Stacy Griggs had just plopped down for the train ride home when he noticed the guy in front of him had his newspaper open to a page of computer-career ads.
"You looking for a job?" Griggs piped up.
Griggs' job at the University of Pennsylvania Health System is to spend long days looking under every stone for a scarce resource -- information systems professionals -- and he wasn't about to leave that stone unturned.
He is not alone in his search.
As healthcare organizations bulk up for the information age, they're finding it takes more than multimillion-dollar purchases of software systems and telecommunications. It also takes people with new types of skills to implement new breeds of information systems (Feb. 23, p. 70).
And it still takes people with "old" types of skills to keep vintage systems from turning on their masters.
Also needed are people with the insight to integrate all the expensive pieces into a complex network -- one that exploits the combined potential of all purchases and serves the wider picture of strategic and operational interests.
The problem is, there aren't enough people out there. And those in most demand are always being hunted down with offers to work somewhere else at higher pay and more perks, industry observers say.
To make things worse, the shortage isn't just in healthcare but in every industry that relies on information technology, from automakers to banks to Wall Street brokerage firms. Add to that the consultants, computer software vendors and other suppliers to each industry.
A number of executives contacted by MODERN HEALTHCARE compare the problem to the industrywide nursing shortages of the late 1980s and early 1990s. Healthcare organizations already are trotting out signing bonuses, finder fees and other incentives that became common to lure caregivers. Griggs, however, said the comparison understates the case.
"I think it's a bigger problem than the nursing shortage," he said, noting that back then, "other industries weren't hiring nurses."
Universal shortages. A U.S. Department of Commerce report issued last year estimated the nation's companies will need more than 1 million new computer professionals in the next seven years.
About 200,000 information-technology jobs will go unfilled during the next three years, according to a report by the Meta Group, a Stamford, Conn.-based research and consulting company. No specific figures were available for the healthcare industry.
The extent of the shortage was enough for CIO, a magazine for chief information officers, to devote its entire Jan. 1 issue to framing the crisis and suggesting solutions to recruit and retain computer pros. Its survey of 316 U.S. companies set the average staff turnover at 14.5%.
That demand outside healthcare makes it more difficult for hospitals to match offers against industries with deeper pockets.
Wei-Tih Cheng, vice president of information systems at Memorial Sloan-Kettering Cancer Center in New York, remembers making an offer last summer to a top pro he needed to lead a technical team developing a clinical information system, only to be outbid. "We had to compete against Wall Street, and we lost out to them."
The same wider competition complicates hiring for Thomas McNulty, chief financial officer of Henry Ford Health System. "Detroit is a technical town -- we build cars," he said.
The Big Three automakers not only soak up a lot of the talent pool; they also create a parallel demand for computer-driven supply industries, from robotics to computer-assisted design and manufacturing. As a result, Detroit is "chock-full of high-tech companies," McNulty said.
But because the same skills are needed from industry to industry, healthcare can lure people in just as easily as lose them, said Ward Keever, CIO at the University of Pennsylvania Health System.
Cheng said people on his staff have been hired from advertising agencies, legal firms and banking institutions. "And we've lost people to those industries also."
A significant need, Keever said, is for technical experts such as network managers or whizzes at working with certain operating systems. They're "high-priced, hard to find, worth their weight in gold but don't need to know healthcare."
Healthcare's woes. Partly because healthcare is so specialized, CIOs and others who hire computer pros have looked for prospects within the industry who know about delivering healthcare information and services.
In today's market, that means raiding the staffs of other providers, trading employees back and forth, said Betsy Hersher, president of her own Northbrook, Ill.-based healthcare recruiting firm. Executives "don't know how to recruit them in other industries," she said.
That will have to change if the proliferating demand for information systems employees is to be met, she said. "Staffing has risen way up there as one of the absolute top priorities" of healthcare information systems operations, Hersher said.
