Summary
When is DesignOps about more than building tools and systems that improve the effectiveness of R&D? For athenahealth, our DesignOps team has housed two cross-product teams—by organizational necessity at first—that have become critical early adopters of the instruments and programs their DesignOps colleagues have developed.
Key Insights
-
•
Athena’s software originated from a birthing clinic and evolved over decades, accumulating massive design debt unique to healthcare documentation demands.
-
•
The end of federal EHR incentives in 2016 shifted buyer focus from payment speed to usability, drastically changing market dynamics at Athena.
-
•
Agile transformation replaced Athena’s waterfall approach, restructuring teams into feature-based scrum squads with generalist designers supported by centralized specialists.
-
•
Design ops at Athena was created to reduce friction for embedded generalist designers by providing tools, systems, and specialist support.
-
•
Design quality audits using Nielsen's heuristics were developed to quantify usability issues across 55 mission-critical clinical workflows for better prioritization.
-
•
Introducing design quality scores gave senior leadership a shared language to discuss usability and made design debt visible in hard numbers.
-
•
Scaling design audits required asynchronous review via a custom app, enabling broader participation despite heavy resource demands.
-
•
Athena’s frequent reorganizations exposed the flaw of using work structure as taxonomy for knowledge management, prompting adoption of a jobs-to-be-done based job map for stable tagging.
-
•
Design ops at Athena plays an extended role in optimizing product development processes, providing tools at multiple software lifecycle phases.
-
•
Athena is experimenting with a design ops-hosted cross-product scrum team to lead visionary UX initiatives, testing the boundaries of design ops influence.
Notable Quotes
"I joined the design ops team about six months after it was created, and I'm not the head but part of its leadership."
"We’re an older company by tech standards—older than Facebook, Twitter, LinkedIn, and even Google by one year."
"No doctor wants to use an EHR; we’re often the least bad option in a field full of poor usability."
"The first year federal incentives ended, the market changed completely; buyers started listening to end users more."
"We had 85 UX specialists peppered around and reshaped them into generalist designers supported by design ops to reduce their load."
"We audited 55 mission-critical workflows over nine two-week sprints using Nielsen’s 10 usability heuristics."
"Giving senior leadership a shared language for design helped product teams better communicate what needed focus and why."
"We built an app to let reviewers asynchronously capture design audit findings, significantly reducing scheduling friction."
"Using work structure as a taxonomy for knowledge failed due to frequent reorganizations; switching to a jobs-to-be-done taxonomy gave us stability."
"We’re exploring if design ops should host a cross-product scrum team focused on visionary redesigns to have bigger impact."
Or choose a question:
More Videos
"Giving people time and space to think individually and pressure test with AI before group discussion prevents dominance by power."
Kurt McCullochFaster alone, further together: Rebuilding collaboration in the age of AI research
March 10, 2026
"How do we train AI models to prevent bias and preserve privacy, especially considering disability data is often seen as medical data?"
Sam ProulxTo Boldly Go: The New Frontiers of Accessibility
November 18, 2022
"This networked micro economy in medical marijuana transformed the world once recreational use was legalized."
Leah BuleyClosing Plenary: The Crisis of Digital
March 31, 2020
"I hope you’ll come out of the day feeling energized and excited about the opportunities and the possibilities."
Christian CrumlishIntroduction by our Conference Chair
December 6, 2022
"The smartest person in the room is the room itself."
Stephen AndersonPuzzled? How to Coordinate Humans for Complex Challenges
May 27, 2021
"You don’t need a huge planned research study; even two participants can uncover valuable insights."
Gabriela BarnevaOperationalizing Inclusive Design in Service Design
November 20, 2025
"You can’t put the toothpaste back in the tube once biased AI harms your brand or users."
Jay BustamanteNavigating the Ethical Frontier: DesignOps Strategies for Responsible AI Innovation
October 2, 2023
"If the survey wording changes, measuring change over time becomes difficult, but improving the survey builds trust."
Chris EngledowlA Mixed Method Approach to Validity to Help Build Trust
April 28, 2023
"You lie to yourself more than anyone else; the lie is that you are completely rational and objective."
Dave GrayLiminal Thinking: Sense-making for systems in large organizations
May 14, 2015