “If you’ve seen 50 hospitals, you’ve seen 50 hospitals.” I say that to emphasize the importance of listening first, as each organization has its own values, challenges, and culture.

One onboarding practice that I picked up from the Cleveland Clinic was a new leader assimilation process, something that I had not experienced up until that point. It’s a structured method for integrating new leaders into a team and ultimately the organization. It aims to accelerate the leader’s effectiveness through a facilitated process that clarifies expectations, expedites building rapport and relationships, and fosters open communication. It’s more like a qualitative 360 within your first month of hire that involves your boss, peers, and direct reports.

I found the process to be so effective, especially with my direct reports, that I have used it ever since then in every onboarding scenario. I took it a step further in that I invite my previous direct reports to spend a day with my new direct reports to share what it’s like to work with me as a leader. Often, they end up sharing work practices and forming some relationships of their own. One of the fun stories from this effort is when one of my direct reports from Parkland met and interacted with a current direct report at Advocate and today, they are married with two sons!

Judy: Can you share more about the process?

Jim: I was in a room with two of the vice presidents of learning. We spent about two hours together, and they asked all sorts of fun, silly questions, like, “In an emergency situation, do you prefer a call, a text, or an email?” I said, “Well, whichever works or whichever is going to get the message across.” They took notes, and the conversation continued from there. “What do you do first thing in the morning?” “Do you prefer one-sided or two-sided copies?” I was starting to think it was silly. After 50 or 60 of these questions, I was exhausted. They said, “Thank you for trusting the process. We’ve done this many times with leaders, and we will be back in two weeks.”

In two weeks, they sent me a five or six-page report. Unbeknownst to me, they had also met with my direct reports and asked them a bunch of questions. In the report, they combined the questions I asked with those my direct reports had asked.

Next, I had a meeting with my direct reports, and in a fun way, I shared with them all the things I enjoy doing. They laughed, and I laughed at their questions. There was an abbreviated version of this meeting with my new C-suite peers, and I absolutely loved it. In three months, I felt like I had been there for two years. The way I interacted with my team, and they interacted with me, eliminated all the awkwardness that you usually feel when starting a new job. It was wonderful, so I decided to do that in the future.

Judy: When interviewing candidates for senior leadership roles in healthcare, what are the most important attributes and how do you test for them?

Jim: All organizations like to start with their mission and values. However, very few of them interview candidates for alignment with those values. It’s important to focus on assessing their understanding of the organization’s purpose and how those resonate with their own personal values. Essentially, they should understand their own WHY? And how their WHY shows up in a leadership role.

I would also recommend using a tool to gauge levels of emotional intelligence, because it’s becoming increasingly important that healthcare leaders have the capacity to understand and manage their own emotions, while being empathetic towards others. This not only helps leaders build trust and resolve conflicts but also supports those caring for patients during challenging situations.

And finally, using behavior-based interviewing questions, assess their level of constructive collaboration as a member of several different teams, sometimes as a leader and other times as a contributor.

Judy: Not all new hires succeed in an organization. What is your advice for making sure the right person gets hired?

Jim: I believe that it starts by reframing hiring as mutual discovery, not a one-way vetting process. Every hire is an investment in the unique skill set of an individual and should be viewed as such. Secondary to this is the importance of emphasizing alignment with organizational values and team dynamics over technical skills.

We use a variety of different assessment tools, customized to the needs of the client and the role, to build robust hiring frameworks to make sure they hire candidates who are the right fit. For more senior and C-suite roles, it often involves a minimum of two assessment types as they each provide different predictive value and multi-dimensional views.

Judy: How do you decide which assessments are best for a situation?

Jim: Well, sometimes the organization is already in a contract with one of the assessment companies, or if you use an external search partner, they may have a preferred assessment, and you use that one.

The meeting I just came from was with six of my client leaders going through a debrief of the DISC assessment. The reason why I chose DISC in this situation is that they wanted to zero in on behaviors that are not necessarily conducive to team culture when individuals are under stress. So that is really good for an intact team. But if you are looking for a data point and selection of a leader, I would more likely go with the Hogan.

I see the assessment as one data point. The resume is a data point, and then you have the interview itself. But when you’ve gone from 15 candidates down to two or three finalists, you can only select one to hire.

I don’t use assessments early on in the process. I advise waiting till you get to the top two or three finalists. That’s where the additional data point is valuable.

Judy: Jamie Dimon, CEO of JPMorgan, questions the effectiveness of remote work, especially for individuals earlier in their careers. What is your view?

Jim: I believe organizations should strive to achieve a balance, as one size does not fit all when it comes to work preferences. Research does suggest that proximity accelerates learning in early careers. However, there are a couple of realities: One is that remote work is here to stay and is quickly becoming the linchpin by which many new cultures are being created. The second is that, for it to be successful, it must be bigger than individual (CEO or C-suite) preferences. 

But the point is that remote work is here to stay. Hybrid work is here to stay. So in HR, we’re going to have to figure it out because the talent will continue to want some sort of hybrid approach. We just have to figure out how to build SQ, EQ, and culture in a different way.

Judy: What advice do you give organizations to strengthen their culture, especially with remote and hybrid work?

Jim: As an example, I’ll use a national client organization that embraces a remote-first work environment or hybrid approach where employees can work from anywhere in the 50 US States. We started with why a remote-first strategy works best for the organization, recognizing the value and benefits of remote work, including better work-life balance, more flexibility to work a schedule that fits personal needs, and improved productivity.

While a remote-first working environment has many advantages, employees must still meet organizational expectations. Set clear expectations such as employees shall be available for meetings and collaboration between the hours of 10:00 A.M. and 4:00 P.M. Leverage technology to make remote work collaboration easier and develop some ground rules for how teams will use technology to communicate – email, Teams chat, texts. Be clear about which channels to use.

And finally, I recommend longer and more developed onboarding processes for remote employees, emphasizing mentorship, structured learning, and feedback loops. I tend to have the onboarding go for about 90 days in remote environments. It involves numerous connection points, including exposing them to key leaders and fostering a sense of community and culture. It is important because they won’t be around those people regularly, seeing them every morning and chatting in the hallway or by the coffee maker. You don’t have any of that. We help clients build out much more expansive onboarding programs, and they absolutely love it.

Judy: These are stressful times in healthcare. As a human capital consultant, what are you hearing from client organizations, and what advice are you giving them to help improve their culture?

Jim: What I’m seeing consistently in organizations from all industries and of all sizes is uncertainty, from the C-suite level all the way down to entry-level roles. Uncertainty stemming mostly from concerns over automation, technological advancement, the threat of layoffs, etc.

I’m advising organizations to double down on the basics—evidence-based things that we know work across different cultures. People want to feel seen, heard, and valued, not just compensated. A preponderance of evidence shows humans are biologically predisposed to desire human connection, regardless of individual personality styles or types. Therefore, we encourage leaders to be visible, vulnerable, and value-driven.

We are seeing success through frequent employee pulse surveys where resulting actions are broadly communicated, and through listening tours and specific well-being programs for all employees. 

Judy: There are many terms flying around like “quiet quitting,” “grumpy staying,” “bare minimum Mondays,” and “acting your wage,” all reflecting a trend of worker disengagement and dissatisfaction. To what do you attribute so much disengagement, and how do organizations reengage their teams?

Jim: I recently did some research on this topic in preparation for a keynote address, and I learned that employee disengagement is a process that typically progresses through stages and most often reflects unmet expectations. It also showed the largest culprits for overall employee disengagement to be 1) a lack of appreciation for their work, 2) no opportunity for career advancement, 3) a lack of autonomy, and 4) the organization’s values don’t align with employees’ values.

Solving one or more of these would be a start towards reengaging teams. I published a Forbes article, “The Recipe for Effective Leadership Has Changed, And Humility Is a Key Ingredient,” in which I highlight that sharing wins with your team, acknowledging personal shortcomings as a leader, and highlighting the successes of others are at the heart of re-engagement.

Judy: How do you think AI will affect the workforce over the next few years, and how can individuals and companies prepare for the possible elimination of their jobs?

Jim: I think AI, machine learning, and robotics will take over the more mechanical and IQ-heavy roles. There is great potential for these to be commoditized, whereas roles requiring human touch and relationships (high EQ skill sets) will demand higher wages.

Also, as time passes, people will see that AI in mechanical and IQ-heavy tasks will be more reliable than humans, and they’ll trust it more and more.  Meanwhile, if they experience AI in high emotional situations, they will realize they prefer a human. This understanding and preference will accelerate over time.

In December 2023, I published a Forbes article aimed at helping HR leaders overcome some of the anxiety around AI, for both them and their workforces. HR leaders need to be well-versed in the capabilities—and limitations—of AI to ensure or lessen panic among their workforces.

Judy: Many organizations now say they can train for skills, and that college degrees may be less important than they once were. EQ and SQ seem to be at the top of the list of what employers want. What are your thoughts on the right balance?

Jim: Finding the right balance is definitely the right approach, Judy. Let me say that formal education has and likely will always be a valuable foundation, providing people with the underlying set of skills that make them effective employees and leaders. Because of the time and cost involved in the pursuit of a four-year degree, many people are opting to avoid the traditional college route and find success through skill development and experience alone.

As it relates to EQ and SQ, the ongoing debate remains if it can be learned. I believe EQ is not a fixed trait but a set of skills that can be learned and enhanced with practice and the right resources. This relates to self-motivation, self-awareness and emotional regulation.

Judy: Looking back on your 30-plus-year career, which of your positions was most satisfying?

Jim: I must say that I am very fortunate to have enjoyed most, if not all, of the roles I’ve had, each serving as a building block for the next opportunity. If I were forced to call out one, it would be my time working for and with former President Jimmy Carter at the Carter Presidential Center in Atlanta. Beyond his presidency, having a front row seat to experience his focus on human centered rights and conflict resolution strategies, was remarkable to watch and helped shape how I view the world and others.

