Juan Valera and UX Design in Healthcare

March 21, 2019

Joshua and Kellen talk to Juan Valera a senior UX designer at Amazon who has previously worked at Microsoft and worked on the Forza Motorsports game UIs. Juan shares his passion for solving real world problems in healthcare using ux design and walks us through a project he worked on to help connect cancer patients with clinical trials.

As a heads up! The podcast is usually clean, but Juan is passionate about what he does and there are a couple expletives in this episode!

• 00:02 Joshua

  Welcome to getting apps done, a mostly non technical podcast with the goal of helping you deliver software because if you didn't ship it, it didn't happen.

• 00:15 Joshua

  Hey folks, today we have Juan Valera joining us. He is a senior user experience designer. He worked on things like the UI in several of the Forza motorsport games. He worked as a product designer for Microsoft and he currently works for Amazon. Hopefully that's enough of an introduction to him and gives you some kind of a feeling for why what he says about user experiences is really important.

• 00:37 Kellen

  So yeah. Welcome.

• 00:38 Juan

  Thanks. Happy to be here.

• 00:40 Joshua

  Uh, so Kellen knows you from the coworking center that you both go to.

• 00:44 Juan

  Yup. From office nomads, office nomads.

• 00:47 Joshua

  That's a really great name for a coworking center.

• 00:49 Kellen

  It is.

• 00:50 Joshua

  Uh, and he said, Oh, you both have a background in healthcare software.

• 00:55 Juan

  Oh yeah. Yeah. I think that was like the first thing that we started talking about, wasn't it?

• 00:59 Kellen

  Yeah. Office Nomads would do the, what was it like conferences? A show and tell. There we go, show off and talk or whatever it was. But yeah, we were always showing off the things that were healthcare related or at least being very angry about things that were healthcare related when somebody else presented them.

• 01:15 Juan

  HIPAA!

• 01:18 Kellen

  Exactly. So we didn't actually have a plan for the today, right? Like we actually had a topic?

• 01:22 Joshua

  We have a rough plan. Oh yes. I was gonna say, we don't necessarily have a plan, but we do have a topic and Kellen sent over a couple of your medium articles and one of them really, you should not apologize. One of them actually really caught my eye, was really interested in, I wanted to talk to you a bit more about it. It's the WithMe clinical trial navigator. Okay. I found that whole concept where the interesting, because it's something that's really relatable. I mean, you're talking about cancer patients and maybe it's just me, but I think most people are at least marginally terrified of cancer.

• 01:56 Juan

  For sure. Understandably. It's kind of a, it's untreatable, comes on mysteriously, can be fatal, I mean, most of them are fatal eventually. Um, yeah, it's, it's understandable that people would be scared of the topic.

• 02:14 Joshua

  Yeah. And so walk us through what you are doing to improve the situation with WithMe.

• 02:21 Juan

  Sure. So a little bit of background, um, when I was in Grad School for healthcare informatics, which is a very broad program. My capstone project was just do, do something related with the, the information problems within the healthcare space and tackle that meaty problem to show the like what you've learned, you know, in this, in this graduate program. So, we came together and came up with this idea that, a lot of the research we were looking at says that cancer patients as a whole tend to be pretty altruistic. They tend to want to give back and help people in general, especially other cancer patients. It's a trait that they seem to share. So it was weird then that if cancer patients were altruistic in that way, then why is it that 95% of cancer patients in this country are not participating in clinical trials?

• 03:29 Juan

  Because the whole point of a clinical trial is to move forward the treatment for anyone that has a particular kind of cancer or a particular treatment history. So it seems kind of weird to us that there was this discrepancy. Uh, and our theory when we started the project was the, the user experience must be total shit if it's scaring away 95% of a really motivated audience. Yeah. It's really enormous. So that, that was our thinking. Um, and yeah, we got it started in a, in a really fun way by doing a design sprint. This is a methodology coined by Google, but it's used in all kinds of ways now by all kinds of people. Are you familiar with that kind of thing?

• 04:20 Joshua

  I certainly am. Yes.

• 04:22 Kellen

  I am. Because you showed me.

• 04:24 Joshua

  There you go.

• 04:25 Juan

  Nice. Corrupting the youth. It's my favorite pastime.

• 04:30 Joshua

  That's a reasonable pastime.

