Lonny Northrup has spent his career at the intersection of technology, data, and healthcare transformation long before AI became a boardroom imperative. Today, as an AI Governance Strategist at Inova Health, he is helping one of the nation’s largest regional health systems navigate both the promise and the risks of generative AI. In this conversation, Lonny shares candid perspectives on what healthcare executives still misunderstand about AI, where the technology is already delivering measurable value, and why governance, not hype, may determine who succeeds in the next era of healthcare innovation.

Inova Health is a nonprofit healthcare system serving Northern Virginia and the greater Washington, D.C. region. Founded in 1956, Inova operates five hospitals, including its flagship Inova Fairfax Hospital, as well as a network of primary care, specialty care, urgent care, and outpatient facilities, and employs more than 25,000 people.

Q & A With Lonny

Judy Kirby: Lonny, thank you so much for speaking with me today. Your career has moved across manufacturing, aerospace and defense, enterprise architecture, healthcare data, medical informatics, advanced analytics, digital therapies, and now AI governance. How has that path shaped the way you think about technology’s role in healthcare?

Judy: You were working on big data roadmaps to reduce healthcare costs and improve outcomes before many healthcare organizations were even using that language. What did you see early that others did not?

Lonny: Again, I think the key goes back to outcomes. Big data started to make it possible to have access to information that could be analyzed, but the quality of the data was, and will always be, an issue. A lot of what we did in that timeframe was demonstrating that the data quality wasn’t sufficient.

Judy: Have we gotten there yet with data quality?

Lonny: No. But with focus, it can be done. We used to struggle with something called an ensemble model. So, if you wanted to take into account, instead of two variables, 10 or 15, but every time you added variables, the quality of the outcome was degraded. Now with the advent of large language models, instead of handfuls of data dimensions, you can get thousands, hundreds of thousands, even millions, tens of millions. The data doesn’t need to be as curated, but you still need something to compare it against to get ground truth. That ability to deal with lots of dimensions of data in an intelligent way is really important. When you combine that with reinforcement learning, you can get really high-quality results without having to be quite as rigorous on how the data is being curated.

Judy: At Intermountain, you were part of data and analytics work tied to significant improvements in outcomes and costs. What examples of that work come to mind?

Lonny: Intermountain had curated EMR data since the 1970s. We had a centralized electronic data warehouse that had normalized, curated, and cleaned all that data. So we had a huge advantage. One of the most significant examples was a reduction in sepsis mortality. At a time when sepsis mortality in most health systems was in the 30 to 40% range, our sepsis mortality rates were in the low 20s. But through a very deliberate approach to improve the process to find what worked well and what didn’t, and using what I would describe as a reinforcement learning approach, we drove our sepsis mortality rates down below 7% over a period of about six years.

Judy: What do healthcare executives most often misunderstand about AI governance?

Lonny: I think it’s kind of a mystery to most people right now. We should have been, and should be now, governing software the way we’re talking about governing AI. But the reality is that software isn’t governed as well as it should be. For instance, an EMR is not an ROI type of thing. It’s a cost of doing business, so it didn’t get the attention that it should have. AI is getting more rigor applied to it, and it’s forcing us to actually do things we should have been doing with software for years. I think governance is important to make sure that behaviors are aligned with the mission and with the culture of the organization.

I’m also a huge advocate of logging and tracking so that you can go back afterwards to confirm, “Yes, this was good,” “No, this was bad.” We shouldn’t suddenly be concerned about ethics just now. Were the decisions we were making before not in the best interest of the patient? If you are systematically denying valid claims, you’ve got an ethics problem. Whether you use a traditional mathematical algorithm or you use AI, there is no difference. So, what you do with AI needs to reflect your mission and be true to patients and be driven by helping patients get better care.

Judy: So, when AI governance is working well inside of health systems, what decisions are being made differently?

Lonny: Some organizations are still behind on setting up a governance structure. Here at Inova Healthcare, we have a really good AI ethics and oversight committee. Sharp Healthcare, where I was previously, does as well. You just need to have the right people in the room so that they’re aware of what’s going on and there’s agreement about things being used appropriately. There are several things that have worked quite well in healthcare with AI.

One of those is ambient scribes for clinical visits. The AI is listening to the conversation, it’s transcribing the conversation, and it’s summarizing and formatting the notes so that they’re ready to go into the medical record. But first, the doctor reviews the notes that the AI has created before she commits them to the medical record. At the end of the day, the doctor owns it.

Judy: Ambient listening has been one of the most viable early AI wins. Where else do you see realistic opportunities for AI to create meaningful clinical, operational, or financial impact?

Lonny: There are areas that I just call everyday AI. Using it for email communication, using it for meeting minutes and meeting summaries, creating documents, especially draft documents of policies, and training materials. AI is becoming a better answer engine. We’re accustomed to searching for things, and Google says it found 7,942 documents and put them in order of relevance.

Whereas AI says, “Here’s the answer to your question. And here’s the three documents, down to paragraph level, where the answer came from.” That scenario is very valuable in a lot of use cases, particularly in customer service. The thing that’s just starting to emerge is agentic AI, where instead of just answering questions and generating content, the AI is actually pushing buttons and executing things in your systems. So, it’s navigating Epic, it’s navigating Workday, it’s navigating Oracle. That’s just starting to be explored, but it has become capable faster than I expected. And again, it’s going to be really important to have human oversight.

One really good use case we had at Sharp was for our call center. When patients call in, voice calls use AI and basically navigate menu selections audibly. So instead of pressing 1 for this, pressing 2 for that, we had 67 different things that you could end up doing by answering questions from the system. It is a great experience. We had about 44% of calls (the average is 20,000 a month) lead to self-service closure without a live agent.

Judy: How should health systems decide when to build AI capabilities internally, when to rely on vendor-embedded tools?

Lonny: It’s just a new version of an old problem, build-versus-buy. Should a healthcare system be in the business of developing software? Maybe, if you’re big enough, you may be able to turn that into revenue streams as well. I think we’ll see a lot more homegrown solutions using AI because you can develop things dramatically faster than before. It just happens to be one of the things that AI is extremely good at, whether it’s vibe coding or lights-out coding. But still, you don’t do anything without people, and when you have good people with good tools, they are able to do things significantly faster.

Judy: With the financial pressures that healthcare organizations are under, do you think AI can genuinely help? Also, where do you think expectations may be too high?

Lonny: You have to test it. And if it works, great! Scale it. If you test it and it doesn’t work at the atomic level, it’s not going to work at the system level. Here is a really high-value example that comes up quite a bit. You do a patient survey or an employee survey, and one of the questions has a free-format text response. When you have tens of thousands of responses, someone has to go through all of them and see what people were saying. AI is exceptionally good at reviewing all the responses and coming up with the top five categories of responses and counting them. It would take a person four or five, six weeks to do that. AI will get an initial answer back in minutes. Anytime you’re dealing with free-format text responses to surveys, you should pull AI in. It will probably be helpful.

Judy: Earlier, you alluded to the rev cycle. Health systems are using AI to get more claims through. Insurance companies are using AI to deny more claims. How does that work? Are we getting into a sort of Dr. Seuss “better batter” or “better bread-butter battle?

Lonny: The battle of AI. Basically, you’ve got AI systems competing against each other, but it’s just speeding things up. Hopefully, you get the resolution on a denial of a claim faster by having AI working on both sides. It should create a more efficient process that’s more adherent to the rules of the road. People who systematically deny valid claims should go to jail for that and pay lots of penalties.

But if you’re trying to do things efficiently, it should just increase the throughput. We see that radiologists can be effective and have a significantly higher throughput. In the area of claims and rev cycle, it’s the same thing. It increases the speed and the quality. It can flag things where there’s insufficient data, then go collect that information. I’ve seen it cut the time needed to track down documentation in half. It’s not an “us versus them.” It’s, “Let’s get this done faster.”

Judy: Interesting. What advice would you give to healthcare executives who know they need to move faster on AI but are worried about the risk?

Lonny: At this point, I think there are enough proven cases that you can be safe just by following the early adopters. Everyone should be doing ambient scribes in clinical visits. Same with rev cycle, claims, and denials. Epic has been very good with their AI roadmap, so you can lean into what the big vendors are providing and see what’s working and what isn’t. So, I think there, it really comes down to seeing what others are doing and being a fast follower of things that are working.

Judy: People are concerned about losing their jobs to AI. Companies are doing massive layoffs and saying it’s because of AI, but there hasn’t been validation of that. How do you stem fears that jobs are going to go away or change substantially?

Lonny: If you’re not learning how to use AI to do your job more efficiently, you should be. If your job can benefit significantly from AI and you’re not learning how to use it, you should be concerned about the future of your job. The first wave of layoffs I saw was companies that were going to do them anyway and blaming it on AI. Others thought, “We probably don’t need as many people here, so we’re going to let some people go.” I’ve seen many of those companies hire those people back, and I think there will be more of that. AI is good at doing tasks, but it can’t really do the job. You need humans doing the job, with AI helping to do the tasks more efficiently.

