Fractional Hiring

Finding The Developer in the Haystack

When a healthtech startup needed an Intersystems Cache developer — a skill so rare that a dozen candidates were already off-limits — Fraction found the right engineer in under two weeks.

Fractional Hiring Healthcare IT Developer Sourcing Case Study
Finding The Developer in the Haystack
TL;DR

A healthtech company needed a developer with Intersystems Cache and Epic Systems expertise — one of the rarest skill combinations in healthcare IT. Traditional recruiting was failing because qualified candidates either worked for competitors or were excluded. The fractional model solved it by offering flexible engagement instead of a full-time ask, achieving response rates 100x higher than conventional outreach.

5 Key Takeaways

Most engineering searches fail not because the developer doesn't exist, but because the recruiting approach can't reach them. Niche skills concentrate in specific employers, and those employers don't advertise their talent.

What makes hiring niche-skilled developers so difficult?

When a skill is rare, it lives in a small number of organizations — often just one or two employer types. Traditional job postings reach people who are actively looking. But developers with highly specialized knowledge are almost never actively looking. They are employed at the very organizations that trained them.

Adding an exclusion list — candidates you can't approach for competitive or legal reasons — narrows the already-thin pool further. Standard recruiting processes aren't built for this constraint. A headhunter working from a short list of known names hits walls immediately. A job posting on a general board gets no relevant responses. The search stalls not because the skill doesn't exist, but because the conventional channels don't reach where it lives.

Why is Intersystems Cache expertise so rare and where does it concentrate?

A healthtech startup came to Fraction with exactly this problem. They needed a developer with knowledge of Intersystems Cache — specifically Cache as used in an Epic Systems environment. Cache is built on MUMPS, a language that predates C and was developed at Massachusetts General Hospital in the 1960s. Intersystems took over the language and generalized it into a NoSQL object database.

Epic, the largest electronic health records company in the world, bases all of its systems on Cache. Developers who know how to work directly in Cache at the Epic level exist almost entirely at two places: Epic itself, or the large health systems running Epic. Our client added a further constraint: a list of a dozen known developers they could not contact due to non-compete agreements or prior interview processes.

Definition

Intersystems Cache — a high-performance object database built on MUMPS (Massachusetts General Hospital Utility Multi-Programming System), a language developed in the 1960s at Massachusetts General Hospital. Cache underpins Epic Systems, the dominant electronic medical records platform in the United States. Developers with direct Cache and Epic experience are trained almost exclusively at Epic or at large health systems that run it.

How did the fractional model unlock a hidden pool of candidates?

Fraction's approach was to canvas the full market — every developer working in the United States with Intersystems Cache experience — rather than working from a named shortlist. The fractional model made this practical. Understanding how fractional developer management works in practice makes clear why the ask matters: instead of inviting developers to leave their employer, fractional outreach invites them to take on part-time project work alongside their existing role.

That difference in the ask changes everything. A developer at a large health system is not going to leave a stable, well-compensated position to join an early-stage healthtech startup full-time. The risk calculus simply doesn't work. But taking on a part-time engagement that runs alongside their primary role — contributing evenings or weekends to a focused project — is a completely different conversation. The developer keeps their job, keeps their benefits, and adds interesting work and supplemental income. The barrier to saying yes is far lower.

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What response rates does fractional recruiting actually achieve?

The difference in response rates is not incremental — it is categorical. Traditional full-time recruiting to a passive audience generates roughly 0.5% response rates. Fraction's fractional outreach to the same audience generated approximately 50% responses — a 100x difference. Finding the right fractional work balance matters from the candidate's side too: part-time work that complements, rather than replaces, their primary income is a fundamentally different proposition.

When you reach a developer who has the exact skill you need and offer them a way to engage without leaving their current employer, many of them say yes. The ones who don't are usually restricted by explicit non-compete clauses — and even then, the wider canvassing means there are other qualified candidates available who aren't subject to those restrictions.

When is fractional the right approach for specialized technical hiring?

The fractional model is particularly well-suited to three types of hiring problems: skills that concentrate at large employers who outcompete startups for full-time talent; legacy or niche technologies where the developer pool is small and already employed; and situations where the work volume doesn't justify a full-time hire. The ethics of fractional work — particularly around non-compete clauses and disclosure — are worth understanding before structuring the engagement.

In this case, Fraction found a developer at a non-profit health system with the exact Cache and Epic experience needed, and the engagement started within a week. The client got senior-level expertise that would have been effectively unreachable through any conventional hiring process. The developer got a compelling part-time project that used a skill they rarely got to apply at full depth in their primary role. The fractional model made both outcomes possible — not despite the constraints, but because it was designed for exactly this kind of search.

Praveen Ghanta
Praveen Ghanta
CEO, Fraction

Praveen has spent 20 years building and scaling software companies. At HiddenLevers, which he founded and sold to Orion at 16x revenue, he ran a 52% pre-tax profit margin. At Fraction, he leads a team of senior engineers, designers, and growth operators who work embedded inside SaaS companies as fractional hires.

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Frequently Asked Questions

Why is Intersystems Cache so difficult to hire for?
Cache/MUMPS is a technology with an extremely small developer pool concentrated almost entirely at two employer types: Epic Systems and large healthcare systems that run Epic. Developers are not being trained on it outside those environments. The total addressable talent supply is both small and almost entirely employed — making traditional job postings largely ineffective.
How does fractional recruiting get higher response rates than traditional hiring?
Traditional recruiting asks candidates to leave their current job — a high-commitment ask most developers decline unless dissatisfied. Fractional recruiting asks for part-time work alongside their existing role. That lower barrier generates dramatically higher response rates. In Fraction's experience, fractional outreach achieves roughly 50% response rates compared to 0.5% for traditional full-time recruiting — a 100x difference.
Can a startup compete for specialized talent against larger organizations?
Through fractional engagement, yes. Large organizations have advantages in salary, benefits, and brand for full-time roles. But developers at enterprise companies are often willing to take on interesting part-time work they would never accept as a full-time move. Fractional removes the risk for the developer — they don't have to leave a stable employer — which makes a startup far more competitive for their attention.
What happens when you need a developer whose name is on an exclusion list?
By canvassing a much wider pool than traditional recruiting, you increase the odds of finding candidates who are not on the exclusion list but still have the relevant experience. Fraction's approach is to map the full addressable market — every developer with the relevant skill — not just the names already known to the client.
How quickly can a fractional developer engagement start?
In Fraction's experience, once a match is identified and screened, a fractional developer can typically start within a week. For the healthtech client in this case study, the full process — from identifying the candidate pool to first day on the project — took under two weeks.
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