Summary
There is nothing more frustrating than dedicating your blood, sweat, and tears to developing a product, only to see it shut down for no particular reason. We still lack standards for measuring potential opportunities and solutions—so leadership continues to base decisions on intuition, personal experience, and other factors that often barely correlate with success. Organizations large and small need agreed-upon measures of potential product-market fit for their concepts and solutions, ones that help establish unmet needs and lead to designs that users understand and want to use. The DesignOps team at Athenahealth has solved this problem by creating a standardized measurement framework—including qualitative and quantitative instruments—that helps product teams measure their concepts and solutions early and often. These are measures that leaders can use to make informed investment decisions across the larger portfolio, and that free product teams to be awesome at what they do: designing, managing, and developing products that lead to better experiences for users.
Key Insights
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Scale should be measured by the quality and meaningful impact of design, not just quantity or organizational reach.
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Lack of team agency in decision-making leads to unhealthy behaviors like cutting corners and skunk works projects.
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Athena Health flourished initially due to government-subsidized demand rather than superior user experience.
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Physicians using EHR systems often feel like clerks, frustrated by poor usability and forced workflows.
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Enterprise software delusion occurs when companies succeed despite poor design due to weak competition and high switching costs.
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Proving design impacts business outcomes requires identifying and analyzing key metrics like user retention and referrals.
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Creating a shared design language involving product managers and subject matter experts fosters organizational alignment.
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Systematic workflow audits guided by Jakob Nielsen’s heuristics can uncover actionable improvements to complex software.
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Redesigning product decision-making to empower teams early in the process accelerates better pivot, shelve, or proceed calls.
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Introducing self-serve experience measurement tools, including concept validation surveys, supports evidence-driven design iterations.
Notable Quotes
"Scale isn’t just about quantity, it’s about the quality and impact you have on organizational outcomes."
"So much change was killed just because leadership said so, and that really breaks my heart."
"Doctors don’t like using EHRs because it turns them into clerks; they’re engaging with a machine instead of a patient."
"You’re born on third base but think you hit a triple—that’s the enterprise software delusion."
"Users aren’t happy because they’re trapped; they have no sense of agency over the software they use."
"If design doesn’t move the needle, what needle are we even talking about? You have to find that needle."
"Creating a shared language lets others articulate design issues and makes design part of the conversation."
"Redesigning decision making means teams should have the autonomy to recommend pivot, shelve, or proceed earlier."
"We cut the claims editing process in half—four pages and 10 steps down to one page and four steps."
"Concept validation helps us spend time building useful things before making them work well."
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