This interview was originally featured on HIStalk.
Gregory Jacobson, MD is co-founder and CEO of KaiNexus of Austin, TX.
Tell me about yourself and the company.
I am an ER doctor and co-founder and CEO of KaiNexus. At KaiNexus, we’re making improvement easier by improving the process improvement process. It’s a mouthful, I know [laughs].
The problem that we initially discovered was that it’s really hard to connect all of your staff to implement process change. For example, I was in the emergency department when I worked at Vanderbilt. How do you get the 200, 300, 400 staff, nurses, techs, transporters, and physicians to all be able to engage as a group and to identify process problems and design and implement solutions? It’s really hard. KaiNexus was born out of the idea that we can provide a collaborative platform that’s optimized to help healthcare organizations engage a broad spectrum of users to improve processes.
This is your staff – your most valuable resource. Let your staff help your organization. They know what needs to be improved on. Let them do that. Empower them to do that.
Can you describe the product?
It’s completely Web based. We have an iOS companion app. It is enterprise-wide software supporting thousands of employees, but also works with teams as few as five or 10 people. It’s really scalable and adaptable.
We do a lot of our work based on information workflows. Every part of the organization can work differently, and they can do what they’d like within the system. KaiNexus manages what we refer to as daily improvement, a.k.a. ideas, suggestions, small little observations from daily work. KaiNexus also manages improvement projects and more complicated things that need multi-disciplinary teams, for instance. It also manages improvement events, oftentimes referred to kaizen events or rapid improvement events.
There is extensive reporting, allowing senior leaders and quality folks to monitor how improvement work is going in their organization.
Let’s say I signed up to use KaiNexus as a hospital with 1,000 employees who I want using it. What does the process look like in terms of the setup and getting started?
It’s easier for an organization to get up started than you’d think. We made everything in a way that doesn’t need much or any IT help, so we can build your website in a matter of minutes. We have built a very easy to configure collaboration platform for your organization. For instance, setting up strategic initiatives and categories and building projects or improvement events is simple and intuitive.
We support importing large numbers of users from an Excel spreadsheet that can be pulled out of an HR system. This is not a multi-week, tens of thousands of dollars installation with servers and such. There’s actually no installation at all in the traditional sense, and setup is very easy. We typically start it off with a smaller group like the senior leadership and quality department and then deploy throughout the organization in six to 24 months, depending on the size of the organization.
Does it also support a crowd-sourced model where staff suggest ideas that can be voted up / down, or is it more of a top-down approach where management has identified a few key initiatives to push?
It’s a little bit of both. There’s a crowdsourcing element to it, but it’s not a Facebook for your organization. We think social media is not a great place to do productive work, but there are elements in social media that are great for doing real work.
Having visibility, transparency and accountability, and allowing people to engage and give their opinion, that’s great. But I think that making it a popularity contest for ideas detracts from making it a productivity network. Popularity contests are great for making new products, for instance, but not for improvement work.
So yes, there are social media elements, such as letting people engage in a system from the bottom up. There’s also the other side of things, with the ability for department leaders and management to challenge their department or multiple departments to implement strategic initiatives. But it’s not designed with a Facebook or traditional crowdsourcing mindset.
Does KaiNexus integrate with EHRs in any way? I would imagine that with quality improvement if you’re recording clinical metrics you might want to get that data from the EHR.
What we want in KaiNexus is an environment that doesn’t need to draw a lot of heavy integration to function. You don’t have to put in patient identifiers to do process improvement. A lot of this boils down to simply saying, "Hey, we had a patient where X happened."
It’s not necessarily an incident reporting tool at this moment. We have future versions planned where we’ll be integrating incident reporting, either by developing our own elements or integrating with some of the more popular incident reporting tools out there. Not integrating with EHRs allows us to keep our prices down.
KaiNexus has been around for about four years. Do you have case studies on how it has helped quality improvements?
Yes. We started out as an academic research project in 2005. After about three years, it became evident that we had developed a collaboration methodology that while born from manufacturing and automotive improvement work, worked in healthcare too.
So by 2008 or 2009, we had licensed my research out of Vanderbilt and started the company. We went live with our beta in 2011. We now have just under 20 organizations using KaiNexus.
We have a number of white papers and customer stories on our website. We have a number of use cases on how organizations are using KaiNexus. We just finished a new one on how KaiNexus supports the Baldrige Performance Excellence Program improvement journey as well. There is also a great ROI white paper where we have aggregated the estimated improvement impact across all of our customers. It allows an organization to estimate how much benefit they will get by implementing KaiNexus. The numbers are pretty amazing.
Healthcare is ripe for improvement. There is so much work that needs to be done. The government, senior leadership, medical advancements, and insurance / payment reform are all parts of the solution. It’s amazing how much improvement knowledge is not being harvested from the people who actually deliver medical care. This is a part of the solution that organizations so often forget about. It’s the low hanging fruit, so obvious it is often overlooked.
What is the pricing model?
It’s per-user pricing. The more users, the lower cost per user. We are very competitive on the question of price.
Is it a SaaS model? Monthly subscription?
Yes. We also allow organizations to pay for discounted annual usage, too. There’s a lot more information about pricing on our website.
Any final thoughts?
I don’t think anyone in healthcare doesn’t understand that healthcare is going to look a lot different in five to 10 years than it does today. Huge changes are coming. A lot of those changes directly relate to reducing cost while improving quality. The organizations that are able to figure out how to improve quality and decrease cost the quickest are the ones that are going to emerge as the most successful in the next decade.
It’s going to take a lot of work. In order to really do that, in a very practical, manageable way, we built an improvement platform that helps makes it easier to do exactly that. If a C-level executive is really serious about leading their organization in the next decade, they have to figure out a practical, actionable strategy to engage staff to make change happen. Change doesn’t happen by itself. They need a system to help manage that change.
We need to focus on big picture solutions that are real and practical. Figuring out how we can do process improvement more effectively is a great problem to be solving.