Listen to Users

No matter what you do or where you work, you have users. These can be patients, members, providers, or vendors. It doesn’t matter if you’re B2B and sell to enterprises, you still either have users at that enterprise or that enterprise has its own users (patients and providers) for your tools. EHR vendors like Epic have enterprise customers, provider users, management users, and patient users (through Epic PHR solutions). B2C apps like the new AskMD app from Sharecare sell directly to users, in this case consumers. Even a content business like HIStalk has users — they are the readers, even those readers who aren’t on our mailing list.

If you work directly with users, good for you. It’s a lot easier to get feedback and ask questions and it’s a lot easier to understand how users are actually using your service or product. You can poll users really easily. You can also respond a lot more quickly and you can be a lot more of a hero to users.

If you have a customer intermediary such as an enterprise, then you have to work a little harder to understand your users. You still ultimately need to sell to customers, but knowing and incorporating users into your product or service is essential. There’s the adage “know your customers’ customers.”


User tell you everything you need to know, even stuff about your customers if your customers are different from users. It’s a beautiful experience to spend time with healthcare IT users. And I mean real users, not focus group users that aren’t really reflective of users you need to engage. I’ve been spending a lot of my time recently talking to healthcare IT users — providers, consumers, marketers and even developers and CIOs.

The challenges that people deal with when it comes to healthcare services and technology still shock me, even though I’ve spent the last several years deep in the industry. The shock is partially because the industry is slow moving, partially because a lot of the hype in the industry isn’t implemented or at scale, and partially because a ton of challenges are still not being addressed.

There are lots of stories about large, enterprise vendors telling customers, “Sorry, we can’t do that” or “That’s in an upcoming release,” which can mean years from now. It can be anything from adding label colors to adding significant functionality.

If you’re a healthcare IT user, when was the last time you engaged with a vendor about product improvements or feature enhancements? What enterprise vendors are working closest and listening to users, not just reactively, but proactively? I’m just curious because I think eventually a lack of attention to users is going to have a significant effect.

This lack of responsiveness from vendors happens outside of healthcare, too. The trends and expectations of users, even when it comes to enterprise software, are changing. Use any modern web service or application and you’ll likely have nearly real-time access to support and management. I’m often astounded at how responsive companies are to user feedback and support needs. Just as consumer expectations are changing expectations when it comes to the types of access and technology they use, so are their expectations about their relationships with companies.

That’s because in the consumer software space at least, technology is no longer a differentiator. What differentiates companies is the overall experience, the community, and the goodwill between users and a brand. On the enterprise side, and in healthcare, it’s not that simple, especially as large vendors sit on and hold essential data hostage (I consider charging thousands of dollars for interfaces to be holding data hostage.)

In healthcare, there is a significant switching cost. Spending years and millions of dollars also makes switching hard. But some of these data silos are starting to open up, and the movement in the industry around data ownership and patient access to data as part of MU, is driving that. In time, those switching costs are going to down.

And then we’re going to see companies that know users, that work with users, that make users happy whether they can deliver a feature or not, succeed and pull away. But you have to reach users and listen to them. You have to engage them.

There’s another challenge that I didn’t write about, which is software and services that just can’t be adapted quickly to meet industry and user needs. In healthcare, this lack of agile abilities can result from (1) regulation — FDA-regulated products have very clear and long release cycles by necessity; (2) outdated and bloated software that’s hard to modify or change; and (3) mission critical systems that can’t be changed easily because clinical decisions and treatments are dependent on the quality of data. This last excuse is one I’ve heard a lot lately, and one I understand and appreciate for a limited set of data and fields, but one that I think is overused. Regardless of the reason or excuse, there are still ways to engage users and create goodwill without building every feature that users request.

In the long run, the industry will course-correct to reward those vendors, systems, and payers that listen to users and adapt, in the process punishing those that don’t adapt and don’t listen. It’s some time away and will likely take longer than most VC investment cycles will allow, but we’re closer to the tipping point than most people think and the rewards for user-focused organizations are almost here. Keep listening, keep adapting, keep moving.


Travis Good is an MD/MBA and co-founder of Catalyze. More about me.

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