• 04:31 Juan

  Yeah. So, um, so we started out by, uh, so the, the tenants of this design sprint are that you have, five days to get some kind of solution around a really meaty, vague problem. And there's a couple of phases around the design sprint. You have to first do research and you have to then brainstorm, come up with potential solutions, create potential prototypes that solve the problem that you hypothesized at the beginning, and then you test that solution in a real world setting or as real a setting as you can, to see if you're, if you're idea holds up, you know? Yeah. It's meant to be really lean in, like very, scrappy, I think is a good word to describe it.

• 05:27 Kellen

  I like that. So that was the approach you took to with the, WithMe.

• 05:31 Juan

  Yeah. We started out like interviewing, we couldn't interview cancer patients directly. We had some like ethical, and practicality concerns. So we tried to get as close to cancer patients as we could. We talked to healthcare IT professionals and cancer and nurses and people that had worked in clinical trial coordination before, um, to try to get a feel for the journey that the patient goes through from the moment they're diagnosed with cancer, all the way to starting or finishing treatment or you know, wherever their journeys may take them, we want to know what happens in between and at what point in that journey other people come into the process. Like where, where is your doctor and your nurse, where are they involved. Um, and when we actually drew this on a, on a whiteboard, we, we did a lot of white boarding as well, as one does.

• 06:29 Juan

  And it became pretty clear pretty quickly that the brunt of the mental load and the practical work that needs to be done to sort through all of this was on the patient. But the patient is not the person best suited to handle these problems because they're overwhelmed. They have fucking cancer, but also like they didn't have a decade and a half of medical training to understand, you know, why this treatment history is relevant to this trial, what the specific terminology means to you, all that kind of stuff.

• 06:59 Joshua

  Whether they even qualify for it.

• 07:01 Juan

  Exactly, yeah. We found that that was the biggest thing, that cancer patients couldn't always reliably tell what they qualified for, so they're like not their best. They're not, they're their own best advocate,

• 07:12 Joshua

  But it's all on them anyway.

• 07:14 Juan

  But it's all on them anyway. Right now. Yeah.

• 07:16 Joshua

  There's a lot of value on what you were doing, particularly in an area that, as you say, 95% of cancer patients aren't going out for this, that that's just, that's an unbelievable number. It's not even 50% I could see that. Okay. Maybe between it being hard and some people just not being willing to, or not understanding, but 95% that's almost all of them are missing out on potentially lifesaving trials.Or if not life saving, saving somebody else's life down the road.

• 07:46 Juan

  I think it would be overly optimistic to say that it's lifesaving for any individual, but it is markedly moving the needle forward for every cancer patient ever, or at least patients like you, like this is a huge, you know, you could potentially make a huge difference by participating in these trials. And so it was, it was like I said, weird that most, most of them don't. Um, yeah, so we started with the design sprint. We interviewed as many relevant people as we could get our hands on and to try to build a map, basically a journey map of what everyone goes through and how they, how and when they relate to one another. And from that we realized, yeah, okay, it's all on the patient. So we, we then tried to come up with potential solutions and we cast a really, really broad net.

• 08:41 Juan

  Where else do we find super complicated information being relayed to a relatively lay person audience, so that that audience can take away what they need from it. So we looked at like Bill Nye videos, like how do you explain like complex science to someone? In a basic way. We looked at NASA explaining astronomy and astrophysics in simple terms, we looked at a lot of airline companies have invested a lot in streamlining the experience of getting you from the door onto your airplane with as little confusion as possible. Uh, and they do it in a lot of different ways by having good way finding good like signage in the airport. They give you good clear documentation like in your, in the old days, they would give you like a pamphlet along with your plane ticket and in that little pamphlet where like directions or like, here's what you need to know. You know, you might need to take your shoes off in 10 minutes, that kind of thing. So we looked at like every kind of example we could.

• 09:46 Kellen

  Was there one that was, I guess more guiding than the rest?

• 09:50 Juan

  I, that's a good question. I don't know if any of them did it like way, way better than the others. One of the samples that we took was a Tinder because..

• 10:02 Joshua

  Swipe right if you want cancer, swipe left if you don't.

• 10:04 Juan

  Exactly. Easy cured cancer with an app, five minutes. No. No, because it boils down the, a lot of complicated like this person appeals to me for this and that reason. Like I read about, you know, their profile like their similar, like around my age or around the age that I like, um, and then all of that, all of that decision making boils down to a simple like gesture in one direction or the other. And so we thought that would be, that was one of the several prototypes that we made to try to boil down decision making to a really, really simple thing that could get patients just kind of moving through the process.