Judy: What has been the key to your career success, Jim? 

Jim: The fundamental belief that nobody owes you a living–that what you achieve or fail to achieve in your lifetime is directly related to what you do or don’t do. No one chooses their parents or childhood, but you can choose your own direction. And lastly, don’t take yourself too seriously and continue to learn and seek new understandings. 

Judy: What advice would you give other CHROs in healthcare to help them be more successful?

Jim: I tell people that as a CHRO in healthcare, first and foremost, you must have an appreciation for those who are serving the patients on the front line. Sure, you have to be there for management, you have to be there for the CEO, for the board, but you equally have to be there for the people who take care of the patient.

If you are the type of person who’s afraid to get fired for doing the right thing, afraid of fighting for the right thing, which most often is the culture, the climate, and making your healthcare system a great place to work, then a CHRO role in healthcare is probably not for you. Because we have so many stressors that we can’t control in terms of reimbursement rates, and in terms of the health of our communities, your primary focus should be taking those stressors off the front-line staff.

Judy: Was there anything specific that led you to write the book, 101 Lessons in Leading with Laughter?

I do understand and respect that not everyone values appropriate humor as highly as I do. Historically, cultures around the world have used humor to connect, to cope, and to celebrate. If used appropriately, it can be a social facilitator; it can disarm tension, promote inclusivity, and even aid in conflict resolution.

Specifically, the book is divided into five distinct sections–Lessons in Humility, Lessons in Endurance, Lessons in Commitment, Lessons in Resilience, and Lessons in Levity–because these are the key areas in which I feel we can learn from humor’s application. Each section opens with one of my own experiences and supportive research that ties humor to these five critical aspects of professional life. Then, this research is supported by qualitative data in the form of contributed stories–101 to be exact–from people across multiple countries.

In this C-Suite Conversations interview, Lisa Abbott, EVP & CHRO at Boston Children’s Hospital, shares her perspective on leading through change in today’s healthcare environment. From supporting employee well-being to navigating hybrid work and embracing AI, Lisa offers practical insights on building a resilient, people-centered culture in one of the nation’s top pediatric medical centers.

Boston Children’s Hospital is one of the largest pediatric medical centers in the United States, offering a complete range of healthcare services for children from birth through 21 years of age. Boston Children’s is home to the world’s largest pediatric research enterprise and is the primary pediatric teaching hospital for Harvard Medical School.

Q & A With Lisa Abbott

Judy Kirby: I appreciate your time today, Lisa. You’ve been a CHRO for very prestigious academic medical organizations. As you’ve moved from organization to organization, what have you done to make each transition successful?

Judy: What is your advice on how to adapt when there is a significant leadership transition, such as a new CEO?

Lisa: You have to recognize that no two leaders are alike, and it’s our job, especially if you’re talking about a new CEO, to remember that we work for that person. We’re all intelligent adults and have our jobs because we’re subject matter experts. But at the end of the day, our job is to support the new leader, so we need to learn what that leader’s style looks like. We must learn what makes them get out of bed in the morning and adapt to their work approach as needed. Do not assume the new relationship will look the same as the previous one.

Judy: So there’s been a book out there for a while by Michael Watkins called The First 90 Days. Are you a fan, and what would you change about his advice?

Lisa: Is it 60 days? 120 days? I think the idea is to measure the organization you’re joining, and push the envelope enough without pushing yourself off a cliff. I’m a person who’s wired to make change, so I have to modulate depending on the organization I’m in. Some organizations want us to move quickly in certain areas. In others, we have to be more thoughtful in our approach. So the pace of change is governed in part by the change tolerance of the organization. That said, most people are averse to change, so you have to overcome that inertia at some point. But in my experience, it’s a lot easier to ask for forgiveness in the first 90 days than to get permission too much longer after that.

Judy: Amid all the uncertainty and looming changes, $340 billion in Medicaid, site neutrality, and so on, how are you dealing with the organizational stress people are feeling?

Lisa: We are in academic medicine, so we are in the crosshairs of every executive order that is coming out, whether it’s Medicaid changes, research funding changes or impact on visas. All of the things happening right now are heightened in academic medical centers. We have lots of students who come from overseas. We have lots of researchers who are paid from grant funding. Many of our patients are Medicaid recipients, so people are on edge. As a result, I think there has never been a more critical time to be really intentional about workplace well-being.

Are we ensuring that our community members understand all the support that is available to them? From Employee Assistance Programs (EAP) to financial planning assistance to paid time off to deal with these emerging issues. There are people asking for access to legal advice right now. What does that mean? So, holistic well-being has taken center stage, which we take very seriously. We’re bringing as much intentionality as possible to that right now, and it’s never been more important.

Judy: Everyone is trying to address physician and clinician burnout, but I recently came across an article about HR leaders becoming burned out too.

Lisa: Right. Anxiety doesn’t stop at the doors of HR. The people who work in HR are human beings, just like the people in the communities that we’re serving. We had an HR town hall meeting yesterday, and we talked about what’s going on in the world. We didn’t try to shy away from it. We talked about the organization’s commitment to upholding our standards and our values, but also emphasized that it’s really important, like they say on airplanes, to put the oxygen mask on yourself before you help your fellow passenger. I believe people need to take time out for self-care, and it is not selfish to do so.

One of the things that we try to focus on, especially in these days of remote work, is to make sure you check on your neighbor, a colleague who isn’t showing up the way they used to. “Is everything okay? You don’t seem like yourself.” Just asking the question and offering to help may be the support your colleague needs.

Judy: What are some of the well-being programs you have implemented for the employee population?

Lisa: We recently hired a Director of Well-Being. Well-being means different things to different people and has many dimensions. We’ve talked about mental and emotional health, but there’s also social well-being, physical well-being, and financial well-being, and we offer solutions in all of those areas. The challenge we’re trying to overcome right now is how to package it and ensure people know what is available.

Judy: During your time as CHRO, you have learned to deal with multiple generations of workers with different needs and priorities. What have you learned? What has worked and what hasn’t?

Lisa: That challenge has increased exponentially over the last decade or two. We see four or five different generations in the workplace. We have emerging workers who are technologically savvy but sometimes interpersonally limited. We have a more seasoned generation of people on the other end of the spectrum who are often lagging adopters of technology. They would like young people to work differently and have the same level of investment in their organizations and careers. When they don’t see that, they perceive it as negativity and laziness.

But the reality is that everybody brings value, and our more senior workers can be amazing mentors, leaders, and teachers. I see them helping the younger generations understand the history, but not living in the history, which is an important differentiation. It’s important to understand how we got here, but in the words of Marshall Goldsmith, “What got you here won’t get you there.”

Young people are the future, so we’d better be paying attention. We need to appreciate their technological prowess and the fact that maybe they have a keener sense of work-life integration. If we can be more purposeful about meeting people where they are as opposed to judging them for where they aren’t, we’ll all see more success in our workplaces.

Judy: COVID sent a lot of people home to work remotely. Some organizations are bringing everybody back on-site, while others are making hybrid and remote work permanent. How are you dealing with that at Boston Children’s, and how does it affect promotions?

Lisa: I’m not sure anybody has the right answer on this. Jamie Dimon has a strong opinion on this and JP Morgan Chase is bringing everybody back to work on site. He talks about the impact on future generations of leaders, and I think he’s right about that. I think that there is real value to incidental contact, that proverbial water cooler chat, or the chance to pass a leader in the hallway and have an impromptu conversation or ask them for career advice.

On the other hand, we have benefited enormously from the ability to attract a much more geographically dispersed population of employees. Plus, some roles are very well suited to being remote, like corporate services roles, some HR roles, IT, and finance. If we, in Boston, were to say everybody has to come back to work, we’d lose a large part of our workforce, not just because people have appreciated the ability to be remote, but because Boston is a really expensive city. It’s expensive to live here. It’s expensive to commute.

You really have to weigh the pros and cons if you’re deciding on anything other than a hybrid model. I imagine Jamie Dimon will see a downward blip on the radar at JPMorgan Chase, because it will take a while before they can start staffing up with people who are proximal to where their banks and offices are. In Manhattan, they have the same problem we have here in Boston. You lose hours of your life just trying to get to work.

Judy: Some positions cannot be done remotely, like surgeons. What have you implemented to get the talent you want to move to Boston, considering the high cost of living?

Lisa: We pay a premium for our geography. That’s just the reality. In cities like Boston, New York, and San Francisco, you pay a geographic premium on top of what the job would be valued at in the Midwest, for example.

The Harvard affiliation is really attractive to people. We are a teaching hospital of Harvard Medical School, and that matters to people. They want to be affiliated with the institution. Many of our clinical colleagues and physicians were trained here in the Harvard system, and I hear a lot of comments about how glad they are to be back. It feels like home.

But we really try to make sure that the job is right for the specific individual, especially at the executive level. As you know, executive turnover is expensive, so when I’m working on an executive search I pay a lot of attention to what the family unit looks like and what their needs are – whether there’s an accompanying partner or children or pets or in-laws.

Judy: Have you implemented effective testing and interviewing techniques to ensure the right person is hired in every position?

Lisa: Everything we do is a data point. We do our best to think about not just the job description and whether the person can do the job, but the leadership competencies that the person needs to bring for the time we are in and, more importantly, for the future. A leader four years ago is a different leader than what we need today, dealing with massive uncertainty and change. It’s not for everybody. We certainly do the aptitude assessment tests, but I’ve had people interview extraordinarily well and pass their Hogan Assessment with flying colors, and then still fail. There is no silver bullet.

Judy: How are you using AI, and how do you think it will affect you and your team over the next few years?

Lisa: I was in IT before I was in HR, so I’m all about freeing up human beings to deal with real problems, not transactions. For example, we’ve used AI to automate the nursing licensure renewal process, which had been exceptionally manual and arduous. No one is complaining that AI took away their grunt work of manually digging for primary source verification.

