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There’s no time like now for rural healthcare providers to consider ways to strengthen their practices.

What Rural Health Facilities Need to Survive in 2018 and Beyond

By 2050, it's estimated that 139 million people worldwide will have dementia, but by today's standards, 60% will be undiagnosed. It's clear that there's a significant gap in dementia detection and care, but what can your organization do about it?

Get perspectives from clinical leaders and neuroscience experts about the underlying causes and consequences of these gaps, practical opportunities to address them, and a proven roadmap that shows how leading health systems have successfully transformed their dementia screening and care processes.

Closing the Dementia Care Gap: Expert Insights and Proven Strategies for Health Systems

Health systems increasingly turn to centralized fulfillment to meet rising demand, reduce costs, and free up pharmacists for patient care. This whitepaper outlines 10 critical RFP questions to help pharmacy and operational leaders evaluate vendor fit. Topics include fulfillment model selection, scalability, pharmacist verification models, software integration, implementation support, and long-term compliance. It’s a must-read for any health system preparing to modernize its pharmacy infrastructure.

10 Critical RFP Questions for Choosing a Centralized Fulfillment Partner

 - The University of Texas MD Anderson Cancer Center is operating a virtual nursing program to help patients navigate their hospital stay, and also offer some assistance to nurses working on the floor with patients.

Lavonia Thomas, nursing informatics officer at The University of Texas MD Anderson Cancer Center, spoke with Chief Healthcare Executive® at the HIMSS Conference about the virtual nursing program, its growth, and some promising results. She also offered advice for other hospitals looking at virtual nursing. Here’s a portion of our conversation.

University of Texas MD Anderson Cancer Center sees success with virtual nursing

MD Anderson Cancer Center and virtual nursing

Q: Can you talk about the virtual nursing program at MD Anderson Cancer Center?

A: “So our virtual nursing program launched in April of 2023. We started out with one demonstration unit, and we worked one workflow, which was the admissions of patients. Since then, we have spanned across our entire medical and surgical cohort of units, and we've introduced virtual nursing into our emergency room for patient admission workup.

“We started with five nurses. We are now at 16 virtual nurses, all with a tremendous amount of oncology nursing experience from MD Anderson. We are continuing to scale this effort. We will be moving into our hematology units, and we're also having some discussions with our ambulatory treatment center to adopt some workflows in that area.”

Q: And you're encouraged by the results you're seeing so far with virtual nursing?

A: “Extremely encouraged. Our feedback from our frontline nurses has been extremely positive. We have utilized their feedback to continue to augment our workflows and make any changes that we need to and our patient feedback, as we have talked to them anecdotally, has been extremely positive about their interaction with the virtual nurses.”

Q: What advice would you offer other hospitals looking at virtual nursing?

A: “There are opportunities to improve the efficiency and to support our nurses at the front line. I would advise anyone not to allow a lack of technology or what they see as a lack of resources to hold them back from looking at what could be done around this virtual space. Many organizations have been very creative about introducing virtual nurses to that work space, and I would encourage folks to start where you are at.”

Lavonia Thomas of MD Anderson talks about the program’s growth, encouraging early results, and advice for others looking at virtual nursing.

Topic

MD Anderson Cancer Center and virtual nursing | HIMSS 2025

Kettering Health is grappling with a cyberattack that is disrupting patient care and other key functions.

 that it has experienced “a cybersecurity incident resulting from unauthorized access to our network.” The incident has caused a “system-wide technology outage,” Kettering says. 

 are reporting that Kettering has suffered a ransomware attack.

Kettering said Tuesday that it has postponed elective surgeries at hospitals and procedures at outpatient clinics. Kettering says it will provide more information about when those surgeries will be rescheduled. The system, based in Dayton, Ohio, operates 14 medical centers and more than 120 outpatient clinics.

While Kettering has postponed surgeries, the health system says its emergency rooms are open and receiving patients. Ambulances are being diverted, the Daily News reports. Kettering’s clinics are open.

