Success in business is most achievable when the entire team is on the same page.
Doubling as co-founder and chief operating officer at DrChrono, a healthcare software provider, Daniel Kivatinos understood that he needed the cooperation of his team members to achieve the organization’s goals. So he created effective systems to carry everyone along in their daily operations.
[1:55] Dr. Jeremy Weisz introduces the guest, Daniel Kivatinos.
[3:14] Daniel talks about the importance of being innovative in what you do.
[7:33] Daniel explains the ideal clinics or hospitals for DrChrono.
[10:09] What processes are in place at DrChrono to ensure that everyone agrees on the best way to be innovative?
[14:33] Daniel sheds more light on the activities that helped keep the DrChrono team on the same page in terms of being innovative.
[26:48] Daniel recounts his experience at the White House.
Daniel grew DrChrono from two founders to hundreds of people working with the shared vision to fix healthcare. He strongly believes that technology should serve healthcare, not the other way round.
Announcer: Welcome to the Process Breakdown Podcast, where we talk about streamlining and scaling operations of your company, getting rid of bottlenecks and giving your employees all the information they need to be successful at their jobs. Now let’s get started with the show.
Dr. Jeremy Weisz: Dr. Jeremy Weisz here, host of the Process Breakdown Podcast, where we talk about streamlining and scaling operations of your company, getting rid of bottlenecks and giving your staff everything they need to be successful at their job.
Dr. Jeremy Weisz: Before I introduce the Co-Founder of DrChrono, Daniel Kivatinos, Daniel, I always like to mention other episodes people should check out on the podcast. We’ve had David Allen of Getting Things Done, which was a great one. I really like his book. Michael Gerber of the E Myth. We had the past COO of Charity: Water and so many more. So check those episodes out on the Process Breakdown Podcast.
Dr. Jeremy Weisz: This episode is brought to you by SweetProcess. If you’ve had team members ask you the same questions over and over again, and maybe the 10th time you spent explaining it, but there actually is a better way. There is a solution. SweetProcess is a software that makes it drop dead easy to train and onboard new staff and save time with existing staff. Daniel, when I was talking to one of the owners, Owen, he told me not only do universities, banks, hospitals, and software companies use them, but there were first responder government agencies that used them in life or death situations to run their operations. So I’m like, "If it’s good enough for them, it’s good enough for me." You could use SweetProcess to document all the repetitive tasks that eat up your precious time so you can focus-on growing and empowering your team. You could sign up for a free 14-day trial. No credit card is required. You go to sweetprocess.com. That’s sweet like candy, S-W-E-E-Tprocess.com.
Dr. Jeremy Weisz: I am really excited to introduce today’s guest, Daniel Kivatinos. He co-founded and grew a startup from two founders to hundreds of people working to fix healthcare. Daniel believes that healthcare should be simple and accessible, and as Co-Founder and COO of DrChrono, you can check him out at drchrono.com … It’s D-R-C-H-R-O-N- O.com, Daniel drove brand vision and corporate strategy for over 13 years. Daniel, thanks for joining me.
Daniel Kivatinos: Awesome. Thank you so much, Jeremy, for having me. Excited to be here.
Dr. Jeremy Weisz: One of the topics since a lot of because listen in, is a topic and your topic that we discussed was getting everyone on the same page. It’s a simple statement. It’s very hard to do. Getting everyone on the same page. So we’re going to talk through some examples in this episode of how Daniel and his company was able to work through getting everyone on the same page. As we said before we hit record, there’s a lot of friction points when this happens. One of the things that led you to the White House, which we’ll talk about in a second, is being innovative and making sure people understand that they can be innovative. So talk about that.
Daniel Kivatinos: Yeah. I think innovation is honestly the reason why my company was thriving. We rethought what healthcare could be. In the past everything was on paper and doctors were charting on paper, they were writing prescriptions on paper, and they were doing just about everything on paper and then they started using fax machines and that sort of thing. I think innovation is critical not only to my company, but to every company. We have this saying, you’re either living, you’re either growing or you’re dying as a company. There’s some real truth in that because if you’re not creating new product for industry, you are going to start to lose customers to new innovative products that people want to buy.
