At most companies, a strong corporate culture is a by-product of leadership rather than the result of a conscientious effort. Smart companies are realizing this must change as retaining tech talent becomes more challenging. Niko Skievaski, Co-Founder & President at Redox is doubling down on his culture-building efforts to ensure the company can continue to scale and succeed.
Perks and Pay Are Not Enough
In the past, Health IT companies could land talented candidates by offering competitive pay and reasonable perks like flexible schedules, cool offices, occasional work-from-home days, and a good benefits package. Those days are gone, and it is doubtful they will return.
Health IT companies are no longer competing with their peers. Tech giants like Amazon, Google, Apple, and Microsoft are hoovering up talented people across all disciplines – development, implementation, marketing, sales, and even customer service. Their deep pockets and the cache of working for one of them is difficult to compete against. However, there is one way smaller, more nimble companies in Health IT can compete – by having a better corporate culture.
Culture as a Differentiator
Health IT companies have an innate advantage – a direct line can be drawn between the work employees do and the impact on patient’s lives. That is not something that can be said about other industries. Many of us in Health IT, who are bought in, are here for more than just the paycheck. We are here because we want to, and believe we can, make a difference.
This point was made by Skievaski when Healthcare IT Today sat down with him for an impromptu discussion about corporate culture and the work he is doing at Redox.
“Redox is an infrastructure company,” explained Skievaski. “We’re layers removed from making an impact on patient lives, but we can still draw that line. We like to draw that line a lot because it really motivates people and get people excited about why they are here.”
As the labor market continues to tighten and as the rules of work continue to evolve, corporate culture will be a key differentiator. Talented individuals are not just looking to be paid what they think they are worth, they are also looking for a place where they are respected, where people are treated well, and are aligned around similar values.
“Even though someone can make more money somewhere else, what they do on a day-to-day basis, how they are treated, how much safety they feel in their job, and their sense of belonging within the team – those things are a much deeper human need than just making money,” said Skievaski.
Culture Needs to be Cultivated
Redox has always had a strong corporate culture. It is something that the company founders and early employees made a conscious effort to build.
“When we started Redox, we sat down – our first three employees and our three founders – and we basically did a brainstorm,” recounted Skievaski. “What is the type of company that we want to build and work at? We wrote down our answers on sticky notes. The groups of those sticky notes turned into our values. Those were the values that we tried to hold ourselves accountable to and aspire towards. As we grew, we evolved those values to fit more with who we were.”
Skievaski recently rewrote the core company values – simplifying them down to three key pillars, eliminating overlap and making them easier to remember:
- Growth Mindset
- Belonging
- Give a Sh!t
Using those values, the Redox leadership team created a “cultural strategic roadmap” complete with goals, objectives, and timelines. To achieve those goals, the leaders realized that they would need help from key staff members to cultivate the desired culture.
Culture Ambassadors
Redox did more than just name these key staff members as Culture Ambassadors, they went the extra mile and created a curriculum to give them the skills necessary to build bridges, diffuse situations, and protect the company’s culture. The leadership team and these Culture Ambassadors went through the program.
“We call it Camp Redoxy,” said Skievaski. “We bring people into the woods for three days either in Austin, Texas or Boulder, Colorado. We get super deep on what it means to build a sense of belonging, to build a collective flow within your organization, to really live the values, protect them and bring them out in others. For people who have attended, it’s been transformational. But the impact that they make within their teams has been really where we’ve seen the ROI.”
This leadership-backed and formalized approach to engaging employees in building their corporate culture, won Redox the 2022 Medigy HITMC Award for Employee Engagement Campaign of the Year.
Watch the full interview with Niko Skievaski to learn:
- How the team handles a “culture bomb” that sometimes goes off in their Slack channels
- The corporate trauma Redox experienced that was motivation to put more focus on their employees
- Why helping Redox employees bring their “whole self to work” is so important
Learn more about Redox: https://www.redoxengine.com/
Listen and subscribe to the Healthcare IT Today Interviews Podcast to hear all the latest insights from experts in healthcare IT.
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Transcript
[00:00:09] Colin Hung: Hello and welcome to Healthcare IT Today where we explore the latest healthcare technology trends and discover valuable insights in health IT. I’m Colin Hung and joining me today is Niko Skievaski, Co-Founder & President at Redox. Niko, welcome back to the program.