Kettering said on its website that its call center has experienced an outage, among the disruptions.

Adding to the problems, Kettering Health says patients are getting “scam calls” from individuals claiming to be representatives of the health system. The callers are demanding payments for services. Kettering said it hasn’t confirmed that the “scam calls” are tied to the system-wide outage.

“We have confirmed reports that scam calls have occurred from persons claiming to be Kettering Health team members requesting credit card payments for medical expenses,” Kettering said on its website.

Kettering Health says employees typically call patients to get payments for bills, the health system says it’s suspending such calls for the time being. The health system encourages anyone getting such calls to report them to law enforcement.

The health system says it’s working to contain the damage and is continuing to investigate the attack.

More hospitals and health systems, along with other organizations that have health data, have suffered cyberattacks in recent years. 

Three out of four Americans were affected by breaches of private health information

Cyberattackers are demonstrating more technical proficiency in their attacks, Steve Cagle, the CEO of Clearwater, a cybersecurity firm, told Chief Healthcare Executive® in a recent interview.

“The attacks are becoming much more sophisticated,” Cagle says.

Ransomware gangs are using artificial intelligence to craft better phishing emails, and they’re also using AI to gather intelligence on companies that they’re targeting.

“You can gather information on a company using artificial intelligence,” Cagle says. “You can write the ransomware, by the way, or write the code … if you're doing a phishing campaign, you can use AI to help support that. You could use it to write the malware.”

The Dayton Daily News reported that hackers are threatening to publish private health information and destroy data if Kettering Health doesn’t negotiate within 72 hours.

Ransomware gangs routinely target hospitals because they have private health information which can be sold on the dark web, and 

because hospitals will often pay to restore their systems and care for patients

A ransomware group’s attack on UnitedHealth Group’s Change Healthcare last year proved to be t

 the healthcare industry has ever seen. UnitedHealth said 190 million Americans were affected, and hospitals and medical groups around the country faced disruptions and financial losses from the attack.

Even as some ransomware groups seek big paydays, they are willing to negotiate on their demands. Andrew Carr, a ransomware negotiator for Booz Allen, told Chief Healthcare Executive® that some attackers hold firm on demands, but others will take less than they initially sought.

“Early on, there were a lot of hard-nosed threat actors,” Carr says. “But they've realized that some money is better than no money. So they often will negotiate.”

What it’s like to negotiate with ransomware gangs

Ransomware groups are more likely to negotiate if their attacks were less successful than they expected, Carr said. He also stressed the importance of hospitals developing strong cybersecurity defenses and robust response plans in case they are attacked to minimize disruptions.

CHE cybersecurity panel: How hospitals can protect their patients, and their systems


The Ohio-based system says its call center was affected and customers are getting calls from individuals claiming to work for Kettering and seeking payment.


Kettering Health cyberattack delays surgeries, system reports ‘scam calls’

Many nurses have left bedside roles in recent years, and more could be joining them.

About 40% of registered nurses say they plan to leave the workforce or retire within five years, according to a 

 released last month by the National Council of State Boards of Nursing.

Claire Zangerle, CEO of the American Organization for Nursing Leadership, says she’s been worried about the departure of nurses for some time. She tells Chief Healthcare Executive® that the shortage of nurses is a particularly disturbing problem in hospitals.

“Most of this is in the acute care settings,” she says. “It’s not that it's not a problem in other areas like ambulatory or post-acute care, but it's really troublesome for the acute care areas, because where are the sickest patients? They're in the hospitals within those four walls. And not being able to care for those patients at their most vulnerable times because we don't have the staff to do it is troublesome.”

Many nurses are leaving due to high work demands because of 

the high rates of violence and hostility nurses are encountering in hospitals

Nurses are making a ‘desperate cry’ to fix their work environment

But Zangerle says she and her organization are very motivated to tackle the problems in nursing.

