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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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“You Ugly”: Creating 8 cow software

Ugly (ŭg’lē) adj.

  1. Displeasing to the eye; unsightly.
  2. Repulsive or offensive; objectionable
  3. Likely to cause embarrassment or trouble

UPDATE: I was able to talk with several senior executives, including Jonathan Bush (CEO) and Rob Cosinuke (Chief Marketing Officer) about my concerns. The great news is that athena is finally getting serious about design and hired their first UX folks last fall. They have begun their work and I look forward to hearing about their progress. I also was given some insight into athena’s plan to leverage their new Communicator platform (functional PHR) as a first foray into creating virality (as in viral) to their software. The approach is still a “push” and I believe they will find that their design efforts will create more of a viral “pull” than anything else they can do on their side. As one of the best UX people I know recently said, ” UX design is business strategy, not just making something look pretty.”

One of my favorite stories from my childhood was the quaint but profound story of Johnny Lingo. As you recall, Johnny was a young man who was the original Bachelor on his sleepy south Pacific island. The village was abuzz as Johnny prepared to make an offer on his future wife. All the village girls primped and pranced in an effort to win his heart as they heard that Johnny was preparing to offer a significant sum for his wife. However, one young woman, did not participate in the festivities. Mohanna was different than the other girls and was treated very poorly by the other villagers as well as her own family for her plainness and painful shyness (the cutting words of her father, “Mohanna, you UGLY!” became a familiar epithet used around our home and on the playground).

But the noble Johnny Lingo saw something that no one else did. On the set aside day, Johnny gathered his friends and began the processional march into town. To everyone’s amazement, Johnny was followed by eight cows – more than had ever been offered in the entire history of the island. He passed house after house of eligible bachlorettes to both their deep disappointment and obvious dismay. Finally he came to the humble house of Mohanna’s father and offered his 8 cow dowry for his daughter. The shocked father questioned Johnny’s sanity, but ultimately agreed to the gifts in exchange for his daughter. Mohanna, affected deeply not only by the amount that was paid for her hand in marriage, but also by Johnny’s ongoing devotion and deep love for her, rapidly blossomed into an amazing beauty. For the first time ever, people were able to see the incredible beauty that had always been there.

Athena is the most powerful software “solution” I have seen in the market to date. I have highlighted the solution repeatedly because I believe so profoundly in the underlying principles (dang, there is some funny stuff in there):

The important concept to understand is that athena is promoting “service enabled software” meaning that an entire service organization is built up around the software platform. The software is a tool that is highly leveraged and works synergistically with the service organization to create an unprecedented practice performance level. Having implemented the software now for three months, I can see the real, tangible, and immediate benefits of athenNet services. It has lived up to its promise and we are pleased with our results to date.

HOWEVER, “athenaHealth you UGLY”!

It has a 1999 interface, with way too much content and information, too many clicks between screens, not enough help in creating templates, and not enough attention being paid to overall presentation and functional utility for the user. Athena simplifies my life in so many ways but it still reflects the complexity of the insurance world in which it lives and is optimized. This needs to be abstracted out for me just like they abstract out the other difficulties in my practice life.

Given the robustness of the platform, I remain shocked that athena only has about 1% of the overall market. I often heard Jonathan bemoan this fact as well. I would argue that if Jonathan Bush and his team would drop the 8 cows dowry to improve the UI, more people would be able to see and appreciate the inherent beauty of the platform. If you want viral growth, you have to have a viral interface that can be rapidly adopted. You can’t just push it out either, it has to get “pulled” out by the users because of its inherent “awesomeness” and the subsequent referral communities that build up around it.

I believe that athenaNet is 8 cow software, but its going to require to an 8 cow dowry to help others see it as well.

2 comments on ““You Ugly”: Creating 8 cow software

  1. I’m not sure I agree with everything you’ve mentioned, but definitely some good points made.

  2. I’m not too familiar with the software, but I think cloud computing is the way most of these things will migrate when it comes to health care.

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