[00:00:27] Niko Skievaski: Thanks for having me Colin. So excited to be here with you.
[00:00:30] Colin Hung: Niko, today we’re going to be talking about a topic that is a little bit different than what we normally talk about. Normally when you and I get together, we’re talking about interoperability and the state of health IT, but today I’m excited to talk to you about corporate culture.
[00:00:44] Niko Skievaski: Yeah. Yeah. Something that at least for me has been top of mind over the past couple of years, but I know for a lot of people, as work has really changed in the pandemic, has become really top of mind as people are transitioning, how they work, if people are in-person and you know, all of the other sort of stresses of our lives that the pandemic has brought on and how that sort of creeps its way into the workplace. So yeah, I’m pumped to talk about this.
[00:01:12] Colin Hung: So maybe before we dive into some of the things you just mentioned, Niko, how would you define corporate culture? When someone says that word, what do you think about?
[00:01:25] Niko Skievaski: Yeah, I think of it as behavior at scale. The at-scale part is important because it’s not behavior of people with each other, it’s what happens across your organization. The way Luke, my co-founder put it is he says: “culture is what happens when you’re not around”. So much of it is influenced by leadership and the way people behave with each other.
[00:01:51] But it’s really like the next ripple after that wave of behavior. It’s like, how do people treat each other on a day-to-day basis? How do they show up with customers within the industry? All of that is kind of encompassed in culture. The way that we think about it at Redox is that our mission is really like the “why” – why we do what we do. Our strategy is the “what” – what are we going to do to accomplish the mission? Then our culture is the “how” – how do we put it all together. What do we do with our hands in order to actually move that mission forward? And so that’s how we think about culture. It’s one of the three pillars of organizing our company.
[00:02:39] Colin Hung: I love it. You’ve touched on a couple of things that you’re doing at Redox. I want to dive more into that because, you and I spoke, at the last couple of conferences where we saw each other, and you told me that basically you’re putting a lot more focus on the culture side of Redox. Can you share with us some of the reasons why you’re doing that? And second, can you share some examples of some of the things you are working on?
[00:03:08] Niko Skievaski: For sure. Well a few things happened in our history that has made me focus on this. First off when we started Redox, we sat down, there was probably six of us at the time, our first three employees and our three founders, and we basically did a brainstorm. What is the type of company that we want to build and we want to work at. We wrote down sticky notes and then we went around sharing that and then we grouped them. The groups of those sticky notes turned into our values and those were the values that we tried to hold ourselves accountable to and aspire towards and really build the culture. But that was, at the time, six guys who used to work at Epic who were aspirational about the culture. As we started to grow, we evolved those values to fit more with who we were.
[00:04:00] The first many years of Redox was…you know, I think about like the startup journey for a lot of companies…we had a pretty spectacular, fairytale startup journey. We found product market fit. We grew quickly. We were tripling the company every year. Everything was looking great. We were accomplishing our vision. Then when 2020 hit, the pandemic, we probably had 300 active projects with health systems and 250 of them got paused or canceled or delayed in Q2 of 2020.
[00:04:36] We were like, “oh no” we don’t think we’re going to hit our goals this year. So we had to look at our spending and figure out how to get it under control to live another day. That was, I think, one of the first big cracks in our cultural container at Redox. What we ended up having to do in June of 2020 was lay off 25% of the company…so 44 people at the time…by far the hardest thing that I’ve ever had to be a part of as a leader within an organization. We had to lay off those people, but what happened was everyone who was left, including myself were like, why…why was it them and not me? Why did I make that list? We literally had to choose this person or that person, like that’s what it comes down to and making those decisions. I think we handled that process well, but it left this feeling within the organization of: could this happen again? Am I safe here? Should I start looking for another job to have a backup or a pipeline in place?
[00:05:43] That was a trauma within the organization that we had to figure out how to deal with. Years later, the people who were here at that time are still dealing with it. They’re still thinking about their friends that they worked with, that are no longer with us. Luckily, things turned around for Redox.
