Health IT leaders say the skill they can’t find isn’t AI or security alone, it’s someone fluent in both.
The job title doesn’t exist on most org charts yet. But two health system IT leaders who spoke with Becker’s point to the same kind of gap. Both describe a person fluent in artificial intelligence and in a second discipline that used to stand entirely on its own, whether that’s clinical operations or cybersecurity.
For James Wellman, vice president and CIO of Nathan Littauer Hospital & Nursing Home in Gloversville, N.Y., the gap became clear as the rural hospital began rolling out its own AI initiatives.
“That is already top of my mind as we have started implementing our AI initiatives. I have been working on this as we try to figure out what we need in the future,” Mr. Wellman said.
The role he’s struggled most to define, let alone find, is something like an AI solutions architect or clinical AI integration architect, someone who can bridge clinical operations, healthcare workflows, AI technology, data architecture, security and change management.
“Healthcare has plenty of IT professionals. We have very few people who understand both worlds deeply enough to deploy AI safely and effectively. This is compounded for us in rural health,” Mr. Wellman said.
The difficulty isn’t buying software, he said. Every AI deployment raises questions that sit at the boundary of IT and clinical practice. Is the underlying data trustworthy? Does the tool integrate with the EHR? Will providers actually use it? Is it HIPAA compliant? Does it introduce bias? Can it be audited? Will it improve outcomes? Does it create new liability? Answering those questions requires fluency across clinical workflows, EHR architecture, HL7/FHIR, data governance, cybersecurity, AI models, regulatory requirements, project management and change management, not any single one of them in isolation.
“Finding one person with all those skills is exceptionally difficult and when/if you do, then be prepared to compensate them accordingly,” Mr. Wellman said.
At Atlantic Health System in Morristown, N.J., Sunil Dadlani, executive vice president and chief information, digital and AI officer, is watching a related convergence play out, this one at the intersection of AI and security rather than AI and clinical operations.
“The hardest healthcare IT role to fill in 2026 is the hybrid AI/cybersecurity security engineer, someone who can secure clinical systems and govern AI risk, while understanding HIPAA, medical devices, and clinical uptime constraints,” Mr. Dadlani said.
The AI angle is now central to the search, he said. Demand has shifted toward people who can operationalize AI at scale, govern its risks and use it effectively without trusting it blindly, including governance and red-team roles that didn’t exist on health system org charts three years ago.
“In addition, hospitals lose these people to Amazon, Google, and well-funded health tech startups that don’t carry hospital-system overhead, a pay gap most health systems can’t close,” Mr. Dadlani said.
That competition cuts both ways this year. As big tech companies cut jobs by the thousands in 2026, citing AI investment and automation, some of that same talent has started flowing toward health systems rather than away from them. Lisa Stump, executive vice president and chief digital information officer of New York City-based Mount Sinai Health System, told Becker’s in June that the layoffs have widened her hiring pool for the same skill sets Mr. Dadlani described: cloud, cybersecurity, data engineering and AI/machine learning.
Neither Mr. Wellman’s rural hospital nor Mr. Dadlani’s multi-hospital system is describing the same job. But both are describing a similar problem. In both accounts, the hardest position to fill in health IT isn’t a traditional specialty. It’s a hybrid one that combines domains health systems used to hire for separately, and it doesn’t yet have a settled title or a standard job description, and in many cases still can’t compete on pay with well-funded tech companies, even now that some of that talent is easier to find.
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