[Post by clinicea.com]

Descent into “Enterprise Software”

Wanting to be the best, is an aspiration that every company harbours. We are no different.

Over the past 5 years, we have been proactively introducing new features and new modules, trying to keep Clinicea in sync with emerging requirements of Clinics across disciplines and geographies. But let’s face the facts, the older a system gets, the more dated it becomes. If the software is called “enterprise software” – it essentially boils down to software that is BIG, has tons of features, and requires days of training and months for implementation. User interface is usually clunky and looks dated. But what such systems lack in terms of speed and looks, is compensated by their gigantic feature set. This is what Clinicea was becoming, an “enterprise software”.

We had started off with lofty dreams about wanting to make a difference in the niche industry of Clinic Management Systems. We had loved spending hours, picking up nuances in clinical workflows, figuring out ways to improve, automate, and debate over the tiniest of tweaks for hours on end. We had enjoyed competing across geographies, against the largest and the smallest competitors we came across and tried to get better with each failure and success. We were by no means socialists, making money was a critical part of this entire exercise too. But money alone cannot keep you motivated for 15 years unless you really love what you do. The realisation of where we were heading now, this gradual descent of Clinicea into yet another “enterprise software”, started making us squirm in our skin. We were a far cry from the word “best”, and at the pace at which we were going, there was no way we would even have a real shot at getting there 5 years from today.

 

Go Left or Right?

In Nov 2016, we came to a crossroads. We needed to make a choice between staying in our comfort zone, or resetting the clock on past achievements and put it all back in. A debate regarding the pros and cons of each approach was initiated internally. The major argument behind going all-in was, that if from a position of reasonable financial stability and technical strength, we opted to play it safe, who were we fooling then, when we say “one day, we will deliver the best clinic management system that’s out there.” If to be the best, is the reason why we started Clinicea, then why were we afraid to re-invest all our energy and resources to achieve the goal we had strayed away from. Unwilling to do so would just require a self-admission that were we just another wannabe who ran the race on hyperbole grand vision statements that a company puts out to impress, but does not follow through on. The issue for us was, that this was our 3^rd EMR company, we had already build 2 other companies in different geographies. So the motivation to start the 3^rd one was not based on a vision statement but on ground reality that EMRs were indeed complex, that a reasonably sized clinic did have to use a plethora of different systems to function, and those aesthetics was not the prime area of concern when it comes to the line of business, complex systems such as clinic management systems. To address all of those concerns with one scalable system for “clinic chains” is why we started Clinicea. Ignoring the ethos that led us to create Clinicea, and to settle for mediocrity now, would mean we no longer stood by the reasons why we had started this company, we would no longer have an identity left.

This is why all the more, it was critical that whether we decided to play it safe, or whether we went all in to reset the clock, the decision had to be unanimous. This was not just about building a new version any more, it was about accepting and living with from hereon what we stood for and whether the team we had, was aligned with what the company stood for. A week from when the discussions began internally, the fractured lines in the sand were clearly drawn. A set of team members believed we should use the upswing in startup valuations and investor interest, to sell out and make hay while the sun shines. Doing all of these massive changes were fraught with risky overruns in cost and schedule with no immediate upside in revenue. At best, results will come in the medium to long term. Now, “Medium to long-term” is the least focused-on time period for startups nowadays, where most companies focus on the next round of funding and the next quarter’s growth to secure that next round of funding. 3 years is considered an eternity in our business as 80% of startups will fold within 36 months of launch. So, to do something today that will have a return, “maybe”, 3 years down the line, sounded financially irresponsible. “Rome wasn’t built in a year” is no longer quoted or remembered in the startup community. Our industry prefers 50m short sprints, as opposed to running the 42km full marathons. So it was understandable why some of our own guys did not buy our logic. That is why we had to downsize the team down to those who had similar beliefs and were willing to subject themselves to extreme pain in return for a shot at their dreams, of trying to be the best of who they could be. Our commitment to the team was that no expense would be spared and no corners cut. We would source the best designs, the best technology stack and the best software components, from across the globe, and we will then spend as much time and as much resources as we could afford or “not afford”, till such time we feel we have gotten it just right. So with the discussions finally over, we agreed that let’s go all-in trying to make Clinicea run the race again in trying to be the best Clinic Management system, that is possible. The unanimous vote told us, that we now had the vision right and the team right.

This unanimity would get tested severely in the days to come, as the journey ahead would demand tremendous sacrifices from each and every member of the team. During the course of this 1 year, marriages would get postponed, surgeries would be put on hold, the entire quota of annual leave each team member is entitled to (4 weeks) would be let go by one and all, and public holidays as mandated by law – would be self-declared as working days at Clinicea, and in spite of putting in 80-hour weeks, month after month, the finish line would seem not to have moved even an inch closer. The last part was the most trying of all challenges, as it broke the back of even the strongest person in the team. The list of changes was endless, it was a bottomless pit, where no matter how hard you worked, the list kept getting longer, and longer and longer. This was happening because after each weekend more ideas were added to the list by the guys who were researching during the weekend. But then everybody on the team was either working or researching on the weekends.

