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Scott Shreeve, MD

Hey there!

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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We use the Gallup Survey bi-annually to evaluate employee engagement at Crossover Health. This survey is based on millions of data from multiple millions of field tested, validated questions that identify the level of employment engagement. More importantly, their own studies and several others correlate how employee satisfaction translates into higher corporate achievement as well as increased customer satisfaction. It really shouldn’t be surprising that companies with happier employees have happier (and more loyal, and therefore more valuable) customers, and that the link between the two data points was strongest in industries where employees have the most direct contact with customers.

Just like healthcare.

You have to dig deeper to unpack what makes employees happy, but the core reasons go far beyond the cliche free lunches, foosball tables, and bean bags. First, happy employees are those that find meaning in their work. Secondly, they are clear on their purpose and how their role contributes to the success of their organization. Finally, they believe that their contribution is respected and valued and they are provided the tools and environment for success. What this all boils down to is that successful companies (and yes, public companies that have higher employee and customer satisfaction ratings tend to have higher valuations) understand they have to address and align the needs of their employees before they can start doing a great job with their customers.

This might even go a bit deeper still. Companies need to think about not just designing but also architecting their cultures to achieve these ends. One of our Crossover Bombora keynote speakers, Kevin Slavin, spoke about Service Design in detail as right foundation for modern businesses. In addition to introducing the crowd to the phrase “architecture is destiny”, his essential point was that even businesses that sell a “product” are really selling a service and relationship with the product. As a result, you need to design for happy and engaged employees who deliver a consistently delightful experience. This is actually encoded in the definition of Service Design by its ideologic founder Don Norman:

“The activity of planning and organizing a business’ resources (people, props, and processes) in order to (1) directly improve the employee’s experience, and (2) indirectly, the customer’s experience.” 

Nielson Norman Group, Service Design 101

I’d wager, even if they don’t use the term, that the companies that came out on top of the Gallup poll list year after year implicitly or explicitly follow this definition of Service Design.

So where are we in healthcare with Service Design? Where are we at Crossover?

In all honesty, healthcare in general been “immune” to Service Design. Do we really think that the processes and props in healthcare are designed around employee’s needs, and even if they are, are they designed around the goal of valuable customer (patient) experience? This leads to the next point—service design is a long term investment in employees who then can enable truly memorable and lasting patient engagement.

In my most recent Surf Report to our Crossover family (our XOhana!), I outlined the elements of our new approach to care delivery which we call the Connected System of Health. What was striking about the list of items was how many of them are directly employee-enabling and less so directed at the members. We are just beginning to organize our teams properly around the Service Design ethos, but I am really liking what I am seeing. We have a rare opportunity with our evolution to including virtual primary care to design or redesign much of our business around the people, props and processes that will allow us to deliver on our promise of engaging members everywhere, anywhere, all the time (thats a tall order BTW!).  This will also include designing new interfaces for all of our technology that remove friction and barriers to use. New approaches to data aggregation and synthesis that lead to easily-shared best practices, insights and care plans. New training and certifications for our employees to better understand the member journey into the wider health eco-system. And finally, new training and templates to help our providers be just as effective virtually (maybe even more) as they are in person.

Our business purpose and promise are the architectural endpoints guiding how we design our Connected System of Health service.  I like to think our Service Design approach will be liberating, simplifying, and accelerating how we design experiences for both our employees as well as our members. I’m confident as we get the experience architecture correct, the design and subsequent delighted employee and then member experience will follow! 

5 comments on “The Power of Service Design

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