Claire Nichols Interview Kalix Health
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Who are you and what business did you start?
My name is Claire I am CEO and co-founder of Kalix. My background is as a dietitian.
Kalix is a fully featured telehealth, practice management, electronic documentation and electronic medical record for private practice dietitians and other healthcare professionals. It is a completely web-based solution or software as a service ( SaaS).
Telehealth technology supports the provision of health services electronically (or virtually) facilitating long distance patient and clinician contact. The telehealth features Kalix offers includes HIPAA compliant virtual meeting (video conferencing), secure client messaging, online appointment scheduling, electronic forms and agreements, online payments and electronic food and exercise tracking.
Practice Management Software are solutions that manages the day-to-day operations of private healthcare practices. The have a range of features including; appointment management and scheduling, appointment notification, client management and billing (insurance billing and online payments).
Electronic medical records are electronic information files containing information about individual client medical history and health.
Electronic documentation systems assist with the systematic documentation of client medical information, clinician-patient interactions and correspondences electronically.
Being web-based, Kalix is available online world-wide. We follow a subscription model, users subscribe to Kalix and are charged either on a monthly or yearly basis for ongoing access. Subscriptions and billing are automatically through the website (using Stripe).
We currently have over 1000 paying users from 19 countries. The majority of customers are from the United States of America- (90% of users). Other countries include Australia, Canada, New Zealand, Israel, Arab Emirates, Switzerland and Trinidad to name a few.
What’s your backstory and how did you come up with the idea?
I trained and previously worked as a dietitian. I graduated with a Master of Science (Nutrition & Dietetics) with Distinction through the University of Wollongong in Australia. Working in both the public health sector (acute, subacute and outpatient) as well as private practice, I was very lucky to experience a diverse work history.
The idea for Kalix arose while I was working as the sole dietitian in an orthopedic surgery early intervention team. The position was funded by a special government grant, so I was under a lot of pressure to measure and evaluate the effectiveness of my professional practice.
With a heavy workload and stuck using a documentation/tracking system built for medical staff not dietitians, I needed to get creative. While investigating how to measure and evaluate professional practice, I came across the Nutrition Care Process Terminology (NCPT). NCPT is standardized language developed by the Academy of Nutrition and Dietetics. It describes the specifics of what a dietitian does. Because NCPT is standardized and covers all the data that a dietitian collects during initial and follow-up assessments, I surmised that if I was to write all my patient notes using NCPT, a software system should be able to track changes in the variables associated with NCPT terms. Tracking the changes in these variables would be an easy, sensitive and efficient way of evaluating my professional practice without having to spend extra time measuring, recording and analyzing data. The statistical analysis could be built into patient documentation and hence save me a lot of time.
The problem was finding a software system that uses NCPT in this way. I needed a program that supports quick electronic documentation using NCPT terms, tracks of changes in patient data over time and correlates changes in the variables. There was not a system like this available on the market.
Co-founder Felix Jorkowski was looking for a new product to undertake. After 4 months of initial development work in September 2012, we first launched Kalix at the International Congress of Dietetics (ICD 2012) held in Sydney. By attending ICD 2012 were able to expose and receive feedback about Kalix from dietitians from around the world. We invited key stakeholders to an “interest group”. We also paid for flyers to be included attendee’s welcome bag. Kalix was also made available to use free online by anyone.
Describe the process of designing, prototyping, and manufacturing the product.
As described above, Kalix was initially launched as a documentation system only, not a complete electronic medical record and practice management solution. The decision for this change in direction came after analyzing the feedback we received at ICD 2012. While we initially identified public hospital dietitians as our target market, there was a major issue we kept bumping into. Each hospital already had their own electronic medical record system and the dietetic departments required their integration with the Kalix system. They also not willing to pay the cost of this integration. Unfortunately, this was not a viable option for us at the time, so we decided to explore different options.
There was a lot of ongoing interest for Kalix from dietitians working in private practice, especially those in the US. While dietitians working in the hospital system already had their own EMR system, private practice dietitians on the other hand, were still most commonly using paper-based systems or stuck with ill-fitting EMRs and practice management solutions designed for medical staff and other professions. There was no practice management solution/ electronic medical record designed specifically for dietitians. It became increasingly evident that dietitians working in private sector should be the target market we pursue.
