Take Six with Paul Micheli, Senior Product Manager

Careport highlighted me for their Take Six blog in August of 2020. I am re-posting the interview here:

Tell us more about your role as Senior Product Manager at CarePort. What does your average day look like?
There are a couple things that happen during my typical day. I usually start the day early with a call with one of two offshore development teams in India, one of which I’ve been working with on our new Denial Management module, and the other with which I discuss our ad hoc reporting. These check-ins serve as a time to make sure what the development teams are building, and what I’ve intended for the product, are aligned.

I then have other meetings throughout the day – whether with clients or internally – which could include showing clients or stakeholders new product concepts and receiving feedback, or working on a product roadmap and determining what updates come next.

When I’m not in meetings, I’m either writing product requirements, documenting what’s coming with a new release, or designing new product concepts. Lately, I’ve been spending a lot of time reviewing documentation and working with internal stakeholders to in preparation for our next product release, Care Management 20.2.

What is your favorite aspect of your job?
I love collaborating and working with people. I absolutely love talking to clients – whether learning their problems and workflows, understanding their day-to-day processes, or identifying their pain points. It’s exciting to have new problems to solve.

Once we’ve developed new solutions or product concepts, I like talking to clients to receive their feedback to ensure the product addresses the challenges they’ve discussed with us. I was a user experience designer before working in product management, and speaking with clients and end users was always the most enjoyable part of my job. I enjoy user research, and fortunately I’m able to do that in this role, as well.

I also love brainstorming as a group – particularly during the conceptual phase of product development. I really enjoy collaborating during those early processes, when there are several possibilities to solve a problem and we need to work together to identify a singular solution before moving forward.

What’s next for the Care Management product?
Thanks for asking! The Care Management 20.2 release will be live in August, and it includes two new exciting features. I’ve been working on the Denial Management module, which has been completely redesigned. We have a new front-end technology that we’ve been working with, and it’s the first of – hopefully – many updates to the Care Management platform to ensure that we provide users with a modern and flexible user interface. I know that many of our current Denial Management clients are very excited to see this new offering. I’m looking forward to its launch, and hope that Denial Management improves workflows for clients that are tracking their denials.

The other exciting new feature within Care Management 20.2 is our post-acute authorization feature. This actually a huge release for us! It’s the first time that we’ll have two significant updates happening in one release. Moving forward, we hope to remain innovative and nimble so that we can address the quickly evolving care management market.

What else makes this release unique? Can you tell us about the redesign process?
This has been a long, three-year process. We took a user-centered design – or design thinking – approach for this. We spent a lot of time interviewing managers and end users, both on- and off-site. We did a six-month research effort to better understand how the legacy denials module was used, and I listened to feedback from clients and internal stakeholders. I like to call myself the “dartboard” on products like that: throw all of the darts at me, I will listen and I then figure out how to improve it.

We also worked with a UX designer for quite a few months to develop different design concepts, and we took those concepts to our clients for feedback before finalizing and moving forward. There were a couple false starts on the technology side – trying to find the right technology that would fit the solution.

It’s taken a lot of patience and persistence, but I feel like we did things in what I would call the “right” way. By identifying clients’ challenges to better understand what they were going through, we put our users first. I think the outcome is going to be fantastic for our clients. There’s a lot of buzz, internally and with the clients that I work with, about this release. I hope that, in the future, we follow this design thinking approach for all of our initiatives and major releases.

What’s something about you that coworkers would be surprised to learn?
Over the last year and a half, I’ve taken improv classes at The Second City, and I completed their improv program in October 2019. It’s been a fun process! I initially signed up because I thought it would be a good way to become a better public speaker – and be quicker on my feet – but I absolutely fell in love with it. I’ve met amazing people, and it’s been a great way to make friends – including a lot of very funny people from all walks of life. At first, I was petrified to go on stage… growing up, I never did drama or school plays. The first time I went on stage and performed a 15-minute show, however, it was a huge growth experience for me. From that moment on, I’ve been addicted to improv and have looked for any opportunity to perform. It’s probably the thing I’ve missed the most during COVID-19, which has been hard. I’m hoping that world will open up again sometime soon. In the meantime, I’ve tried to do some comedy writing in my free time.

What are your hobbies outside of work?
I try to keep myself really active, and I’m very outdoorsy. I ran a half Ironman the past two summers, and I used to run marathons. Unfortunately, there’s no racing going on right now – so I try to make up for it with more hikes, camping, stand-up paddle boarding and visiting local forest preserves outside Chicago. I have a dog named Biscuit, and I like to bring her along with me.