I’m all for it, and our younger employees expect it. I’d like us to become more proficient with automation and AI. Not everybody feels that way. It can be pretty scary, but there’s only upside for people willing to learn and be upskilled. Yes, your existing job may go away, but we will create a different role for you where you are doing even more valuable work.

Judy: Throughout your career as an HR leader, how have you collaborated with other departments to enhance their culture?

Lisa: We do this in various ways. When you’re on your listening tours, you start to figure out where there are challenges, where people aren’t interacting as we would want them to, and so forth. So, we use observational information, and then sometimes people will raise their hand and say, “Our team needs a shot in the arm. What can you do to help?”

We use our Press Ganey survey data and have partnered with Chartis to gather data on burnout and resiliency in the workforce. We also do what I would loosely call “interventions.” We figure out the problem they’re trying to solve, where the obstruction is coming from, what the leader is like, what the leader wants, and help them create better interpersonal and team dynamics.

I want people to bring their very best selves to work. But more importantly, I want them to bring their very best selves back home because that tells me that they’re engaged, feel valued, and that their work matters. That feeling is tied to how well they get along with their colleagues and their leader. A big part of that work is teaching people how to resolve conflict because the ability to resolve conflict is a key driver of a favorable culture.

Judy: What work have you done to strengthen the IT culture? That’s a group with a high proportion of remote and hybrid workers. We’ve heard horror stories of people taking on two or three jobs while working from home.

Lisa: I believe it. You hit on a key example, the tech roles, but I also think about medical coding and billing. Those are jobs that people from all over the country do and lend themselves to multiple potential employers. So, if hybrid or fully remote work is something that you plan to continue, it’s incumbent upon you the leader to work harder to engage the people who aren’t sitting next to you. Isolationism is not necessarily conducive to teamwork without an extra level of investment. It requires very deliberate behavior, and it is hard work.

Judy: So, you have remote workers all over the country. Has that been the case since COVID?

Lisa: I’ve been at Boston Children’s for two and a half years, so people were remote when I got here. I’m still regularly asked, “Are you taking away remote work?” As if I have the power. But I’ve heard leaders in our organization say, “I want to take away remote work as an option. I want my people back.” To that I say, “You are empowered to make that decision for your work group, but I’m cautioning you, you will lose people, and you have to be prepared for that.”

Judy: What career advice do you have for professionals interested in becoming a CHRO one day?

Lisa: The first thing I tell people is, “learn how to speak the language of the client you’re serving.” I’ve learned that myself. Nobody wants to hear FLSA, wage and hour law, fair labor, OSHA, and all the acronyms. They don’t care about that. They care about P&L, patient populations, and adjusted occupied beds. They care that we understand their strategy as a department within the business we’re in – and that business is healthcare.

Judy: What else?

Lisa: It’s important to learn the varying aspects of HR and understand that we are the compilation of a bunch of different functions. Employee relations is very different from benefits which is very different from compliance. Another thing is that it is really important to have thick skin. We deal with a lot of really complex people problems, things that can sometimes make you feel bad about the human condition. If you’re overly sensitive, this is not a great job for you.

You have to be able to discern the truth in a lot of storytelling. People will come to you with big stories, and when you start to dig a little deeper, you find that there’s an element of truth to that story, but there’s also another side. So you have to have impeccable judgment, a little bit of a poker face, and the ability to take information in and not necessarily react in the moment.

And lastly, you really have to possess the ability to be discreet and to hold information in confidence. This isn’t the old days of the personnel department. CHROs are integral consultants to the CEO and the executive team. Since COVID, the value of human capital and the people that lead the human capital function have become recognized as equally critical to every other resource, so we have an obligation to own that responsibility in a really deliberate way.

Judy: What are some things keeping you up at night right now?

Lisa: Right now, it’s the external environment. Like I said, we sit in the crosshairs of so many of these executive orders, and I worry about the impact on actual people. When we lose grant funding, there are people at the end of those transactions. When Medicaid cuts happen, there are patients at the end of those transactions. I want to do everything we can to ensure we continue to deliver the extraordinary care that we are known for at Boston Children’s and that the people delivering and supporting that care feel safe, feel valued, and still have a paycheck. So that weighs on my mind regularly. I wake up daily wondering how many more shoes will drop and who they will impact. So, we’re doing the best we can in this uncertain time.

Judy: What do you enjoy doing in your free time?

In this edition of “C-Suite Conversations,” Jim Venturella, SVP & CIO and President of Population Health Services at WVU Medicine, shares the leadership insights and strategies that have shaped his successful career. Jim reveals how he has unified a fast-growing, geographically dispersed IT organization into one centralized team while cultivating a culture of collaboration and career development.

WVU Medicine is West Virginia’s largest health system and the state’s largest employer, with more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues. The health system is comprised of 25 hospitals.

Q & A with Jim Venturella

Judy: You started your career in consulting. How has that influenced how you approach technology and health systems?

Judy Kirby: You’ve been with two organizations that have grown substantially through acquisition. Can you talk a little bit about what you’ve learned through those experiences, and any advice you have for CIOs going through mergers and acquisitions?

Jim Venturella: The number one piece of advice is to set expectations early in the process, and ideally, through due diligence. When I joined WVU Medicine, we had six hospitals that had come together through mergers, and they weren’t all aligned. One of my early jobs was to create a common vision and bring things together, which was challenging. My leadership team went through a learning curve. Now, when we go into due diligence, we make sure people are aligned on what changes are going to occur, when they are going to occur, and how fast.  Making it clear that we wouldn’t maintain separate portfolios or teams. Once those expectations are set, when the merger does occur, things go more smoothly.

Judy: How have you brought disparate teams together and gotten them to function as one?

Jim: My early days at WVU Medicine were a challenge. The org chart illustrated that we were one, but it was really five different departments that were not integrated. So, I spent a lot of time on the road, meeting with teams face to face, articulating my vision and where we were going. I’d attend executive leadership meetings at each one of the hospitals. My message was, “We’re not five teams anymore. We are one team, and that’s how we will support the system. If there are issues, I will listen, and we’ll work it out together.  It wasn’t a question of if we are going to change – just how and when we’d consolidate.”

Once the consolidation was complete, it was much easier as new hospitals came into our system. It’s about easing people’s fear of change. It’s going to be different, but they are going to be welcomed onto the team. They will have great opportunities and be part of something bigger and better.

Judy: How did you approach handling duplicate positions, as far as either letting go of people, or reassigning their seats on the bus, so to speak?

Jim: We are committed to bringing everybody into the team. We go through a process of identifying the individual’s skills, what they’ve done in the past, and where they might fit within the team. We then look at where our needs are and do our best to match them up. If there’s not an exact match, we have a conversation with the individual about the training we will give them for their new role. For the most part, people are open. We’ve certainly had some people who decided to move on to something else, but we give everybody the opportunity to be a part of the team.

Judy: You’ve succeeded in keeping your team engaged and not having huge turnover. How have you achieved success there?

Jim: I think it starts with the organization. We have a great culture at the health system – very mission-focused versus feeling like a corporate entity. We focus on developing individuals, allowing them to grow their careers. I am always telling my management team that the first thing they should be focused on is their people. Do you know where they are in their career? Are you doing things to help them move up? Are you focused on recruitment so that you have all the people you need? Who on your team needs extra help, and are you focused on that?

Our talent management process allows everybody to grow their career and move up. This helps to minimize the reasons for them to go somewhere else from a pure career opportunity standpoint.

Judy: WVU Medicine is spread out over a fairly large geographic area, so how are you handling remote and hybrid workers?

Jim: Pre-COVID, I probably had two-thirds of the team in the greater Morgantown area, and almost everybody came into the office daily. As we’ve grown and added more hospitals, new team members are located outside of Morgantown. Since COVID, we have not brought people back. Logically it wouldn’t make sense, because now we’re so dispersed. We’re in four different states, so it’s hard to justify forcing people to come into the office and sit in Teams meetings.

I do think we are losing something by being remote. I think human connection is extremely important for teams. We try to minimize the impact by getting teams together at least four times a year at a minimum.  Hybrid is here to stay, so we are figuring out ways to maximize the new model.

Judy: What do you see are the pros and cons of that, as far as the professional growth of the individuals, and how they interface with the users of your systems?

Jim: For people who’ve been here for a long time, it is less impactful to their professional growth. They know the organization well and have built many relationships. I worry more about the new people we are bringing into the organization.  How do we help them feel connected and part of the team? How will they feel that sense of contributing to our mission?  We must continue to focus on it in ways that are different from how we have in the past.

Judy: I recently saw in an article that organizations are more likely to promote somebody who is hybrid instead of fully remote. Have you seen anything like that?

Jim: A lot of it comes down to the individuals themselves, and how they’re going to manage and how they’re going to interact with their teams. I have one manager who is fully remote, and that was a struggle for me mentally to get through my old-school thinking. I think managing people when you don’t see them is a real challenge, for both sides. I think hybrid is a better option, but that could hinder the growth of talented people on your team.

Judy: Some CIOs are concerned about the division of technology within their organization. Some have data, some have AI, cyber, analytics. At some, it’s more siloed. At WVU Medicine you pretty much have it all.

Jim: I am very fortunate, and it really started when I joined. As I mentioned earlier, there was no central IT group, so I set the expectations coming in that we were going to bring everything together under one group for the whole health system and operate as one IT team. Any shadow groups would be migrated in. And when there is a merger, that IT group joins our team on day one.

For one of the shadow groups, it took some failures before we were able to fully integrate them. There were lots of issues with getting things done, too much overlap between the groups, and escalations were coming in on a regular basis. We eventually gained support to consolidate, and ever since, it’s been a huge success. People wanted control so they could decide priorities. You can still accomplish that with a centralized model. In addition, you can ensure consistency from a standards and toolset standpoint. Also, if one area has some excess capacity, or we have backlogs in another area, we can move things around for the benefit of the entire organization. When you have silos, you can’t do that.