Kalix was relaunched in May 2013 as a complete practice management solution. Our initial aim was to build the minimal viable product make it available online, receive customer feedback and continue adding to it. In August 2013 we also received ,000 seed funding for product commercialization and the development for the US market. Australian private practice dietitians are a very small market and we needed to expand to other countries to be successful. There are over 68 000 Dietitians in the US, compared to less than 3000 in Australia.
The major hurdle to sell in the USA was achieving HIPAA compliance. Health Information Portability and Accountability Act (HIPAA) is the data privacy and security legislation that describes how electronic health information is transferred, received, handled, or shared. With a few modifications to Kalix and lots of assistance from legal specialists, we achieved HIPAA compliance in October 2013. That month we also exhibited Kalix at the biggest trade show for nutrition professionals in the USA. After receiving much useful feedback, we completed some fine tuning and started selling Kalix in the US during January 2014. The United States quickly became our primary market and the company was relocated to Los Angeles in August 2015.
Describe the process of launching the online store/business.
Our goal for Kalix has always been to build a minimal viable product and make it available online for use and purchase. This allows us to receive customer feedback right away, so that we can continue to fine tune and release new features based on popular request.
Kalix’s co-founder, Felix is a software developer so there were no costs associated with site development and making it available online. Kalix was part of the Microsoft BizSpark program (now discontinued) which gave us free website hosting and access to other services for three years. We paid to work with various graphic designers for site design and branding including freelances and a personal friend that provided us with discounted rates. Being a little bit arty myself I taught myself to use Illustrator and Photoshop to complete some of the design work.
To create product awareness we attended several tradeshows in both the United States and Australia. Through product demos, the handing out flyers and the collection email addresses for marketing lists we were able to generate strong interest. We were able to get Kalix listed on as a suggested resource on a number of external websites utilized by our target market. This was very important for establishing credibility. We achieved over 900 sign ups during the initial launch period.
Since launch, what has worked to attract and retain customers?
Because Kalix follows a subscription model, retaining customers is just as important ( or even more so) than attracting new ones.
Regular communication with customers to encourage engagement and the frequent release of new features, helps keep existing customers invested in Kalix. Adapting Kalix’s development schedule based on the changing market requires has also been beneficial. We continuously update and improve existing features to improve workflows customers have trouble with.
How are you doing today and what does the future look like?
Kalix has experienced ongoing growth since its initial launch. Our net revenue has increased by 44% over the past 12 months. Our subscriber churn rate continue to be quite low, currently sitting at 2.3%. The life time value of each of our customers is $1,140.
We are currently in the process releasing a new subscription level at a higher cost point. The new features released as part of the telehealth component of Kalix are very popular, but costly. Increasing the price is required to maintain our profitability. We are currently working on how to manage this price increase without losing customers.
We are also working on market expansion target other non-medical healthcare profession e. g. therapists, social workers, speech pathologist. No modifications are required to Kalix to target these professions.
Through starting the business, have you learned anything particularly helpful or advantageous?
Marketing is just as important as the product develop side of things. You can have the best product in the world but is no one knows about it; your effects are wasted. The saying “If you build it, they will come” is just not true any longer.
Learning from your mistakes is a must. Customers generally are understanding when things can go wrong. As long as we are responsive and take actions to prevent the issue from recurring you can bounce back.
What platform/tools do you use for your business?
Intercom – we use Intercom for all of our customer support, onboarding and marketing requirements.
Status Page – provides our customers with real-time and historical data on system performance downtime and scheduled maintenance.
Stripe – online payment processing platform. Our customers’ subscriptions and billing are automated through the though the Kalix website using Stripe. Stripe also have analytics to track growth, customer retention etc.
Xero – our accounting software.
SocialPilot – social media scheduling tool, to create and schedule social media post ahead of time across multiple platforms.
Canva and Place it – for the generation of social media images.
Advice for other entrepreneurs who want to get started or are just starting out?
Complete your research, check for other similar products that are already available, is there room for one more? If it is something brand new, will there be a large enough demand? Talk to your target market and receive feedback early and often. Find out if (and what) they willing to pay for your product. Do not be afraid to change direction in product development if needed.
Are you looking to hire for certain positions right now?
Where can we go to learn more about you?