A chief information officer of a Midwestern hospital network called in a top staffer with good news: Forget about that $50,000 salary, it's now $73,000. Just like that.
A Philadelphia provider network popped for an 18-month course on the latest Microsoft technology for 20 computer engineers, at $6,000 in tuition apiece -- a deal that locks up their services for at least 30 months.
A Detroit network not only increased its budget for hiring in-house information pros but also committed $6 million a year to hire outside contractors for long-term projects.
The demand for new healthcare information systems has created a bulging work list of implementations, upgradings and remedial retrofitting at healthcare organizations across the nation. That in turn has sent providers scurrying to find the professionals needed to build and run the information networks called for in many a strategic plan.
But finding the right people is only half the battle. Officers in the personnel wars recommend paying attention to those already among the ranks. "The key is not to recruit them but to keep them," says Stacy Griggs, a full-time human resources director for the information systems department at University of Pennsylvania Health System in Philadelphia.
The only thing worse than not attracting a good implementation team is losing team members in the middle of a key project, says Ward Keever, the Penn system's CIO.
The loss of a project leader or other essential staffers can disrupt project schedules and put an implementation behind schedule, Keever says. Plus, the provider is faced with finding someone with the credentials to fill a high-demand job in a tight market.
That's why Penn is spreading some money around to keep information staffers happy, committed and advancing in their careers. "I'd rather spend $1 to retain someone than $6 to go find someone," he says.
Paying the price. The first step to achieving retention goals is to offer a market-level salary and benefits. And in this area, chief executives might have to prepare themselves for a shock.
Meta Group, a Stamford, Conn.-based information technology research firm, cites U.S. Labor Department statistics forecasting that salaries in the information technology work force will be growing at a rate five to 10 times the national average.
The Labor Department says the average American worker is getting a 4% annual raise, but raises in information technology "soon will average 20% or more," according to a Meta Group report on staff retention.
And don't expect to stretch the payroll by getting computer-tech grads fresh out of college, says Dan Vogel, Meta Group's program director for healthcare. The number of computer software majors has decreased by 43% during the past 10 years. That's creating an inability to staff 200,000 new information technology jobs across all industries annually, Vogel says.
Major information system companies also are combing universities to offer jobs to top prospects a year or more before their scheduled graduation, he adds.
One skill-dependent giant, Cisco Systems, is trying to cultivate a work force much earlier than that. The San Jose, Calif.-based company specializing in the Internet has created an $18 million vocational high school program to teach information technology to entry-level students, Vogel says.
Tug of war. Anticipating market demand, healthcare information technology consulting firms and software services companies are creating implementation businesses offering expertise and staff contractually to providers lacking in-house talent.
But while those vendors are solving a problem, they're also creating one, says Vogel, because they're luring away some of the staffers whom providers are struggling to retain.
Unlike not-for-profit healthcare organizations, vendors can offer big pay raises, stock options and whatever else they have to dangle in front of seasoned project managers to bring them on board and get them working on the vendor's own bulging book of business, Vogel says.
Frustration about staff shortages and retention problems spilled into an annual survey of information professionals conducted late last month at the Healthcare Information and Management Systems Society convention in Orlando, Fla.
Recruitment and retention of quality staff topped a list of their highest priorities for next year (March 2, p. 24). Respondents also listed lack of adequate financial support as the biggest barrier to successful implementation of projects.
With information systems budgets at 2% to 3% of their total operating budgets, providers "are having a really hard time looking attractive" to both pro-spective computer pros and those already on staff, says Cynthia Spurr, president of HIMSS and corporate director of clinical systems management at Partners HealthCare System in Boston.
"Even if you train them thoroughly and bring them up, there's so much opportunity out there. . . . There are a lot of skills walking out the door," Spurr says.
It's gotten to the point that health networks want their top professionals to remain a best-kept secret. The CIO of the health system that raised a staffer's $50,000 salary to $73,000 didn't want to be identified, so as not to tip off the market that the system has someone so valuable on board.
