Microsoft’s Nuance Healthcare executive vice president & general manager on AI’s role in transforming patient care

In this episode of the Heidrick & Struggles Leadership Podcast, Heidrick & Struggles’ Josh Clarke speaks to Diana Nole, the executive vice president and general manager for Nuance's healthcare division. Nuance, now a Microsoft Cloud and AI company, created the voice recognition space more than 20 years ago and continues to be a pioneer and leader in conversational AI innovation. Nole shares how differentiated experiences helped her grow as a leader and which leadership capabilities have helped her succeed, including curiosity, risk-taking, pivoting, and decisiveness. She also shares how she thinks about balancing the need for innovation with the need for stability and offers advice to aspiring board members and shares how being a board director has made her a better leader.

Below is a full transcript of the episode, which has been edited for clarity.

Welcome to The Heidrick & Struggles Leadership Podcast. Heidrick is the premier global provider of senior-level executive search and leadership consulting services. Diversity and inclusion, leading through tumultuous times, and building thriving teams and organizations are among the core issues we talk with leaders about every day, including in our podcasts. Thank you for joining the conversation. 

Joshua Clarke: Hi, I'm Josh Clark, a partner in Hedrick & Struggles’ Boston office and global leader of our health tech practice. Today, I'm thrilled to be joined by Diana Nole, executive vice president and general manager for Nuance’s healthcare division. Nuance, now a Microsoft Cloud and AI company, created the voice recognition space more than 20 years ago and continues to be a pioneer and leader in conversational AI innovation.

Nuance works with thousands of organizations globally across healthcare, financial services, telecommunications, government, and retail. Prior to Nuance, Diana was the chief executive officer at Wolters Kluwer, Health Division, and president of digital medical solutions at Carestream Health. 

Diana, thanks for joining us today.

Diana Nole: It's great to be here. 

Joshua Clarke: Great. Well, jumping in here, Diana, throughout your career, you've worked in different environments, including large public conglomerates, private equity–backed companies, and standalone technology businesses. How have these differentiated experiences helped you develop as a leader, and which leadership capabilities do you think helped you the most as you navigated across all of these environs?

Diana Nole: Definitely; differentiated experiences help a leader grow. It's allowed me to leverage skills that I've had but continue to evolve and mature them to new and different experiences. For example, Carestream was my first divisional president role, and it was under a corporate carveout structure. I was actually part of the executive team that set up corporate functions, policies, infrastructure. This built upon my own experience, having worked in almost every business function prior to that, but at a very different scale of decisions, organizational set up, and even more. When I went to Wolters Kluwer, it was a publicly traded company with a history that goes back over a hundred years, so a very established company. But it provided me new experiences, such as working for a company headquartered in Europe, and a company that continues to transform itself specific to the healthcare business. I was leading that growth, and transformation occurred heavily through strategic acquisitions. 

And one of the key mandates that I was brought in to do was to unlock the full benefits of those acquisitions and to scale them globally, integrating them with the right divisional structure in the areas of emerging technology, cross-solution marketing, and global expertise. [That] required bringing in new talent to support the great talent already in the business. 

And then Nuance brought additional experiences—most uniquely, the skills associated with being acquired by a company the size of Microsoft. Microsoft has a very similar culture to Nuance, but it also operates differently. As you can imagine, it's an advanced global technology leader in the market. Beyond this though, it has come at a time of great pressure on healthcare. So prioritizing where to spend time and resources has shifted more in the last years than previously. Healthcare has typically not moved as fast, and right now there's so much change. As a market leader, it's important to lead and foster that change. Across all of these [roles], I've had the opportunity to interact with the board and the investor community, but each of those were at a different and unique experience that did help me grow as an executive.

And then when I think about the leadership capabilities that I've had to use to navigate across all of these, I would first start with curiosity—a strong interest in learning. I've always had a deep interest in learning about the people, the products, our customers, our competition. So, using every day to learn something new has helped me lead better and make better decisions.

I think, secondly, being able to adjust quickly, adapt with speed. Sometimes people say to pivot, being decisive. The first capability underpins this one. So, learning and curiosity. But if you continue to learn, you must also commit to continuing to pivot and grow. So, nothing ever goes to plan. Some things go better, and the organization needs to be nimble and shifting toward that. Other things don't go as planned so quickly. Assessing how to get back to plan is important. 

And then, finally, I would say collaboration and communications. As a leader, so much of our role is about helping the organizational team come together. Being able to communicate regularly, especially in what now is a very remote work environment, is critical. The way we speak, the words we use, are critically important. It's something I continue to work on myself and with my leaders. 

Joshua Clarke: That's great. And I want to pick up on one of the points you mentioned, Diana. Thinking about the time with Nuance and now Microsoft—and I'm sure this is also applicable to many other roles and companies you've been at—how do you balance the need for innovation and disruption while also maintaining stability, especially in the context of the market dynamics we're dealing with today? Some companies are dealing with cost-cutting, are managing margins more carefully. How do you strike that balance in the work that you're doing today? 

Diana Nole: Great question. It's always important, in my experience, to fund innovation at all times, challenging times or prosperous times, however, you want to define it. Knowing the specific economic climate will just guide you on to approach that investment balance, but you always have to do it. I really lean on a grounded principle of listening and being elbow-to-elbow with customers. An organization should never sacrifice doing that. It's an easy, simple thing to do, but allowing our organization to spend time out with customers is very helpful. It informs us on where money is still being spent, or what the greatest need is to prioritize our investments, for example, patient engagement and telehealth solutions in the healthcare industry. Were very critical at the start of Covid and continue to be. However, we also saw the rise of need for solutions for nursing. Given the great resignation, burnout and shortages are top of mind. So during times of cost-cutting, spending time on where you can delay some costs but also still invest, I think, is critically important.

