Iora Health is transforming health care, starting with primary care. We created a high-impact relationship-based care model that particularly benefits adults on Medicare and those who might need more attention. Our care model changes everything – the team, outcome-focused payment, customer service, and the technology that supports our care.
Each team is asked to select, explain, and rank their top 8 values in order of importance.
Bonded by Love for Product
We all share the goal of restoring humanity to healthcare.
Iora Health was founded on the belief that the relationship between a patient and their provider should come first – and quality of care should never be secondary to billing. Much of the tech that healthcare providers currently use, however, is built entirely around documenting, coding, and billing. As a practicing physician, Rushika (Co-founder and CEO) was frustrated when healthcare was reduced to a series of transactions. He recognized the need to rebuild the system entirely and start from scratch. Thus, Iora Health was born.
Our innovative care platform, called Chirp, is uniquely centered around the patient. We’re pioneering a payment system that’s based on each individual’s care needs and building our technology around people, not process. The COVID-19 pandemic only underscored the need for providing quality care for the elderly and people on Medicare, which is the main population we serve. The desire to get solutions into the hands of our users is what drives most, if not all of us, at Iora. We love the fact that our users are also our colleagues – the doctors, nurses, and health coaches on the front line of care – and that we’re building a product that keeps people healthy.
While some engineering groups like to build tech for tech’s sake, we’re not chasing the shiniest new library or buzzword out there. Instead, we’re actively dogfooding our own product and remain focused on how we can solve real world problems for patients, doctors, and providers across the country.
Our goal is never to tell engineers what features to build, but rather give them the tools they need to solve whatever problem they’re facing. Instead of following a roadmap that’s decided on in advance, we have a list of prioritized business problems that business owners weigh in on. For example, let’s say we notice it’s taking too long for providers to refill medications. We don’t know why or what the solution is, but we might say, “It currently takes an average of 36 hours and we need to get it down to 12, go!” Teams then work cross-functionally with users, providers, designers, and business analysts to create hypotheses and test them using software.
Scrum teams working on Chirp are made up of 3-4 engineers, a product manager, a product designer, and a representative from the market the team is serving. This is usually a provider who has a high level of insight into the day-to-day operations of the primary care clinic. Teams are typically set for about 1-2 years before we mix them up, and most of our teammates (we currently have around 20 on the team) have all worked with each other at some point.
Uses Agile Methodologies
We’re a small but mighty team.
For the first half of our existence we only had five or six engineers. In fact, we were only three engineers when we built version 1.0 of our software. We literally had to function in an agile way or we wouldn’t have survived, and that remains true today. It’s important that we pick problems, and quickly deploy software to test our hypotheses. This is partially due to the fact that executive buy-in and stakeholder feedback inherently requires agile functioning. We’re a fraction of the size of other teams building electronic health records (EHRs) and that’s only possible because we embrace the idea that perfect should never be the enemy of good. We’re deliberate about the problems we work on and iterate efficiently.
We're continually gathering feedback from both our end users and our team.
Unlike many companies who have to guess at what customers are looking for, we have the unique opportunity to interface with the folks who use our software daily. We’re regularly communicating with the providers that use our platform so we can make the best product possible. Whether it’s a practice based in Seattle or Arizona, we tend to know our providers’ names and faces very well. Engineers work closely with providers to get feedback during our two-week sprint cadence, and even more so when we’re doing an alignment sprint and brainstorming what to build. In non-pandemic times, engineers visit practices around the country at least once a year to shadow our users, look over their shoulders (literally), and see first-hand how they’re using the product. During the pandemic, we’ve shifted to virtual office hours, but hope to get back on the ground as soon as it’s safe to do so.
When it comes to gathering feedback within the Chirp team, we have quarterly surveys, so engineers can provide input on our team’s leadership priorities. We’re very open about sharing the results so we can learn from them and take action. This also allows us to have several snapshots to track against instead of just one per year. That way, when it comes time for annual reviews, managers can use these multiple (more informal) check-ins to help them build a much better picture and advocate for the best results for their direct reports.
Fosters Psychological Safety
We want you to feel safe to be ambitious, ask for help, fail, and learn.
