A very close friend of mine once said to me, “Therasa, if it doesn’t breathe, it doesn’t matter.”  Like the poignant moments in everyone’s life…these words had a profound impact on me and forever cemented how I would lead my life.  It wasn’t as if I had been living this self-centered, me-first lifestyle…I hadn’t.  I have worked hard to make selfless decisions and put others first.  But…it was more about the clarity and decision-making context a simple statement brought to me in all parts of my life.

When life gets chaotic and tough, it can be easy to forget or forgo what may be required to make the most difficult decisions facing us, especially when others, particularly those with influence, are of a different mindset.  But consistently made in the context of this simple statement, decisions will never have a bad outcome.  They may not yield the highest financial return or accelerate you to first place near term, but they will prevail.  I have experienced it, both on the receiving and giving end, many times.  So, many times, that in my view, this is as close to a fact-based statement as one can make without involving some sort of stat.

In October of 2009, Dane Meuler and I, determined to start a company that was solving a very simple, but impactful, problem in healthcare.  At the time we started the company, we had worked together for over 10 years (mostly me working for Dane) and came to trust the decision making and integrity of each other.  I always knew…and still know, that Dane will make decisions that are the best for others involved, whomever they may be, in any given situation.  The established trust permeated the decisions we made, some of them being very difficult as a startup, but set the foundation of who the company was.

At that time, Dane and I decided to go after parts of the market that were under-served, both technically and financially.  We witnessed the way the money was flowing in healthcare with stimulus funding.  So, as many IT vendors were making decisions to move towards easy money, we decided differently (try having that conversation with your board and investors). We knew that markets like post-acute, behavioral, dental, vision, emergency medical services, community services and others were critical and would become instrumental in delivering effective, less expensive options as we watched our healthcare system continually straddle the line of collapse. We made the decision and have never looked back.  If it doesn’t breathe, it doesn’t matter.

As we started to grow to the point where we need to hire our first few employees, we implemented a hiring model that continues to be used today at Kno2. Some argue that it’s not sustainable, but I would challenge that and will defend it in another blog.

Largely, we decided to hire people we had known and had the experience of working with in some capacity and were able to experience their skills and work ethic, but most importantly their approach to life versus hiring through formal job postings, resumes, interviews and the like.

Our key filtering question – Do they manifest the same selflessness as we would like to see throughout the company? Through that simple hiring requirement, we have been privileged to be surrounded with employees that would be considered by anyone’s definition, the salt of the earth. It’s truly humbling to watch Kno2 employees behave every day in ways that reflect decisions made on behalf of our partners, our customers, the patients, and each other.  As a side note, we have made a few decisions to hire folks that we previously have not known and we’ve been very fortunate to make good decisions with folks that carry the same values.  If it doesn’t breathe, it doesn’t matter.

As we continued to experience growth, I recognized that the organization had outgrown my skills and desire to continue being the CEO. Although, we were still quite small at the time, the growth trajectory in front of us was significant and required leadership and talent I did not have. But, the biggest challenge, and arguably the most important decision made in the company, was to find a CEO that could lead us where we needed to go, but more importantly, embraced the culture with which Dane and I had started.  Fortunately, I had the experience to have been working with a person that had been a customer of our company and then an adviser to myself and the board. His name was Jon Elwell and he had previously run the healthcare division at Ricoh North America.  I had worked and experienced Jon’s passion, decision making and strategic nature for nearly two years prior. More importantly, I experienced his values throughout, especially under fire, and knew he was the right person.  I was right (yes…I am patting myself on the back).  The company would not be here today nor have maintained the culture without him.  If it doesn’t breathe, it doesn’t matter.

As an example of Jon’s value system, a few weeks ago Kno2 leadership sat in a planning meeting and we were working through new pricing structures and financial models given how much our company had grown and changed. Our previous models were becoming outdated. As we looked at the opportunity to substantially increase our prices, Jon chimed in and said, “I hope we all realize that we are in the privileged position of bringing interoperability to all of healthcare. Our technology breaks down historical barriers that have prevented it from being available to everyone. We will not continue to propagate that.  From the physical therapist providing care in the strip mall to the largest health system, our pricing models and technology will always be affordable and available to all.”  I will never forget that moment.  If it doesn’t breathe, it doesn’t matter.

As we celebrate our 10-year anniversary in 2019, I find myself reflecting on how much this value statement has infiltrated all parts of our business. From strategic planning, to hiring, to partnerships and customers, leadership and the difficult decisions Kno2 leadership has had to make, consciously or not, “If it doesn’t breathe, it doesn’t matter” is the ethos of Kno2. And…when we (speaking for Kno2 leadership) have been in situations that have forced decisions anti to our culture, it sits as a dark cloud over the company for a sustained period of time. We have vowed to stay the course, avoid those situations and believe it is the key to a successful business.