Judy: Does AI report to you as well?

Jim: Yes.

Judy: What are you doing with AI at this point?

Jim: Like everybody else, we are involved in lots of different activities. First, there are the AI functions that come from our vendors, like Epic and Workday. We’re trying to implement their capabilities when we feel they’re good. We’re doing ambient listening and just signed a new enterprise agreement, so we’ll be getting that to every physician who is interested. We have some conversational AI in our call center. We’re building out some custom solutions around the total patient journey, bringing structured and unstructured data together into new models. This provides interesting new capabilities for clinicians and population health groups, giving them a full picture of a patient’s journey throughout the health system. We have a laundry list of other ideas, and we get many new requests on a regular basis. We have been working on more efficient ways to screen them to determine value, so we don’t get distracted by every shiny object out there.

Judy: Did you set up governance to deal with everybody coming to IT saying, “Look at this bright shiny object. I need it now?”

Jim: To handle the added AI complexity, we’re bringing more people from across the organization onto our governance committee, including legal and compliance. We’re still in the formative stage, but the increased focus on governance is critical in this new era of AI.

Judy: I was talking to a CIO recently who said that risk reports to her, because it’s so key to everything that technology does. Does it report to you?

Jim: No, risk reports up through legal at WVU Medicine, and we work closely with them. Cybersecurity is always number one or two on our risk register. AI has become one of the top risks recently, which was the trigger for expanding our governance committee.

Judy: Another thing we hear is concern about the lack of up-and-coming IT leaders to fill future healthcare CIO positions. What are your thoughts around that, and what are you doing in terms of succession planning?

Jim: I do see fewer people with their eyes on the management track. We have three different career tracks, and we’ve identified that once people reach a senior level, a larger share want to be in the technical track or the project management track versus the management track. So, we’ve put a new mentorship program in place this year. We identified high-potential candidates who we think are good candidates to move into a management role. We team them up with leaders to help clarify what the transition looks like. I think helping people understand what life looks like in the management track is going to help us. We’re just four or five months into this program.

We also have a more formal talent management process that I brought over from my consulting days. I spend two full days each year with my senior leadership team, reviewing everybody in the IT organization, where they are on their career path, and who should be up for promotion. We also focus on the leadership team, who’s next in line, and if they are getting the right training and experiences to move up. We’re constantly thinking about growing and developing leaders, and dedicate resources and our time to it.

Judy: Looking back over your journey, what career advice do you have for rising technology professionals interested in becoming a CIO one day?

Jim: One piece of advice is to get comfortable leading without being an expert. As you move up it’s very easy to lead people in an area where you’re an expert. But as you take on larger responsibilities, you must figure out how to balance between managing at a high level, versus when you need to dive down and get into the weeds. You must know which managers are solid and who may need more hands-on support. But as you move to these bigger, broader roles, you have to do that efficiently and not get stuck in the details. It’s certainly a skill that you develop over the years with experience.

Judy: If you hadn’t become an IT leader, what other career do you think you were cut out for?

Jim: I like building things and designing things, so I could have seen myself as a contractor or something in construction. I have a degree in mechanical engineering so naturally I thought I was going to be an engineer. When I got into consulting, my expectation was that I was going to be working in manufacturing. However, my first consulting project was in healthcare and thirty-some years later, I’m still in healthcare.

Judy: Thinking like a mechanical engineer, what would you design to improve healthcare?

Jim: There are concepts from manufacturing around process design that could be applied to how we get patients in the door, through the process, and back home safely. In my population health role, we’re looking at how to ensure high-quality results and great outcomes. In surgery for example, we look at the process from the initial clinic visit to the activities that occur prior to them coming in for a surgery, and then what happens post-procedure. How can we make the entire process as efficient as possible?

Judy: What do you do in your free time, when you have it?

Jim: I like to work with my hands and do things outside. At work there is a lot of time spent in front of a computer screen or in meetings, and while we do a lot of great things, it doesn’t always feel tangible. But doing a little building project or working outside is something that you can step back from and visually appreciate – something tangible you built yourself.  I get a lot of satisfaction from this.

Judy: What have you built?

Jim: Little things like tables or shelves around the house, or a fire pit outside. Nothing major at this time. That’s for retirement.

Donna Roach, CIO at University of Utah Health, brings a valuable blend of healthcare operations expertise and systems analyst skills to her role. Donna leads with a systems mindset and a strong focus on people. In this “C-suite conversation” with Judy Kirby, she shares her perspective on leadership, digital health strategy, hybrid work, and the real-world impact of AI in the industry.

University of Utah Health is the Mountain West’s only academic health care system and provides patient care for the people of Utah, Idaho, Wyoming, Montana, and much of Nevada. The system is staffed by more than 24,000 employees, including 1,600 board-certified physicians at five University hospitals, 12 community clinics, and several specialty centers.

Q & A with Donna Roach

Judy Kirby: Your career has spanned very different organizations, including consulting and academia. What were the skills you possessed or learned that helped you with transitions to different organizations?

In healthcare IT, I started as an application analyst, so I understand how the applications work and how to implement them. I also did a lot of project management work, which came to me naturally.

Another important skill is something I call zooming in and zooming out. When something just doesn’t feel right, it is the ability to zoom in and ask the right questions, listen to the answers, gather information, and then zoom out to offer guidance or advice. Some people might call that micromanagement, but actually, it’s micromanaging when something doesn’t feel right and stepping back again and letting the team do their work when things are back on the right path.

I love leadership development–finding great leaders, understanding the skills they bring to the table, and meshing that into a team. I tend to bring together team players who have very different make-ups, behaviors, and personalities. It’s more work to lead that team compared to one where the people are all on the same bandwagon, but that’s dangerous because you can get into some really bad groupthink and nobody is challenging you.

Lastly, I would say, is relationship building. My top priority is my C-suite executives. They’re the ones that I have the closest relationship with, and to understand what’s important to them and what they need from me. I’ve learned how to be more thoughtful about the questions I ask so that it doesn’t sound like I am challenging them in a negative way, just trying to get better information.

Judy: What do you look for when hiring leaders?

Donna: I want them to know and appreciate that healthcare is unique. Sometimes I’m hiring IT people who have no healthcare experience. They need to understand that they’re going to have to develop and learn, that healthcare is about serving the community, the patients, and our clinicians, and they have to be willing to embrace a servant leadership model. Do they know up front that this is very different from a Fortune 500 or a manufacturing job because there are people at the end of our systems, and they could harm them?

I also look for people with great communication skills, not just written but verbal. Not everyone in IT has high EQ, but as a leader, I need them to bring that to the table because they’re going to be dealing with executives, physicians, and clinicians who aren’t always going to understand the IT speak.

I also like people who have innovation in how they think, aren’t stuck in their ways, and are willing to challenge themselves.

Judy: What has been the biggest challenge during your career?

Donna: The thing that is the hardest to wrap my head around is when people see me and my role and think, “You’re just the computers, right?” Or “You’re just the network.” They look at the CIO role as a director of IT. No, I’m your chief executive when it comes to all things IT and the big C of change management. So it’s a challenge sometimes working with another executive who only wants to bring you in when something’s gone wrong on a system that was implemented five years ago. Why didn’t you bring me in earlier when we could have had a better discussion? It’s like the musical Hamilton. I want to be in the room when it happens. I want to be in the room when we talk about strategy because IT is going to connect to everything.

Judy: You and I have talked about giving back. Can you speak a bit about how you’ve accomplished that and how it has influenced your career?

Donna: Early on, I was very involved with HIMSS, especially at the local chapter level, and I truly appreciate what HIMSS did for me by connecting me with other healthcare professionals. So now I serve on the advisory board, which is my way of giving back to HIMSS because that organization was there for me throughout my career. I’ve also been on the CHIME board, and I’m really active right now on the Federal Policy Committee, lending my voice to comment periods of federal policy. I think that’s giving back, too.

We’ve done some great things here in Utah, and I want the rest of the industry to benefit from the experience, so I try to present at national forums.

Judy: So, one of the questions we’re hearing now is, what’s the difference between a CDIO and a CIO? Is there really any difference?

Donna: I don’t see a difference. I don’t feel the need to have “digital” in my title because I’m doing it anyway. I think it is duplicative. I will say that I’ve had this discussion with my CEO in the context of succession planning. One day, when you are backfilling my job, you may need to add “digital” because otherwise some candidates may not think you’re digital.

When I came to Utah, I worked closely with our chief marketing officer, who has digital over her space. And I think that the collaboration that we created was amazing because she didn’t feel like I was competing with her. The message is “I’m here to collaborate with you, not to take it over.” What’s more important is acceptance among my peers and their confidence that I’m doing the job that will support them and the strategy and vision of the organization.

Judy: One of the big concerns I hear over and over is about the lack of up-and-coming IT leaders to fill future healthcare CIO positions. We’ve seen a lot of retirements recently. What are your thoughts around this void?

Donna: I think it’s real. I think the pandemic did not do our industry any good, especially for female leaders. I think some really strong female leaders look at this job and think, “Why would I take on this level of stress when I could be doing something just as beneficial in another job, in another industry?” It’s similar to the thought process we saw physicians go through, realizing how stressful it was and leaving their medical practices.

It is a high-stress position. Cybersecurity will always keep me up at night. And you have to wear a lot of hats, and I think that can take a toll on your well-being.

Judy: Looking back over your own journey, what career advice do you have for rising technology professionals interested in becoming a CIO one day?

Donna: Create your relationships and contacts with the various groups, like HIMSS, CHIME, and other professional organizations that can put you in contact with other people at your level. If your goal is to be a CIO someday, you will get it through the network you’ve created.