Daniel Kivatinos: There’s this book called The Innovator’s Dilemma out there. You start making a lot of money and you create this really great product, and then if you can’t make something more than that, that innovation tends to get eaten by better innovation out there. You see it in other industries. Like in the car industry, you could see with Tesla and all these EVs coming out now, the guys who are not doing EV, they may lose out in 10, 20 years, meaning they might just lose their whole market. It goes to many different industries. You look at Blockbuster Video. Remember when you could go into a store and you could go and pick out a DVD and that was amazing. People like, "Wow, this is amazing. I could go into the store." Prior to that there was the movie industry and then you had Netflix come around and they started shipping out DVDs at first, and then people started to get more comfortable with the web. Why didn’t Blockbuster Video innovate? What went wrong there?
Daniel Kivatinos: The same thing with the whole music industry. You can look at the music industry and say they should have owned it all and built out their own Spotify and built out their own Apple Music. Why didn’t they do it? A lot of it has to do with the innovator’s dilemma, which is, "I started making all this money from all these CDs and all these musicians. We’re not going to go on the web. We don’t want to do that." If you don’t start to rethink things, someone else will come along and eat your lunch.
Dr. Jeremy Weisz: Talk for a second, Daniel, about DrChrono and what you do as a company so people understand a little bit.
Daniel Kivatinos: Yeah. So I’m one of the founders of DrChrono, which is a medical records platform for physicians and for patients. Think of it as the operating system for a medical practice to go live, turn on the practice and they can start to see patients, they can start to chart and put documentation about those patients into the software, and then they could get paid for that software, and they can message the patients, the patients can message them and prescriptions can be sent and labs can be ordered.
Daniel Kivatinos: Really we wanted to enable the medical practice to use digital technology to run everything. The goal from the beginning was to really just help create that process. Sounds like you’ve been in the medical world for a long time, so there’s a lot of friction there. You mentioned one company, CollaborateMD, which you had used in the past. Why would you use that? I think going into this industry, that was where I was kind of thinking why and how do we fix healthcare? If you can go there into that one point, you could really start to build amazing things and have doctors do amazing things.
Dr. Jeremy Weisz: What type of clinics are ideal for your platform or hospitals? What’s a size or typical size or type of clinic that uses DrChrono?
Daniel Kivatinos: Yeah. This was a debate when I was there. The company has changed now. There’s a lot of different things that are going on in the company. But when I was there, we had a debate around what kind of practices we should go after. The way that I kind of thought about things was let’s go after the common denominator, which is the actual user using the product. A lot of companies will go after the corporate large-
Dr. Jeremy Weisz: The practice admin that would basically implement it, but you’re going after directly to doctors.
Daniel Kivatinos: Right. So we went after grassroots approach saying, "Okay, if a doctor is looking for something, let’s grab their attention. Let’s have them feel and touch the product and start to see if it actually works for them." It was initially for one to five doctors, meaning the doctor could find it, it was on the iPad, the iPhone, on the web. Say you just buy an iPhone and you’re like, "Oh, this looks so cool. What can I do with this," you type in medical records, try our app out. It instantaneously gives you that "Oh, wow. I can use this for not just music. It actually can run my practice." Then we would get them involved and get them educated and then they could start to use the product. But it is for every type of provider. So chiropractors, gastroenterologists, neurologists, general practitioners, surgical groups, plastic surgery, you name it. It’s-
Dr. Jeremy Weisz: Any different specialty, essentially.
Daniel Kivatinos: Any different specialty. But we were moving up market as we went and some companies try to move down market. I think it’s a harder ask for a company to go really large and sell to corporate and then try to go down market to the individual user. If you look at companies like Salesforce, they were selling to individual company sales people, and then they started to get larger and larger and larger groups. We took that approach versus the other way.
Dr. Jeremy Weisz: We talk about being innovative and you did this and we’ll talk a little about being innovative … How do you get everyone on the same page with that? What are some of the processes of actually doing that? Getting everyone on the same page with being innovative?