• 10:46 Joshua

  I find that actually really important there because a lot of people, when you talk to them about user experience, either they don't get it at all or they kind of have it in their head that you just go on Google images, do a search for related applications and pick one that looks nice and that's it. But actually there was a lot of thought into what kinds of problems those other solutions were solving and how they related to yours. You were looking forward not just other applications, but you're talking about airline, uh, information and other things like that. Trying to find other people who had to solve a very similar problem and things that worked well for them and things that didn't work well for them in the solutions that they provided to help guide your solution.

• 11:24 Kellen

  I noticed when you had the in the article itself, you actually mentioned the swiping and people actually having problems with that. So I guess you had to iterate a bunch on those.

• 11:35 Juan

  Oh yeah. So, yeah, we, so we came up with a few ideas that we thought this might help us handle this problem. The like Tinder version was one, the like airline pamphlet, where like it guides you, it's like a literal, that guides you through the journey. That was another one. And we ended up only prototyping the Tinder one. So the way that the Tinder prototype of the app works is it asks you a clinically relevant question in regular human words. So for example, have you had any cancer treatment before or are you pregnant? Have you, have you had surgery for your breast cancer before and you could only swipe left or right for yes or no. And then we also added a swipe down for, I don't know. So the idea was that we would quickly get clinically relevant information from these patients as much as, I mean we weren't just like bombarding them with questions.

• 12:36 Juan

  It was a very targeted, like think like 13 or 15 questions.

• 12:41 Kellen

  Relatively short.

• 12:42 Juan

  Yeah, we wanted it to be sure because some of the research we did found that we were, uh, so there are other solutions that try to do this kind of thing. Like connecting patients with, um, health care, or sorry, with clinical trial coordinators. Um, ah, man, there's like one or two very famous ones, but they all look terrible and the user experience is horrible. And there's like a, like a 200 question, like seriously, like hundreds of questions form to fill out. And there was like, we did a whole bunch of research trying to figure out what problems existed with that approach. And like it was easy, like everybody was falling off filling out the forms because they would get confused and like, and just, and they would give up like halfway through having already wasted like 45 minutes and they have another three hours to go. Like no wonder.

• 13:35 Kellen

  Can see where the 95% rate comes from.

• 13:38 Juan

  Right, right. Yeah. Like is it any surprise that you lost all of your patients' interest when they couldn't make it through the process?

• 13:46 Joshua

  Yeah. It's no different than the original problem they had. It's all information that they don't understand and waste too much of it for them to ever really understand it or...

• 13:55 Juan

  We found that a lot of cancer patients are, are spending their nights and weekends reading about, you know, cancer anyway because they want to be informed. They want to make the best decisions they can for themselves. So they're incredibly well informed patients. But even with all of that, it's just not enough because this is a super dense topic that you need to understand very well to make these kinds of decisions. And, you know, even the best intentions and the best informed patient isn't a trained clinician.

• 14:25 Joshua

  Yeah. And that's gotta be taxing on you to have to look at building a user experience for people who are at the moment overwhelmed. And only 5% of them are getting through this process. Yeah. That's a huge ask to build something that is going to improve that number, that's going to take an emotional toll on you as well.

• 14:44 Juan

  Yeah. Um, that was one of the reasons why this was the most important and an project from, for me personally to take on. Um, because like I really understand, or I empathize strongly with someone that just wants help and they're just like overwhelmed in so many ways and they're just trying to do the best they can, but like the resources are out there, they're just like frustratingly out of reach. So, uh, that was one of the reasons why I wanted to take on this project. And yeah, like that, that kind of, um, that kind of patient, um, that has those particular like emotional needs, uh, along with informational needs was, was pretty interesting to me. And that was why I wanted to work on this. So, yeah, we did definitely keep that in mind when we were designing this though, there's, there's something called a user persona, um, that it's a, it's a term in user experience design where you come up with like a fictional character that is representative of your audience at the very beginning so that you kind of have a north star when you're designing.

