Health systems need to attract learners to their organizations and give them sustainable career paths, says this CMO.
As healthcare executives everywhere work to overcome staffing shortages, it's important for CNOs, CMOs, and other clinical leaders to focus on providing career advancement opportunities to staff that fit career expectations.
According to Dr. Lindsay Mazotti, chief medical officer at Sutter Health, medical students are thinking differently about how they want their medical careers to unfold.
"The draw of academic medicine is still there," Mazotti said, "but there are people who are wanting to think differently about how they take care of patients and how their careers are sustainable through their lives."
These changing expectations are affecting recruitment and retention, and at Sutter Health, Mazotti sees graduate medical education (GME) as a helpful tool.
"For us, building graduate medical education programs means attracting learners to our system," Mazotti said, "[and] building a compelling reason why people want to come join us at Sutter Health."
HealthLeaders sat down with Mazotti, live from the Workforce Decision Makers Exchange in Washington D.C, to discuss how CMOs can use GME to improved their residency recruitment strategy. Tune in to hear her insights.
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Health systems and hospitals are ditching their competitive aspirations and joining forces to develop innovative new technologies and programs
Expensive technology, limited budgets and uncertain ROI are all combining to make healthcare innovation a challenging arena. So how are the nation’s forward-thinking health systems and hospitals responding?
They’re collaborating.
In what is often considered a competitive market, healthcare’s innovation leaders are finding value in sharing their ideas with their peers, in hopes of developing technologies and programs that can be scaled across much larger and more varied patient populations. And with the weight of multiple organizations supporting these ideas, they hope to create sustainability with more receptive payers, including the Centers for Medicare & Medicaid Services (CMS).
Just a few months back, Providence, Novant Health, Baylor Scott & White Health and the Memorial Hermann Health System announced the launch of Longitude Health, with the three-pronged goal of transforming business models, improving health system performance and empowering healthier futures.
“Innovation is a multi-faceted strategy and we are approaching it pluralistically,” Sara Vaezy, Providence’s chief strategy and digital officer, said in an e-mail to HealthLeaders.. “Thorny operational challenges that require networks, capital, and broad expertise to come together to solve these issues at scale can be tackled in partnership across health systems.”
“The defining components of the health system strategy of the future are transformation through innovation and collaboration,” she added. “We need to position ourselves as a trusted partner and navigator of services for our communities—rather than trying to do it all ourselves. As healthcare institutions, we must now think beyond our individual organizations and core delivery models to build solutions that serve the greater good across health systems, patients, and communities.”
“We will also pursue innovative individual partnerships with organizations that have built up scale and special capabilities in certain areas,” Vaezy noted. “In some cases, we’ll also engage in innovation on our own before seeking partners. There are many roads to innovation and this accelerates one of the paths.”
The latest to join the trend is the American Telemedicine Association (ATA), which unveiled the ATA Center of Digital Excellence (CODE) this week. The new center is billed as “an innovative alliance with leading health systems dedicated to advancing the integration of digital care pathways to support patients throughout their healthcare journeys.”
CODE’s founding members are Intermountain Health, the Mayo Clinic, MedStar Health, Ochsner Health, OSF HealthCare, Sanford Health, Stanford Health Care, UPMC and West Virginia University Medicine Children’s Hospital. The center will be overseen by Elissa Baker, BSN, RN, formerly of eVisit, the FemTech Lab, Phase2 Health and KeyCare, who was named the ATA’s SVP of digital strategy and clinical Innovation in October.
The ATA is uniquely positioned to usher in a new era of collaboration within healthcare,” ATA CEO Ann Mond Johnson said in a December 12 press release. “Through CODE, we are convening top health systems to establish models that seamlessly integrate digital care into broader care delivery approaches. Telehealth is not an either/or solution but a critical addition to in-person care, addressing gaps where traditional access is limited or unavailable. With these renowned health systems, we are setting the standard for how innovation and technology can enhance, extend, and equalize access to high-quality healthcare for all."
In a more unique partnership, Mass General Brigham and Tampa General Hospital have been collaborating for more than three years, beginning with the expansion of MGB’s innovative Home Base program for veteran healthcare and wellness to Home Base Florida in 2021.
“Our collaboration with Mass General Brigham is key to advancing innovation and expanding access to world-class care across Florida,” Tampa General CEO John Couris said in an e-mail to HealthLeaders. “We’re sharing expertise and best practices to capitalize on what both systems have to offer, leading to the best possible patient outcomes.”
The two health systems have been working together on cancer care and treatments, a bone marrow transplant program and cell therapies through the TGH Cancer Institute. They’re also planning to build a new radiation center in Palm Beach Gardens, where patients will be able to access either MGB or TGH clinicians for radiation oncology, medical imaging and clinical oncology services.
“The increased collaboration between our two health systems is a reflection of our mutual goals: To enhance, innovate and be at the forefront of medicine to offer Floridians the absolute best care options while simultaneously responding to the very complex needs each person has over the course of their lives,” he added.