Some people think a CIO role will just eventually happen, but no, you have to have a plan. You have to be purposeful. Think about your background and where there may be some holes, and try to gain some experience in those areas.

Judy: Can you talk a little bit about remote and hybrid working models and what you’ve done there?

Donna: I was hired here in the middle of COVID, so everybody was remote. Then, as the pandemic wound down, there was talk about bringing everybody back into the office. But my IT folks were like, “No, no, we like it.” So I decided that, even though it may make my job a little bit harder, I would support the hybrid model.

I think I get more out of my staff by giving them this flexibility. There are people who want to come into the office every day, and we have that capability. And we do things where we bring everybody in. I have about 450 people in my IT department, and we just had a meeting at one of the big theaters, and we had 300 people in attendance. You have to incorporate those opportunities so you can get people together and have camaraderie and a sense of community.

I’ve heard other CIOs say, “How do you know that they’re working if you can’t see them?” I think, “How did you know they were working when they were all in the office? You’re not watching them all of the time.” It is more about how you are driving your value metrics, whether it be projects completed or project timelines. Those tell me more about how well we’re doing versus me watching people to see if they come in at 8:00 and leave at 5:00.

At the same time, I don’t want someone working 20 hours a day. We even put some rules in place so that if somebody’s in a different time zone, you can’t call a meeting at 5:00 pm for you when for somebody else it’s 7:00 pm. You have got to be thoughtful about that.

Judy: Can you talk a little bit about the status of your succession plan and the approach you’ve taken?

Donna: We’re just kicking off a project to plan for that so that, if I get hit by the proverbial bus, there is someone to step in. I do feel confident that any of my leaders could step in and run the ship for me. I’m very confident in all of their skills because it’s been a team effort. Succession planning must be done across the whole C-suite, and that’s what our CEO is doing right now.

Judy: How is generative AI impacting your organization and your strategy? What type of AI work are you leading, and most importantly, what sort of ROI are you looking for?

Donna: This is probably one of the most exciting things I have seen during my career, but it is early days for us. The university CIO and I issued a guidelines statement, a one-pager. We have a chief AI officer and a Responsible AI initiative on the university side. In healthcare, I hired someone to capture AI use cases and look at the value metrics to make sure we’re working on the right use cases as opposed to the shiniest objects, and to understand what will bring the most benefit back to the organization.

We’ve incorporated different large-language models. We haven’t settled on just one. Part of the secret sauce is that these models are all different, and they have different benefits. Where one may work great for one specific use case, another one is probably more beneficial and has higher viability for others.

One of the most exciting use cases–and I am sure you are hearing this from others you talk to–is ambient listening. I have never been in a situation where physicians come to me and say, “I absolutely love this. If you take it away, I will leave. I will retire.” I love the fact that they have embraced it, and they’ve also helped us refine it and make it better. We started out in the ambulatory space and implemented it in our inpatient space. I want our nurses to be able to tap into it, too.

Even in the Clinical Document Improvement space, there are AI triggers giving the physician feedback as they are documenting. I mean, we’re on the cusp of really changing and improving our clinician workflow. Now, sometimes the workflow is broken, so you have to remap the clinical workflow so that AI can be utilized effectively. It’s an iterative, agile process that’s reducing the administrative burden of documentation, and that’s been fun.

We’re on Epic, and we probably have six or seven applications with the Epic AI tools, but we’re also looking at others. I have a group that is called “Reimagined EHR,” and one of our physicians is improving the clinical workflow within just the EHR and bringing that actionable data back to the clinician.

I have an AI model for the ED that, as people come in, if the model detects a stroke, it immediately calls out the stroke team. And as you know, with a stroke, the faster you can treat that patient, the better. That’s one truly clinical workflow that’s been improved dramatically by AI.

Judy: Have you looked at the cost versus the benefit of ambient listening? Are you able to point to real ROI?

Donna: The way we track the value metrics is by looking at the soft and the hard benefits. Right now, I would say the financial ROI isn’t there. But if we add in the soft metrics, you see real value. For example, we’ve improved things for physicians who can now be more efficient, close out their charts at the end of the day, and not have to work nights and weekends to get that administrative work done. We have essentially removed the administrative burden of documentation.

I think responsible AI will be a factor too–what models we are using and the GPU usage. We don’t have an electrical grid system that can handle all the power required, so it’s also important to understand which is the right model to use and put some guardrails around it.

Judy: If you hadn’t become an IT leader, Donna, what other career do you think you were cut out for?

Donna: Well, two areas. One is a pathologist. I’ve always loved looking under a microscope and the science of pathology. But if I didn’t do something in healthcare, I would have been a farmer, like a fruit orchard or blueberries or something like that. My grandparents were farmers, and in the summertime, I always did 4-H. I’m a farmer at heart.

Judy: What do you like to do in your free time?

Donna: I golf and I play tennis, and I love both. I’ve golfed ever since I was a little kid, but I wish I were better. I am outside with people that I enjoy, and there’s camaraderie. I love tennis because it keeps me really active. I enjoy the competition, and I am getting better at the game. I am very aggressive at the net, which intimidates my opponent.

Judy: How do you have time for all this?

Donna: I make time. If I don’t carve that time out, I don’t do well at work. I like to wake up in the morning and think about what I am excited about today. That excitement, even if it’s just one small thing, like I’m going to play in my golf league that night, that excitement carries me through the day. It gives me a better outlook on my day and affects how I interact with people. When I don’t do that, I carry the weight of the world, and that’s not good. There’s a lot of stress in what we do, so if you focus on something you’re really excited about, it spills over into everything else that you do.

In this edition of “C-suite Conversations,” Judy interviews Doug Dean, Chief Human Resources Officer (CHRO) at Children’s of Alabama. With over 26 years at the organization, Doug brings a wealth of experience, humility, and forward-thinking wisdom to his role. From tackling burnout and embracing AI in HR, to fostering cross-generational understanding, he offers a candid perspective on what it really takes to lead with heart in today’s healthcare environment.

Children’s of Alabama is one of the nation’s largest pediatric medical centers, offering inpatient and outpatient care at its main Birmingham campus and locations across central Alabama, including Huntsville and Montgomery. As the state’s only health system dedicated exclusively to children, it also serves as the primary teaching hospital for UAB’s pediatric programs.

Q & A with Doug Dean

Judy Kirby: Doug, I’m so impressed that you’ve been with Children’s of Alabama for 26 years! What has kept you there all this time?

Judy: You’ve seen the evolution of the role over 26 years that we now call the Chief Human Resource Officer. What do you predict will be the focus of the CHRO role for the next three to five years?

Doug: I love that question. It is almost universal that if you ask not only CHROs like myself, but CEOs and COOs what keeps them up at night, they almost all now point to concerns about staffing the organization, developing leaders, and the challenging supply of talent. So, talent acquisition, recruiting, and retention are in the CEO vernacular these days, which means that the primary impact by CHROs and their teams is at the top of the leadership agenda.

Judy: A lot of the CHROs feel that they don’t have a seat at the executive roundtable. Why is that?

Doug: I don’t think there’s, as perhaps some colleagues may believe, an inherent disdain for HR leaders or underestimating the importance of the human resources function in an organization. If you’re not at the executive roundtable, it is often a self-inflicted wound if we’re honest. Frankly, some don’t polish their skills and learn to be a compelling presenter and use data to make their case compellingly. So I think we still earn our seat on the big issues.

I try to hire people who are smarter than me and then turn them loose to research who’s ahead in the world, especially in the healthcare industry. Are there good ideas we can borrow or adapt? In HR the trend can be to seep into being transactional and focus on pushing mundane work out the door. You really need to wall off – quite literally, physically –  the strategic planning work and protect it from the transactional grind.

Judy: How do you see AI influencing HR in the future?

Doug: I was at a seminar recently given by a well-known international HR consulting firm, and they presented some findings from a survey of a large group of HR leaders. Not surprisingly, only about 25 percent of those surveyed are doing what they consider meaningful AI implementations. We too are playing a little bit of catch-up, but I’ve started. I do think we need to step on the accelerator with AI in the HR profession. The cost of waiting or being risk averse as a “late adopter” might be higher and more painful.

It’s a simple step, but I encourage my HR team to play with simple AI applications, get their feet wet and go to conferences where people are talking about what’s already happening in HR with AI.

For example, almost all of us in HR love to use video as a communications method. It’s just more compelling in many instances. There is AI technology that produces very high-quality videos for your messaging with incredible speed and for dirt cheap.

I think we’ll also see more use of AI in the screening of candidates, and candidates more comfortable interacting with a bot. It’s already happening. Then, the only candidates that come across my and your desks will be the finalists, which reduces costs and the time required.

Judy: Everyone in healthcare hears about physician and clinician burnout. I saw an article at the end of 2024 about HR leader burnout too. What are your thoughts?

Doug: I think that there’s a constellation of issues, and many of them don’t have anything to do with what we experience at work. For some, maybe it is just life as they envisioned it in terms of the architecture of life, whether that’s relationships, friendships, or even the stress and joy of raising children. There are unprecedented pressures and demands on people outside of work, and yet we bring our entire self to the office. I think companies are only recently coming to terms with that – that we don’t want you to compartmentalize.

But I think that there are ways to forestall and overcome burnout by deliberately taking on new challenges at work that excite you. That might mean redirecting your career and it might mean a temporary drop in salary. What’s the saying? “If you do something you love, then you’ll never work a day in your life.” It’s kind of sappy, but I do think there’s a kernel of truth to it. So, I encourage my colleagues who have very long tenure like myself, to start to be a little selfish in their non-work life. “What things really give you joy when you’re away from work?” If you can optimize those and make sure you practice great self-care, that you’re eating well, you’re exercising, you have good experiences outside of work, I think it can dramatically forestall the ill effects of burnout through a more holistic approach to life.