• 15:53 Juan

  Like, so ours, I think it was called Jane Jane was a cancer patient, 35 years old, single mom that worked. Uh, I think she was like a business admin by day. Um, and she, you know, really, really cared strongly about doing something so that her daughter would not have to suffer the way she was suffering. Yeah. So we have the simple yes and no, um, swipe left or right metaphor for these questions. And, um, at the end of answering like 13 or so questions, we would ask for your permission to, uh, first we would ask for your location. Like, Hey, if you wouldn't mind connecting this APP with Facebook will grab your location and we'll use that to connect you with a clinical trial coordinator near near you. And if it, if you give us permission, we'll bundle up your answers, the answers to these clinically relevant questions and send them to that coordinator because we found that these are the bare minimum that they need to start connecting you with some trials.

• 16:57 Kellen

  So instead of the full 200 or however many questions you just kind of got it down to the first ones that were I guess kinda the gatekeeper questions.

• 17:05 Juan

  Yeah. Plus, um, in like the original experience, patients who are doing a 100% of the work, but clinical trial coordinators are professional, clinically trained people whose only job is to help cancer patients are well to help patients find clinical trials that are perfect for them. So these two groups like desperately needed each other, but they didn't even know that the other existed. So we took a little bit of a different approach with this app and rather than have the patient do 100% of the work themselves, we asked them to do the bare minimum and then connect that to the coordinator who can help them, um, from there on and kind of do as much of the work as they could.

• 17:49 Joshua

  I didn't even know that was a job.

• 17:51 Juan

  Oh yeah. I didn't either, before we started this.

• 17:55 Joshua

  I'll bet the 95% don't know either.

• 17:57 Juan

  Yeah. Yeah, they definitely don't. Um, yeah, that's a big part of this is just, um, what information is out there and having it be available.

• 18:07 Joshua

  Now, you were talking about Jane, your persona, and I've worked with personas before. You know, when you're building a shopping app, you kind of start to relate to this single mother who struggles to get the shopping done or whatever it may be. And you start to really empathize with them and feel for them. And if you're not doing your job really well, you feel bad for them. But I can imagine... You're talking about... Jane is a cancer patient, worried about her children who... Quite often cancer does travel through families. And that's gotta be really emotional for you. I know it's emotional for them, but for you as the designer starting to think about how you supposed to be helping Jane, that's gotta be hard on you. How did that make you feel while you were building this?

• 18:50 Juan

  Um, to be perfectly honest, while we were focused on the problem, it was two weeks of just like constant researching and talking through the problems and designing solutions. Um, I didn't have time to think about it during, um, but in... It's been, um, about a year since the project has wrapped up. And, um, in the interim, I have definitely thought about, you know, the, the potential, the people that this could potentially help. And, and more, more often I think about the people that aren't being helped by healthcare technology as a whole today. Uh, and that, that takes some, something of a toll on me. Um, a lot. Um, I get pretty frustrated that this most critical element of, of technology that's meant to keep you safe and take care of you and help you be well is just failing. It's failing everyone in in many, many ways. Um, and I consider a lot of the problems pretty low hanging fruit. Um,

• 19:51 Joshua

  Yeah.

• 19:52 Juan

  They're not difficult design problems. Um, that was kind of the biggest takeaway from my entire Grad program is these problems aren't difficult to solve. The reason they're not technically difficult. The reason that they haven't been solved yet is because there's so much bureaucracy and there's, there is everything is a very convoluted process that requires a lot of moving elements to come together and agree on a solution. And that's where a lot of things are slowing down and failing people.

• 20:19 Kellen

  Yeah. The technical, just the way that everything technical works in healthcare is just a very different industry and, not necessarily fruity real reasons. It just kind of is different. And I definitely agree on the, a lot of the, a lot of the problems were very simple to solve or have been solved in other industries. And there's examples of how you can go about making them better and then, you know, health care just didn't grab them if for whatever reason, different priorities. But there, there is a lot of things like that that I... Right on board with you. That one.

• 20:48 Juan

  That's why I especially like doing a design sprint where it was relevant to healthcare because design sprints are made to be like super quick, super cheap. Like, this is a way of kicking out potential solutions at like the lowest possible cost. Um, and you start to see some like quick validation instead of spending like a year building a potential application or something only to have it fail later cause you didn't, you know, do the right research or whatever.

• 21:14 Joshua

  Absolutely.

• 21:15 Kellen

  I would actually argue that's a great advice for health care as a, as a thing from this little podcast. You should try... Try some cheap... Iterate, see what you like. A lot of healthcare projects are really long and you know, they're big and they're expensive and there's a huge investment rather than a quick, "let's see how this works".

