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HIStalk Interviews Shane Adams, CEO, Sagacious Consultants

February 17, 2014 Interviews 14 Comments

Shane Adams is Founder and CEO of Sagacious Consultants of Lenexa, KS.


Tell me about yourself and the company.

I have to start by giving Epic a lot of credit. It is where I met my wife, but also was the catalyst for starting my company, Sagacious Consultants. They do a lot of things exceptionally well. I wanted to take that and apply it to the consulting industry. 

We focus on our culture and treating everyone like family. I don’t just say that because both of my brothers and my wife works with me, but we put our employees first and they put our clients first. In turn, both our employees and our clients are number one.


Epic has a strong reputation for its culture, which is geared around the demographic of employees they hire. Do you have to compete with that or can you take what you learned from Epic and extend it?

No, I don’t think we compete with that much. They obviously have a lot of great benefits. Some of the benefits we offer are extensions of what Epic offered. We took the things they did well and we tried to do even better. We took the things that maybe we didn’t think were the best for our culture and we flipped those and thought of some new things we could do.


What’s the secret to getting and keeping the best quality Epic certified and experienced people when everyone is looking for them?

We have a team of people that focuses on retention. I worked at Epic. My wife worked at Epic. Our first employees were friends of ours that worked at Epic. It’s really building a team of A players. 

When we recruit people, they know we’re number one in KLAS and they know we have an amazing culture. They want to be a part of that. They want that work-life balance that we’re able to offer. Frankly, a lot of the other firms out there are just after making the difference between their bill rate and the rate they pay their consultants.


What does the Epic consulting market look like and how is it changing?

We see a lot of the market moving from simple staff augmentation to more strategic consulting services. With all the federal stimulus money over the past several years … that was money that was being thrown at these organizations to implement Epic and other EMRs as quickly as possible. 

Now since some of that money is a little bit harder to obtain, organizations are using their own money. They need to see an ROI out of that. They’re now just trying to realize the benefits of an EMR system and squeeze out every dollar that they can. A lot more of our focus is moving from staff augmentation to realizing those benefits through efficiencies, through cost savings, and better use of the system.


Do you think Epic itself will run into a more mature market where the implementation work will taper off and optimization will be the most-demanded service?

I see two things happening. Domestically here within the US, I think the services for the clients already live on Epic will be more the maturing type of client for Epic. But there’s a big market for the smaller organizations, the ones where Epic is indirectly expending via their Connect model. We’ve been getting a lot of interest from smaller organizations who are looking to either partner with a bigger institution to obtain Epic or we’ve been working directly with an organization that has Epic to serve as a vendor themselves to extend to these smaller community hospitals their Epic solution. 

The second part is overseas. There’s still not much market penetration for EMRs. I believe that’s where Epic’s major focus is going to be in the coming decade.


What’s the market pressure been on consulting rates over the last year or two?

I would say they’ve been fairly stable. There is definitely an influx of consultants, so there’s more supply there. But there is also an uptick in demand over the past couple years. Overall, we’ve seen rates stabilize and we think they’ll probably be in this spot for at least the foreseeable future.


Epic limits the consultant supply by who it certifies and by its non-compete agreements. Can they turn out enough supply to meet the demand?

I think they can. There has been an uptick in supply. Epic is getting bigger, therefore there’s more certified people. But there’s also some people with a little bit lower of a skill set who may be credentialed or just have experience. We’ve been seeing a lot of those people turning into consultants. Initially, those are putting downward pressure on the rates. But I believe over the past year or two, clients are starting to realize what it means to have somebody who has that industry knowledge and that Epic certification, that Epic experience.

Over the past couple years, KLAS has noticed that clients are now more interested in engaging with consulting firms that have that direct Epic experience, not just generalists out there. The consultant’s experience really does make a difference.


What’s your reaction to Epic going into consulting?

That’s been something I’ve talked with Epic about over the past several months. They’ve done it on and off over the past few years. 

I believe Epic is most focused on the proliferation of their software. They’re most focused with getting Epic out in as many hands as possible. I like to think of it similar to the Google approach — getting the Android platform out to as many mobile phone users as possible. Because what they’re really interested in is their software and the licensing fees, just like Google is with their ad revenue. 

Epic’s interest and our interests are very aligned. All we do is Epic, so we want Epic to remain the best EMR out there and that’s Epic’s same interest. If Epic were to jump into the consulting, I think it would be more of a partnership with firms like us than a direct competition.