[00:06:02] We were able to raise more money. We were able to hit our goals. We were able to hire another a hundred people since then, including some of the people that we had to lay off. We were able to hire many of them back, which was awesome that they would even give us the opportunity to do that. Now we’re up to about 220 people in the company. We passed Dunbar’s number, which is the number of people, human beings can be acquaintances with. Really what that means from a cultural perspective, is that you can’t depend as much on relationships to govern how we behave with each other. You have to depend a little more on processes because you’re not going to have a tight relationship with every single person at the company. It’s about that 150 mark where that happens. So that’s a couple of things that has forced my focus on culture now – the trauma that we had through the pandemic, both with the layoffs, as well as just the personal trauma and then us passing that number and continuing the scale.
[00:07:10] We’ll be at 300 by the end of the year, if we can hire. I know hiring’s a challenge for everyone right now. I had to think about how can our culture actually gets stronger as we grow? Not even maintain what we already have, which I think we have a pretty strong and effective culture, but how can we actually leverage the people that we’re hiring now to make our culture stronger? From my perspective, that means not only do we have to understand who we are today and have strong cultural infrastructure that says: “this is who Redox is today”, but also be inclusive enough to take the best out of the new folks coming in and improve upon that structure. So that’s what I’m thinking a lot about as we’re hiring more and more people. How can we build an organization that can actually evolve as we get bigger.
[00:08:00] Colin Hung: I really like that. You’re making a conscious effort to scale your company because you know that from this point forward, it is the culture, the process that’s going to carry you as opposed to the personal relationship that you have with the 150 or 200 people that you’ve worked with. That’s now going to become impossible for you and the other founders to do.
[00:08:25] Niko Skievaski: My role at Redox had always been at the beginning, focusing on the market and our customers and the way I saw it was like being the pace setter out in the market. It’s running as fast as I can at opportunities and then my team kind of follows and fills in the gaps and closes the deals and stuff behind me. What’s changed for me recently is that instead of thinking about the market as my customers, I’ve started to think about my employees as my customers.
[00:08:53] They are the ones that I’m serving on a day-to-day basis so that they can serve our customers in a more effective way. That subtle change has really allowed me to embrace this role of looking internally, rather than looking externally, because I know that I’m not going to have that big of an impact if I worked with customers individually because there’s only so much time I have. But if I can make an impact with each of our employees, then that that’s an exponential impact that can be had in the market because all of them are working with customers. And if they’re doing it in ways that are aligned with our values at the company then we’re going to be so much more successful in the long run.
[00:09:30] Colin Hung: Is there something you’ve worked on in the past 12 to 24 months that was directly related to culture that you have implemented or that you have put into place at Redox?
[00:09:43] Niko Skievaski: Yeah. For sure. We’ve done a few things. I’ll highlight some of them. First and foremost, we refined our values. We used to have 10 of them and what I did was I said: “This is a lot of values and a lot of them are kind of saying similar things”. I feel like this is something that only founders have the privilege to be able to do, otherwise it’s pretty difficult – I rewrote our values. I think of it as leveling them up. Now we have three values and I think there’s so much more useful. Our old values kind of nest under them as example behaviors of it.
[00:10:21] The three of them are: Growth Mindset, Belonging [which I’ve talked a lot about already] and Give a Shit, which was actually given to us by one of our customers. We do these customer interviews where you bring customers in and this customer told us “you know, the big difference with Redox is that you guys just seem to give a shit”. We were like – doesn’t every vendor in this space? And he’s like: “well, they say that, but the way that we work and the way that we show up” and I thought that was something that was reflected back at us. So we have those three values.
[00:10:51] We’ve essentially created a cultural strategic roadmap where we have goals and a big goal for 2020 was how can we get everyone at the company to this foundational level within our culture. That means certain behaviors that align with each of those values. In order to get the entire company to that foundational layer, we decided that there’s going to need to be people within the organization who are what we call the “emerging layer” – a layer above the foundational layer.
[00:11:20] This means that they need to… For example, within our cultural container, if you’re at the foundational layer, you’re participating, you understand that you actually co-create the culture with everybody else. If you’re at the emerging layer, your job is to not only understand your impact on the culture, but also protect the culture. When something happens or when something is said on Slack that people are reacting to – it is your role to protect the container to repair it if there’s cracks in it. Play an active role.
