HIStalk Interviews Drew Madden, President, Nordic Consulting

Drew Madden is president of Nordic Consulting of Madison, WI.

Tell me about yourself and the company.

I have 11 years of EHR experience. I’ve done everything from “roll up your sleeves, build the system” to project management and business development and now to helping run things here at Nordic.

I started my career at Cerner Corporation and then moved on to Epic consulting. I always tell people I felt like I was drinking Pepsi for four straight years and wanted to try a can of Coke — I was intrigued by the other big vendor out there. The company I was working for was ultimately acquired by Ingenix Consulting. I spent some time there as an Epic implementer and business development person until I joined Nordic.

When I met [Nordic CEO and founder] Mark Bakken, the light bulb went off. It was the right place. It was the right time. It was the right culture and vibe that I would have been looking for as a consultant and what I think a lot of consultants are looking for.

It must be interesting running a consulting company right in Epic’s back yard and with all the connections I imagine most of the employees have with Epic. What’s that like?

It’s really pretty good. Only 30 percent of our employees live in Madison. One of our differentiators is certainly being in Madison, but we end up finding a lot of people who worked at Epic and lived in Madison, but life got in the way. Epic requires people to live in Madison in order to work at Epic. They do a great job of finding the best and brightest people in the industry, but some of them want to move back closer to home when they start having kids or their spouse wants to do something different. But like myself, a lot of them still want to be in the EHR area.

They are super excited to be able to continue working on Epic, and ultimately our goals are very much in line with Epic. We want customers to get the most value out of their Epic system. We want to make sure they’re using it in an efficient manner and make sure that we can help do that.

Is it difficult to stay in Epic’s good graces as a consulting firm?

Mark, who started Nordic, started two Microsoft consulting companies. He has his own history and experience with the way Microsoft worked with consultants and consulting companies, so it’s different than what Mark was used to. But I think they do have channels with people that you can communicate with. 

We preach transparency to our employees. That’s part of our selling point. I think if you’re open and honest it’s not difficult to work with Epic. We’ve found a way where I think they recognize the value we can bring to a project when the time comes. Our relationship is really solid.

A lot of what makes consulting companies successful is their culture that they instill with their employees.  Epic folks are used to the culture there. Does that spill over into Nordic’s culture? How do you manage that when you have employees whose first job was working for Epic?

Two-thirds of our employees used to work at Epic. The other third have like an IT or clinical background. We feel like that’s a good mix.

We take a lot of time to get to know the people that we interview. We currently don’t have any recruiters. We have a couple of people who schedule interviews with the inbound interest at Nordic. We take a different approach. We don’t do LinkedIn e-mails and that kind of stuff. I always joke and say that I still get invitations to work as a Cerner consultant based on my LinkedIn profile, but you wouldn’t want me implementing Cerner. We take a different approach and try to get to know the people.

For the first couple of years at Nordic, I think I talked with almost every single consultant, up until we got to maybe 120 or 125. As we scaled, we made sure that we had people that really understood Epic that were talking with the candidates. To a certain extent even over the phone they feel the camaraderie, the secret handshake so to speak, that this person on the other end really knows Epic. We get a lot of respect and excitement from that.

Epic talent is in short supply. How difficult is it to stand out among all the other places they could work?

The secret is focusing on their needs. Our average consultant could probably get a job at five other places in 48 hours, so we’re trying to understand their needs while we’re understanding our clients’ needs. A lot of the work we do is trying to put that puzzle together. It doesn’t always fit right out of the box and intuitively, but we spend a lot of the time trying to make sure that our consultants are in the right role and they’re happy. 

We always say if you have a happy consultant, most likely you’re going to have a happy client. The caliber of people we have here is, I would say, second to none. It’s certainly better than any other organization I’ve ever worked for. If you focus on making sure that your consultants are happy — and that doesn’t always mean giving them exactly what they want, but helping them see that the partnership between Nordic, the individual consultant and the client has to work for all three parties – we spend a lot of time trying to make sure that happens.

What does the staffing curve look like in comparing an Epic implementation to go-live support versus post-live support and optimization. Are clients surprised by the ongoing needs?

Some of our clients probably are surprised by that. I think it’s a byproduct of a tight deadline for an implementation. You do everything possible to meet that deadline and it eventually means that you probably gave up a few things that you wanted. You decide you’ll circle back and get to them post implementation.