In a recent interview with Chief Healthcare Executive®, Zangerle talks about the steps hospitals need to take to retain younger nurses. She also talks about the steps needed to help nursing managers, and why nurse managers can play a key role in helping retain nurses if they get the support they need.

(See part of our conversation in this video. The story continues below.)

A nursing leader talks about the steps hospitals can take to be sure nurses don't walk away

How hospitals can help retain new nurses

Hospitals that are struggling with retaining nurses need to examine their compensation. If hospitals are not competing with peers when it comes to pay, nurses are willing to go elsewhere, Zangerle says.

“Make sure that you are market competitive with your compensation,” she says. “That is table stakes. If you're not market competitive, then you don't even get to play the game. So you have to stay market competitive.”

Beyond compensation, hospitals and nurse leaders need to be nurturing young nurses early in their careers. Newer nurses need more “check-ins” from their managers to make sure they aren’t getting overwhelmed and can help them grow.

Health systems need to be “intentional around onboarding,” she says.

“Those first couple of years as a new graduate nurse when you're coming from school to a job are very critical, because that could define your future,” Zangerle says. “And how a health system manages that onboarding, and continual feeding and watering in those first couple of years, is foundational to your future.”

Some newer nurses were educated during the COVID-19 pandemic, and may have had less socialization in nursing schools. Some may also not have had as much experience in their clinical rotations than others who came before them.

Younger nurses possess a strong work ethic, but they also want to have some semblance of work-life balance, and that’s something hospitals must realize, she says.

While Zangerle says it never would have occurred to her to say she couldn’t take on an extra shift when she was younger, today’s young nurses are more willing to draw boundaries. And she stresses that’s not a bad thing.

“Our expectations of our new nurses have to be aligned with their expectations of how they want to live,” Zangerle says. “And we're seeing that in every industry.”

“Everybody wants to have a life. And it's not that people don't have a work ethic. They just want more balance … they're playing the long game, and they want to make sure that they have the stamina to play that long game, and they don't want to burn out quickly. And we're seeing a lot of burnout because they're being pushed to the point where they don't want to work that much because we have the shortage,” she says.

Nurses in hospitals: Burnout by the bedside

Nurse managers can help hospitals keep talented nurses, Zangerle stresses.

Managers need to be checking in with younger nurses, and more experienced nurses, she adds.

It’s not enough to meet with nurses when it’s time for an evaluation. And as Zangerle says, it’s difficult for managers to do a proper evaluation without spending some one-on-one time with their nurses.

“Checking in and doing sort of a pulse check on a regular basis with your team is super important,” she says. “Because everybody's an individual, and they all have individual needs.

“You can't assume that everything is okay because you haven't heard something. You have to be a nurse leader. You have to be the initiator of the conversation, because these are your people. This is your team,” she says.

Hospitals and health systems need to put managers in position to succeed and to be able to check in on their staff. If nurse managers are overseeing too many people, it’s virtually impossible to regularly check in with them.

If nurse managers are supervising 90 or more direct reports, turnover rates among newer nurses reach up to 40%, according to a recent 

from The American Organization for Nursing Leadership and Laudio. Conversely, managers with fewer than 45 staff members saw turnover of 27%.

“Sometimes these nurse managers have upwards of 100 direct reports,” Zangerle says. “Nobody can keep up with that.”

And she says having enough managers to check in on staff is crucial for the well-being of nurses, especially at a time when health systems are struggling to keep them.

“That check-in is so important because it could mean the difference of somebody staying and somebody leaving. Because they feel appreciated if they get this check-in, they feel like they have somebody to talk to, that somebody has their back, that somebody is interested in their own professional development. And it's very important to have those check-ins,” Zangerle says.

Plus, nurse managers faced with managing up to 100 employees are going to be more prone to burnout and more at risk of leaving their job.

Zangerle says her organization is focused on how to retain nurse managers, and encouraging nurses to take on those important roles. She says nurses should look at being a manager as an attractive position.

“What we don't want is having those potential leaders who are looking at their current leaders saying, ‘I don't want that job,’” Zangerle says.