Judy: Some people say AI is more hype than reality. IBM Watson was supposed to revolutionize healthcare, and it didn’t. Can you talk a little bit about that and why AI won’t go the same direction?

Lonny: Yeah. Watson played on “Jeopardy!” almost 14 years ago. And at that point, many of us thought, “Wow, this AI is real, it’s going to change healthcare!” One of the greatest accomplishments of my career was preventing healthcare systems from buying IBM Watson because it was just too expensive, and it wasn’t good enough. But generative AI is very cheap, and it is good enough, and it’s getting better at a rapid pace.

There’s a lot of talk that we’re in a bubble right now that resembles the dot-com bubble. But the reality is that there are real things happening, and it’s not a bubble, and it’s only going to get better. For instance, the combination of quantum computing and AI makes each other better. And as one improves, it improves the other one in a virtuous loop. So to me, this time, it is real.

My daughter and son-in-law have had an internet business for several years. They spent three years and $25,000 developing this app, and it never did what they wanted it to do. And long story short, they tried vibe coding the app themselves. In three weeks, including a learning curve, they developed an app that was better than the first one. That’s just a real anecdotal story, but a lot of people fall into that category with apps. I see some big systems looking at refactoring the entire code base to look for efficiencies and to get rid of antiquated and old technology underneath. So, this is not hype. There’s certainly more than enough hype around it, but it’s also extremely real and extremely cost-effective.

Judy: You have also done work focused on helping people live healthier, longer, and more fulfilling lives, especially around retirement. How has that shaped your view of where healthcare should be headed?

Lonny: For those who are not familiar with it, there’s a very rigorous scientific approach to better health called functional medicine, but it doesn’t get reimbursed. And here’s a problem with our current healthcare system. I use an AI through a company called Function Health, and, for three years, I have gone in for exhaustive lab tests. Previously, these would have cost thousands of dollars, but have come down to hundreds of dollars, and they’ve added AI.

So now I can ask, “What’s the trend of my A1C? What are the top two things that I should be focusing on to improve my health?” When the lab tests alone are not sufficient, I can feed in more information, like blood pressure and sleep data. Now the AI knows more about me than any doctor ever will. These AI-driven advances can help us optimize our health rather than just sit around waiting for something to break.

Judy: So, in your opinion, it sounds like the future of healthcare will be driven by AI.

Lonny: In the past, I was a real skeptic of AI, especially in the IBM Watson days. Today, I think that generative AI is going to be more impactful than personal computers, more impactful than the internet, and smartphones, and all those things combined. This is going to be a revolution.

Drew Smith offers a perspective shaped by nearly two decades in the retail sector. Drawing on his experience as a data and analytics leader at IKEA and Little Caesars, Smith and OhioHealth are demonstrating how healthcare can rethink technology, data, and the patient experience through a consumer-centric lens. Drew takes a candid look at what happens when you bring outside thinking into a traditional industry, and why such a shift may be essential for the future of healthcare.

OhioHealth is a large, nonprofit healthcare system based in Columbus, Ohio. It operates 16 hospitals and over 200 urgent, primary, and specialty care sites spanning 55 Ohio counties.

Q & A With Drew

Judy Kirby: Drew, I’m really interested in your background in retail and how you’re able to look at healthcare differently from people who’ve grown up in healthcare.  

Judy: So, let’s start with the first one, technology.

Drew: It’s clear that in healthcare, technology is treated as a cost, and in other industries it’s more often seen as an investment. That mindset means systems that require more manual entry. They’re a lot less flexible and less responsive to changes. So, the technical landscape in healthcare is, to my mind, undernourished compared to other consumer-facing industries.

Judy: Okay, and the second challenge is data.

Drew: Right, and as I said, they are very interrelated. The reason you build a technical infrastructure is for the aggregation, harmonization, and normalization of data. You have all these different signals you’re getting – a loyalty club, data from Nielsen, stimulus from a website interaction, and many others. Those files typically come in different formats, and you have to spend a lot of time. If you don’t have the right system, smashing those together so we can get a complete picture of a customer. That’s why loyalty programs are so big in retail. They are basically just a data collection engine.

Judy: So, when you left retail to go into healthcare, how were you able to apply the loyalty programs? Because frankly, I don’t want to have a loyalty program where I show up at doctors’ offices more often.

Drew: Exactly. We certainly don’t want you to get sicker, so we can see you more often. We want to see you less, so there’s obviously an inversion there. This is when I first understood more clearly the term meaningful use. The way to think about it is if we’ve given you care for something, and later on you need care for another thing, how do we know that you’ll choose us?

So, meaningful use doesn’t mean that you can’t collect the data. It means that you can’t use the data to target people. You can know more about people when they interact with your system if you’ve caught that longitudinal record. So, you aren’t doing loyalty, as you say, but you log into MyChart before and after every appointment. You interact with our revenue cycle, and we know who you are. The principle still applies in healthcare, even if we don’t create a program to increase what we know about you.

Judy: And point three.

Drew: Point three is that mindset shift. So, now you’ve got this technical infrastructure, and you’re beginning to collect data. You don’t always have to know exactly why you’re collecting it. The big retailers did not inherently know everything they were going to do when they were building this longitudinal record. But as you’re collecting data, you can start to think a little differently about the people who interact with your system. Many people call this consumerism.

I remember very clearly the look on the face of the first doctor I said the word ‘consumerism’ to. I didn’t know I’d said a dirty word, but he valued patient-provider intimacy and thought consumerism cheapened it, and I understood that conceptually. But so much of how you interact with the healthcare system has less to do with the great appointment you had with your APP or your doc and more to do with whether you could get an appointment when you wanted it, whether the bill was clear and correct, and how easy it was to schedule a follow-up. That’s where the friction points lie, and that is the kind of thing you want to address with a consumerism mindset.

Judy: We hear that today’s consumers of healthcare want that Amazon experience. How are you able to give that to them with the data you have? How do you take what you did with your 17 years at IKEA and Little Caesars, and put that together to give patients that great digital experience?

Drew: Even if you are a data leader, an analytics leader within healthcare, you need partners in your digital product areas. You need to understand, for example, how your MyChart and your organization are set up. Your obligation as a data leader is to make the environment where you have positioned the data rightfully governed, so it’s safe and very flexible. So, if it is used for digital outreach or to close care gaps, it’s the same data used differently.

So, it goes back to having the right technical infrastructure, which these days is not as expensive as it once was. You have to build it with the notion that the data around patients and their interactions with your system will be useful for more than just one thing. Have you augmented that data? That’s another opportunity. For example, there are systems in most states that share where people are getting care. You can augment that data so you can figure out where you are most likely to need additional booking slots or understand where people are skipping medicine because they don’t have the financial means. So, you’re essentially creating a repository of data and a set of capabilities in your analytics that enable people to understand problems they’ve long been trying to solve. 

Judy: You were doing things at IKEA and Little Caesars before meaningful use and data really became important to healthcare. How are you able to apply that in healthcare?

Drew: EHR started to come on board in 2010, 2012, and 2014. In retail, point of sale (POS) systems and inventory systems have existed since the ’80s. So, they had a 20-year-plus head start building up this loyalty data, and they built up enough of it to understand how it worked together. So, healthcare doesn’t have to take as much time because the technology that was created to power up Amazon and Procter & Gamble’s massive machine is available in most cloud infrastructures, like Amazon, Google, or Azure, at a relatively low cost.

Retailers have been collecting data and putting different types of data together to get a clearer picture of why people choose their brand and why they drop out. That’s always possible within healthcare as well. Why do people go to your care site to have a baby, arguably one of the most important moments in their lives, but not for primary care? That’s a question you should ask.

Judy: So, how do you use your data to identify reasons and solve for that – people going elsewhere?

Drew: We call that leakage. I don’t hear that term used in healthcare because it feels cheap or tawdry. But I can give you an example where we were able to use data to understand the behavioral drivers of women who would not get a mammogram. We had a ton of data on women who were eligible for mammography, on those who got mammograms, and those who were eligible but didn’t get one. But we were able to get additional data from open sources, including an economic index in Ohio, which will identify the probability that you are under-resourced based on zip code. There are ones that do other health equity measures and demographics.

So, we profiled the data first and found there were about eight variables that were meaningful in moving people to get a mammogram, while two variables were meaningful in stopping them from getting one. If you had a primary care doc, you were going to get a mammogram. If someone in your family had breast cancer, you would get a mammogram. Some of these are not surprising, but others were. For example, we found that if you had a job, you were less likely to get a mammogram, which sounds counterintuitive. And this relates to another counterintuitive finding – distance to a mammography center didn’t seem matter.

Then we determined that most of the people who had a job but didn’t get a mammogram were low on the economic index. So, they most likely had jobs that were not flexible, like hotels and restaurants. So, that changed the way we would tackle that problem. So, instead of building a fixed asset, a new $10 million mammography center, we decided to send a mobile mammography downtown so that you can actually do scans near where people are working. And see if you can get large employers, like hotel chains, to give their employees an extra half-hour break to go get a mammogram. If we hadn’t done that analysis, what OhioHealth was going to do was build mammography centers.