Judy: There are multiple generations in the workforce. From your point of view, what are the differences between those generations in terms of what they want from the work experience?

Doug: What we’re experiencing is the outflow of baby boomers who have run our organization for a long time. They’re so loyal and hardworking. And there is an inflow of millennial and Gen Z workers. Our total population at Children’s of Alabama is just under 6,000, of which about 65 percent are in the millennial and Gen Z category. To me they seem so young, but you know what? They’re incredibly well-educated, well-trained, very high-tech, and very compassionate about what we do and what they bring to the table.

You’ve got to pay attention to the demographics. The minute our leadership starts building the work experience around people in my demographic – I’m between boomer and Gen X – we are making a strategic error because the reality is we’re only going to continue replacing experienced workers with younger people. So, we need to get really good at understanding these workforce demographics, their work preferences, and how they like to be led, the kind of feedback they want. It’s become a very big deal.

Judy: What differences are you seeing among the younger demographics?

Doug: Sometimes when we’re talking about generations, it still feels like we’re stereotyping with a broad brush. Dominant profiles of demographics like Gen Z, millennials, etc. are useful in many ways, but we should always be open to the possibility that an individual’s life experience and their upbringing and who they are might put them outside the mold. You might meet a Gen Z in their late 20s who is an old soul, and talking to them might sound like you and I having a conversation, Judy.

The differences I see mostly with the younger generations are that they really value when you check in with them so they can ask, “How am I doing?” Sometimes they literally mean, “Am I secure in my job? Am I performing well?” So, leaders and future leaders need to develop the habits of sincere and authentic ways of talking about development, growth, and performance, and paint a picture for the younger generations. “Hey, you’re really on track to be in position for advancement soon.” Frankly, they’re more like free agents, which I do not equate with disloyalty. I think younger workers have seen that if you stay at a company for 20 years, you can still get RIF’d or laid off. So, what’s the point in excessive loyalty, they may think? And I don’t feel that is a cynical point of view – maybe they’re the smart ones.

Judy: Relocation continues to be an issue for a lot of executives or high-level leaders. What have you implemented to get the talent you want to move to Birmingham, Alabama?

Doug: You need to have the good fortune of city planners and leaders who are working on the quality of life. For example, my HR colleagues and I had nothing to do with the food and wine scene here in Birmingham, which has become unbelievable! When my friends from cities like Atlanta, Chicago, New York, and Boston come here, they rave about our fine restaurants. If it’s a family moving here, there is access to very high-quality schools. The natural resources include freshwater lakes, and in 3 ½ hours you can drive to the world’s most beautiful beaches in Destin, Florida and Gulf Shores, Alabama.

Some may come here kicking and screaming because of outdated preconceived notions, but once they’re here and they get plugged into what we mean by southern hospitality and the friendliness of a place like Birmingham, Alabama, they want to stay. We see it time and again.

Judy: What testing, interviewing techniques, or other strategies do you employ to make sure you hire the right person in every position?

Doug: This is going to sound like a paid endorsement but we’re about 10 years into the very successful use of an instrument called Judgment Index. It’s not a personality or IQ test, neither of which is very predictive of performance, especially in a leadership role. But we believe strongly in the Judgment Index, which is considered to be among the most reliably validated and tested assessments of its kind. It is much more predictive of performance in a work setting, especially in a leadership role.

Judy: Over the course of your career as the HR leader, how have you partnered with departments to improve their culture?

Doug: What’s interesting about your question is that you’re invoking the notion of not just the organizational culture, but a culture within a particular department. I think we’ve done that but I would describe it as informal. I’d be a little nervous about a department veering away from the organizational values much at all. If they are able to take our organizational culture and values and put their own unique stamp on it, as long as those two are compatible, that can be a beautiful thing. It’s mostly my OD leaders having a lot of conversations with a director and asking, “What does your team need? What will attract talent?” For some, that might mean offering four 10-hour days and letting people have long weekends during the summer. For others, it might mean the ability to cross-train so people feel like they’re growing and developing. So, it can be a wide array of things.

Judy: What is your organization doing when it comes to remote and hybrid work, and what has been successful for you?

Doug: At the start of the pandemic, we had to send upwards of 1,800 staff members home. It was for safety reasons; we had no choice. What’s that phrase, “Necessity is the mother of invention?” If we didn’t do something, their income would be impacted. So, we quickly got very good at people working productively from home. Of course, patient care is not remote, but the corporate service areas.

Culturally, we think great things happen with teams when they’re physically in contact and come to a central office. That’s not to say this subject hasn’t been controversial. People got used to being at home and working remotely, and it was popular. But except for IT workers and a handful of other areas, we’re mostly back at the office, and that’s unpopular with some. Maybe they have work-life balance challenges. But I think there is a socialization and a mental health that can come with going in and being with people and not getting too isolated in your own home space for long hours. I do expect that the world will compel us to offer some hybrid work-from-home options, but we’re unlikely to have leaders leading their teams remotely.

Judy: Is IT still fully remote?

Doug: It is case specific. For those in IT doing a lot of heads down systems work, it doesn’t require a great deal of face-to-face communication, many of those are fully remote. Others want to come in a few days a week, so they are taking creative approaches that are driven by the nature of the work as opposed to enacting broad, deep rules. We’re trying to be nimble and flexible, and when we can, we adapt the rules to what will make the most sense for a particular employee.

Judy: There has been a lot of quiet quitting and early retirements in healthcare. What are you seeing as CHRO at Children’s of Alabama, and how are you addressing these challenges?

Doug: For more than 15 years, we were successful at keeping voluntary turnover under 12 percent system-wide, which is remarkable. Then in the wake of the pandemic, we joined the throngs of hospitals where it spiked to over 20%. The worst year was probably 2021. That was a shock to the system that forced us to ask a lot of difficult questions around what our workforce planning assumptions should be. 

One strategy when good people leave the system is that maybe they’ll be interested to come back and work with us again in the future. So let’s get really good at re-recruiting them because we’ve already made this enormous investment in them. And, when we make an offer and fill a single position, we should still be very interested in the two or three runner-ups. They were talented enough to be a finalist so could they be a quality hire for another position?

Judy: Were you successfully mentored at key points in your career?

Doug: I was very fortunate along the way that in several cases, my bosses were friendly and didn’t always have to act like my superior issuing directives, and we became mutually respectful. My experience has been that people are usually delighted to share their lessons learned, and what they see in you, where you can grow and improve your chances to have impact as a leader.

My advice is to be a sponge when you’re around leaders you really admire and become a student of their leadership. If your company will help fund it, I highly recommend a quality executive coach as a safe space where you can go talk about a weakness or a specific mismanaged situation, and get coaching on that. Maybe they’ll do a 360 with your peers and subordinates, but be prepared for that to sting a little and point out some areas that you really need to improve. I think it’s just being humble and never feeling like you’re a finished product, and finding the joy in continuous development.

Judy: I hear from HR executives that often, one of their strongest relationships is with the CIO because IT touches everything. From your experience, what does a really strong partnership with the CIO look like?

Doug: I admit that we don’t speak the language of IT, but the CIOs I’ve worked with understand and are happy to translate. I think it’s critically important that you hire a very capable, strong HRIS leader so that you have a translator walking along with you. We’re trying to turn data into useful management information to operate our workforce and do all the powerful things that you can with technology. So, build a relationship and get to the point where your gap in technical knowledge compared to a CIO’s does not become an impediment.

Judy: What do you like to do in your free time?

And anything outdoors, whether it’s on the water, in the woods, on a golf course, or just sitting on my back deck with my sweet little yellow lab. I love the fresh air, and I think getting  into the great outdoors is good mental health advice for all of us.

Heather Nelson brings a unique blend of operational skills, strategic vision, and deep dedication to healthcare to her job as SVP and CIO of Boston Children’s Hospital. In this edition of “C-suite Conversations” Heather shares with Judy how she launched her IT leadership career, the mentors who shaped her path, and how she’s building empowered, forward-thinking teams.

Boston Children’s Hospital is one of the largest pediatric medical centers in the United States, offering a complete range of healthcare services for children from birth through 21 years of age. Boston Children’s is home to the world’s largest pediatric research enterprise and is the primary pediatric teaching hospital for Harvard Medical School.

Q & A with Heather Nelson

Judy Kirby: Heather, your entire career has been in healthcare technology. How did you choose technology and healthcare, and why have you stayed?

After a year, I got a job as a system administrator in case management. The job was implementing a case management system for our case managers in the hospital and our health plan, Priority Health. I taught myself what I needed to know because I was not a computer programmer by any stretch. Later this led to a job as senior analyst in IT when Butterworth and Blodgett were merging to become Spectrum Health in the late ’90s. We had selected Cerner as our EHR and my job was to focus on the legacy systems. That’s how I got into healthcare IT.

I stayed in healthcare IT because I had a tremendous manager who saw something in me that I didn’t see in myself right away: that I was a people leader, a strategic thinker, and that I knew how to bring people to the table to have a conversation. She promoted me from an analyst to a team lead while we were implementing Cerner, rolling off legacy systems. This allowed me the opportunity to understand hospital operations from a perspective larger than just the project I was focused on. I’m just so fortunate, Judy, because I’ve had such tremendous mentors and folks who looked out for me as I grew up in my career. As I always say, “In IT, we’re the people who take care of the people who take care of patients.” That’s why I stay.

Judy: You’ve continually been promoted and grown into increasingly responsible positions during your career. What skills and abilities have helped you do that successfully?

Heather: I love operations and understanding the problems we’re trying to solve. I love the relationship aspect of what I do. I think what’s helped me succeed is building and fostering those relationships, especially coming into a new organization. So I credit my listening skills, my ability to build relationships, and the fact that I’m a straight shooter. I’m an executor, which means I like to get things done. Sometimes that’s a weakness that I have to balance, because I’m not a very patient person.