The health system's new Virtual Care Center aims to use the latest in digital and telehealth technology and programs to address key pain points in rural healthcare.
Sanford Health is giving its virtual care strategy a very real base of operations.
The South Dakota-based health system, the largest rural network in the country, recently opened the Sanford Virtual Care Center at its Sioux Falls campus. Executives say the 60,000-square-foot building, divided into an Education Institute, Innovation Center and Clinical Service Delivery labs, will be critical in developing, scaling and sustaining innovative technologies and programs addressing rural health needs.
“We have lots of problems with access, quality and sustainability, and we firmly believe that virtual care is the single most important tool we have to address these shortages in our rural footprint,” David Newman, MD, Sanford Health’s CMO of virtual care, said during a recent HealthLeaders podcast.
David Newman, MD, CMO of virtual care for Sanford Health Care. Photo courtesy Sanford Health Care.
The new center comes at a time when Newman and his colleagues across the country are facing acute workforce shortages. Roughly one-third of doctors will be retiring in the next 10 years, Newman says, and there will be 25% fewer rural docs by 2030. There aren’t enough new doctors, nurses and other healthcare workers coming into the pipeline, and many of those that are will be heading to urban and suburban areas, where the patient base is bigger and the pay is better.
Enter telehealth and digital health, and the idea that a patient can access any care needed at home or in a local doctor’s office or clinic, while a rural health system can reach out and either provide those services or act as the conduit between the patient and a specialist or a larger health system with those resources.
“With a click of a button on your phone, just like ordering a pizza or talking to your grandkids on FaceTime, you can see a behavioral health provider,” says Newman, noting that roughly one-quarter of all behavioral health services are now handled via virtual care.
The center serves three specific functions. The Education Institute allows Sanford Health to have a hand in training the provider of the future, offer guidance on virtual nursing, robotics, AR and VR technology, remote patient monitoring (RPM) and so-called webside manner. Through this, the health system is bringing its current workforce up to date on new strategies and creating an environment to attract new providers.
“A lot of the younger doctors coming out, a lot of the younger nurses, this is an expectation,” Newman says, “And we see it as a huge recruitment and retention tool to offer these things.”
“Some younger providers want fully virtual careers,” he adds. “They want to be able to work from home. There's a work life balance that is a much bigger thing for younger providers than it has been for older providers, and we want to be able to offer them work life balance.”
The Innovation Center gives Sanford Health an area to work with small companies and start-ups, as well as providing workshops for their own doctors and nurses to test out new ideas.
“One of the biggest problems in healthcare right now is operationalizing really great ideas,” Newman says.
The Clinical Service Delivery labs, meanwhile, gives Sanford Health an area to test out new programs that pull family and caregivers into care management, as well as testing out Hospital at Home and other home-based care concepts. One lab might be designed like an exam room in a doctor’s office, while another represents a skilled nursing facility room and a third looks like a patient’s bedroom or living room.
“A big part of healthcare is not just examining what it's like through the provider lens, but also seeing what it's like from the patient,” Newman says.” We want to know how that patient is receiving healthcare” in different environments.
“We honestly want to be very, very nimble,” he says. “We designed the center to be changed. The rooms can be flexed, [because] we really don't know where digital healthcare is going to be going in the next 10 years, and we're OK with that, that we hope it's very, very different and we hope that we're ready to be different.”
Staffing, workplace violence, and potential legislative changes will challenge CNOs in the new year, according to this CNE.
2024 was a rollercoaster ride for healthcare, and 2025 will likely be no different.
This year, CNOs and other nurse leaders faced a wide array of challenges, from expanding the nursing workforce through recruitment and retention, to tackling new technologies like AI and virtual nursing, and to addressing nurse burnout and wellbeing. Many of these issues are expected to continue, while more will appear on the horizon in the new year.
"We continue to have a large number of early career nurses leaving their organization and maybe even leaving the profession soon after they join us," Norton-Rosko said, "and we continue to see an increasing number of nurses retiring, because at the same time the population in general is aging, so is the nursing population."
Nurses nowadays have more opportunities to be employed in non-traditional roles, Norton-Rosko explained, which creates more competition to keep nurses working clinically at the bedside. Nurses are also experiencing record levels of burnout.
"While they're working to address urgent patient needs, they’re still dealing with the staffing crisis," Norton-Rosko said, "and we need to continue to pull on their expertise to help support the innovation related to new models of care and integrating technology."
Looking ahead to 2025, Norton-Rosko believes that the staffing challenges will continue, along with workplace violence incidents. Change management will be essential for CNOs moving forward.
"We also need to work on striking the right balance between providing care and supporting technology solutions," Norton-Rosko said, "[and] really balance how much change our teams can take at one time."