So, when you get the data rich enough, and you augment it, and apply statistical principles to it, and then have a robust discussion between clinicians, operators, nurses, data scientists, and analysts, you can get sharper about the conclusion.

Judy: Healthcare has so much data. How do you work with data coming from many different sources, and tracked differently? For example, there are many different meanings for the length of stay. How do you make sense of it all and help a healthcare system bring consumerism and better health to its patients?

Drew: I think I’m better at doing the first and need to partner with people who know what good health looks like on the second. But you’ve brought us into something that is really important when you talk about length of stay, and that is data governance. Across all industries, I can say that everybody’s bad at this, but you have to get it right. We had a situation at OhioHealth where we were implementing a new predictive algorithm and found that we had four different definitions of length of stay. We simply cannot put into an AI or machine learning model four different definitions and expect a reliable output. It doesn’t work.

So, you have to get around the table and say, “Okay, why do we sometimes use length of stay starting at 12:01 on the day of admission, and then another, which is based on the exact time you’re admitted?” You find that there might be reasons. One might be a rev cycle calculation.

We had something similar at Little Caesars, too. We had four different definitions of on-time store opening. At Ikea, I had 14 different definitions of a sale. So, this is just the hard work of getting good AI, starting with getting aligned metrics, measures, terms, and definitions within your system.

Judy: When you moved into healthcare in 2023 as a chief of data and analytics officer, how far behind retail did you think the industry was? How did you help them scale and build, especially not understanding some of the nuances of healthcare that others did?

Drew: I think that the infrastructure was what was the furthest behind. It wasn’t data. Data was number three. So, infrastructure was number one, and data number three. Number two was the awareness that this longitudinal, non-episodic view, a complete picture of your patient population at an individual level has value. That has stood so long in retail that it’s intuitive. No one doesn’t believe in a customer 360 in retail, but in healthcare, they still need convincing.

People started seeing the value of having a complete picture of a patient over time through sharing some interesting stories. That created the need to make the data more complete, which we did, and to stand up more cloud platforms, which we did. So, we start with a little bit of inspiration around the types of things you can do if you have a complete picture of the patient, and then you go backwards down the pipeline from there.

Judy: Let’s talk about AI. Everybody wants big shiny things that are going to make life easier. People are afraid they’re losing their jobs. What are you seeing and what are your thoughts?

Drew: This was actually a big topic at Becker’s Annual Meeting. This notion that I can talk to a machine or train a couple of machines to talk to each other and do some of my work, that is still very much in the promise stage. People are finding simple generative AI tools like Microsoft Copilot useful, but all the studies say that it’s not returning cost savings. It is not necessarily reducing headcount. It might be reducing administrative load, making it possible for you to spend more time thinking strategically, but there’s no proof of that yet.

When you talk about agentic AI, there are a lot of people saying they’re building AI agents, but they are building them in really tiny environments. There’s a big difference between a Geek Squad doing a few agents for themselves and scaling that out to a healthcare system of 35,000 people. That still hasn’t happened. We’re still a ways away from how that will derive value. But there are many conceptual use cases in healthcare where agents would be extremely helpful. Think of anything at a healthcare provider where someone does the same thing over and over. You can train an agent to do that: coding, some admission stuff.

There are many useful applications of AI that aren’t a big shiny thing. Machine learning, which is classic AI that can be trained to anticipate patients’ decline as Epic has in their deterioration index, is a valuable model. That is also AI. The prediction for sepsis is also AI. The need for Palliative care can be anticipated with AI. I think healthcare just hasn’t necessarily seen that as an economic gain. That can be really frustrating because you have to spend money to get it to work, and you might have a CFO’s office saying, “If you’re going to spend a million dollars to build this thing, you’ve got to give me five 5 million in return.” The reality is that’s a very hard promise to deliver on right now.

Judy: Have you seen any agents or any type of AI deliver ROI at OhioHealth?

Drew: I try to avoid the term ROI because in healthcare, I think we need to measure value more than ROI. The classic example I would give is ambient listening. Almost everybody has ambient listening these days, and there are systems claiming they’re booking more appointments as a result. When we started that, our ambition was threefold. One: make it easier to be a provider because the competition for doctors, APPs, and nurses is fierce. We have great ones, and we want to keep them, so it became sort of a defensive play. Two is that patients appreciate being able to look at their doctor. From our consumerism mindset, we know you are more likely to stay with OhioHealth because you have eye contact with your doctor. Ipso facto, this is worthwhile. And third, it’s harder and harder to be a primary care doctor because your patient population is getting older and has more comorbidities. It’s hard to keep track of all that. But ambient listening separates things a little better than people can, and can listen to a patient talk about their condition of diabetes, and then say something which might be relevant to their heart condition. Doctors have said anecdotally, “It caught things I probably would have missed.” So, happier docs, happier patients, and a reduction of problems for people who have comorbidities. These don’t necessarily return cash into the system, but they are valuable things.

Judy: What about other AI that people are putting in while trying to generate returns to satisfy their CFO and CEO?

Drew: Especially in large health systems, you have an enormous supply chain. You have an enormous HR function. You have an enormous FP&A function, rev cycle function. So, if you want to get ROI out of AI, you can do that in those back office functions, which is what retailers have been doing for an eternity.

Judy: Coming from outside of healthcare, did you find resistance to your ideas and strategies?

Drew: No, I didn’t, but I thought I would. The exception would be the reaction from that physician when I use the term ‘consumerism’. I didn’t get resistance, but I did have to work at translating why I thought this could be done in healthcare and how it had been done in other industries. I certainly didn’t get a red carpet rolled out because I had saved $3 billion in supply chain at IKEA, and increased conversion at Little Caesar. There was negotiation, and there was engagement. There was discussion.

Judy: OhioHealth is a fairly large system comparatively. What can smaller systems with financial limitations extrapolate from what you’ve been able to accomplish?

Drew: If I were at a cost-constrained system, I would develop cross-functional capability to maximize the proven AI models coming out of Epic. I’m not talking about their latest gen AI model. I’m talking about using the models that they already have for claims denial, for sepsis. You can reduce the burden on your staff with those models. You can capture a lot of the value in the rev cycle. So, take a fast follower approach, get people in the room, your Epic specialist, your rev cycle experts, your nursing experts, and make them a pod to launch these models quickly and widely in your system so that you get the scale.

 
For this edition of C-Suite Conversations, Judy sat down with Tamara Saunaitis, Senior Vice President and Chief Human Resource Officer at the University of Maryland Medical System (UMMS). With decades of experience leading HR in major healthcare organizations, Tamara shares her insights on navigating leadership transitions, shaping a strong workplace culture, and addressing today’s most pressing workforce challenges, from burnout and hybrid work to AI in recruitment. Her thoughtful perspective reveals how UMMS is redefining employee experience and fostering a culture where people can thrive. 

The University of Maryland Medical System (UMMS) is a private, nonprofit healthcare network based in Baltimore, Maryland. It is affiliated with the University of Maryland School of Medicine and includes 11 hospitals, a network of University of Maryland Urgent Care centers, and more than 150 other locations in 13 counties across the state. 

Q & A With Tamara

Judy Kirby: Tamara, thank you for taking the time to talk to me today for our C-Suite Conversations series. You’ve been the CHRO at some very prestigious organizations. What advice can you offer about successfully moving from one organization to another in a leadership position? 

And it matters because you will make mistakes when you arrive. Being culturally fluent makes those early missteps easier to recover from and shows your team that you’re invested in understanding who they are and how they work.

Judy: With all the changes in reimbursements, a lot of organizations are facing tighter budgets. How are you coping with that, and with employees asking for more benefits, money, and flexibility?

Tamara: In our surveys, compensation is always number three on the list of concerns. Team members will never turn down more money, but what truly shapes their commitment is whether they feel they belong and can thrive. We’re always going to be responding to questions of why we can’t pay more, but the real work is defining what makes you different as an organization.

At UMMS, that differentiation is purpose and community. People come here with a clear mission and purpose, and once they’re here, we focus on empowering them – creating a psychologically safe environment where they can grow, contribute and show up as their best selves. Our new Employee Value Proposition, “Unstoppable You” helps connect potential candidates to our purpose and culture. We’re leaning into that identity.

Judy: How are you communicating the employee value proposition down into the rest of the organization?

Tamara: It starts with clarity and repetition. UMMS’s communications and marketing team debuted a new Corporative Narrative earlier this year, and the Employee Value Proposition is a natural extension of that narrative. You’ll see the same connection to purposefully show up everywhere – in how we present ourselves on social media, our intranet and websites, and in the day–to–day interactions our team members have with leaders and colleagues. We’re also redesigning the entire first year onboarding experience, so new hires feel the brand from the moment they join us. And we’re aligning our core people processes to that same identity. We’re completely overhauling the performance management process to reinforce both our high-reliability culture and our commitment to psychological safety through a just culture model. It’s all part of creating a consistent, authentic experience where what we say about UMMS is truly how it feels to work here.