Year 2000 crunch. The tug of war for essential staff is exacerbated by soaring personnel demand brought on by vulnerability to computer-date malfunctions inherent in representing the year 2000 in computer code (Feb. 17, 1997, p. 98).
For one thing, the sheer magnitude of searching for and fixing every potential glitch in every computer system will divert legions of project managers and specialized programmers from other implementations.
Providers are faced with tedious months of scouring internally for faulty coding but are counting on vendors to do their part in fixing faults within particular software systems. The dilemma: Providers and vendors are fighting over the same scarce supply of fixers, with the clock ticking for both.
Such crushing need already has driven up the price for programmers skilled in a code called COBOL. That's the venerable computer language in which most of the flaws are written.
Meta Group found, for example, that after only one year of seasoning, COBOL programmers hired for $30,000 at a large south-central U.S. multihospital system have been offered $50,000 for comparable positions with vendors. "People with a year's experience in healthcare are no longer considered green," Vogel says.
In addition to the year 2000 repair job, some hospitals starved for staff must nevertheless root for vendors to attract enough help to handle a spike in orders for new financial and patient-accounting systems between now and the year 2000.
Many provider organizations are running software that is past fixing and will not survive into the new millennium.
Budget strategy. To lock up their in-house talent, some observers say healthcare organizations will need to shake some money loose.
And the initiative will have to come from the top information officers, says Betsy Hersher, president of a Northbrook, Ill.-based healthcare recruiting firm.
"CIOs are beginning to go to the mat and say, `I've got to get my salaries up to an appropriate level so I can keep my people,' " Hersher says.
But given budget limitations, providers might have to redistribute payroll for maximum benefit.
At Rush-Presbyterian-St. Luke's Medical Center in Chicago, executives recently committed to identifying their best talent and paying them well. That means having fewer staffers, but quality is more important than quantity at this stage of the implementation game, says Patricia Skarulis, vice president and CIO.
"You're better off having those few who really know their stuff and hang on to them," Skarulis says.
Vogel of Meta Group says high-value employees must have an incentive to stay for long-term implementations in the face of short-term windfalls promised by vendors and consultant organizations (See chart).
"To prevent (information technology) departments from becoming a training ground with high turnover rates, they must create incentive programs geared toward the high-value employees and heavily backloaded toward project completion," a Meta Group report concludes.
Project managers and "top gun" programmers in high-demand areas are so important that CIOs must adjust pay and bonuses accordingly even at the risk of creating a financial "caste system" among information systems pros, the report says.
Money isn't everything. Amid all the big-bucks talk, however, a little bit of the right attention can go a long way. Information technology is a skill-driven field that's constantly on the march, and employees are more apt to stay at a place where they can grow and move up the career ladder, says Griggs of University of Pennsylvania Health System.
When he arrived at the system last year, a common lament among technical staffers was the lack of career mobility. Since then, the Penn system has revamped pay ranges to increase potential rewards based on skill levels. The Penn system also is monitoring individual skill improvement and bumping up salaries following extra training, Griggs says.
One help-desk employee, for example, completed training for a certain e-mail software, demonstrated his skills and received two pay raises totaling 25% over a 10-month period, Griggs says.
Penn also enrolled 20 engineers in a trade school to get them certified in Microsoft software techniques and skills, picking up their tuition of $5,995 apiece for the 18-month course. The only requirement was that they commit to a year at the system after completing the course.
"For $6,000, to keep them 21/2 years and give them added skill sets, that's a great benefit," Griggs says.
For some in the work force, job satisfaction can count as much as pay and advancement, and healthcare can marshal its mission of care and cure to attract technical staffers who want to make a difference.
For years, Brigham and Women's Hospital in Boston has been able to run a cutting-edge and renowned information systems department on 1% of the hospital's total operating budget, and so far it hasn't been starved for staff, says Mary Finlay, corporate director of information systems.
While market surveys make sure their salaries are competitive, the hospital also offers the prospect of supporting medical breakthroughs and staying on the leading edge of technology.
Because of that, Finlay says computer pros are motivated to sign on and stay on: "It's always been the environment and the chance to do really cool stuff."