As for new challenges, Norton-Rosko emphasized the importance of focusing on diversity, equity, and inclusion (DEI), and addressing social determinants of health. Potential policy changes under a new administration will also be a point of concern for CNOs in 2025.
“While nurses play a large role in identifying disparities," Norton-Rosko said, "we need to work really hard with other disciplines to make sure we can then address the disparities once they’re identified."
Listen to this week’s episode of the HealthLeaders Podcast to hear more about nursing trends and challenges going into the new year, and how CNOs should plan to address them.
Jim Gilligan, Vice President, Health System and Group Engagement at the American Medical Association (AMA), chats with HealthLeaders Exchange team member Abby Mathis to discuss challenges and trends...
Partnering with international organizations can help influence nursing education and give nurses global experience, says this nurse educator.
On this episode of HL Shorts, we hear from Dr. Yolanda VanRiel, the department chair of nursing at North Carolina Central University, about how CNOs can create pipelines into the nursing industry by partnering with international organizations. Tune in to hear her insights.
Peggy Norton-Rosko, system chief nurse executive at the University of Maryland Medical System, chats with CNO editor G Hatfield about nursing challenges in 2024 and what the industry will look like...
Anger toward health insurers reflects people's 'pent-up pain'
In the aftermath of UnitedHealthcare CEO Brian Thompson's fatal shooting, an outpouring of rage at the U.S. health care system has risen to the surface.
Social media posts have ranged from mournful to apathetic to joyful, including morbid celebrations of Thompson’s death. That deluge has forced people across the country to grapple with two heavy subjects at once: the callousness of a slaying, and an undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans.
“People feel there is an inherent unfairness in the way that the system works,” one advocate said. “That someone who has health insurance gets sick and then it’s a company, a business, that can be the barrier to them accessing the care they need to sometimes save their lives.”
Despite the hype, AI has the potential to cause harm as well.
AI may be at the top of the hype cycle in healthcare, but its uncertain governance and potential for misuse are also making it the top technology hazard for 2025.
‘Risks with AI-enabled health technologies’ soared to the top of ECRi’s annual top 10 health technology hazards, after placing fifth last year (when it was called ‘Insufficient governance of Ai in medical technologies.’).
The rise to the top of the list underscores growing concern over AI. Health systems and hospitals are embracing the technology at a rapid pace, even as industry groups and the federal government try to keep up with governance.
According to the ECRI report, inaccurate or incomplete data fed into AI algorithms can lead to disparate health outcomes or inappropriate responses, as well as hallucinations and data drift. Healthcare leaders who don’t invest in and emphasize continuous monitoring run the risk of overlooking these lapses and threatening their patients.
“Further, AI solutions can yield disappointing results if organizations have unrealistic expectations, fail to define goals, provide insufficient governance and oversight, or don’t adequately prepare their data for use by the AI application,” the report stated.
“The bottom line? Placing too much trust in an AI model—and failing to appropriately scrutinize its output—may lead to inappropriate patient care decisions,” researchers concluded. “AI offers tremendous potential value as an advanced tool to assist clinicians and healthcare staff, but only if human decision-making remains at the core of the care process. Preventing harm requires careful consideration when incorporating any AI solution into healthcare operations or clinical practice.”
Healthcare in the home setting continued to score high on the list, reflecting both the industry’s interest in remote patient monitoring and Hospital at Home strategies and a growing senior population interested in living out their years at home. ‘Unmet technology support needs for home care patients’ placed second on ECRI’s list, while last year’s list was led by ‘Usability challenges with medical devices in the home.’
“For many patients, healthcare at home is an attractive alternative to hospital-based treatment,” the report noted. “But delivering care in the home has unique concerns, particularly when the patient or a family member is responsible for operating a complex medical device. Devices such as ventilators, dialysis machines, and infusion pumps traditionally have been used in acute care settings under clinical supervision but increasingly are being used in the home.”
“Minimizing the risk of harm requires providing home users with the support they need to operate, maintain, and troubleshoot the device successfully,” researchers concluded. “This involves anticipating challenges that the user may face and selecting devices that are well matched to the patient and the environment of use.”
Rounding out the list:
Vulnerable technology vendors and cybersecurity threats
Substandard or fraudulent medical devices and supplies
Fire risk from supplemental oxygen
Dangerously low default alarm limits on anesthesia units
Mishandled temporary holds on medication orders
Poorly managed infusion lines
Harmful medical adhesive products
Incomplete investigations of infusion system incidents
Cybersecurity scored high on the list, coming in third following a year in which data breaches and ransomware attacks often dominated the healthcare headlines. Last year, ‘Ransomware as a critical threat to the healthcare sector’ scored 6th—only a few months before the devastating Change Healthcare attack.
“Measures that can help a healthcare organization mitigate thirdparty risks include thoroughly vetting vendors at the start of the service acquisition process, building in redundancy, conducting incident response testing, and developing recovery procedures,” the report stated.