• 21:32 Joshua

  Yeah, certainly I've seen some on this side of the pond where they've spent a lot of money on solutions that just weren't good in the first place and after months and years of spending tons of money trying to get these things pushed through to have them push through and then not really help the people they were meant to help in the first place, it's just, as you said, frustrating. Does that frustration in that lead you to want to do more with the health care industry in the future or has it kind of put you off?

• 22:02 Juan

  Hmm, that's a good question. Um, no, I, I'm, I'm one of those people that, uh, when you tell me I can't do something, I buckle down harder so that I can do it. Um, so yes, I, it has many want to work in the healthcare industry more. And, um, in, in about two, um, two months or so I'll be starting, um, as a product designer at a healthcare startup called We Connect.

• 22:28 Joshua

  Which is excellent. You started this, when did you say you were in, you're a Grad student days starting with these things and it's, was that something that you would go on into school thinking, I want to try that out? Or was it something that you run into while you were there and realize, actually this really clicks for me, I want to improve this and help here?

• 22:47 Juan

  Uh, it was, uh, it was coincidental. Um, I, I chose this grant program, uh, because I needed to understand the healthcare space broadly speaking. Uh, I had kind of started to get it in my head that I want to work in healthcare because I feel like that's where I can make a difference. Uh, that's where like my soul feels good working, you know what I'm saying? Yeah. Um, and in order to do that, I need to know a lot of things about the space. I don't have no idea what a doctor does when they make their rounds. I don't know why my doctor asks me the same questions every time I go to a doctor's visit. So I had to understand the space better and for that I chose a graduate program to do that. So ever since then everything has just kind of been working its way towards that, but not in like a super like crystal clear way. Uh, but it has, it has been working well.

• 23:47 Joshua

  I think most careers kind of go that way. You kind of have a vague idea. And somehow by the time you go around in circles a few times, you end up somewhere that's slightly different than what you thought you were going to be in the first place.

• 23:59 Juan

  Absolutely.

• 23:59 Joshua

  But I liked the phrase makes your soul feel good when you're working with these things. And it's actually a really important thing in any role is to feel good about what you're doing. Because if you're crunching numbers for banks all day long and you really don't care about crunching numbers for banks, you're going to burn out. You're not going to do a good job. But if you really feel good about what you're doing, that's the best possible situation

• 24:22 Kellen

  And something we talk about a lot on this podcast is the motivation.

• 24:26 Joshua

  It is. Yeah. We just finished a series on motivation the other day and that's exactly what a lot of it is, is trying to find things that almost self motivate you because you care so much about that particular problem set.

• 24:40 Kellen

  And you just do it that much better and make that much more of an impact. It's great.

• 24:44 Juan

  That's the hope.

• 24:45 Joshua

  That's the hope. Particularly when you're talking about numbers like 95% that's just ridiculous.

• 24:51 Juan

  Yeah! Right? A little bit of effort would go so far. Come on.

• 24:55 Joshua

  Yeah. I just, when I read that, I kinda sat there. I thought maybe I'd read it backwards at first because...

• 25:02 Juan

  I wish

• 25:03 Joshua

  But after I read it two or three times where realize, no, no, I'm not reading this backwards at all. 95% are not seeking any of this. That could be, as you say, not necessarily helping them but potentially helping their family members or other people who they are naturally invested in because they're part of the same community that are suffering from the same thing. Yeah, I think that would actually hit me really hard and certainly one of the reasons I never went into health care of any kind is I think it would be really hard to do because I... Particularly once you getting more involved with patients and things that will directly help people and all the frustrations you're talking about where you just, you can't help them because of all this red tape and the way that would, I think it would be for me soul draining because I would really struggle. As it is within the corporate world. I struggle enough because I can't put the right solutions in sometimes.

• 25:54 Juan

  Sure.

• 25:55 Joshua

  But when you're then talking about people's health and safety, then that's a completely different thing altogether.

• 26:02 Juan

  Um, I think I totally agree with you. Um, and have, have come across people that burn out in the industry because of reasons like that. But, um, I think these are... I think of them as design constraints. Um, like, okay, you have to deal with a patient that is severely overwhelmed and has five minutes of time tops. What can you do with five minutes to, to help them, you know, maybe that's an application. Maybe it's uh, an educational resource or maybe it's like simplifying some process that they get more of their day back or whatever. Like there's always some that you can do even even given what little you have.

• 26:47 Kellen

  I think that's a really great way of looking at it. The, the kind of taking the constraints, just accepting them and figuring out what you can do about it.

