From finding the right candidates to keeping them, how hospitals are using AI to address workforce needs

Healthcare organizations struggling under a mountain of unfilled job postings are turning to technology to address staffing shortages.

Artificial intelligence and machine learning models are easing the application process, automizing workflow to decrease burnout and offering leadership time to connect with employees, health tech executives say.

The technology also is providing ways to help healthcare professionals find the right job, stay at the right job and interact with coworkers and patients on a more human level.

Almost 334,000 clinicians, including physicians, nurse practitioners and physician assistants exited the workforce in 2021 due to retirement, burnout and pandemic-related stressors including increased workplace violence, according to a recent report from Definitive Healthcare.

On average, hospitals are experiencing 27.1% nurse turnover, up from 18.7% in 2020. Overall hospital staff turnover is at 25.9%, up from 19.5%, according to the 2022 NSI National Health Care Retention and RN Staffing Report.

Dani Bowie is vice president of clinical strategy and transformation at Trusted Health, a labor marketplace and workforce management platform for the healthcare industry. She began her career as a nurse manager at Providence Health. Her firsthand experience hiring nurses later informed her time as vice president of nursing workforce development at Bon Secours Mercy Health and helps steer Trusted Health today.

Bowie now works to apply the lab innovations of AI to the practical application of nursing, a part of the healthcare labor force that was experiencing a shortage long before the COVID-19 pandemic, which only revealed and exacerbated the workforce challenges, according to Bowie.

The average age of nurses is already 57 years, according to Definitive Healthcare’s data, pointing to a quickly approaching cliff where the healthcare shortage will become an even greater crisis. Even with hefty sign-on bonuses, human resource departments cannot hire people fast enough as organizations can’t get hires to stay.


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“Large health systems tend to do a lot of manual work around staffing, scheduling, timekeeping and they do so without the support of predictive models, automation, or any type of intelligence,” Bowie told Fierce Healthcare. “And what you see as a result, typically, is higher labor costs, lower nurse satisfaction and lower retention and satisfaction of your nurse managers.”

Trusted Health’s nurse staffing platform, called Works, sifts through nurse scheduling and finds which shifts need hiring, thereby decreasing the manual work of nurse managers who have anywhere from 80 to 120 direct reports, according to Bowie.

The San-Francisco-based startup unites internal staff and external contract professionals (like travel nurses) in an operating system to increase flexibility to meet staffing needs due to seasonality, turnover, sick calls and acuity changes.

“We're able to take a completed schedule that's been built and then automate the recruitment of the shifts that are unfilled or change,” Bowie said. “As soon as those shifts are generated and are open, we come in, we integrate with the schedule, we pull in all those open shifts and then we automate the recruitment of those open shifts to the right workforce based off of skills competency, price point, as well as ensuring that they're not overworked.”

Many managers hire a core base of nurses based on predicted bed capacity, however, during a public emergency or changes in local populations, hiring needs to change fast, Bowie said, and this is where automation comes in and fills shifts as they arise.   

Once a nurse finds the right position, Bowie says retention grows as nurse managers are less bogged down by red tape and better able to connect with nurses regarding their professional aspirations.

“Typically, there's about 20% of untapped potential in your existing workforce. The ways that you can leverage it is to upskill, cross-train and get new experiences to the workforce,” Bowie said. “What’s going to help increase retention? Flexibility and new opportunities. It’s a way to engage your existing workforce, to allow them to have the opportunities that historically are challenging to manage manually.”

Some organizations are turning to Paradox, an AI-based platform that speeds job recruitment. Carlos Fernandez, director of talent acquisition at Houston Methodist, turned to Paradox partially due to the power of asynchronous communication.  

“Nursing was our focal point because of just the fact that we have over 2,500 to 3,000 openings at a given time, we average over 7,000 hires annually; 30% of those vacancies are nursing-based,” Fernandez told Fierce Healthcare. “We wanted to position our sourcing chatbot, powered by Paradox, to be able to scale from a hiring standpoint.”

Houston Methodist is comprised of an academic medical center in the Texas Medical Center along with six community hospitals. The system boasts a total of eight hospitals, 1.6 million outpatient visits annually and 27,947 employees.

Fernandez realized that many nurses who he hoped to hire for night shifts were getting off the night shifts they already had and were not able to communicate with hiring managers in an effective way.

“We wanted to align a technology to be able to, one, schedule timely interactions with our recruiters and, two, for our sourcing team to be able to connect the dots. We like to say administrivia; we reduced administrivia when it comes to some of the calendar scheduling with candidates as well,” he said.

Once an applicant gets to the interview stage, hiring managers can ensure that more nuanced connections are being made like shared culture and philosophy of care. All other objective qualifications can be left to the computers, easing hiring and decreasing HR staff burnout.

Paradox states that it automates over 90% of the end-to-end process for hiring managers. The platform’s automated chat assistant, Olivia, can direct prospective hires to new positions and interview times with only a few bits of screening information.


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“From an AI perspective, we're continuously growing our organization, continuously evolving from a tech stack and innovation standpoint,” Fernandez said. “We have a center for innovation that is essentially research and development for our organization to bring to light technologies and innovations that help us grow in the space of patient care. Our talent acquisition team has been able to bring to light technologies in that space and AI being a key part of that.”

Fernandez said that after adopting Paradox’s technology, Houston Methodist saw a 30% increase in applications for hard-to-fill positions, 60% of qualified candidates were sending in those applications after hours and 88% of interviews were scheduled the same day a candidate applied.

Demand for health system hires extends to IT

Hiring for health IT presents an entirely new set of challenges like cost, reflective of high competition in the market, and matching skillsets. With an increased move into digital health and the complete digitization of healthcare, more professionals than ever are needed with the stakes being much higher.

There’s also a high demand for talent as hospital cyberattacks continue and cybersecurity becomes a higher priority.

But with flashy benefits packages and eye-popping salaries at tech companies, even with a tech recession looming, hiring IT experts for hospitals is no easy feat.

“There's still a lot of manual effort that goes into contacting talent in order to verify data points or information about those individuals to see if they're really an aligned, available resource for a need that an organization might have,” Steve Glomski, CEO of Abra, a healthcare IT talent platform, told Fierce Healthcare.

Abra’s talent platform launched in October and is designed specifically for the healthcare IT ecosystem.


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The app aggregates various sources of health IT talent including independent contractors, consulting firm benches and other application teams. By leveraging AI and machine learning, Abra matches talent with health systems while adding transparency to the hiring process.

“By automating a lot of those manual processes that go into aligning talent with opportunities, we cut out a lot of the costs that are associated with that process,” Glomski said. “That cost can be passed on to organizations that are consuming their capacity and using them to progress their projects. That should help benefit talent, to be working on things that they enjoy working on more. With the cost savings, it also allows employers to potentially afford more to attract the talent and pay them up a reasonable wage.”

The company claims that it can help organizations reach 47% in cost savings.

Abra also works to cut through the noise of job posts. Unlike nursing where a licensure number can be confirmed quickly, health IT qualifications are more nuanced. Through using AI and machine learning, Abra’s technology can collect more data points, including reviews from former employers, and better determine if a candidate is qualified earlier in the hiring process.

“The one big point is around the need for a flexible workforce specific to healthcare IT,” Glomski said. “Healthcare demands change consistently. Flexibility within their health IT teams has been critical for a while. Until now, it's really been challenging and costly to create that flexible workforce.”