What did not make things any easy was that there would be no raises given, no extra bonuses and no financial acknowledgement of the hard work being put in by each individual. Barring words of encouragement, there was nothing more we could do till we did not finish. We had to remain fiscally responsible to ensure we could self-sustain the schedule overruns and bootstrap our development plans.

As months stretched to quarters, and quarters into a year, things got very difficult. But we were out of options, in too deep to not finish. The only option left on the table for someone seeking to regain normalcy in their lives was to quit their job at Clinicea. I am grateful to the good wishes, prayers, and to destiny, that not one person in the team who stayed back when we started the journey, gave up on the dream. Not one of them quit, despite all the suffering they underwent.

 

Revenue lost and nothing gained

New signups during this period were put on the backburner, trials were phased out, the Sales and Marketing budget (which was created for the first time in 2016) was again rolled back down to 0, and its resources were reassigned to the Technical Team.

What we also did was back out of closing a deal with a few investors we had been in discussions with. Over the last 2 years we had received a considerable amount of interest from VC’s, and had been entertaining the option internally to make our lives a bit easier by bringing on external investors. It would afford us more resources and speed up the roadmap. But now, knowing what we were about to start, we felt this journey was way too risky, to have someone else bet their money on it. We wanted to rebuild the entire front-end of Clinicea from the ground up, using the best commercial UX components available around the globe, we wanted to upgrade the infrastructure to the latest changes in Cloud Technologies that were going to come into play, and we wanted to use 5 years of search patterns from millions of transactions to re-design parts of our back-end, and when you have so many things planned, with the same sized team, it is going to come at the expense of something else. That something else was revenue. Doing all of the above would lead to a marked improvement in the platform for existing clients, but doing all of the above by cannibalising the marketing budget, meant that it would lead to no additional revenue for the company. We had limited resources and could not do both at the same time. Not being able to increase revenues after spending for an entire year, would not result in happy investors. We may get asked to do this in phases, or to not do all of it at once, making the entire process of change much longer. Either way, if an investor was brought on board at this juncture, the risk-to-reward ratio on the newly employed capital would be very high. It would add pressure on us, requiring us to inadvertently shift the focus from finding the best possible solution to each problem, to instead finding a more balanced approach that would compromise quality by factoring in the concept of timebound return on capital. Clinicea was a labour of love, and we could not reasonably expect somebody else to fall in love, or risk their capital on our passion to try to be the best. We went in “fully aware”, that the additional investment we will incur, and the revenue loss we will suffer, will not get compensated for, so there is no immediate pot of gold at the end of this arduous journey, but there is hope that we will create something wonderful, and thereupon over the long-term benefit from this hard work being done today. This is why we abruptly ended all discussions with the investors, unable to share the reason why, and instead deployed our own capital to accomplish the task. The stage had been set, all we now had to do was lock ourselves in the maze and throw away the keys, and that is exactly what we did.

 

The Expedition Begins

Next, we split the team in the middle, 50:50, with 1 team supporting the current version, and the other tasked with conducting a thorough gap analysis of where Clinicea stands as compared to the best EMR system out there (we found the best to still be paper), the best Cloud Scheduler (Google Calendar & Microsoft Outlook), the best Inventory Management System (vend.com), and so on. Our intent was to learn the best bits from each of the specialist software and then translate it to what was relevant for a medical clinic, thereby closing this gap. The splitting of team in two, meant our workload doubled and speed got halved.

At the end of the gap analysis, we had our estimates. We computed that we could see this through in 4-6 months. However, our estimates and schedules would soon go way over budget. After being at it for 9 months, we had covered a little over half the distance. The reason is, our constant obsession with the user manuals of the leading products in the market. We would comb through their user forums, help manuals, and training guides, repeatedly, to understand their workflows and review the public comments of their users about those features and workflows. It helped us compare ourselves not just to 1, but to multiple software platforms, and re-look at what more we can do –  how can we make this feature simpler than the simplest of the lot, how can we make what we have more intuitive, look better, work faster and automate further. So, we kept iterating, improving, tweaking, replacing components where required, and pestering our software vendors (suppliers), to achieve a functionality that we felt was the right answer but which they did not inherently support, so that we could build the better of all the systems we compared ourselves to.

 

Where to from here

Now we are at the end of this journey. We have to our satisfaction, completed all the new features, and simplified existing ones. We have been able to rebuild the front-end using the best available commercial components in the world, and re-architected our infrastructure using the best of what Cloud Technologies has to offer as on March 2018. Is our wish list over? No, we want to reach out and connect more dots with Clinicea, so Integrations with other platforms will be our mainstay for 2018 and a lot of work on that front too has been completed. It will get released by end of April 2018.

With both teams merging into 1, we will finally be able to operate at full capacity, which will give us room to breathe. What is next on the agenda? Phase 2 of our journey is already chalked out and the team is ready to start. Onwards in our quest to one day make Clinicea, the best Clinic Management System. That’s our dream, what we live for, what gets us out of the bed. We hope we will eventually live up to your expectations, and ours.

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