They haven’t said why they’re doing it, but it sounds like one motivation is that they are losing people who quit, sit out their non-compete, and then make more money by going to work for a consulting company. Do you think that will limit your supply of quality candidates?

No, I don’t, for the simple fact of, if we were to just recruit half a percent of the people that leave Epic, we would still be growing like crazy. There are just so many people that have that experience that I don’t think that will limit our growth. I think that the people that are looking to leave Epic, it’s for a number of reasons. The majority of people do not leave Epic to become a consultant.


What do they do after they leave?

I would say the majority of people who leave Epic get into another industry. As you know, Epic hires most of their people directly out of college. They hire without discrimination towards a certain degree. The people who join Epic have various backgrounds. 

Epic’s a great point to get your feet wet in the professional world and use it to launch a career into whatever you might decide to pursue, whether that’s going back to school to get your master’s degree or whether that’s going into another industry that might not be as highly paying. Now you’ve done some time at Epic and you were able to save up some money.


Consulting runs in cycles where the companies that rise to the top get bought. None of the Epic-only consulting companies that have sold to a big firm yet, right?

Not that I know of. The way that we’re trying to prepare ourselves is, we want to be agile, but we also have to be in the lean in the way we conduct business. Whether there’s pressure from competition, tightening up our budget and tightening up our processes, or there’s pressure from an industry level with rates going down or if Epic were to start losing some market shares. 

We’re just concerned about continuing to offer relevant services to our clients, broadening out besides just staff augmentation, and looking to the future what our clients are going to need from a consulting partner three, five and ten years down the road.


You’ve said that you want to create a brand and not just a consulting company. How do you see that happening?

It starts in-house with the culture, with the people we recruit. We recently won Best in KLAS, but prior to that, we also were listed as one of the best places to work in healthcare. We focus on our employees, and making Sagacious a long-term career option for them and by making sure that everybody shares the same vision as Sagacious, which is to become that brand. It’s lining up our interests with our employees’ interests and our clients’ interests. It’s establishing that long-term partnership with our clients, and ensuring no matter what their need is when it comes to Epic — whether it’s staff augmentation, clinical optimization, AR reduction — we are the first vendor they call for support.


How do you see an Epic ecosystem building?

Epic announced that they were going to open up some of their software to outside developers. We see that eventually third-party players that are more so integrated with Epic may start becoming prevalent. We also see a second area is the adoption of the smaller organizations, under 500 beds, adopting Epic via the Connect relationship. We see services such as working with these organizations to increase revenue and decrease AR days. That’s a mix of not just optimizing Epic, but also optimizing their business processes and their operational work flows.

The same thing on the clinical side. Big data is a term similar to what cloud was two or three years ago. Big data is really about, now we have this data within Epic and these organizations have this data at their disposal, how are you going to leverage that to better patient care, better patient outcomes, and to increase your revenue so that you can provide patient care to the community? Those are the areas that we think will be where the industry is moving in the coming years.


How do you see analytics playing out for Epic customers?

We’re going to start seeing a lot more of revenue spent on analytics. The first stage of this EMR life cycle is adoption. We’ve seen that in the US, a lot of big institutions now are on an EMR such as Epic. 

The second phase of that is leveraging the EMR to increase your bottom line and improve patient care. You can’t do that without analytics. We think as an industry that healthcare is far behind retail such as Amazon and Google. They are very far ahead when it comes to leveraging that data and using it for predictive ordering or predictive shipping, which Amazon might be getting into. 

We think that the industry as whole has a long ways to go. We think that will be a big market for Epic and the other EMRs in the coming years.


What do you want the company to be in the next two to five years?

I see Sagacious transforming to more than simply staff augmentation and taking on more of those strategic-level partnerships with our clients. Going into organizations and assessing them from top to the bottom and seeing where there are inefficiencies. These are things that they may know about themselves, but there’s a lot of inertia when it comes to these projects. They’ve been doing things the same way they’ve been doing them for years. They might have gone live on Epic 10 years ago and taken some upgrades, but have they really leveraged the most they can out of that system? 

We’re that outside driving force. We want to come in, provide them with an independent third-party assessment, and determine what are areas where they could strengthen themselves. What are those opportunities to drive patient care and drive their revenue metrics? That’s where I see Sagacious continuing to advance. I see our partners, our clients continuing to go down that path of optimization.


Do you have any concluding thoughts?

As an industry, a lot of people may think that we’re at the peak right now because so many organizations within the US have adopted an EMR and a lot of clients now are live on Epic. But the truth is, that’s just one piece of the overall business cycle. Adoption is just the beginning of it. Next is leveraging the data analytics to optimize. Then, finally, it’s using that data to predict patient outcomes and to make business decisions to drive revenue. 