I look for opportunities to stretch my abilities. The CIO role is so different today than it has ever been, and it’ll continue to evolve. You have to be seen as a strategic partner and have a seat at the table, not be seen as an order taker. I don’t want anyone on my team to be an order taker. I want them all to feel empowered as strategic partners, to have the conversations, and to bring options forward.

Judy: How do you position your team not to be order takers? How do you train them and help them show up as strategic partners?

Heather: A lot of my team members were used to someone calling them or sending them an email, and using a first in, first out approach. We had to restructure how we take in work and how we prioritize work. I told them, “As we move to new enterprise systems, we have to be very thoughtful, and we have to think through an enterprise lens. We have to understand the risk and the impacts of making a change or a request.”

We talk a lot about this in our monthly departmental town halls, and at quarterly leadership meetings. We talk about how important it is that they all feel empowered to ask questions, to ask for a seat at the table, and to bring options. I’ve been here three and a half years, and we don’t have it nailed down perfectly yet. We’re still learning, both as a leadership team and as a department, but I practice what I preach. My job is to advocate for my teams and their job is to let me know when they need help, when they need a different voice at the table. That’s really how I enable and empower my teams.

Judy: How did you decide who to seek out as mentors, and how have they bolstered your career? And as a corollary, how are you helping your team pick mentors?

Heather: For me, it was observing senior leaders in the organization, watching how they interacted and communicated. Then, I would ask my manager, “Can I go meet with so and so? Would you mind if I reached out to them?” I was fortunate that I never had an upline who felt threatened by that. I sought out female executive leaders because IT was a very male-dominated environment when I was getting started.

When I’m asked to be a mentor, one of the first things we talk about is, “How are you building your network? Do you understand what that means? Do you have someone besides me who you trust and who you look to for guidance?”

I still have a lot of mentors I can reach out to and throw something at them that I’m struggling with. You’re one of them, Judy.

I encourage folks to look for leadership mentors and peer mentors. I think having peers you can lean on and trust is just as important as having someone who can move you up in your career. You need to strike that balance.

Judy: I hear from a lot of CIOs who are concerned about the division of technology within the organization. Some are responsible for data while others aren’t. Some have AI, some have cyber, some have analytics. What areas fall under your leadership?

Heather: I see digital as part of what healthcare IT is responsible for. Every organization is structured differently, but here at Boston Children’s Hospital, there is a separate digital health team. Obviously, we work very closely together. And there are times when the lines are blurred a little, but we just work through that. Everyone brings value to the table. Everyone has a job to do.

I have data and analytics, I have cybersecurity, research informatics, medical informatics, and all of the systems and over 22,000 devices across the enterprise, so it is a very big scope. I’m partnering with our chief innovation officer on AI. The two of us have stood up AI governance in partnership with our senior executive leaders, who have provided tremendous support for this. I don’t want his job and he doesn’t want mine, so we have found a way to partner, because there’s so much potential for AI in healthcare.

We’ve been using AI for a long time at Boston Children’s, especially in the research space. Now, how do we take innovation happening in one small group and make it work for everyone? A lot of good things are happening and AI is crossing multiple teams, which is okay because we’ve created those guardrails and some structure.

Judy: How do you see the CIO/CDIO role evolving over the next three to five years? What are some of the new responsibilities and new job qualifications?

Heather: Having strong financial acumen is so critical for a CIO or a CDIO. We manage multi-million dollar operating budgets and capital budgets. You have to make sure that you help the organization build ROI from the investments it makes. Healthcare organizations are doing a lot of building, a lot of facility work. More and more we’re moving out into the communities. Then we also have connected care, hospitals at home, virtual visits and virtual care. What technologies do we need to bring to bear there? How are we pivoting from only bricks and mortars to supporting these new workflows?

And it is different for our care teams, who are accustomed to having the patients and the patients’ families physically in front of them. But it’s hard to get to Boston Children’s because driving in Boston is not easy. If we can care for our patients at home with wearables, or with a virtual visit, and they don’t have to worry about the stress of driving or finding parking, how awesome is that? So as CIOs and CDIOs, we have to make sure that we’re at the table early, that we understand what problems we’re trying to solve, and bring some recommendations, whether that’s from a business lens or financial lens, and support the processes.

We’re change leaders and change management is hard. No one wants to change but I need to ensure that utilization and adoption is where it needs to be. Therefore, we need to wear business hats, strategy hats, operational hats, and financial hats as much as we have to wear technology hats.

Judy: A lot of CIOs aren’t at the table early, or they’re late to the party, so to speak. How do you make sure you’re present early in the conversation?

Heather: One way is using situations where we were late to the table as examples. So often we’re given dates – “We have to open the facility to our first patients in January.” “Well, I appreciate that you’ve set this date but we need lead time to be able to deploy and to test it, so realistically, it’s going to be February. We have to help them understand the complexities of the technologies, and that we can’t just flip a switch and make everything work. Next time, please bring me and my team to the table earlier.”

Governance is a big part of this. We have an IT executive steering committee that is chaired by some of my operational partners.

Judy: Another big concern I hear about on a regular basis is the lack of up-and-coming IT leadership talent to fill future healthcare CIO positions. Are you seeing this?

Heather: I don’t see it, and maybe it’s because of the market that I’m in. I’m in the Boston market and previously the Chicago market. Every market is so very different when it comes to talent, whether it’s recruiting or retaining. I’ve spent the last three and a half years building a team. The leadership team I have today is completely different from the one I had when I started.

Whenever I’m hiring leaders, I’m thinking about who can potentially sit in this seat if I leave for a new opportunity or if I win the lottery. We spend time as a leadership team talking about succession planning at Boston Children’s. Not every organization does it but I think you have to be intentional about it for it to be successful.

Judy: So you’ve been recruiting and retaining the best senior level talent. What are some of the keys to your success there?

Heather: I think it’s the name, Boston Children’s. People want to work here, and many of them have worked here for a very long time. I mean, I have tenure on my team of 20, 30, 40, even 50 years. I think a hybrid work environment is a big draw as well. We have team members from Florida, from Idaho, from almost all the states that we can hire from, which has enabled us to get some really great talent.

Having big projects like an Epic implementation, and our next big, a new ERP implementation draws talent as well. Sometimes they start as a consultant, and then they want to stay and work at Boston Children’s full time because they are so excited about the mission, and seeing the fruits of their labor.

Judy: Some organizations are calling their people back. Some are struggling with the remote versus the hybrid and how to grow those who haven’t built the relationships. What have you learned along the way? What’s made you successful doing that?

Heather: We are not calling people back. Boston Children’s senior leaders, in partnership with our Chief Human Resource Officer, have created the policies and the environments where some people will be 100% remote. Their roles are conducive to that, but for the most part, I have a hybrid environment in IT. I’m in the office most days. There are 20 to 30 people who are in the office every day. During the EHR implementation we had folks who needed to be on site four days a month. Not four days a week, four days a month. Some people didn’t even want to come in four days a month, so they chose to leave and I was okay with that.

Judy: What unique things have you done to engage your team in activities remotely?

Heather: This past fall, we did a costume contest, and we had it online. We even did a pet costume contest. We had different virtual conference rooms set up so people could walk through and see each other. Sometimes at our town halls, we’ll do a water cooler session, give people a topic, and send people off into groups to engage. I do a “coffee with the CIO” for all my new hires every month, just to get to know one another, because many of them will remain remote and will never come into the office.

Judy: I read an article recently saying that people who work in the office, at least part-time, if not all full-time, are more likely to be promoted than those who are totally remote.

Heather: I haven’t seen that in this organization. I think that the work that you do, whether it’s remote or in person, speaks for itself. And I think those who are remote are very intentional, and want to grow and want to take on new things. I think they actively seek it out and make themselves known to their leaders. I don’t have metrics on that, but anecdotally I have a nice blend of that in my department.

Judy: As CIO, are you involved in any strategic initiatives around sustainability?

Heather: Yes. One of the pillars in our enterprise objectives and strategic plan is around sustainability. In the Boston market and being in Massachusetts, sustainability, being green, the environment are top of mind. We’ve done a lot of building over the last few years, and there are many requirements and regulations around sustainability that our senior VP of facilities understands. She is amazing. I try to help as much as I can by limiting the size of our technology footprint and keeping things in the cloud. Maybe we don’t need a printer in every room, just one printer at the nurses station, for example.

There is a realization that how we’ve operated in the past is just not sustainable. It’s not good use of our finances and it’s not good for the environment. So we are very, very conscientious about how we deploy any new facility and what goes into that facility. Because it is an enterprise priority for the organization, all of us are aligned with that and my teams think about it a lot, especially in our data centers.

Judy: If you hadn’t become an IT leader, or a doctor or PA, what other career do you think you were cut out for?

Heather: I would love to be a COO, or a CAO, or even a CEO of a health system. I’m just so drawn to operations. I love learning the ins and outs of the hospital and I think being a CIO has afforded me that because IT crosses every single vertical of the organization. Maybe there’s still a COO or a CAO or some type of operational role in my career path. I wouldn’t shy away from it.

Judy: What’s something you love to do in your free time?

Heather: I am a workout fiend. I love the Peloton and the Peloton app. I have a 667-day streak going of doing something Peloton. Whether it’s running, biking, whatever, lifting weights, it is a stress reliever for me. It’s something that I make time for every day. It’s a non-negotiable for me.

Few understand the intersection of healthcare and technology better than Terri Couts, EVP and Chief Digital Officer at Guthrie. With a career that began in teaching and pediatric nursing, Terri has navigated the complex world of healthcare IT, leading transformative initiatives that enhance patient care, efficiency, and operational effectiveness. In this interview for ‘C-suite Conversations’ Terri covers a range of topics from sustainability to AI’s role in healthcare.