Daniel Kivatinos: In the early days of the company, we would put as many whiteboards up as possible. I learned that whiteboards are a really good way … Prior to COVID, I learned that if you had a whiteboard around, people would tend to utilize it. It sounds so silly, but having a whiteboard and a marker allows you to write an idea down, even a complex idea, in a way very quickly that others would be able to instantaneously see that. If the room has say 10 whiteboards in it, they could write their idea down and it doesn’t get erased for a few days or a week or a month. We’ve kept stuff up for two years, because we’d write something down and be like, "This is important. Let’s execute on this." But we had different whiteboards and we would put, I called it a micro OKR where you’d do a weekly script of something.
Daniel Kivatinos: So in the early days of the company when we were small, we would write down on this board, "Okay. What is my goal this week, and how does it relate to everyone else’s goal? Let’s all execute on that." It was extremely effective in everybody on Monday would look at that board and be like, "Was I able to accomplish those two things that I put on that board?" Because as you go into your day, customers will call you, possible investors will reach out, new possible hires will reach out, any issue comes up. You’d be surprised at how hard it is to retain focus. But if you have something written down on a whiteboard and it’s staring you in the face weekly, it’s apparent that you haven’t executed on what really was for the greater bigger picture.
Daniel Kivatinos: We did that for honestly, probably four years in the early days of the company when it was just a few people and it really helped everyone gel. Talk about the early days, why we got as big as we did as a company, in the early days, we would also have weekly show-and- tells where everyone would show-and-tell what they’re working on if they had something relevant. It was kind of uncomfortable, but a lot of people didn’t feel comfortable presenting. I would still make them present, and it could be for a minute, it could be for 20 minutes, but you get a few people that are working on things up there, it allowed the whole entire company to know what everybody was working on. It really-
Dr. Jeremy Weisz: It fosters collaboration and input too, because a lot of innovation comes from outside the industry, outside probably departments. You probably have different departments contributing to that person’s idea that maybe they never thought of, I imagine.
Daniel Kivatinos: 100%. I think it was really insightful to see what people were working on and how they were thinking about it. Sometimes you just kind of just hide, people will hide and they don’t want to communicate because it’s stressful to present. But it’s one of those things where it’s a double-edged sword. I’ve seen people terrified of presenting become amazing presenters after doing a year. They’re like, "Just let me go up there. I’ve got four minutes-
Dr. Jeremy Weisz: It’s a muscle. I mean, you flex it and it becomes easier and easier, I imagine.
Daniel Kivatinos: Yeah. Yeah. I think different cultures cultivate different skill sets. I think for me, I really just wanted people to be able to communicate effectively because I felt like it was an issue in past working experiences prior to starting my company.
Dr. Jeremy Weisz: Yeah. I could see how these baked-in processes help. Getting everyone on the same page with innovation. Having whiteboards around, making sure they put their goals on there, we can see them, contributing and collaborating, having the weekly show-and-tells. Was there anything else that was kind of baked in to the culture and what you did that helped with people to get on the same page with being innovative?
Daniel Kivatinos: We would have a weekly Monday meeting. I think it’s more all about getting on the same page or information exchange or getting to know people. As time went on, I realized it’s not all about business, meaning sometimes in the morning people would come into the meeting and I would have a silly question like, "Okay, let’s do the weekend report." Everybody’s like, "Why do we need a weekend report? What’s the point of that? I just want to get to work and let’s talk about work." I think when someone came in and would tell us they just had a child … It’s like, "Over the weekend, I just had a child," everybody knew and it made them feel really-
Dr. Jeremy Weisz: Connected.
Daniel Kivatinos: Connected. Or someone would bring up really amazing things and horrible things that happened to them. I think it allowed people to work with them in a different way for that week. The weekend report was just one tool in the toolkit that I would use. There were several questions that I thought up over time and then you kind of bring them up in the beginning of a meeting and it allowed people to kind of gel more. Even doing that through Zoom. I kept that going through Zoom. It really kept people really connected.
