How health system CIOs compete for top tech talent with peers, tech giants

Health systems are bringing a range of new technology tools into the fold—advanced analytics, smartphone apps, virtual care and more. But building and maintaining those programs requires skills and training from employees beyond traditional information technology functions, pitting healthcare organizations against new competitors for technology talent. Modern Healthcare technology reporter Jessica Kim Cohen caught up with three chief information officers from a cross section of health systems to discuss how their organizations’ technology workforces have changed and what challenges they’ve run into when recruiting for new roles. The panel included Jake Dorst, CIO and chief innovation officer at Tahoe Forest Health System in Truckee, Calif.; Pete Marks, vice president and CIO at WakeMed Health & Hospitals in Raleigh, N.C.; and Ellen Wiegand, vice president and CIO at Virginia Mason Health System in Seattle.The following is an edited transcript.

MH: How has the composition of your organization’s technology workforce changed over the past five years? What teams have you added or built out?

Marks: The big one right now for us is analytics. Over the history of information services, we would be buying systems or making investments, and those investments would be primarily focused on workflow and making sure that there’s an integrated workflow—but now it’s all about what happens with all the data from all these different systems.

Dorst: There are a lot more clinical people now than there used to be historically in the IT department, which is a good thing. It cuts down on the time it takes to really understand what your users’ pain points are.

Wiegand: We’ve had, as most have had, an increasing emphasis on security. While we’ve always had a security team, we’ve really beefed up that team over the last several years. We’ve also consolidated our privacy and security programs, so we’re working as one now to address both of those concerns under the guidance of a chief information security officer, which is a new role for Virginia Mason for the last several years.

MH: When you’re launching a project in need of a new skill set, how do you decide when to recruit new staff and when to train current staff?

Wiegand: We occasionally will create a new position for a particular subject matter, and then obviously we’ll bring somebody in from the outside with that set of skills and experience. But we tend to train our existing staff. We’ll typically bring folks in from the outside to help train our teams, and then our teams will carry that work forward. Our existing team has a great understanding of our current architecture, so being able to add knowledge to that has actually worked out really well.

Marks: Our hiring is about 50/50, so about 50% of the people are internal hires and about 50% are external hires. We make every attempt to hire from within first. But if it just doesn’t seem like we have the skill set that we’re looking for, we’ll go outside. It takes a long time in certain specialties to get folks, especially in this area, because we’re in the same area as Duke Health and UNC Health.

MH: What technology roles have proven particularly challenging to fill?

Marks: Mostly it’s the heavy duty technical things that are the hardest to fill—like storage engineers. If we can’t do some of that, we’ll try outsourcing a little bit of it. But that gets really expensive, really fast.

Dorst: Leadership roles. I get people who have the technical background and technical acumen to learn, but they have zero experience managing and leading a team. You can learn that, but if you’ve never done it before, it takes a bit to catch up with it.

Wiegand: We’re really focused on electronic health record optimization, which requires team members who have really in-depth knowledge of Cerner and the EHR from a technical perspective, but also a clinical workflow perspective. Those types of roles are really challenging to fill, especially since we’re a Cerner shop. Anything highly specialized like that we’ve found is more difficult.

MH: What challenges have you run into when seeking out the right talent for new technical projects?

Dorst: It has been harder in the market to find people with the right background and the right training. You’d think it would be getting easier with the focus on technology nowadays, but the last couple of roles I had to fill have been slim pickings. There’s a lot of good roles out there for people who have a technical background, and healthcare is just not as sexy as working for a Tesla or Google.

Wiegand: There’s a lot of work here in Seattle; we have a lot of the big tech companies in our backyard. So to be a healthcare company and recruit someone to come work for us, as opposed to one of the big tech companies, that can be a challenge. We really have to do a good job of articulating what the value is in coming to work for a healthcare organization, and using your technical skills and knowledge to make the patient care experience better for patients and work life better for our team members.

MH: For WakeMed and Tahoe Forest, what challenges does the location of your organizations bring when hiring for new team members?

Dorst: Living in Lake Tahoe is a draw for some people. Especially the people that like the outdoors and like to ski, and do that kind of stuff—so if there’s a job that comes attached to it, that’s a draw. But property here is expensive, so that’s a bit of a challenge in hiring here for anything. If you want to live in Truckee, it’s going to be expensive. So we’ve looked at how can we perhaps build some workforce housing and ease some of that burden.

Marks: In Research Triangle Park in North Carolina, there are three major medical organizations: WakeMed Health & Hospitals, Duke University and University of North Carolina. Everybody knows the three health organizations. It can be challenging to find people in certain areas. We use where we are as a culture, how we’re focused on patients and families, how we’re focused on the underprivileged to help attract talent. We tend to find that people will gravitate toward that.

MH: What are some changes you’ve made to your strategy to recruit new team members?

Wiegand: In Seattle, the cost of living is really high. To get some people to move here, especially people with these highly specialized skills, can be really challenging. We’ve actually started hiring people in certain roles—not all roles—to work remotely. So if you don’t live in Seattle that’s not necessarily a requirement anymore. We have a few people who are continuing to live where they live and work for Virginia Mason full time remotely.

Marks: In the beginning, before I got here, one of the requirements to get promoted was you had to have a bachelor’s degree. But really when we started to look at it, for a lot of really heavy duty technical roles, our peer organizations didn’t require that. We’ve made changes along the way to provide the opportunity for somebody to show the things that they can do, but not give them something like that that’s such a barrier.

MH: What types of organizations do you tend to see as your main competition for technology employees?

Marks: For the most part, it’s the other healthcare organizations, with Duke and UNC. But they have such different personalities—UNC is a state organization, and Duke has an academic model. We tend to trade people, but eventually people find their sweet spot in terms of culture, and then they tend to stay in that culture.

Dorst: There’s some pretty heavy-hitters in the healthcare space that we’re competing against. We’re pretty close to Reno, Nev., and there’s a big system there called Renown Health. Then there’s another one called St. Mary’s Regional Medical Center, which is also a 30-minute drive from here. And then on the other side of the hill is UC Davis Health and Sutter Health.

Wiegand: For some of our healthcare-specialized roles, like our electronic health record analysts, the competition is likely to come from other healthcare organizations, but for some of our infrastructure and technology roles, the competition is likely going to be outside healthcare. There’s several major health systems in the Puget Sound area, so the competition is pretty tough to recruit technical folks. But we do see people moving between healthcare and the tech companies, so back and forth with Amazon and Microsoft in the area, depending on the skill set and their role.

MH: A lot of those tech companies are able to offer some really high salaries and significant benefits. How do you compete with that?

Wiegand: We’ve started to be competitive with salary and benefits, but your work life isn’t just about your salary and benefits. The types of projects and work that we get to do here, to help improve the lives of the patients within our community, is a compelling mission. We know we can’t compete on a pure salary with some of the major tech players. We’re a not-for-profit company and that probably isn’t possible, but we definitely can (compete) on the quality of work that we do, the types of projects that we offer to our team members and on our work-life balance.

Marks: Our patients are at the top, so that is our greatest recruiting weapon that we have. If you want to come to a place where you are able to be a servant leader—people just flock to that.