• 26:54 Juan

  Yeah. It doesn't make it any less frustrating.

• 26:57 Joshua

  No, no. I'm sure it doesn't, but it is a really great outlook. I also liked something, we talk about getting apps done here, but you mentioned something there that sometimes the right answer isn't an app. Sometimes it's an educational resource or a pamphlet or just calling somebody on the phone and talking to them about their options or...

• 27:15 Juan

  Definitely.

• 27:16 Joshua

  And I think a lot of the times, particularly as application developers and application designers and user experience experts who designed applications as their primary role, sometimes we get kind of siloed into that, that we automatically assume an app is always going to make things better. And sometimes that's not the right answer. And I liked that you noticed or mentioned there that you have to look at other things as well. What is the best solution for this five minute gap that I've got that I need to use?

• 27:44 Juan

  Exactly. Yeah. It's very easy to see the whole world as nails when you have your app hammer.

• 27:51 Joshua

  Yes.

• 27:53 Juan

  Um, so I want to make sure I get through the project just to give your listeners some closure and you folks as well. Um, so we were in the middle of the design sprints. We came up with various solutions, potential solutions that had been at this point untested. Um, and we chose the Tinder-esque one to, uh, to like answer clinically relevant questions and connect a patient to a clinical trial coordinator. The idea when you're, when you're testing a solution like this, um, you know, before you like build anything, it's a, it's a prototype. Um, it's something, it's fake. But if you fool the user into thinking it's a real app or if you can't actually convince them, then you get them as close to believing that it's a real app and functioning like a real app as you can so that you can see their genuine reactions.

• 28:47 Juan

  Um, you ask them to speak out loud as they're using it and you take note of like their body language and where they get hung up and where they're confused and that all helps you to make a better solution. Or it might help you understand that you made the wrong thing entirely and this doesn't solve your problem at all and then you need to go back and try a different prototype or something.

• 29:05 Joshua

  Yeah.

• 29:05 Juan

  But that's a cheap way to get that answer instead of spending like a year developing this thing. So, um, so what we did is we couldn't get real cancer patients. So we did get some volunteers though and we, and um, this is where Jane, the, the, the persona comes back in. We had them read Jane's, um, bio. So we wrote a biography about Jane the cancer patient, that detailed kind of like her, her life ever since cancer diagnosis.

• 29:35 Juan

  Why... That for the fact that she was concerned about her daughter. Um, just a little blurb that was like maybe two or three paragraphs long that let you get in Jane's head a little bit. So we asked these volunteers to read this bio and then pretend to be Jane, put yourself in her shoes as much as you can and then use this application and, and then do the usual user testing stuff. Think out loud, tell me what you think is going to happen when you click this button. Um like, before you get to the next thing, um, to help me understand what would this be like for a cancer patient, at least through the medium of a bunch of volunteers. Um, and then that was when we ran into, uh, the feedback that you mentioned, Kel, that swiping like was not actually as intuitive a gesture as I hoped it would be.

• 30:22 Juan

  Um, so we actually ended up iterating on that prototype and making it into a different, uh, a different interaction. Uh, it's just like a, still a very simple question, but then you answer it through like a series of buttons that says yes, no, I don't know. Instead of using the swipe gesture, they still...

• 30:38 Kellen

  More traditional design

• 30:39 Juan

  Right. It's more traditional, it's more straightforward. And that was exactly what we needed. We found that 100% of our test users, which was only five people, um, managed to get to the end, uh, which would be, uh, sending their information to a trial coordinator. Uh, and like following up with that coordinator,

• 30:57 Kellen

  I thought it was kind of interesting looking at the, uh, you know.... I'm impressed how close you were able to get your volunteers to finding a good solution. Cause he was, you know, looking at it, what you ended up with was like, yeah, I can absolutely see how this is better for most people than the original solution, but it wouldn't have been as obvious when you're actually trying to create it and iterate it.

• 31:16 Juan

  Right? Yeah, of course.

• 31:17 Kellen

  Hindsight.

• 31:20 Joshua

  Yeah. Hindsight is 20/20.

• 31:21 Joshua

  Do you find when you get feedback like that, that design or user experience, that you've built isn't actually as good as you thought it was? The, that stings a little bit or... ?