Guthrie is a non-profit, integrated healthcare system offering a comprehensive range of healthcare services across 12 counties in north central Pennsylvania and upstate New York. The organization manages over 1.5 million patient visits annually, providing care to predominantly rural communities.​

Q & A With Terri

Judy Kirby: Terri, you started your healthcare career as a pediatric nurse. How did you end up on the path to becoming a technology leader?

So I interviewed for an analyst role with ASAP, which is Epic’s emergency department information system. I didn’t truly understand what the job was even after the interview, but they offered it to me, and I needed a change, so I took it.

I really loved solving problems through technology. If there was a way to make what they did better it really interested me, so I dove in and got every certification that I could. After some time I was managing the inpatient team at Akron Children’s. Meaningful use had kicked up so I decided to go into consulting. I learned a ton about all kinds of different healthcare systems, big and small, and how we could make EPIC enhance that work.

In 2014 I joined NYC Health and Hospitals, leading their Epic implementation. When our CIO Bert Robles left there and landed here at Guthrie, he recruited me. At that point, I was ready to be off the road. I had a daughter entering high school and she was a little bit in need of some parenting at home, so we made the leap and moved to Pennsylvania.

Judy: Did you have a strong mentor who helped you?

Terri: I’ve had a couple of mentors, starting with a physician at the Cleveland Clinic. He was a renowned pediatric surgeon, and while some surgeons can be socially inept, this one was the opposite. He really wanted you to be engaged in the care he was providing. He wanted you as part of the team. I’ve had some mentors in IT also. Because I was a nurse leading IT, there was constant questioning of my ability. But I know how technology ties to the patient, and I think that’s what my mentors have focused on—the art of storytelling, the art of understanding the why, listening, and relationship management.

Judy: What do you bring from your background as a pediatric nurse that helps you be a strong IT leader?

Terri: I think being able to meet people where they are. As a pediatric nurse, I had to assess the child’s capabilities, you know, their understanding and communication and all those things. I’m a great observer and listener, and I’m able to get to know the audience that I’m talking to. Another attribute that a pediatric nurse has that is valuable as a CIO is patience and a certain level of empathy and compassion. I want to make sure that I’m meeting people where they are, not to always say “yes”, but to make sure that they understand my position, that I understand their position, and we can meet somewhere in the middle.

Judy: Has your lack of hands-on technical expertise been a positive or a negative?

Terri: Honestly I think it’s been mostly positive. The reason I say that is because I can ask all kinds of questions and it requires people to think differently because my questions come from a clinical framework and not from a technical framework. Sometimes I will even ask questions that already I know the answers to just to help the technologists think a little differently. I listen a lot. I want to learn enough to understand the why behind things and make sure that I can pick the right vendors and partners. I don’t need to be highly technical to lead relationships and to drive innovation and serve our patients, but I make sure I have a strong team underneath me.

Judy: One of the biggest concerns I hear over and over again is about the lack of up-and-coming IT talent to fill the CIO positions. There are a lot of CIO positions open right now. What do you see as the reasons for this, and how are you helping your leaders position themselves for career growth?

Terri: You know caregivers are not the only people who burn out in healthcare. With the challenges around cyber threats and infrastructure and audits and rising technology costs, it is a high-stress job. It takes away from time with your family and being able to care for yourself. I have a hard job but I actually like the challenge. I thrive in this kind of environment. But five years down the road I might not want to, so I can understand it.

IT is so diverse, we have to have an EPIC expert, an infrastructure expert, we have a desktop expert. There’s not one person who knows it all and I think that makes it challenging to groom individuals into leadership positions by allowing them to get outside their particular area. I try to connect people with other groups on my team, and have them participate in some of the boot camps and the training that will give them experience but also the peer connections.

I coach people that it’s okay to be uncomfortable. If I were comfortable every day in my position, then something is probably wrong. Four or five years ago, I had somebody who had started out as a lab technologist. She came into the EPIC space and she was managing that really well because she was meticulous in her detail. We didn’t have a project management office at the time so I said to her, “I want you to lead my new project management office.” At first she was like, “What are you talking about?” But she thrived in the role even though she was so uncomfortable at first because it wasn’t what she knew.

Judy: There are a lot of conversations about the CIO position. What should their responsibilities encompass and what should it be titled? You’re a Chief Digital Officer. Others are still CIO, but there are CHIOs, the Chief Data Officers, the CMIOs, the Chief Analytics Officers, Chief AI Officer. They all have different parts of IT. What do you think it should be called and what parts do you have or don’t have, and why?

Terri: I think it depends on the organization. I started out as the CIO and we changed it under Dr. Sabenegh’s guidance, our CEO, to add digital because of his beliefs around how technology enables care and how we strive to be more transformative in our care model using technology. I have all the traditional CIO responsibilities and AI now falls into that. We don’t have the type of organization that would need a chief AI officer, but at a place like the Cleveland Clinic that has a lot of funding to invest in building large language models that they could even sell at some point, it makes sense to have that oversight. But there is the worry that having a lot of chiefs can lead to fragmentation. When you have silos, particularly in larger organizations, things start to break down, like security and change control processes, and redundant technology tends to grow out of that. If you have an academic center and a large research center, having a chief data officer makes sense. But we have a small research center. We are building out our own data lake house and keeping it under my purview makes a lot of sense to ensure we have all the security.

Judy: One of the other concerns I hear is recruiting and retaining top talent. It’s long been a challenge for IT, especially during and after the pandemic. What’s one of your most effective recruiting or retention strategies? And what positions are the most difficult to fill right now?

Terri: We’re a hard organization to recruit to for pretty much every role due to the rural location. If you recruit a physician, you have got to make sure their spouse is also happy in this environment. It’s an hour to Starbucks, so for many, it’s a different kind of lifestyle.

But the pandemic really opened it up for us. It allowed my team to work remotely in an organization where that had previously been frowned upon. They have work-life balance and flexibility now and that has been a large retention factor for us. They don’t have to do all that driving and pay for gas. It also opened up the doors to recruit in other states. I have a manager who lives in Utah, and I have a cybersecurity expert who lives in North Carolina. They work our hours and they make it work for their families, but they don’t have to move.

Cybersecurity is probably our hardest area to recruit in right now primarily because those are entry-level positions doing a lot of groundwork that isn’t very exciting. Infrastructure has been a challenge too, because those individuals need to be on site. As the talent ages out, it’s been a little bit harder to recruit for that.

Judy: With continuing financial pressures in healthcare, how do you meet the rising demands of costs of technology? Are you able to track a true ROI for the investments you are making?

Terri: Outside of the traditional EPIC stuff and standing-up servers and those kind of things, pretty much everything technology-driven that we bring in requires a pro forma. That’s a process we started about four years ago. So for example, with the Guthrie Pulse Center, which is highly technology-enabled, we took a five-year outlook. We put down the hard cost, and we put down the savings. The first year and a half was all investment, but now we’re actually seeing savings. But we plan for all of that. But some things you just have to do even when there is no ROI, like replacing aging PCs. You have to spend the money, otherwise, you’re going to have a cyber event.

I think the pro forma process also helps with other things like adoption of the technology because you already know the problem you’re trying to solve and you’re targeting it together with the business owner. It’s not just about deploying the cool thing.

We try to take a platform approach. We have three major platforms, Microsoft, Oracle, and EPIC. Whatever the ask is, we try to make it work through one of those platforms before we look for something new. But for most things we can prove out at least a small ROI. There’s also a lot of soft ROI that comes down the line that may not have a direct correlation. For example, remote patient monitoring tech in the home probably reduces visits to the ER, but that is not necessarily a correlation being tracked.

Judy: How is generative AI impacting Guthrie’s strategy? What type of work are you doing along those lines?

Terri: We don’t have the shop to do any kind of large language model training ourselves, but we’re working with partners on their AI products. We evaluate AI in three key areas: improving patient care, increasing provider efficiency, and enhancing operations. Every AI tool goes through a governance process to ensure that it’s necessary and ethical.

Generative AI is especially tricky since it relies on sensitive patient and organizational data. We’re using it carefully for operational improvements like predicting falls and pressure ulcers (Artisite), capturing provider-patient conversations (Ambient Listening), and strengthening security.

AI won’t replace human interaction; it’s about creating a more personalized, proactive, and connected experience. AI is both exciting and daunting, but if it becomes more affordable, we could see some game-changing advancements.

Judy: As the CDO, are you involved in any strategic initiatives around sustainability?

Terri: Absolutely. We recently held leadership discussions on transformation—not just for a single project, but for the broader goal of sustaining our ability to serve patients, remain financially responsible, and address workforce shortages. Technology is required to make these things work, and I wouldn’t want to be in an organization where I wasn’t part of that conversation.

We’re trying to balance innovation with cost efficiency. For example, we’re exploring ways to offer our call center services to smaller hospitals or rural healthcare centers that lack the resources to build one of their own. They get access to high-quality support without the overhead, and we earn a little bit of profit. Our goal is to control costs while transforming to meet our community’s needs.

Judy: So, as you look ahead to the rest of 2025, what are your biggest challenges?

Terri: It’s the amount of work. I see a lot of change happening and everything is supported by technology. So, keeping my team engaged while not burning them out will be a big challenge.

What’s happening at the federal level impacts us because there doesn’t appear to be a game plan right now, and there’s a lot of change management happening in our organization when it comes to care model redesign. Because we’re being asked to move fast, and change is coming so fast, we need to be able to support our users through these changes. That is something I want to keep my eye on. That and the patient experience in general.

Judy: If you hadn’t become a nurse who then became an IT leader, what other career do you think you were cut out for?

Terri: When I was growing up, I always wanted to be a pediatric physician, but I got my first degree in education. I was a teacher for about four years before I went back to school and got my nursing degree. I guess medicine has always been where I wanted to be. I never thought that I would be sitting in this chair, although I do love what I do most days.

Judy: Outside of work, what’s something you love to do in your free time?