That’s what I’m most excited about. That’s what we’re most excited about at Sagacious — continuing to partner with our clients and figure out where the future is and help them set some long-term goals to take it to the next stage.

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Currently there are "14 comments" on this Article:

  1. I’m familiar with Sagacious as they have done work on our starship. The work was fine the consultants good as it goes for consultants who only know one thing and one way of doing things. While I’ll agree that it’s important for a consultant to understand the platform they are working on, I believe it’s even more important for a consultant to have experiences beyond just the vendors. Most pure Epic consulting firms can’t provide that Expertise or advisory level of service. Given time Sagacious might grow into a firm that can, but right from my starship needed other consultants that were better equipped to provide advisory services. I’d also appreciate a more genuine dialogue, this piece sounded like a sales job for Sagacious as no mention of the fact that while not the primary reason the money Sagacious is making has to be in the top 3 of the reasons why he is so optimistic.

  2. You should interview some of the Sagacious consultants and see what they think. I don’t mean to spread rumor, but I think you’ll find a lot of people who feel duped.

    I spoke with Sagacious when I was exploring consulting and their pitch sounds great. You get a salary job and are immune to the fluctuations in the market. You get company vacations, retreats, presents, and other shiny things. It sounds amazing. Then, you realize that:
    a) the market is still so busy, that unless you are in something very niche like Tapestry, you will basically always have an offer
    b) by taking a salary role, you’re giving up SO MUCH MONEY that you could still make more by going to a firm that offers hourly comp and being unemployed for a couple months while you look for a great gig
    c) along those same lines – all those shiny things are paid for by money that’s coming out of your pocket (hmm, would I rather take a vacation with my company where I barely know anyone or would I rather make more money and take my own vacations???), and
    d) many of the “executives” and some of the consultants were basically pushed out of Epic (Epic rarely fires anyone)

    These guys are doing fine right now, but I don’t see them doing well in the long-run. In a business like consulting where you are basically farmed out to healthcare organizations and don’t really work for the company, the best way to treat your employees well is to pay them well. Additionally, I don’t see any strategic vision coming out of their exec team.

    I won’t name names as I don’t advocate for any specific firm, but if you want to get into consulting or are considering using consultants, there are definitely better firms out there. Don’t get me wrong…Sagacious still blows away many of the body shops (any ex-Epic person with a LInkedIn profile has been peppered by them with random job requests) that don’t even know the Epic space, but when it comes to Epic consulting companies, you can definitely do better.

  3. Rumor has it, Sagacious has been snatching up former epic consultants from the likes of Deloitte and Huron. If true, looks like they’re making a push for their advisory services.

  4. I transitioned from an hourly firm to Sagacious about a year ago as a friend referred me. I left some money on the table to join, but I feel as if I’m part of a real company now. It’s difficult to explain to someone who isn’t an employee. I’m routinely in meetings with execs and other consultants to discuss challenges facing the consultants/company/industry, and it’s rewarding to share my knowledge outside of day to day consulting. Sagacious isn’t for everyone though.

    I believe the point made anout Analytics and how Epic customers use the data capture is crucial over the next decade and beyond. I’ve noticed customers lacking the ability to turn data into useful information. Additionally, there seems to be difficulty for IT to get proper funding to bring on the skilled resources to make sense of analytics. Not to mention physicians adopting the results…

  5. On the topic of proliferation of Epic, does anyone know what percentage of the word’s population uses Epic? Any idea what the target of Epic is over the next handful of years? I’ve heard their big push last year was international customers, I just wonder what kind of success they’re having.

  6. “d) many of the “executives” and some of the consultants were basically pushed out of Epic (Epic rarely fires anyone)”

    I have friends in Epic’s HR and that is totally false. When a person at Epic reaches a yearly anniversary, the Epic executives meet up and decide if they are worth what they are paying them or if they are better off going with fresh blood out of college. This is why a lot of “early all stars” leave after X years, because Epic decides they don’t want to pay them anymore.

  7. ““d) many of the “executives” and some of the consultants were basically pushed out of Epic (Epic rarely fires anyone)”

    I have friends in Epic’s HR and that is totally false. When a person at Epic reaches a yearly anniversary, the Epic executives meet up and decide if they are worth what they are paying them or if they are better off going with fresh blood out of college. This is why a lot of “early all stars” leave after X years, because Epic decides they don’t want to pay them anymore.”