In order to empower teams to make decisions, engineers have to feel safe enough inside their team to be industrious, make and learn from mistakes along the way, and be able to seek help when needed. We’re adamant that diverse teams with different viewpoints and experiences will 100% create the best software and product for us.
Creating an environment that prioritizes psychological safety starts at the team level, but really ladders up and permeates the entire organization. Being part of the healthcare industry, we have the unique benefit of access to behavioral specialists. We recognize that healthcare can be a stressful experience for everyone, and we’ve had behavioral specialists lead stretching and yoga breaks, Zoom meditation sessions, as well as give talks on how to build resiliency and cope with the pandemic.
While our values have always informed our mission, the events of the summer of 2020 highlighted the sustained violence toward Black Americans and illuminated the social and economic disparities further exacerbated by COVID-19. Our organizational commitment to diversity, equity, and inclusion will always be an ongoing process, and we started to deepen and codify it by focusing on learning from voices across our organization. Executive leadership made sure to check in with colleagues in the Minneapolis area, our care teams reached out to all of our Black patients nationwide to ensure their well-being, and we sent an open letter to all of our patients reaffirming our commitment to racial and social justice. We continue to invest in this work as a key contributor to our success as a culture and community, and believe that all stakeholders (patients, employees, shareholders, and our broader community) are served by Iora’s commitment to this work.
Transparency starts at the leadership level.
Our executive leadership regularly demonstrates open communication and transparency. We have twice monthly Q&As via Zoom, where people fire questions into the chat and the exec team answers them. There’s also a short internal survey every quarter so leadership can hear everyone’s feedback and then share that with the team.
At the Chirp team level, we regularly dialogue with our users and all engineers participate in support rotations. We have a weekly on-call schedule where we directly answer user questions around how certain features work or address obvious bugs.
Finally, group retrospectives are a regular practice to foster transparency and openly discuss what we can improve. We do retros on our day-to-day internal processes and we use this feedback to iterate on our work processes. Everyone is encouraged to chime in and we take all voices into consideration.
Like our patients, we take care of our whole selves, too.
We know you’re more effective when you have time off to recharge and spend on the things you’re passionate about. It’s very rare that you’ll work more than 40 hours per week. We’re very intentional about how we plan our work, leaving enough slack in the system so we almost never have fire drills that require you to be online at midnight or scrambling for an entire week.
One of our software engineers, Laura, wanted to find a job that prioritized work/life balance. As a new mom-to-be, this was top of mind for her. As she puts it, “When I reviewed the Iora Culture Book, I immediately noticed the presence of families and children in the employee photos – and I knew right then that I would belong.”
It’s fair to say that the pandemic presented a challenge not just for our providers and patients, but also for us as employees. For instance, one of our product managers, Eliot, has two young daughters who needed his support when their schools transitioned to online learning. Rather than trying to figure out if it should be time off or time away, we simply trusted Eliot to manage his own schedule and figure out what worked best for him and his team.
High Employee Retention
There’s a reason so many of us have stayed for 6, 8, 10+ years.
Rusty, our Director of Engineering, has been with us for nearly six years, Eliot for almost 8 years, and Patrick for 10 years, just to name a few! Not only that, but our first five engineers are all still with the company and only two people have left the engineering team in our 10-year history. While we’re always doing our best to point you in the direction the team is going in, at Iora your time is really your own (and that includes your work time). In fact, on the Chirp team we have dedicated “engineers time” where you get to use a portion of your time in a sprint to work on whatever you choose. This can be pretty much anything that furthers your growth. For example, one engineer is learning a front-end tech that we don’t currently use, and another is doing a deep learning dive on web accessibility. You can only work so hard before you burn out, and we actively try to keep the pace sustainable.
Bonded by Love for Product
Heavily Team Oriented
Uses Agile Methodologies
Fosters Psychological Safety
High Employee Retention
10 Data Science Engineers
19 Full-Stack Engineers
4 Full-Time Managers
8 Product Managers
Ruby/Ruby on Rails, EmberJs, PostgreSQL, Elasticsearch, RabbitMQ, AWS, CircleCI