Daniel Kivatinos: Another thing that I would do is a lot of meetings were either a walking meeting or a sit-down meeting. You’d ask, "Do you want to do a walking meeting or a sit-down meeting?" Why would you want to go on a walking meeting? I think there’s a lot of … What’s the right wording … There’s a lot of productive thought that can come from walking side by side with somebody. I think when you’re sitting, it’s almost an adversarial situation and it’s just the way that business is done. It’s like, "I’m sitting over here, you’re sitting over there. You need resources and you’re coming to me to ask me for those resources." It’s not that they want to be adversarial-
Dr. Jeremy Weisz: No, I totally see that. There’s also a symbolic piece. When you say that, it makes me think, "Well, you’re walking side by side with someone, you’re going on that journey together." You’re on the other end of the table and it is kind of not confrontational, but you are face to face. There’s some kind of symbolic nature of doing that walking.
Daniel Kivatinos: 100%. I think it goes back to Plato and the philosophers would do this. You had mentioned Steve Jobs doing this. When I was in Y Combinator, the founder of Y Combinator would do this. He would say, "Is this a walking meeting or a in-person meeting?" I think Y Combinator had this idea of office hours, which we also brought into our company. Office hours, I think it’s something that colleges use for students to come in after hours, after the class to ask questions about, "Why did I get a C+," or, "How do I get a better grade because I got a C+?" At our company, we started to have office hours, and then you could just say this is a walking meeting or a sit-down a meeting.
Daniel Kivatinos: In the sit-down meetings, we would always have whiteboards. They would just be there, and then if someone said, "I want to reorg a department."
Daniel Kivatinos: "Okay. What do you mean by that?" A lot of the times they didn’t have a true plan, but they felt like it was needed to discuss. So the whiteboard would allow people to just draw and talk through and then get my buy-in and others’ buy-in because they could see that. After the meeting, the whiteboard is still there. People would just take a picture on their iPhone and then we could execute on that idea together and it was really just a really collaborative way to do things.
Daniel Kivatinos: I think sometimes it’s the simple things in life that allow success. It sounds so silly. It’s those silly little things that allow you to really work productively. I live pretty close to Google. I could just walk around right outside their campus and you’d see people on these … I don’t know, there was like seven people on a bike. It was one bike and they would just … It sounds insane, but I’m like, "Why would they do that?" It allowed them to get out of their environment, get thinking, clear their head. They’re literally talking to each other about biking. When you’re in such a radical state, you begin to think clearly. It’s not, "Oh my God, this person’s my boss. Oh my God. How am I going to ask them for X, Y, and Z?" You start to smile. You’re smiling.
Daniel Kivatinos: It sounds kind of funny, but it allows people to think way differently, and Google was very big on bikes. I would just see bikes going everywhere. So the way that they designed their thing, you’ve got to go from building A to building B, they literally bikes everywhere. You just hop on a bike and you just ride four minutes to the other place and your mind is already, it just cleared. I could see the product productivity there. Things like that inspired me.
Daniel Kivatinos: How do you create innovation? In companies, there’s a lot of negotiation, I’d call it, where there’s stressors that happen where people are not thinking clearly. When that happens, they don’t communicate. When that happens, that communication breakdown happens and there’s fear, that’s a problem. People are not getting on the same page.
Dr. Jeremy Weisz: I want to, Daniel, have you talk a little bit about with this, when you try and get everyone on the same page, you mentioned there is friction. I want you to walk through when there is a friction point, how do you get through that? You have these processes that almost avoid friction points in a way by having these walking meetings and weekend reports. So I’d love for you to talk about some of the friction points, but I just want to say what I love about what you said is anyone next week, tomorrow can implement these things. You talked about whiteboards, having whiteboards everywhere, doing a weekly show-and-tell, a weekend report, walking meetings and having office hours. Any company can implement these things and improve getting everyone on the same page. So talk through when you get friction points, how do you work through that?
Daniel Kivatinos: I think when you’re working to innovate, there will be friction and friction, I’ve learned it’s a good thing, but it is something that just happens naturally because people don’t see why we’re doing what we’re doing.