Judy: Wow. That’s a big project.

Tamara: Yes! And the work resonates with both potential candidates and current team members.

Judy: I hear a lot these days about physician and clinician burnout. There have also been articles about HR burnout. What are you seeing in terms of burnout in your department?

Tamara: Burnout is a reality across every part of healthcare. The pressures of work and home don’t stay in separate lanes, so we shouldn’t pretend there will ever be a world where people never feel stretched. The question is how we respond.

For the HR team, the volume of initiatives is significant. We may not be able to change that, but we need to be clear about our priorities. Not everything can be top priority, but we can sequence and manage the work, so our team members aren’t carrying the weight of competing demands all at once.   

We also need to make it easier for people to get what they need to do their jobs – where they need it, when they need it, and on any device. Whether it’s access to job standards, operating procedures, or policies. Reducing friction reduces burnout. That’s why we’re making it easier for our teams to access what they need, including rebuilding our systemwide intranet and modernizing access to HR information and processes.  

We also invest in emotional support. UMMS has a very strong program called RISE, staffed by trained team members who respond when colleagues experience trauma or distress – whether from a patient event, workplace violence or something internal. They wrap around the person or team immediately, and in the days and weeks that follow. It’s a powerful way we help people recover, not just endure.

Judy: How are you using AI in hiring, and how effective has that been?

Tamara: We’re early in our journey and right now, we’re using very foundational AI to standardize interview questions, streamline workflows and help leaders prioritize requisitions that demand their attention first. When a manager has dozens of openings, reviewing them alphabetically or in a first-in, first-out order doesn’t make sense. AI can help us make those decisions in a more intelligent, efficient way.

We partnered with Phenom, to implement their technology and talent platform. Whether or not we will use all of the AI that’s available, I’m not sure. We have to make sure the technology available aligns with our culture and our expectations for a positive candidate experience. So, we’re starting with the essentials and building thoughtfully from there.

Judy: CHROs right now are dealing with more different generations in the workforce than in the past, with different work ethics, and different expectations of work-life balance. How do you manage it?

Tamara: That’s a great question. It starts with recognizing that this isn’t just about generational differences – it’s about the full diversity of today’s workforce. People naturally bring different preferences, communication habits and expectations to work. You can’t design for one group and hope it fits everyone. You have to create structures, resources and access points that are equitable across the board.

Where we anchor ourselves is with our frontline leaders. They’re the ones who can support people where they are and tailor their approach to the needs of their teams. That local leadership connection is critical.

Communication is the hardest part. There are so many channels now that it is easy for messages to get fragmented or lost. That’s why we keep a strong feedback loop in place. We analyze team member survey results across multiple demographics to understand the feelings, opinions and needs within those workforces. That helps us spot trends early and make targeted improvements – sometimes down to the unit or department level.

Judy: Does that seem to be working well for you?

Tamara: It is and we’re continuing to refine it as our workforce evolves. The good news is that the technology gap we used to talk about so much is rapidly closing. Ten years ago, you could draw clear lines between generations in terms of comfort with digital tools, communication platforms and social media. That’s just not the case anymore.

Across the board — including our baby boomers — people are far more tech-savvy and accustomed to working in digital environments. That shift makes it easier to communicate consistently and support people effectively, because we’re no longer designing programs for stark differences in capability. Instead, we’re customizing our solutions around preferences and expectations, which is a much more manageable challenge.

Judy: How much do you look at candidates’ social media and how is it affecting hiring?

Tamara: We use social media to recruit, but we don’t use it as part of a process to determine a candidate’s potential employment. I’d be curious to see if other organizations really are.

Judy: With some new hires not working out as you had hoped, have you implemented effective testing and interviewing techniques to make sure the right person is hired in every position?

Tamara: It’s an area we’re working hard to improve. Our overall turnover is below the national average, but first-year turnover, depending on the role, is higher than we’d like. That’s why we’re overhauling our entire onboarding experience and modernizing our talent acquisition process. We’re giving hiring managers better tools to help them assess candidates more accurately. But there isn’t one single explanation for early turnover. It’s a combination of fit, clarity of expectations, and the reality of the work. One of the most effective steps we’ve taken is introducing voluntary job shadowing in high-turnover areas. It’s not mandatory, but it’s powerful. It helps candidates experience what the job is like, meet potential colleagues, and make informed decisions about choosing UMMS.

Judy: So, what would you suggest if somebody wanted to get into HR and get to your level in healthcare? What have you learned along the way that’s made you so successful?

Tamara: Well, number one is don’t say no to any opportunity. If somebody asks you to take on a project, take on the project. Find the courage, even if you don’t think you can do it, because you’ll learn something valuable along the way. For HR professionals to grow in their careers, I think embracing opportunities to learn about technology, like cloud-based structures and AI is a big piece. It is an ever-evolving landscape that is hard to keep up with, but it is essential for an HR leader to take an organization into the future.

Judy: If you hadn’t ended up in HR, what career would you have followed?

Tamara: Well, my dad always said I was supposed to be an accountant. And I am pretty good with numbers. But if I had to do it all over again, I’d seriously consider pursuing an opportunity in the culinary arts.

Judy: Oh, wow! What is your favorite food to cook?

Tamara: Chili. I know it’s not very sophisticated, but it’s my favorite. When I retire, I want to go to culinary school.

Judy: When you’re not working, or cooking, what else do you like to do?

Tamara: My husband and I love to take hikes, but that has taken a backseat since we welcomed our first grandchild in December. She’s such a gift and we enjoy every minute we get to spend with her.

Judy: Congratulations! And, thank you for your time today.

In this edition of C-Suite Conversations, Cherodeep “Chero” Goswami, Chief Information & Digital Officer at Providence, reflects on a career shaped by constant change, transformative mentorship, and a deeply people-first approach to leadership. Grounded in Chero’s guiding principles of grit, grace, and gratitude, this conversation offers a thoughtful and human look at what it truly takes to grow and help others grow in today’s complex healthcare landscape.

Providence is a large, not-for-profit Catholic health system founded in 1859 and headquartered in Renton, Washington. It operates a broad network of hospitals, clinics, and care services across the Western United States, including Alaska, Washington, Oregon, California, Montana, New Mexico, and Texas.

Q & A with Chero

Judy Kirby: I appreciate you taking the time to do this C-suite Conversation, Chero. The first part of your career was spent in finance, telecom, and transportation. What did you learn in those industries that has helped you in healthcare? 

Judy: You and I have discussed coaching and mentorship over the years. Who was your first great mentor, and what made them effective at helping you with your career? 

Chero: The first mentor that comes to mind, back when I was in telecom, was a gentleman who pushed me to get an MBA and consider moving into a management track. To this day, every so often, I will call him and jokingly curse him for punishing me. Dealing just with the technology was a lot easier. But he saw something in me in terms of management, and literally pulled me out of my comfort zone. After every course I would complete, he gave me additional responsibilities. So, after I finished procurement, he asked me to manage contracting. When I finished finance, he asked me to do the budgeting for the entire division and so on.  

So, it’s the people who make your life uncomfortable, yet give you the support and the environment to succeed, who come to mind as the best mentors. 

Judy: A lot of people can’t handle uncomfortableness and criticism. How were you able to turn that into a positive? 

Chero: I think it always starts by understanding what brings an employee to work, what drives them. Your value system may not be the same as theirs. There are people who thrive on titles. There are people who look for money. There are people who look for recognition, and others just want to be in the mission of healthcare.  

And that is the difference between criticism and feedback. It is not what you say. It is how you deliver the content of that message.  

Judy: How do you get to what’s important to a person when they may not even know themselves? 

Chero: It’s important to know the full person, not only the employee. Every person is a child of their parents. Most of them have a spouse. Most of them have at least one sibling. Many of them are community leaders and have other responsibilities outside work. Judging a person based on what they do for eight hours is a professional performance review, but to get the best of the person, you need to understand the whole thing.  

Judy: How do you get people to open up? 

Chero: By making yourself vulnerable. That’s always the start, to lead by example. I try to show my values. There are tools out there. Over the years, I’ve used Gallup Styles, which is a great exercise. There’s the Rembrandt leadership model. There is the Hogan Assessment.  

When you have the team do that as a group, it allows the team to understand those values and the styles. Everyone has their own roadmap. Some people open up in 30 minutes, some people take three months.  

Judy: In the past, you have mentioned your personal board of directors. Can you talk a little about that? 

Chero: You reach a point in your career where one mentor is fine, but you learn more working with different people. So, just like a company has a board of directors that oversees its fiduciary responsibility and so on, you surround yourself with a board.  

