ANDHealth+ portfolio company Kraken Coding is on a mission is to transform evidence-based guidelines into interactive pathways that guide clinicians to the right decision at the point of care. We spoke with Co-Founder John Shanks about the journey of taking their freeware platform from the NT to over 70 hospitals across Australia and Canada.

Tell us about your company and the problem you're trying to solve.

I'm a pharmacist who got tired of watching clinicians struggle to find and follow clinical guidelines, so I taught myself to code and built something about it. Our platform, Clinical Branches, turns dense clinical guidelines into interactive step-by-step pathways that a busy clinician can work through in under a minute (our average is 48 seconds), with decision support, dosing calculators and audit tools built in.

The problem is huge: 30 to 40% of patients receive care that isn't best practice leading to avoidable harm and longer hospital stays. The platform is a continuation of a webpage I started as a free open-source project in the Northern Territory, and we're now live in 72 hospitals across Australia and Canada, with measurable results like a 25%+ improvement in guideline-adherent prescribing after implementing.

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Why did you apply for ANDHealth+ and what are you hoping to achieve through the program?

This was actually our second attempt at applying for ANDHealth+, so I am pretty happy we got in this time. We've proven the clinical side – hospitals are using the platform daily and have reviewed the outcomes, and we've done the regulatory yards with ISO 13485, MDSAP and TGA registration.

What we haven't had is structured commercialisation support from people who've scaled digital health companies before, and that’s where ANDHealth+ comes in.

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What have been the biggest challenges in developing or scaling your solution to date?

Enterprise health moves slowly, and as a bootstrapped company that's brutal. Sales cycles run over 24+ months, every health service has its own procurement process, and you carry the cost of regulatory certification (ISO 13485, ISO 27001, MDSAP, TGA registration) long before the revenue arrives to justify it (something we are really struggling with at the moment).

The other big one was learning that free doesn't scale. The original open-source pathways app grew into 15 hospitals and proved demand, but freeware can't fund the support, security and regulatory work hospitals rightly expect.

We had to rebuild the model around sustainable contracts while keeping the goodwill that open source created – we landed on a compromise with a freeware model which is not common in hospital systems.

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How will your technology help improve health outcomes, system efficiency or patient experience?

The outcomes are already showing up. Sites using our pathways have seen broad-spectrum antibiotic use drop by 40%, prescribing appropriateness jump from 56% to 81%, and we are awaiting research to see how that impacts length of stay.

On the efficiency side, we give hospitals automated audit tools and accreditation evidence dashboards that turn weeks of manual work into a couple of clicks, and our virtual stewardship tools let small rural hospitals without a full-time specialist pharmacist get the same quality oversight as a big metro site. Better prescribing, fewer complications and shorter stays is ultimately what patients feel.

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What has been your most valuable lesson as a founder so far?

It's going to take you at least two years to get reasonable traction in enterprise health, no matter how good your product is.

Lay the foundations early, keep your intentions out in the open with the health services you want to work with, and if you're bootstrapping, go in clear-eyed that you'll be putting a lot of your own time and savings on the line before the traction shows up.

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What changes do you want to see to better support digital & connected health companies to scale and succeed?

I'd love to see a better model for public-private collaboration. Too often national programs and health services build in-house or treat local industry as a competitor rather than a partner, and Australian companies end up proving themselves overseas before being taken seriously at home.

Procurement is the other one: a successful deployment in one state should count for something in the next, instead of starting every procurement and security assessment from scratch.

Non-dilutive funding programs have been gamechangers for us, and more of that earlier in the journey would help a lot of companies over the valley of death.

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What's something the sector may not know about you?

Everyone assumes I'm based in Sydney or Melbourne, but I actually live in Forster on the NSW Mid North Coast. When I'm not working on code or clinical pathways you'll find me at one of the great beaches up here.

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