The main reason for the demand is that integrated delivery systems are getting more complex, with many new organizations that have to be connected and coordinated with multiple software applications, she said. "All of these are absolutely new applications that they didn't have to deal with two years ago."
Information technology has enjoyed a spurt of innovation in the past several years to boost the power and latitude of information systems for such complex organizations, but those innovations have created even more need for new skills.
And just as CIOs are absorbing those hits, along comes an unexpected personnel-intensive project affecting the computer universe: the search through older systems and devices to identify, correct and test changes in date-related computer code that won't be fit to function in the year 2000 (Feb. 17, 1997, p. 98).
The year-2000 problem makes prized finds of employees skilled in the computer systems of yesteryear.
Recruiting battle. In such a high-demand market, providers are putting all hands on deck to scout for recruits. A number of providers are publicizing bonuses of up to $1,000 for employees who refer prospects.
That's the sum paid to employees of Sloan-Kettering if the person they refer is hired and sticks around past three months, Cheng said. Even with that incentive, "I personally don't think that's enough to fill certain positions that I have," he said.
The University of Pittsburgh Medical Center Health System is offering a $1,000 "reward" paid six months after the referred candidate is hired, provided that both employees are still with the system.
UPMC punctuated the initiative with more than 12,000 fliers distributed throughout UPMC's health system as well as a news release saying the information services division has about 100 openings to be filled. The division has 400 employees overseeing all computer-related operations.
Across the state in Philadelphia, the Penn health system pays a $750 finder's fee with no time period attached, said Keever, who joined the system in December 1996 as CIO following a long tenure at the Medical Center of Delaware in Wilmington.
Faced with rebuilding and greatly expanding the computer capabilities at Penn, Keever said he realized right away that "a dedicated recruiter was an absolute must" for the information systems department. About nine months ago, he hired Griggs away from the Medical Center of Delaware, where he also had found his top assistants.
Griggs officially reports to the human resources department "but physically sits next to me," said Keever. The tally so far: 51 new hires in nine months. Only two, Keever adds, came via an outside recruiting agency, which may charge a third of an employee's first-year salary.
Wide-angle vision. Besides earning his keep, the Penn recruiter has demonstrated resourcefulness in a tight market by looking for promising people in atypical places. Successful recruits in hard-to-fill jobs have included a former scuba-diving instructor, a college dropout, a training manager at a juvenile detention facility and a clarinet player.
The scuba teacher had information systems experience and kept his technical expertise sharp by, among other things, operating a hyperbaric chamber to treat divers for the bends, a condition brought on by water pressure differences when returning to the surface.
Griggs found out about the instructor through his wife, who interviewed for a job at Penn health system last year.
The college dropout was doing just fine as a "Webmaster" for the university's veterinary hospital. Griggs hired him for the same type of position with the Penn health system.
The woman hired as training manager for computer users had built a reputation getting ideas across to a tough crowd: minors detained in the Delaware juvenile prison system, where she taught courses for a high school equivalency degree.
A clerk in the patient-registration department at Hospital of the University of Pennsylvania turned out to be a good hire as a junior-level Windows NT administrator, which involves meshing the work of personal computers with processing computers called servers.
It turns out he had a bachelor's degree in music and was eight credits short of a master's. "A lot of people who are from musical backgrounds can adapt well to technical tasks," Griggs said. "Just try reading music."
But the clarinetist also had a great personality and a great attitude, which is prized at Penn, he said.
Keever said he has four criteria to judge prospects:
* The right personality, a self-starter who is also a team player.
* Demonstrated ability to complete work on time and under budget.
* Experience in the computer applications being implemented.
* Technical expertise.
"You're not going to get aces in all four suits, but I'm going to demand high cards in the first two," he said. And that has meant being patient even though Keever still needs to hire at least 30 more staffers.
Though the searches have been far and wide, "we've turned down as many as we've hired," he said. The guy on the train, by the way, was one prospect who got an interview but wasn't hired.