[00:11:56] So we said, we need a certain group of people to be operating at that emerging layer. So we built a curriculum around how do we train people on the skills necessary to do that. We’ve done this with our whole management team. We’ve gone on two retreats focused on this entirely and we do it with various, we call them cultural ambassadors, within the organization. We call it Camp Redoxy. We bring people into the woods for three days either in Austin, Texas, or in Boulder, Colorado, depending on the time of year. We’ve done four of these already. What we do is we get super deep on what it means to build a sense of belonging, to build a collective flow within your organization, to really live the values and protect them and bring them out in others. These people start a six month program after that, to work with each other, to bring this back to their teams.
[00:12:53] We’ve had now 33 people across the organization do that and including the management team, that’s up to 40 something people out of a team of 200. So it’s a good portion of the company that has gone through this immersive training and we expect them to protect the culture and bring others deeper into it. That’s a program that is ongoing. So we run those four times a year. For people who have attended it, it’s been transformational is what they tell us. But I think the impact that they make within their teams has been really where we’ve seen the ROI come out, because they understand how to work better with each other. They understand how to bring others within the organization to work cross-functionally and to collaborate more effectively and openly.
[00:13:44] Those are a couple of the more creative things that we’ve done. I think we do a lot of the baseline things that a lot of companies do, but that’s some of the more creative programs.
[00:13:57] Colin Hung: Well, I love it. First of all, I love the ambassador program and I love how you formalized it. It’s not just “oh, we’re going to name some ambassadors and maybe we’ll give them a t-shirt and that’s it.” You actually went to the next step of actually giving them training and giving them the tools to impact and maintain and scale up and level up that culture you have there. That’s amazing I also loved how you pointed to something very specific around Slack and how if left unattended, how that could be a detriment to your culture.
[00:14:32] If something festers in there, if a complaint is left in there and not addressed, if something bad was said and it shouldn’t have been said and no one calls it out. Yeah. That’s stuff that can really replicate and really eat away at a company’s culture.
[00:14:45] And I love how you’re pointing to that and saying you need ambassadors to address it because that’s a symptom of an underlying problem.
[00:14:54] Niko Skievaski: I think that’s huge. Whether you’re in Zoom and the Zoom chat is going or in Slack. It happens probably once a week within our organization where someone says something with the best intention, but it might land the wrong way, or it might make someone feel alienated. It’s often a misalignment between what their intention was and what impact they have. When that happens, how does the organization respond? Because often it turns into a thread of people arguing about it and bringing in articles and things to support whatever point they’re trying to make.
[00:15:31] We actually have protocol around that. When something like this happens, we call it a container bomb – where some little bomb goes off in our cultural container. How do we respond as an organization to that? For company wide ones, our management team responds. Within these ambassadors, when they happen on a micro scale it’s on them to figure out how to respond. Sometimes it’s a matter of reaching out to the individuals and just making sure everyone feels heard and understand that they’re not. If someone feels alienated, reach out to them and lend a hand and have some empathy. If it’s at a company-wide scale and it turned into a thing where people talk a lot about it, it might make sense for a leader within the organization to address it.
[00:16:13] Leaving things unsaid, it can create resentment within the company. It can create feelings that build and grow over time. If you could just address it up front, acknowledge what happened, apologize, potentially talk about what’s going to be different in the future. These are all ways that we try to get ahead of these and not let a culture bomb actually crack our container.
[00:16:42] Colin Hung: Again, I love that analogy and I love how you’re taking it seriously. We have heard in some other cultures and other corporations where they, I won’t say push it under the rug, but they ignore it by saying – just grow up in the workplace, be professional. I think that ignores the reality of our world today. That isn’t how the world is working. You do have to address it. Those that don’t see it as important, they’re going to bear the consequences a year from now when those people, all of a sudden decide “I’m out of here, I’m going to go somewhere else”.
[00:17:19] They [cultural ambassadors] do make a difference and yes, it takes time to deal with it. But when you do it furthers the growth of your own culture. It strengthens it. Your culture and your company will benefit more from that, than if your executive was focused on something externally.
[00:17:37] Niko Skievaski: The way that I’ve really tried to see it is that often it’ll be almost like an argument between two sides, whether it’s a political thing or some ideology. My first instinct is – how can I take sides and be like this person’s right and you’re being a jerk, but what I try to kind of level up. Instead of calling someone a winner and making someone feel bad, how can we actually build bridges between these two in this argument? What are ways to build bridges rather than build barriers.