When I started it, I identified 10 people. Some of them were from my company, some were from my industry group, and others were people who’d influenced my career. I actually put it on my calendar to meet with each of them at least three times a year. And they keep me sharp, challenge me, and will tell me when I am wrong about something which we all need to hear. 

Judy: When you first entered healthcare, did you seek out a mentor who helped you with the transition? 

Chero: Sometimes the right people show up at the right time, and that’s what happened to me. That leader was the group president of the pediatric hospital that I had the privilege to serve in St. Louis. I got introduced to him in the hallways on my third day, and I said, “I’m very new, and I don’t know anything about healthcare.” To which he said, “I’m a very new president of the hospital. I’ve never been a president before, so you and I will learn together.” And that’s how the conversation started. 

After almost 20 years, he’s become a great friend, and no conversation is off limits. I lost my dad at a very young age, so I think he’s become my surrogate father in some ways. He has really raised me to be a good person. But the best part is he gives feedback in a way that, even when I’m wrong or if I disagree with him, I still want to listen. He also creates the path for me to get back on the right track.  

Judy: What were the top three things that you learned from your mentors that have stuck with you over the years? 

Chero: I have a mantra that I call “Grit, grace, and gratitude.” As you rise in your career, you don’t get the easy problems anymore. What comes at you is either controversial, highly conflicting, or needs a lot of money or a lot of human capital. So, it requires grit because you have to just see it through.  

Grace is important because, as leaders, we are often judged not by what we say, but also by the pauses between the words, the body language, and little things. And during times of stress, we show our frustration, and it comes out. And I’m guilty of that just like any other human being. But grace is important because you always have to present confidence. 

In healthcare, our frontline people, unfortunately, have to give a lot of bad news to their patients. We, as supporters of those frontline folks, have to stand with them and have the grace to withstand when they have a bad day.  

And the gratitude is simple. It’s probably the easiest. Know that even in a room of two, you’re not the smartest person in the room, and just be thankful for the person next to you. Nothing happens at our level without support from the team, the stakeholders, and the partners out there. So, every morning or every night, take the time to say thank you to somebody. 

Judy: What have you learned from being a mentor that you didn’t learn as a mentee? 

Chero: The way the younger generation works today is not the same way my generation worked 20 years ago. Expectations are different. Channels of communication are different. So, from my mentees, I have learned to keep up with those generational things. 

I’ve also learned from having mentees who are women. The challenges we face as men are very different from those of professional women in the workforce. We still have room for improvement as a community and a country in finding equality and respect for women in leadership positions, in healthcare, and elsewhere. So, I could never say, “I understand your problem,” because I don’t. I’ve never been in their shoes. But it has stretched my horizons of thinking. 

Judy: When somebody asks you to be their mentor, how do you determine whether you would make a good match for one another? How do you decide if you can mentor them to the next level? 

Chero: It is a responsibility and part of the job description of a leader to be a mentor. I’ve had the privilege of doing this in multiple organizations, and I’m establishing a formal mentoring program right now at Providence. In my previous organization, every director and above had to be a mentor. I had a mentoring school of 40 directors right off the bat.  

When someone comes and asks me to be their mentor, the first thing I want to know is why that person wants mentoring. The sole goal of mentoring is not to get a promotion. It is to groom the individual to be a better person, and part of that may be a promotion. Sometimes that’s a very easy conversation, because if all the person is looking for is a promotion, then I’m just not their guy.  

Then I ask, “Who do you want to be in five years?” And the “who” is not a job title. You’ve got to define yourself as a person, given all the roles you play in life. Why do you want to be that person? What are the skills that will get you there? Then the most important question I ask is, what are you willing to sacrifice to get there, because we all have 168 hours a week. To get something, you have to give up something. You’re going to borrow that time from your family, work, hobbies, or something. Rarely will somebody have an answer on the spot, but it also allows me to see how the person is thinking about this, and it sets the context of the relationship. 

Judy: In your formal mentoring programs, how do you train and prepare your directors to be successful and effective? 

Chero: Yes, you have to do that to have consistency in the outcome. It’s a framework, not step-by-step directions. It’s also beneficial to the organization because that’s how you build in succession planning and strength for the next generation. 

The framework asks questions like, “Why were you selected to be a mentor? How can the mentor help the mentee? What are the value principles of the mentee?” There are some guidelines, such as meeting with your mentee once a month, at least 10 times in a year. Once a quarter, we bring the group of mentors together to report out and share what’s working with each other. 

Judy: For an individual who wants to be mentored, what advice would you offer for selecting a mentor? 

Chero: First is to know yourself. Be you, because often I hear from a mentee, “I want to do that because so-and-so did it,” or, “I want to be like her.” Be the best you. You don’t have to be the second-best somebody else. 

Individuals need to understand what success looks like in their own minds. Money is different from recognition. Fulfillment is different from respect. Understand that and have those conversations, especially when you’re in middle management. In the first one-third of your career, you only need to be better than the people to your left and to your right. But once you get to the big leagues, your biggest competition is actually yourself. So, how do you become the better you? 

Judy: What career advice do you have for rising technology professionals interested in becoming a CDIO or CIO one day? 

Chero: Know the business. Know the business, because the purpose of IT is to grow or lift the mission of the business. When I was in telecom, in the early days, I knew the cost per mile of fiber. Know the business. It’s very important. 

The second piece of advice is to find yourself a mentor who can guide you through the things that you think you know but have absolutely no clue about. And that starts with humility and vulnerability.  

And third is not change jobs every two years to grow. Change jobs because you will learn something more. Learning should be the driver. I worry when people move every two years, because after 10 years, they have done the same thing five times and haven’t learned anything.  

Judy: What should I have asked you that I haven’t? 

Chero: You meet thousands of people every year. How would you guide both the mentors and mentees to have these relationships so that they’re better prepared?  

Judy: One of the themes I would reinforce is the importance of clarity beyond the obvious markers of success like money, title, or location. Understanding what truly motivates you matters, especially when the work gets difficult. What sustains you when progress is slow or decisions are uncomfortable? 

I was also struck by your emphasis on having mentors who are willing to be honest. The ability to say, “This is what you’re missing,” or “This is where you need to grow,” is invaluable. Many people avoid that level of candor out of concern for hurting feelings, but without it, real development stalls. 

Chero: How would you recommend mentors and mentees keep up the relationship in this age of virtual work? I know it’s getting challenging, even with the frameworks that I’ve established, because some things happen best in person. 

Judy: I’m seeing more and more return to the office, at least, part-time.  Part of that, I think, is an effort to rebuild relationship capital that has faded over the last few years. For many professionals, especially those earlier in their careers, the informal learning that comes from day to day interaction has been harder to access in a fully virtual environment. 

That makes intentional connection even more important. Finding people who can help you grow in the way you want to grow often requires proximity at some point. At the same time, I am hearing from many individuals who are thoughtful about saying, “I don’t want to be in management,” even when that is the expected next step. More organizations are beginning to recognize alternative paths for growth that allow people to deepen their impact without moving into traditional management roles. 

Chero: I applaud the people who have the courage and conviction to say, “I’m not going to be in management.” And I wholeheartedly agree with you on the remote work piece, because while the work can be done from anywhere, the relationship building cannot. It’s the same reason we fly and drive hundreds of miles to have dinner on Thanksgiving with our loved ones. You can’t do that virtually.  

In this edition of C-Suite Conversations, Jason Joseph, Chief Digital and Transformation Officer of Corewell Health, speaks candidly about leading digital services through one of the largest health system mergers in the country. From building culture across newly integrated teams to delivering measurable ROI, navigating AI adoption, and reimagining the future of healthcare itself, Jason offers grounded, experience-driven insights for healthcare leaders at every stage of the digital journey. 

Corewell Health is a not-for-profit health system that provides health care and coverage across the State of Michigan. Corewell has 65,000 team members, including more than 12,000 physicians and 15,500 nurses providing care and services in 21 hospitals and more than 300 outpatient locations.

Q & A with Jason

Judy Kirby: Jason, you spent the first nine years of your career in consulting. How did that experience prepare you to be a healthcare digital leader?

Judy: After 16 years with Spectrum Health, you became the technology leader for Corewell Health with the merger of Spectrum and Beaumont. How did you build one culture out of those two IT organizations? 

Jason: From the beginning, we made a deliberate decision to integrate the digital teams on day one—even before all systems were aligned. Culture forms under shared pressure and shared purpose. When you give people meaningful goals and real work to accomplish together, legacy lines fade quickly.  

The technical integration was complex, but we moved quickly. From board approval to being live on Epic across all regions was under two years—an achievement made possible by aligned leadership and clear accountability.

Judy: What about the distinct cultures of the larger organizations? 

Jason: Large-scale integration is never one event—it’s a process. We’ve seen strong examples of teams sharing best practices and adopting better solutions systemwide. At the same time, regional preferences and differences in care models, such as independent physicians versus employed physicians, require thoughtful engagement. You can’t change everything at once. Sustainable integration happens piece by piece, grounded in respect and outcomes.  