I would say my thinking on the right balance has not shifted. I would say what I do is look for leaders and the organization to just continue to build in as much flexibility as they can because I believe that that's truly a key success factor. 

Joshua Clarke: That's great. Thank you. You recently wrote an excellent blog on three trends that will define the future of healthcare and the role AI will play in helping organizations withstand increasing pressures and to move forward with confidence. You wrote that, with innovative AI solutions, organizations can make a meaningful impact in three key areas, as you've just mentioned, collaborative care, tech-enabled workforce and health equity. Why do you consider these to be the greatest opportunities at this point? 

Diana Nole: First, it's important to appreciate the current state of the healthcare provider industry. Clinician burnout is a major issue. The American Medical Association reports that for every one hour of patient care, two hours are actually spent on administrative tasks. And we are estimated to have physician shortages of close to 100,000 by 2025. And, at the same time, the industry has really had what they call the quintuple aim—it used to be called the quadruple aim—and that's really around how we can improve the patient experience, the physician experience, improve the quality of care and access to care, while also reducing costs. That's a big thing that we're trying to do, and if we think about where and how care will be provided, it is going to continue to change, just like it did in Covid. It will not always happen right in an exam room or in a hospital. And so, when you think about how the organization needs to change, to adapt to that, talent really needs to think about the solutions and the organizations that can address this. We also need to consider, with all these shortages that our customers are not going to have the time. And I think it's very similar in other industries in terms of how you adopt technology. You've got to be able to adopt it and get ready to go. So, the types of talent that we look for may be more oriented toward those that have had experience in consumer applications, And also, the connections and leveraging all the different connectivity tools that we have, that we use in our day-to-day lives, those types of things can also be integrated into, actually, business applications. And so the types of talent that we think about that can help us unlock some of these opportunities is really at the forefront of some of our talent strategies. 

Joshua Clarke: And just to follow up on that, it's something that we've certainly seen over the years in the health tech space, this pendulum swing, if you will, between sector, industry experience, and functional domain. So, you've just brought up the consumer aspect of it—consumer versus enterprise. I'm curious, how are you thinking about that dynamic within your team and organization? How do you balance industry experience with functional expertise, for example? 

Diana Nole: Well, first, talent strategy continues to be top of mind, especially over these last several years. You really need to think about the skill sets you’ll need now and into the future, and what those future employees want in terms of their own career experience. So, we continually discuss, on a regular basis, even if it's opportunistic, how we will actually invest in the development of our own talent, but then also [talking about] hiring in, when you think about industry versus functional expertise, certainly industry experience in healthcare is important. It's a complex market to learn. I've been in it for 15 years and I’m still learning. But industry experience, for example, directly in the provider space, is not always required. It really comes down to the needs of the role. It might need more global experience or applications experience, experience in more B2C versus B2B, or if at the time you need operational strength or start-up-type skills. Overall, the talent strategy that I've always leveraged is to look at the existing skills and experiences and then look for diversity of background to match to the current role and how can it augment what we already have and help us to grow into the future. 

Joshua Clarke: Thank you, Diana. I want to shift gears a bit here and touch upon your board of director experience as well. Currently, you sit on the board of Exactech, a company that develops and produces innovative implants, instruments, and technologies for joint replacement. How does your director role influence you as an executive and vice versa? How does your current operating executive role influence you as a board member?

Diana Nole: Board experience is a great way to further career development and evolution. You have access to other great leaders, other complex challenges, specifically. For example, when we were going through Covid and trying to navigate that for Nuance, I was able to learn how Exactech was navigating that, and also to bring things that we were doing at Nuance that might be applicable to Exactech as well.

I always look for boards where I can contribute, but where I can also learn. It provides me a view into the industry, but from a different viewpoint. And so, for example, at Exactech, knowing how that particular space of the market orthopedics was going through Covid or going through its challenges helps to inform how I might think about things back at Nuance and vice versa.

Joshua Clarke: What advice would you have for someone aspiring to get on their first board? What have you learned in your experience about best practices? 

Diana Nole: First, I would think about what the right board is for the person. So, think about where they could bring experiences that could augment the boardroom and think about ideal companies that might be in those spaces, and perhaps reach out through networks to find out more about how they think about their boards and learn about what's important to them. Also maybe invest in your own training. There are a lot of different networks out there, different organizations. I'm actually in the Corporate Women Directors organization. It will help you network and learn from others who have been on boards, are going on boards, and it can help to think about how to look at that journey for you, personally.

Joshua Clarke: One final question as we begin to bring this conversation to a close. Looking ahead, what specific leadership capabilities and skill sets will be most important as you continue to help Nuance meet its strategic goals? 

Diana Nole: I'd probably go back to where we started: curiosity and the ability to learn quickly. The world of technology is evolving so fast, it's an absolute must to be able to learn quickly and understand it. At the same time, being thoughtful in risk-taking, being able to pivot, and being able to be decisive and take action are also critically important because of the competitive landscapes that we all work within as leaders. And then, finally, the ability to bring broad teamwork internally, creating but also leveraging external partnerships, relationships, your networks, or someone that is highly resourceful, [these] will also prove to be very successful. 

Joshua Clarke: Diana, thank you for making the time to speak with us today. 

Diana Nole: It was great to be here.

Thanks for listening to The Heidrick & Struggles Leadership Podcast. To make sure you don't miss more future-shaping ideas and conversations, please subscribe to our channel on the podcast app. And if you're listening via Linked In, Twitter, or YouTube, why not share this with your connections? Until next time. 

About the interviewer

Joshua Clarke (jclarke@heidrick.com) is a partner in Heidrick & Struggles’ Boston office and a member of the global Technology Practice.