We’ve created the Summit series of post-live solutions. The next wave we want to be at the front of is to circle back with clients and do what I would call true optimization. Not just one-to-one staff augmentation and consulting, but more of packaged offerings to go in and do quick assessments on the current state of the Epic implementation or the Epic install is and listen to the client and understanding where they want to go with it. Then do a gap analysis and help them figure out how they get from A to B. We’ve already had a lot of success work with a few customers that had been live for – one in particular has been live for 10 years — but we were able to flesh out 30 months’ worth of potential work they could do to get a little bit more out of their EMR, which was exciting.

Nordic is number one in KLAS among Epic consulting firms. Why do you think that’s the case?

We talk about the fact that not all certifications are created equal. Our consultants are well positioned to really be different. We’ve been told by our clients a lot that a Nordic consultant is different — the way they run a meeting, the way they deliver, the way they’re able to start and hit the ground and have a big impact right away.

I think a part of is that two-thirds of our employees that are former Epic. Epic does a phenomenal job of zeroing in on top talent. At Cerner, they recruited much more from – I was an engineer, my background – so engineering and computer science. Whereas Epic does a fantastic job of looking at the individual. Some of the smartest people I ever worked with at Epic have been zoology majors or music majors, but Epic somehow identifies that recipe for success. Those types of people flourish in the client opportunity. Some of it is again our view of trying to make it a partnership between the client, the consultant, and Nordic. If you can do that, then I everybody feels like they’re getting a fair and equitable deal, which has been successful for us.

Epic doesn’t like people with experience very much — they would rather train somebody who doesn’t have any background than retrain somebody who does. Does the selection process that put them at Epic make them good candidates to work other places?

I think so.  One of the ways that our consultants stand out is they have probably seen between five and 10 implementations. For any given Epic module, they saw a customer do it this way, that way, and three other ways. At last count, our consultants had worked with 240 of Epic’s total client base of around 290. For us to be able to pull from all that data, from all those best practices, and understand the gaps between where a client started and where they want to go … that gives us that extra advantage.

Which areas of specialization or which Epic certifications are the hardest to find or are in the most demand?

Some of that is always driven by what you have. We have almost 100 consultants that are certified in Epic’s inpatient orders and clindoc modules. We have probably 70 in ambulatory and 50 in OpTime. Rev cycle, we have less certified consultants there. That probably has a lot to do with as you look at organizations that maybe are tightening things down financially having a rev cycle person who can come in and help out. There’s a premium on that.

I also think some of the new emerging Epic applications – Cogito, which is the new umbrella reporting application, as well as Willow Ambulatory … we’re fielding more requests from Beaker, the lab module, as more and more clients move that direction.

Beaker follows the typical Epic model where it starts out as being clearly labeled as not ready, but then moves up the food chain. Are there other modules that you see them bringing out or that you’ve heard about?

We don’t really have that visibility. I might take that question and go in a little bit at different direction. I think one of the up and coming modules — more of a methodology than a module – is Community Connect, Epic’s methodology around implementing Epic to reach out to affiliate physician groups or critical access hospitals. It starts to answer the question of how do you offer Epic to areas or organizations that may not otherwise be able to afford, but can work in conjunction with an existing Epic customer in order to have access to an Epic EMR whether they’re acquired by the hospital or not? It’s offered in both capacities. 

We were recently credentialed as one of four Community Connect consulting firms by Epic, which means that we’ve gone through a successful install and that Epic was involved in making sure things went well. As as consolidation happens across healthcare, that will become more and more a need in the industry.

How do you see your business changing as the Epic business changes?

I mentioned the Summit series of post-live solutions. We’ve broken that down into four areas that we think the industry will go and needs to go.

One is optimization. The second is helping customers get the full utility of the Epic upgrade that they take on a one- to two-year basis. We’ve heard from a lot of our customers that doing the upgrade in addition to all of the daily support types of things just becomes … you end up maybe not doing either of them at your level best. That’s another area that we’re looking at, from a command center, sort of a NASA Mission Control, to be able to help multiple customers with upgrades and help them be successful in that area.

The third area is data and analytics. We know ourselves well enough to know we’re not going to create a reporting tool that is going to wow anybody, so that will most likely just be us in trying to be certified industry experts in Cogito and making sure that we can be at the forefront of that as clients have needs.

The last one is ongoing support. What we’ve heard from clients is often they’re left having to choose between, am I going to go out and optimize and circle back and get more efficiency out of the system, or do I just need to keep it running, but I’m having a hard time doing both? In the case where a client wants to use their staff to do some optimization or to run the upgrade, we have the ability, potentially on a remote basis, which could lower the cost of maintaining a system due the ongoing support for the Epic system.