Judy: Many healthcare organizations struggle to produce the expected ROI of a larger system post-merger. How did you accomplish that with two systems that span such a large swath of Michigan? 

Jason: We were intentional about defining ROI upfront. What we call digital services in our organization, because it includes biomed, our PMO, informatics, and data and analytics—we identified clear efficiency opportunities.  

We also captured measurable value in revenue cycle and contract spend. Based on those factors alone, we estimated just under a seven-year return on the integration.  

But financial return is only part of the story. Today we are seeing improvements in quality measures, experience scores and speed to deploy innovation—including AI tools that now scale across the system in weeks instead of months. Scale creates operational leverage. That agility has real strategic value.  

Judy: How do you prioritize time and dollars to accomplish all that’s asked of you and your team?

Jason: Demand will always exceed capacity. The key is clarity. We require documented business outcomes for initiatives. Technology is never the solution—it’s the means to solve a defined problem. 

One proxy we use is leadership bandwidth. If an executive sponsor is accountable for dozens of initiatives, meaningful change becomes impossible. The first question is not. “Can digital services build this?” The first question is, “What change are we trying to achieve—and do we have the leadership capacity to sustain it?”  

Judy: What will AI help healthcare organizations like Corewell accomplish in the coming year?

Jason: Ambient listening is already transforming clinical documentation, and we expect that capability to extend into nursing and other disciplines. 

Over time, we will reduce manual data entry and allow clinicians to focus more fully on care.   

AI also presents opportunities in imaging and clinical decision support. The goal is not automation for its own sake; it is removing friction and cognitive burden so clinicians can operate at the top of their license. 

Judy: There’s a discussion about an AI-first mindset. And how are you preparing your workforce and the organization for what is to come?  

Jason: We operate with a “human-in-the-loop” mindset. It is human first, AI assisted. Over time, as systems prove reliability and trust increases, autonomy may expand, but trust must be earned. Health care requires a higher threshold for safety than many industries, and we will always prioritize that standard.  

Judy: A lot of people are concerned about automation and AI doing away with jobs. What are your thoughts on the future of the workforce? 

Jason: I don’t see widespread job elimination in the near term. What we see is role evolution. AI will elevate certain skill sets and reshape others. 

In health care, many of our most critical roles, nursing, entry-level environmental services and nutritional services are already workforce constrained. AI may augment those roles, but replacement is unlikely in the foreseeable future.   

Judy: I am hearing concerns about the safety of global clouds and the use of global workforces. Do you see any of that geopolitical influence and increasing risks? 

Jason: We maintain a balanced approach between on-prem and cloud infrastructure. Where possible, we prioritize U.S.-based hosting and infrastructure partners. For SaaS solutions, we rely on contractual protections and rigorous security standards.  

Cost optimization remains an ongoing evaluation. Some organizations have rebalanced workload based on economics, and we continue to access what is right for our environment.  

Data security and patient trust remain paramount.  

Judy: How does someone who wants to become a CDIO in healthcare someday get to where you are? What are the key skills and key strategies they need to get ahead? 

Jason: The core leadership skills remain constant. I just came across information on the Chime CIO bootcamp that I attended 20 years ago, and the topics are still relevant today: How do you lead through change? How do you influence others? How do you make sure that you can manage through complexity?  

What has changed is the pace of transformation. Leaders must be comfortable driving both incremental improvements and large-scale shifts.  

A learning mindset is essential. 

Judy: Where do you see healthcare going technology-wise in the next five to 10 years? 

Jason: The 2000s were about implementing EMRs. The 2010s were about optimizing and integrating them. The early 2020s have focused on digital access—portals, mobile, self-service.  

The next decade will be defined by AI layered on top of that foundation, creating more conversational, human-like interactions with technology. Instead of navigating systems manually, patients and clinicals may interact through intelligent assistants.  

I’m very bullish on the opportunity. Organizations that combine scale, trust and a learning mindset will lead this transformation.  

Judy: We’ve been seeing a lot of organizations from outside the healthcare industry trying to get into it: Google, Walmart. Do you see them becoming successful? 

Jason: Healthcare represents a significant portion of GDP, so interest from large technology companies is natural.  

However, health care is complex, highly regulated, deeply local and relationship driven. It is not one large opportunity; there are many smaller, interconnected ones.  

Generative AI creates entry points in areas like consumer navigation and low-acuity support.  

The larger questions will be how those solutions integrate safely into regulated clinical environments. 

Judy: How are you going to approach these opportunities at Corewell? Will you wait until a vendor has it as part of their offering, or will you build, and be at the very forefront of all this? 

Jason: We do not anticipate building a standalone healthcare agent ourselves. However, we do intend to be early adopters and thoughtful partners where innovation aligns with our mission and safety standards.  

The primary barrier today is risk. In healthcare, a 99.9% success rate is not sufficient if that 0.1% causes harm.  

Every organization must decide where it wants to lead, where it wants to partner and where it wants to follow.

Judy: If you could wave a magic wand and change healthcare for the better, what would you wish for? 

Jason: If I could change one thing, it would be simplifying how health care financing works in the United States.  

The current system contains layers of complexity that add cost without always adding value.  

A more streamlined approach to coverage and risk pooling could reduce administrative burden and redirect resources toward direct patient care.  

Ultimately, health care dollars should flow toward improving outcomes, not navigating complexity.  

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

Jason: I actually wanted to go into sound engineering. I was really into music growing up, I play drums, guitar, and keyboard, and I was drawn to music production. I realized pretty quickly I wasn’t destined for the stage, but I loved the physics and the technology behind the scenes. 

That interest in how things work and how you build something that creates impact is what ultimately led me to engineering and technology. In many ways, curiosity about how complex systems create an experience is what pulled me into electrical engineering and eventually into technology leadership. The tools changed, but the fascination with how things work never did.  

In this edition of C-Suite Conversations, Mason Quackenbush, Vice President of Talent Acquisition at Fairview Health Services, shares his decades of insights from leading workforce strategy in large, complex organizations. From executive job searches and candidate experience to AI, remote work, and employee engagement, Mason offers practical perspectives to benefit every type of business leader.

Fairview Health Services is a large nonprofit health care system based in Minneapolis, delivering a full range of medical services across Minnesota and parts of western Wisconsin. Fairview Health operates 10 hospitals and employs over 30,000 staff and providers.

Q & A with Mason

Judy Kirby: Mason, you have held the position of VP of Talent Management at several large healthcare systems. What contributed to your success as you moved from one position to the next? 

Another recommendation is to keep asking “Why”? Ask questions. I think initially we’re nervous about doing that, but it is advice I’ve received from multiple leaders: “Challenge us! You’re from the outside looking in. Ask why we’re doing things a certain way.” 

Judy: You’ve changed positions twice after a 20-year stint with one organization. What are a few key takeaways from your job searches? 

Mason: This will come as no surprise, but every one of them is different. Every process is different.  

I recommend avoiding looking for a job in the fourth quarter during a presidential election. There was a lot of unrest about what was going to happen next with reimbursements and the healthcare side of things. 

Patience is such a huge part of this, and understanding what job market you’re up against, what the economic status is. I’d apply at some places where I know several people within the organization, but it was amazing how long it took, even with connections in pretty high places. So, one of the key things is just patience. 

We have an executive position that we’re recruiting for right now, and the hiring leader is out of the office working remotely for the next month. So that means our on-sites won’t happen for four weeks. That’s not the fault of the candidate. So, we have a meeting this afternoon to finalize what is that tethering going to be?  

Judy: What were your biggest challenges in finding a job that fit your requirements for compensation, relocation, level, etc.? 

Mason: As I started looking this last time, I tried to take a step back and really reflect on, “What do I want to be when I grow up? Do I want to work in an area like retail, banking, the financial industry, health plans, or manufacturing? There’s so many other industries outside of healthcare, so I thought, “You know what? I’ll look.” But I could tell every time I interviewed, it wasn’t comfortable. I wasn’t excited about talking about efficiencies in workforce planning related to a production line. Health plans were not a fit at all. And so, I realized pretty quickly that healthcare is the industry that I want to stay in. 

Every time I interviewed for a talent acquisition workforce planning executive role, I could feel my excitement, my passion for that. That narrowed the available opportunities, which created some challenges because there were not that many healthcare executive roles out there. And I needed to work remote or hybrid, which narrowed things even further, so I had to learn patience. 

When I actually had several opportunities towards the end of my search, I was able to narrow it even further and ask, “Who is the leadership that I will report to? What is the support in the organization for human resources or workforce planning? How strong is the financial performance? What is their vision moving forward?” 

At Fairview, it was just a different feel. My leader here, her passion for what we’re doing and appreciation for the value of the experience I bring, felt stronger. You go in with more confidence knowing that your leader is already excited about bringing you in. It felt like I really would be a fit with Fairview, and I’ve not been disappointed in the nine months I’ve been here. 

Judy: What did you learn about providing an excellent candidate experience during your own job search? 