• 31:31 Juan

  Um, a little bit, but, uh, there is, there's an art to receiving design feedback without taking it personally. Um, and actually I lied a little bit during the a user test. I told people that I hadn't made it, um, because if I tell, if I told them I made it, they wouldn't give me honest feedback. So, uh, I told them it was made by someone else and I was just doing like a comparative analysis or something and just be totally brutal with their feedback. Um, so yeah, like maybe it hurts a little bit, but you quickly learn like they're not critiquing you the person or, or, or your ability as a designer, they're critiquing this particular solution or this way of trying to, to meet their needs. But that's okay. That's, that's what you need in order to, to get something that does meet their need.

• 32:17 Kellen

  Definitely. We've talked to that before too. That feedback is kind of the guiding light for everything. You got the feedback, even if it's negative.

• 32:23 Juan

  Definitely. Definitely.

• 32:25 Joshua

  I kind of like telling them that it was somebody else and not you because..

• 32:28 Kellen

  That is really clever.

• 32:29 Joshua

  You do find that people will naturally try to soften the blow.

• 32:33 Juan

  Yeah.

• 32:34 Joshua

  While that's a nice human trait. I actually, that's not what we need in that situation. You actually want honest feedback,

• 32:40 Juan

  Yeah, exactly. I need you to be brutal.

• 32:40 Joshua

  It's like asking your mom about anything.

• 32:43 Juan

  Yeah.

• 32:44 Joshua

  That's lovely sweetheart.

• 32:47 Juan

  Oh, you made an app, did you? Ah, that's, that's great. I'm sure it'll be number one in the app store. Yeah. I'm so proud of you, honey.

• 32:54 Joshua

  This is why you never ask your mom for feedback.

• 32:56 Juan

  Yeah.

• 33:02 Kellen

  Well, I think it was probably a good spot to wrap up. Let's do another, I don't know if you had another plug. He said did mention your other company if you wanted to plug them real quick.

• 33:10 Juan

  Yeah, sure. Um, so in a, in a couple of months I'll be starting at WECONNECT, uh, they're a startup based here in Seattle, Washington that focuses on patients in recovery and helping to um, incentivize staying in recovery as much as you can. But yeah, so, uh, I am definitely back in the healthcare space and very happy to be there.

• 33:31 Kellen

  Sounds exciting.

• 33:32 Juan

  Mmhmm!

• 33:33 Joshua

  It is. I, uh, was steal something that you wrote on Medium because I really liked it. You said "the pens and pixels come in". I think one of the big things I wanted to bring you on for is because your article, and what you've said today resonate very well with what I got out of the article, that building a user experience really isn't about the pens and pixels as much as it is about actual human experience.

• 34:00 Kellen

  User experience.

• 34:01 Joshua

  Yeah. And learning how people think and what they need to achieve, whatever the goal may be and solve that problem. And I think a lot of people miss that. They think that I, in fact a lot of people seem to relate user experience too closely to design work because they are quite often closely tied, but they aren't the same because design is making it pretty. But user experience is much more, it's about people.

• 34:26 Juan

  Yeah, well said.

• 34:27 Kellen

  And the healthcare that I being able to see it in a space that where... that the things actually matter to really help draw attention to that. You know, rather than talking about an app or like, you know, Tinder itself and like how the left and right works is a very technical aspect, but actually being able to see that when applied to or you know, a problem where there's actual stakes there, it makes the... Makes a big difference. Kind of helps draw attention to all the important parts of user experience.

• 34:51 Juan

  Yeah.

• 34:51 Joshua

  Well thank you very much for joining us today. I really enjoyed this. I was really looking forward to this and it has been as good as I was hoping it would be.

• 34:58 Juan

  Ah, thanks. It's been fun. Uh, I always appreciate talking with folks that have curiosity around this area, so it's been great speaking with you too.

• 35:06 Kellen

  Cool.

• 35:07 Joshua

  Alright.

• 35:07 Kellen

  You snowed in too?

• 35:08 Juan

  Oh yeah. Yeah. It's super snowy out here.

• 35:12 Joshua

  I won't tell you how warm it is here.

• 35:13 Juan

  Ughh.

• 35:14 Joshua

  Alright, so I will post some transcripts up at gettingappsdone.com. As always, please be sure to check out my website at joshuagraham.info and be sure to check out Kellen's website at piffner.com and please do go check out Juan's information. We will post some links to his LinkedIn and other resources in the transcripts. Be sure to subscribe to the podcast we post every Thursday and we're happy to have you listen.