[00:18:15] Having a diverse set of opinions about lots of topics, that’s the diversity that we talk about being really valuable within any organization. So I never want to squash someone’s ideals about the way that they think about the world, even if it isn’t aligned with how I think about it. There is room within an organization to have a healthy debate about it, to bring issues that people are really passionate about into the organization and do it in a way that doesn’t disrupt the work, but actually builds bridges between people. We can say we might disagree on a certain topic, but I respect you and I can still work with you. I can still respect your ideas on that topic as well as topics related to directly to the work that we’re doing.
[00:19:00] We saw this kind of at the beginning of the pandemic and the civil unrest that we’ve had in the past couple of years, where some companies are saying we only talk about work at work and we do not bring the rest of our lives into it. I think that’s pretty sad because that means you’re only going to get people who only bring a portion of themselves into the workplace. I want people to feel like they can authentically bring as much of themselves as they want and feel a sense of belonging in doing so.
[00:19:32] Colin Hung: Awesome. If you and I get together a year from now to talk about the work you’ve done on the culture at Redox, what are some of the things we’re going to be talking about?
[00:19:43] Niko Skievaski: Hopefully it’s that we were able to hit all of our hiring numbers. We’re hiring a bunch and it’s funny Redox has been a remote company since 2014 when we started it. That used to be a big differentiator for us. These days everyone’s remot so it is much less of a differentiator. But we really have to lean into the fact that we have a lot of practice and we are remote first. It’s not that there’s some people in an office and there’s some people not. Everyone is remote and we do it really well. I feel like we’re at the cutting edge of figuring out how culture can work effectively at scale in a fully remote setting. There’s not many companies who have done that over a thousand people out there and everyone is trying to figure that out right now.
[00:20:32] The majority of companies probably won’t stay fully remote. A lot of them are bringing people back and doing some hybrid model, but figuring out how to make that work is going to be a challenge. I hope in a couple of years, when we sit down, there’ll be a little less unknowns about how to make it work and a lot more successes about a new way that people are showing up to work every day, where they are fulfilled from an engagement perspective, working effectively and the unknowns around it from a leadership perspective have been ironed out a little bit.
[00:21:10] Colin Hung: I love it. I love it. Final question for you, Niko. What one piece of advice would you give to other health IT business leaders out there who are listening and watching, what can they do to improve the culture at their organization?
[00:21:25] Niko Skievaski: Oh gosh. I would say going back to what we talked about earlier that the people who work in healthcare are here for a reason and we need to figure out how to tap into that and really leverage that intrinsic motivation that people come with because it’s really easy for a culture to kill that, for people to focus too much on the short-term wins to cut corners. I think that employees can feel that and they can see that. As leaders we owe it to them to not crush the spirits of people who have given up a lot in sacrifice to work in healthcare because it’s not an easy industry. It’s easier to bring our talents elsewhere for the amount of effort we put into it. So I would just say that. How can we figure out how to embrace the hearts and minds of our employees by helping them bring their whole self to work.
[00:22:33] Colin Hung: Niko, this has been amazing. I love this conversation. You brought up so many amazing quotes that I’m probably going to use in the article to summarize this. Thanks so much for sharing all this wonderful information.
[00:22:46] Niko Skievaski: It’s been awesome and it’s been great working with you over the years. Can’t wait to sit down again in another couple of years and do this again.
[00:22:57] Colin Hung: Absolutely. It would be great to do a checkpoint seriously in like a year from now to kind of go, Hey, how does how’s this going?
[00:23:03] Niko Skievaski: Yeah, yeah, yeah.
[00:23:05] Colin Hung: And again, I just want to say, that was what intrigued me so much about getting together with you because you’re one of the few health IT leaders that I’ve talked to you where you’ve put such a focus on culture and it is amazing to see.
[00:23:16] Niko Skievaski: Yep. I think, you know, it’s been because of our culture, why Redox has been successful to date, I think with the increased attention that we’re paying to it and how we’re actively building it’ll only contribute to our, our further success. At least that’s what I’m hoping for.