Mason: That’s really TA 101, how you communicate with your candidates, and it’s nothing new. So, it was amazing to me when I’d applied to places where sometimes the communication just wasn’t there. That’s when you start having a little lack of confidence in yourself. Is it me? They said they’d get back to me last Friday. Do I follow up again? So, it’s really having that understanding of how candidates want to be communicated with. Is it by phone, text, or email? Is it through the system? It should be one of the first screening questions because it enables us as recruiters to have a better understanding of those expectations. 

We have technologies and a lot of automation opportunities, and that was one of my takeaways: How do we maximize technology and leverage the system we have to create consistency, efficiencies, and help with that candidate experience?  

My recruiter was very well-connected. She knows how to tether a candidate, follow up, and say, “I know I said I’d get back to you Friday. Today is Friday, but I still haven’t heard anything from the hiring leader. But I’m going to follow up again next week, and I’ll let you know.” It gives you confidence going into the weekend that they haven’t forgotten about you. 

Now, that’s easier said than done. We have about half a million applications that we receive every year at Fairview, and around 12,000 positions that are filled. It’s hard to balance following up with candidates and communication when you’re just trying to process resumes. So, one of the things we’re doing is looking at our structure. Are we set up the right way to support that experience for the candidate? But communication, a lot of times, will make or break that candidate experience, so it is a priority for us.  

Judy: If you’ve ever felt disappointed after not getting a job, how did you deal with the frustration and negative feelings to keep going, to keep applying?  

Mason: I had my major moments of frustration. My job search plan really helped me work through that. So, I had a network of people that I checked in with, you were one of them, almost immediately after I moved on, and they would follow up with me, which gave me encouragement. When an opportunity popped up, they’d forward it to me. My wife was very supportive, too, because at several points, I was like, “You know, maybe I do need to look at the manufacturing industry again, or maybe I’ll continue in the more business partner leadership role.” But she didn’t let me. She’d say, “You’re going to find your fit. You just have to be patient.”  

I’d never had a break in my career, and it was actually rather healthy from a reset standpoint. I tried to put a positive spin on it. I was able to meet my wife for lunch. I was able to go to my kids’ sporting events and not worry that I was going to get pulled away because of an incident at work. So, I would advise people to take the time and reflect on what is important to you, what you are passionate about doing in life, and what the right work-life balance is. It’s much easier than thinking, “I got turned down for another job,” or “I haven’t heard back.” It’s positivity that can get you through. 

Judy: Have you ever had an organization say to you, “You are our second choice”? 

Mason: No, but I had three or four who let me know there was an internal candidate, and knowing that, I temper my expectations a little bit.  

I don’t know if it would add value to let a candidate know that they’re not the top choice. I think what we have done in some cases is share that we’re in a holding pattern, that we are moving them and a few other candidates through the process.  

In the case of our executive position we’re recruiting, we still have some candidates out there that I don’t want to offer non-selects to because what happens if our two finalists back out?  

Judy: Relocation continues to be an issue for individuals with aging parents and older children. What did you find when you were interviewing, and what have you implemented to get the talent you want to relocate?  

Mason: That’s a tough issue because there’s a swing back to hybrid or in the office. I’m fortunate that talent acquisition work can mostly be remote or hybrid. Not everyone has that luxury. In fact, the position that we’re recruiting needs to be on-site. If that talent pool doesn’t pan out, the hiring leader said he would consider a remote hybrid approach.  

At Fairview, we want the best talent anywhere we can get it. So, we are evaluating where all of our employees are working and where we found talent. So, if we need talent we can’t find in Minnesota, but a hospital closes in New York, and there’s talent there that can be pulled, why wouldn’t we take the best talent rather than keep the position unfilled?  

So, to me, shutting down hybrid or remote isn’t necessarily the best business practice. But do we have an opportunity to do our work differently, and do we have a leader who can manage it? 

Judy: Were you required to take any personality or skills tests during your job search?  

Mason: I have used the Hogan personality assessment and the Myers-Briggs, as well as DISC, but I didn’t see any of them this time around as a candidate. It’s a huge expense in some cases. When I use them as a recruiter, where I see the most value isn’t necessarily on behaviors or skills. It is more about how someone would connect with the team.  

For high-turnover areas, like pharm tech, we are using an assessment by a company called Talent Science. It’s an assessment that you calibrate. Who are our top performers and those who have been retained the longest? What are their preferences, their work styles, and skills? And then you tie that back to the job description 

With senior executives, where I have seen the most value is in written questions sent to candidates before they are interviewed. We do it with almost all of our executives. It provides them the opportunity to reflect and put some good information together. You can extract a lot about their abilities through that written approach, and it enables a much more productive interview because a lot of basic information gathering is out of the way. 

Judy: We’re seeing more people use AI to write their resumes and adjust them for the position. Sometimes they don’t even have the skills they claim. How is your organization dealing with these fakes and with people using GenAI tools to answer written questions? 

Mason: We can use AI just as much as they can. You have to take the initiative to put the writing sample through an AI tool to see if any consistencies are picked up. We recently found that 100 candidates in our system have applied for 100 or more positions. So, we are going back and assessing how many of those applications were through bots that are just reapplying and learning how to answer our questions correctly. 

AI is supposed to help us, but it impedes us, and then we turn it around and use AI against those who are using it against us. It’s a vicious cycle.  

Judy: From a TA position, when people have been between jobs for a long period of time, do you see that as a negative when evaluating them as a candidate? 

Mason: It depends on the candidate’s experience. We look at gaps and try to understand why. But if the right background is there, we’re interested, because it could be that they didn’t want to settle for the wrong job. I’d rather have someone who is looking for the right fit than someone who has dropped from an executive role into a manager role. Or switched industries, and then a year later they’re job searching again. So, I want to learn more about that. I don’t mind job hopping either, if it looks like it’s strategic. We interviewed someone a couple of weeks ago who had three different jobs in seven years. But it turns out that she was following her boss. 

Judy: There are many new terms in the employment field describing dissatisfied team members. Beyond quiet quitting, we now have resentism showing up, quiet cracking, deep unhappiness, all these terms. How is your organization dealing with individuals who aren’t motivated and just doing the bare minimum to keep from getting fired? 

Mason: I’ll give you an example of how we dealt with that at my last organization. We had some massive turnover in the imaging department. Engagement was low. It was a tough environment, and my team and I went in and did “Start, Stop, and Continue” surveys. There were about 50 people in the department, and we met with every single one of them and gathered all that information. There were some pretty easy fixes. A lot of it was communication, as I talked about earlier. But there were also call challenges, rotation issues, and a couple of low performers who created more work for everyone else. 

Their engagement scores ended up climbing quite a bit in just a year. It’s amazing what some conversation can do. Start, stop, and continue interviews are a tremendous tool. 

Judy: What advice do you have for anybody who is searching for a new job today? 

Mason: For me, it’s a positive outlook. And I had to be patient. In my last position, I never thought I wanted to look at other opportunities. Maybe I was complacent. Always be thinking about what’s out there. What is the work-life balance and job satisfaction you’re getting in your current role? Why would you look, and what would you look for? I think it is wise to keep these in mind.  

I can tell you I’m in the best job I’ve ever had with the best team, the best leadership. And I got it because I was patient. I didn’t just jump at something. 

In this installment of C-Suite conversations, Bradd Busick shares how a career spanning multiple industries, including non-profit, government, and healthcare, has made him a stronger technology leader. Now a Principal for AI, Data & Technology Enablement at PE firm Frazier Healthcare Partners, Busick reflects on the defining moments of his award-winning career—none more powerful than joining MultiCare Health as CTO in 2020 just as COVID-19 erupted.

Frazier Healthcare Partners is a healthcare-focused private equity and venture capital firm founded in 1991 and headquartered in Seattle, Washington. 

Q & A with Bradd

Judy: You recently made a transition, and you’ve worked in many different industries, starting your career at an investment firm, moving on to city government in Tacoma, to the Bill and Melinda Gates Foundation, and then to MultiCare Health System. How have these different industries influenced your views of technology leadership? 

Judy: You got your first-ever job in healthcare and joined MultiCare as CTO in March of 2020, right at the start of COVID. Talk about trial by fire! Tell me about that period.

Bradd: So, March 16, 2020, I am attending new employee orientation at MultiCare and this woman comes up to me and says, “Excuse me, are you Bradd Busick? We need you in the command center.” So, we went to our headquarters in downtown Tacoma and into the boardroom. At this point, we weren’t even masking up yet. We just knew that this thing, that hadn’t been named yet was killing our patients. We literally had patients dying in the hallways because we were out of beds, and we didn’t have the infrastructure in place to support virtual health, as it wasn’t even a mature capability at the time.

That Friday, after spending a whole week in the command center trying to figure out how we were going to operationalize, a woman stopped me and said, “Excuse me. I have patients dying, and their families can’t see them. Can you please come up with a technology solution that would allow me to connect them with their loved ones?”