    Yea…that’s not entirely true. The ranking process determines if you get more money or not. And, if you end up with a bad ranking, which many of the folks referenced did, then they basically get pushed out (which is essentially the same thing as fired).

  8. You said that Sagacious employees feel duped, yet I don’t see anything in your post that implies any amount of duplicity on their part.

    “d) many of the “executives” and some of the consultants were basically pushed out of Epic (Epic rarely fires anyone)”

    If you’re going to make things up, at least be less transparent? Are the people who run Nordic and Encore “executives”?

    “Additionally, I don’t see any strategic vision coming out of their exec team. ”

    Strange, because about half a page up there’s an interview where numerous times he explains their focus moving forward.

  9. Nancy Grace – if you consider any of the recycled buzzwords and phrases above to be “strategy” then I am not sure there’s much hope for you. And, yes, the people who run other firms would be considered execs. I’m not familiar w Encore but I do know Nordic has some strong people on their internal team.

    Everyone is free to make their own decisions and draw their own conclusions. Just because someone slams Sagacious doesn’t even mean it’s true. But, you have to be ready to take the bad with the good in these situations.

  10. I rarely follow these feedback strings as the commentary gets buried in the weeds. And this exchange seems to be following that trend. As I said in my first post Sagacious is a decent firm from my Starships use of them. They provided decent build and technical consultants. They were not in a position to offer Advisory services as the majority of their consultants only know Epic and not healthcare. It doesn’t matter why Shane or other members of Sagacious leadership left Epic. They felt they could provide a better mouse trap to attract consultants. From my experience dealing with them and that has been limited as my officers deal with them more than me. They use there consultants network of old clients and Epic connections to secure new clients. That is how they came to us. It would be interesting to know how many of the Epic PM’s and Relationship Managers recommend Sagacious, Nortic, and Vonlay as they are the principal Epic only firms. Related to Sagacious ability to break the glass ceiling on being more than a staff augmentation firm time and money will tell. We use advisory services from some really big firms like Deloitte, Boston Partners, and small boutique firms like Elumin, and Encore.. The one thing each of theses firms have is mind muscle and real life experience in healthcare. Each of these firms have led strategic projects for us and each has done great work. I currently don’t think Sagacious, and Vonlay could handle the complexity of these projects and the skills to deliver solutions, Nortic is close and I thin will be able to sooner than Sagacious and Vonlay.

    In the end, time and clients will be the decides of Sagacious fate. My guess they will find success in staff augmentation overseas with Epic before they make Deloitte, Encore or Elumin worry about loosing business to them. That’s it from Gama Centari.

  11. Sagacious is like Nordic and Vonlay. These are the people Epic pushed out, or who didn’t succeed to a level to be advanced. It’s move up or move out at Epic. Nothing out of the norm. The company has standards.

    If the market wants to pay 125.00 an hour or more for them right now because they need help typing in order sets, setting up preference lists, or verifying the fields in an ANSI Claims transaction, so be it.

    Their day will come and that work will run out. All those people who feel disrespected by Epic and able to survive on doing the menial work of an install will then have to find a path to earn a living not paved by stimulus dollars. It will be interesting to see how they fare then.

    A rising tide raises all ships, but tides don’t rise forever.

    Good luck Shane!

  12. A lot of people leave Epic because Epic grossly under compensates them compared to other companies out there and compared to consulting rates. Some of the best people with the Epic technical knowledge and implementation experience leave because they end up overworked and underpaid.

    That said, there is also a level of internal corruption at Epic. Some people are pushed out because they were very good at their jobs and leadership saw them as a threat to themselves. Some were pushed out because mistakes of others required a scapegoat and they picked a target for the problems. This happens in other companies, of course, but more at Epic than a typical IT company.

    I left Epic (was on the implementation team) and a year later when the non-compete ended found myself making 40% more money, having more vacation time, a better work-life balance, and a more enjoyable and less stressful job with better opportunity for advancement.

  13. Your comment is ridiculous and has no logical basis. You’re insulting everyone who left epic and entered into the consulting industry. Epic doesn’t “push” many people out. Two of the three companies you mentioned have ranked #1 in KLAS.

    You have no mention of epic benefiting from stimulus money. Their explosive growth is directly correlated with the injection of government stimulus in the EMR market.

    This is the pot calling the kettle black.

  14. Certain areas at Epic, you get pushed out for blowing the curve or threatening your TL’s job. The theory that internal politics is caused by incompetent people that Epic puts out is true, but empire building and competition between apps happens at Epic just like Microsoft.

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