Plus, overwhelmed managers struggling with burnout can also pass that stress down onto their teams.

“Those feelings and the behaviors all trickle down to the whole staff, and then you have a toxic environment, which I think is something definitely that would have an impact on patient care and safety,” she says.

Many nurses aren’t getting help for their mental health. That needs to change.

Health systems continue to see shortages of nurses. Claire Zangerle, CEO of the American Organization for Nursing Leadership, offers insights on keeping nurses.

What hospitals must do to retain nurses and nurse managers

The Federal Trade Commission says it objects to Union Health’s planned acquisition of Terre Haute Regional Hospital, marking the second time the merger bid has rankled federal regulators.

 that it opposed the transaction. Facing some public opposition, 

Union Health and Terre Haute Regional paused their merger plans last November

, but then filed a revised proposal to come together in February.

But federal regulators said Monday that the new proposal contains the same problems as the initial consolidation plan. The FTC says if Union Health and Terre Haute Regional come together, it will lead to higher prices for consumers and workers will see lower wages. The FTC voted 4-0 to send comments outlining its objections to the Indiana Department of Health.

Clarke Edwards, acting director of the FTC’s Office of Policy Planning, said the revised Certificate of Public Advantage is still insufficient.

“This repackaged COPA application presents the same problems as before. Competition consistently results in better outcomes for patients and workers than consolidation subject to COPAs,” Edwards said in a statement. “The Indiana Department of Health should deny this attempt by Vigo County’s only two hospitals to eliminate competition and avoid antitrust review.”

Federal regulators note that Union Health has been trying to acquire the hospital for four years. In its 

 to Indiana’s health department, the FTC said the new proposal “presents little new information.”

“FTC Staff continues to doubt that the regulatory conditions imposed by the IN DOH would effectively mitigate the potential anticompetitive harms to patients in the Terre Haute area—both in the near term and in the decades to come. Instead, the proposed merger is likely to lead to higher costs and worse healthcare outcomes for Indiana consumers, as well as lower wage growth for hospital workers,” the FTC letter states.

When Union Health submitted its revised application to acquire Terre Haute Regional last month, the system said the deal would expand the level of healthcare services to residents in Wabash Valley. Union Health said the merger would lead to better care coordination, more specialty services, expanded population health initiatives, and more behavioral health options.

Steve Holman, the CEO of Union Health, wrote in 

 in the Indianapolis Star that the merger with Terre Haute would be best for the region.

“The merger is not merely a business transaction; it is a strategic effort to improve healthcare delivery in our community,” Holman wrote. “By combining resources and expertise, Union Health and Regional Hospital aim to expand services, enhance the quality of care, and ultimately improve health outcomes while maintaining cost efficiency for consumers.”

Terre Haute, a 278-bed hospital, is owned by HCA Healthcare, the nation’s largest for-profit hospital system. Union Health, a nonprofit system, operates its main hospital in Terre Haute, as well as a critical access hospital in Clinton, Indiana.

Zack Cooper, an associate professor at Yale University, has spoken out against the merger. In an interview with Chief Healthcare Executive® last fall, Cooper says the Union Health-Terre Haute merger would result in a local hospital market with no competitors. In addition to higher prices, Cooper said he’s concerned that the deal would lead to lower quality healthcare services.

“What we care about here is the reduction in competition,” Cooper said. “These are two competing hospitals in a fairly close geographic area. It would form a monopoly for local care. It would be the largest employer in the area. It's going to clearly benefit the merging hospitals. It's not going to benefit the local community.”

The FTC has generally raised concerns about hospitals using a state’s certificate of public advantage to come together. Regulators contend that such certification doesn’t allow for sufficient scrutiny, and 

the FTC has raised objections to other mergers and acquisitions under such certificates in other states

Union Health is still seeking to acquire Terre Haute Regional Hospital, but the plan continues to meet objections from federal regulators.

Baha Zeidan

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