So that weekend, my team, that I hadn’t met yet, and I locked ourselves into a conference room and we found a HIPAA compliant solution that allowed for the one-touch enablement of camera and microphone. We didn’t want people to have to download an app and try to authenticate. We needed it to be seamless.

The following Monday, I am ready to present this new solution using PowerPoint slides, but instead I get gowned and quickly pulled into a room with a 34-year-old patient who is intubated. We opened up Epic and got the next of kin phone number, and within eight seconds, her brother, who lives in New York, connected through the iPad that I was holding, which was pointed toward the patient, and I stood there and listened to him say goodbye to his sister.

And as a technologist and an executive, that experience completely transformed me. Healthcare tech is different because the stakes are higher. We are dealing with people’s lives.

Judy: You held the CTO role for about 16 months before being promoted to SVP & CIO. Can you talk about your technology goals for the organization and the accomplishments of which you’re most proud, especially those you brought from other industries?

Bradd: I don’t care about titles. I don’t care if I’m a CIO, a CTO, a CDO or a director, the goal is to actually move the needle. I didn’t need to get put in a CIO role in order to have impact. One of the hallmarks of a great leader is enabling impact within your team, and that is where I started. We built out what is arguably the best healthcare IT team in the country.

But in order to do that – and I mean a full-blown digital transformation, revenue cycle, pharmacy, lab, EMR, ERP, full cloud enablement – we had to overhaul our people, our processes, and dig out of our technical debt. And there’s no way that MultiCare would have scaled the way that we did without the technology play. They’re set to scale again and grow and they’re able to do that because of the foundation we laid.

Judy: Healthcare is known for being slow to change and seeing itself as being different from other industries. How did you overcome those issues?

Bradd: I was really fortunate. It’s not very often that the president of the healthcare system is the former CIO, and she happens to be the one to put in Epic for MultiCare. There wasn’t any mystery about the role that IT could play.

In some cases, healthcare systems still see themselves as healthcare systems and not technology companies. There are companies spending less than 3% of revenue on their IT department, which is embarrassing, or looking at IT as a tax. Healthcare is just fat and it’s ripe for disruption, which is why you have private equity coming in to disrupt the industry.

Judy: How do you get fat healthcare systems that treat IT as a cost center to change?

Bradd: I think it’s a change in leadership. The tenure of the current healthcare system leaders on average is really, really long. If a healthcare system is truly modern, they not only understand the value of IT, but they’re investing in it appropriately, and IT is not only at the table, it is the table. They are literally building and scaling based on technology.

Judy: What are your thoughts on reporting structure? Is the CIO or CDO as effective if they don’t report to the CEO?

Bradd: I think your role as an IT leader is to go make the big time wherever you are, whoever you report to. If I reported to the CFO, I’d probably communicate with him or her in a different way, talking about financial outcomes. But as a CIO, I talk about financial outcomes anyway. That’s just part of our nomenclature. I think there’s an older talk track that you need to report to the CEO to be seen. I didn’t need to report to anybody to be seen. My team was seen in and of itself because of the outcomes. We adopted a mantra of “show them, don’t tell them.” We let our results do the talking, which were faster turn times, higher patient quality, increased throughput, increased panel size, and lowering the cost of IT service five years in a row.  Given the role that technology is now playing in healthcare, do I think the modern healthcare system of the future is better off with the CIO reporting to the CEO?  Yes…but it’s not an excuse for underperforming IT departments to maintain status quo.

Judy: Coming from industries that have been focused on consumers for a lot longer than healthcare, what do you see as the ultimate digital presence?

Bradd: I will start with what it doesn’t look like. It doesn’t look like me not being able to access my MRIs or CT scans on MyChart. What it doesn’t look like is me not being able to get an appointment with a provider for nine months. What it doesn’t look like is having awful quality or being in the middle of a surgery and having the electricity go out because we were doing a generator test. What it doesn’t look like is constant outages and ransomware attacks. Now what the ultimate digital presence does look like: Not having to talk to a human to pay my bill, to get a referral, to get access to a provider. It should literally be like water, just seamless.

But I am super optimistic. I feel like the pendulum is swinging. Some of that’s due to budget, some of that’s due to talent, and some of that’s due to capabilities. But you can’t stay relevant or grow unless you have a digital footprint.

Judy: How did you help MultiCare balance the use, the governance, risks, and value of generative AI?

Bradd: I think AI is going to be a bigger unlock for healthcare than the internet itself. AI is built and trained to do standard repeatable knowledge work, and healthcare is chock-full of those types of patterns, from sentiment analysis of patients to identification of patterns, and revenue cycle, and billing, and coding, and claims management. You couldn’t have drawn up a better vertical for AI. But the problem that you run into is not that the AI can’t do it, it’s that the culture won’t adopt it.

Even for something as blocking and tackling as ambient technology, we ran a five vendor pilot and were one of the very first to jump in with Microsoft. Some of our providers loved it, some hated it. Now they say, “If you try to take this away, I’m gonna retire.” It’s a perfect example of deploying technology to make our clinicians’ lives easier, to remove the pebbles from their shoes, and let them focus on higher value tasks.

Ambient listening was one of many use cases that we surfaced to help govern, measure, and roll those things out. There were many, many use cases across MultiCare when I left. Most of the platforms that we invested in, which were enterprise-grade platforms from Epic, Workday and ServiceNow, all have AI invested in them already. So, we simply turned it on and watched the magic happen.

Judy: You’ve talked about how you embedded yourself as a business leader at MultiCare rather than a technologist. How did you do that?

Bradd: It’s relationships. It’s 100% earning the trust of your partners to go do that work. But then it comes down to results, which can sometimes manifest in terms of financial outcomes, i.e. am I cheaper today than I was yesterday? Or, is my uptime higher? Is our net promoter score the highest in the entire system? (Yes, by the way.)

We put some other teams on notice because of how we showed up. At my monthly all-hands meetings, we celebrated results, highlighted our people, major milestones, anniversaries, babies, weddings, and promotions. And then we’d be wildly transparent about where we were winning and where we were not winning. We also brought business partners into those meetings to speak. That’s the culture that we created and that’s still there. You build it with trust, but you back it up with results.

Judy: You left quite a legacy there when you left MultiCare. Can it continue, or will it change substantially now that you have left?

Bradd: It was never a Bradd thing. That team is still there. My business partners are still there. The IT culture at MultiCare is truly top shelf, and it would be a failure were it just a Bradd thing. We helped launch the careers of four CIOs into other organizations, which is also a hallmark of a healthy team!

Judy: Really? How?

Bradd: The best CIOs have a heart for their people. They want more for their team than they want from their team. When you work for a leader who legitimately and authentically cares about you, you know it. It was very safe for my direct reports to say, “Bradd, I think I’d like to go be a CIO somewhere.” My job wasn’t to hold them back. My job was to use my network to help them get a role, even if that meant a loss for MultiCare. And I think the best leaders do that.  Unfortunately, this approach is an anomaly, and we have leaders who are more concerned with ego, self-preservation, or always being right, which means the growth tree is stunted.

Judy: We hear that healthcare technology is anywhere between 5 and 10 years behind other verticals. Capital continues to be an issue. Technical debt is standing in the way of innovation, but you just said you are optimistic. How is healthcare going to overcome these issues?

Bradd: Capital is tight because the market conditions have changed. They’re hoarding it for growth. At some point you have to fix what you have before you take on additional technical debt. For every single acquisition a healthcare system does across the country, whether it’s a consolidation or a straight M&A, you’re saying yes to additional technical debt. What’s interesting in the world of technology is that it is a realistic expectation if you’ve made the right investment to be able to scale appropriately and do more with the same. But it’s not realistic to buy a company and run four instances of Epic and then wonder why your IT costs are so high. This is what’s happening across the country, and unfortunately, I don’t think that’s going to change until the growth and the consolidation stops.

Until executive leadership turns over, IT is going to continue to be what IT is. They’re going to keep running legacy servers because budgets are going to be flat again. They’re going to keep riding on the backs of IT and then be pissed when a server goes down. My hope is that the really good IT leaders that I know will stay in healthcare because healthcare needs good leaders.

Judy: Any words of wisdom for rising IT professionals wanting to become a healthcare CIO one day?

Bradd: One is, be careful what you wish for. The role of the CIO is lonely because if you’re a good leader, it starts with you and it ends with you. When we have a win, it isn’t Bradd Busick taking the win, it is my team’s win. But when there is a failure, I’m the one standing up in front of the board or my boss explaining the outage or why a platform didn’t work the way we expected.

For almost 6 years, I was on call 24 hours a day, 7 days a week. I missed birthdays, I missed anniversaries. I don’t expect anyone to feel bad for me because I signed up for that. The learning that came from those experiences, and frankly, the relationships that came from them, I wouldn’t change for anything in the world. I’d run it right back if I had the opportunity to do it again. And so patience, for sure, a level of curiosity and taking the time to earn the right to develop those relationships with your business partners, I think is a secret sauce for a great CIO.

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.