Daniel Kivatinos: I’ll give you one example, a real life example of friction. I fundamentally believed APIs are going to be part of the future of healthcare. People are going to start to transfer data in these really unique ways, and we didn’t have an API. We did not have an API as a company. The sales team was cranking on sales and they wanted more features. Why would you build an API? The friction point is why do something that is not creating revenue today for a company?
Daniel Kivatinos: You start small, like an acorn, you start with the idea and you pull a little resource off … A little bit meaning a developer and the developer can work on the idea, and you iterate and iterate and iterate and iterate and iterate. That friction is going to be there like, "Well, we have all this other stuff to work on," but I think as ideas start to snowball, they get bigger and bigger and bigger and people start to see where you’re going. That friction tends to go away.
Daniel Kivatinos: I was watching … What was it? Love it or hate it, there’s a movie, there’s a Netflix show or Hulu show called WeCrashed.
Dr. Jeremy Weisz: I haven’t seen it.
Daniel Kivatinos: Okay. It’s about WeWork and the story of WeWork, but I-
Dr. Jeremy Weisz: Oh, okay. I’ll have to check it out.
Daniel Kivatinos: I saw that friction in that show where the co-founder’s like, "I’m going to lease another office," and the other co-founder’s like, "Why would we do that? We are not even done with this one. What are you doing?" But that friction, if you can work through that productively and the team is into doing it in a respectful way, in the right direction of the company to scale, it is an amazing thing if people are all culturally supporting each other in respectful ways. That allows that growth, which it’s really hard to do. It’s hard to say, "We’re going to build an API." Because people are like, "That’s not what we need," but you push a little bit in that direction and even if you get 5% support, that’s enough.
Daniel Kivatinos: That’s where you can start to get that momentum going for something. Because of the API, we were invited to the White House. President Obama, Vice President Joe Biden at the time invited us there to talk about the way that healthcare could change if we could all communicate data properly to … If there’s a cancer patient that needs data from this hospital to that hospital or this medical practice to this medical practice, the answer is through APIs. We went to the White House as one of these innovative startups that was doing it and executing on it. Innovator’s dilemma, a lot of the larger or multi-billion dollar companies were not working on newer, modern APIs, which I think the world is moving in that direction. It’s exciting to see, but that friction, it made all of that happen.
Dr. Jeremy Weisz: Daniel, last question is I want to hear about what your experience was like when you went to the White House. But just to reiterate, everyone, relisten to this episode of the things that Daniel listed on getting everyone on the same page. Then if there is friction points, Daniel, what I heard from you was just do something very small and prove it out to everyone. That gains momentum within the company because then once they see it small and it builds and builds, it’s not such a big friction point if you go right off the bat, "We’re going to pull 10 developers on this API project." You first did it, proved it out in a small, got momentum just as you would in business, you do in your own company, it seems like. Right?
Dr. Jeremy Weisz: You gain that momentum, and everyone starts to buy into that because they see it working. So I love how you articulated that. Anyone could follow that as far as if you have a friction point, pull a small resource, prove it out. Or sometimes it probably disproves too. It’s like, "Well, this didn’t work. We only pulled a small resource. We’ll try something else." This all brought you to being one of the first to have a modern API that people can use in healthcare. It brought you to the White House. So talk about, just to round things out, what was your experience like at the White House?
Daniel Kivatinos: So you’re talking about the White House?
Dr. Jeremy Weisz: Yeah.
Daniel Kivatinos: It was amazing. It was a real honor to honestly be there. I think for a couple of founders to really get to that point and have the government recognize you is phenomenal. I’m grateful, and I was excited to be there, but it was a lot of fun honestly.
Dr. Jeremy Weisz: Daniel, I just want to be the first one to thank you. Thank you for coming on. Everyone should check out DrChrono. D-R-C-H-R-O-N-O. I know you have a blog also. Kivatinos, K-I-V-A-T-I-N-O-S.com. People check out SweetProcess. People check out the Process Breakdown show and thanks so much, Daniel. Appreciate it.
Daniel Kivatinos: Awesome. Thank you so much, Jeremy.
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