I recently went to Michigan and visited Sleeping Bear Dunes National Lakeshore. I did a brutal hike – two miles each way, climbing nothing but sand dunes to get to the water. I’ve done some pretty intense mountain hikes in the past, but this was one of the hardest hikes I’ve ever done. It was amazing once I reached the water and could cool off, but then I realized I had to do the two-mile trek in the hot sand back to the parking lot!

To learn more about what Paul’s been working on, read our recent blog post about our Denial Management offering, which lives within CarePort Care Management.

How My Secrets to Run a Marathon Apply to Product Management

I recently did an interview with my friend, Silvia Li, for her web series “Three Success Secrets. I discussed my secrets to find success in completing a marathon. Yes, the 26.2 miles on your feet type of marathon.

The three secrets I shared in the interview were:

Home stretch!

• Set a Goal

• Be Persistent and Patient

• Find Help

I am about to launch a complete product re-design of our Denial Management offering that was a 3-year “marathon”. The interview made me take a step back and look at my recent experience. I realized the same secrets I shared also apply to Product Management. It is a challenging role that requires a strong set of soft skills to succeed.

These three secrets have helped me navigate the long road to build a product that many of our clients are really excited to get their hands on.

Set a Goal

When I prepared for my first marathon, I set a goal to finish the 26.2 mile journey. I didn’t focus on completing it in a specific time or running faster than someone else. My goal was focused on what I believed success would look like, and everything else was considered a distraction. I could have walked the entire race, and that would have been okay. That goal kept me motivated on those brutal 18 and 20 mile weekend runs while I was training.

In the same fashion, a good Product Manager needs to set goals for the product they are building. These product goals need to be based on the context of the product and the business. Examples can include launching by a specific deadline, meeting new revenue numbers, getting a specific amount of clicks onto a page, or reducing the time and effort to complete a task.

It can be really easy to get off track when building or updating a product. Product Managers constantly face the pressures of competing priorities, limited time and resources, and those distracting “fires”. Setting goals can give you something to point to every couple months to make sure the development efforts are on the right track. It is important to check in on these goals over the course of a project. I pick up my original Positioning Document every couple months to make sure my project is still going to meet the original goals I set. Doing this keeps me grounded during those challenging times.

I recommend using the SMART criteria to set goals. It will set you up for success to have objectively attainable, measurable goals to attain.

Finally, those check-ins may cause the product goals to change. That’s okay. Business priorities change; market needs shift. Set that new goal and re-focus on obtaining it.

Be Persistent and Patient

It’s a bit of an understatement to say training for a marathon is not easy. It is definitely a large physical undertaking. But I believe it is more of a mental exercise to spend 4–5 months ramping up mileage towards 26.2. It was not easy giving up hours of free time on my weekends, dealing with injuries that slowed me down and took my off my training plan, and changing my diet to support my nutritional needs. Believe me when I say there were days I wanted to sleep in, stay home, and watch TV. It takes a lot of persistence and patience to work through the challenges and stay committed to that goal.

That same persistence and patient is required of a good Product Manager to obtain those previously discussed goals. There are always going to be unexpected bumps on the road to building a product. How a Product Manager responds when things do not go according to plan may be more important than setting goals. Losing patience only gets you further off track and closer to failure.

The product redesign I have been working on had 2 or 3 false starts because we discovered the proposed architecture was not going to meet our business and design needs. I also saw this project get de-prioritized twice for other company initiatives. Half of the original development turned over during this period, which led the project shifting to a completely different offshore team.

That’s a lot of chaos for anyone! But I stayed with it. I kept pushing for the project to not be shelved. I would continue to share feedback from current clients that desperately wanted to see the denial management workflow that would increase their team’s efficiency. I had to argue we needed to move to new technology in order to stay competitive. I continued to remind leadership that we could move onto other projects, but my requirements and design concepts were ready to be picked up by development right now.

The point is: if you really believe in the product you are building, then a little backbone is needed to stay persistent and trust the process will get you to the finish line.

Find Help

Running is an individual sport. It was on me to set the training schedule, set aside the time, put the shoes on, and go out there and hit the pavement. However, to do something as intense as running a marathon, it is important to find support. I joined running clubs to run with like-minded people that were encouraging of my goals. I had the support of my friends and family, while saying I was crazy, still showed up on race day to cheer me on. And let’s not forget the volunteers handing me cups of water and sports drink along the way. I may have run the entire race, but I didn’t get to the finish line on my own.

This same secret applies to Product Management. I may be leading the efforts to build a successful product, but I rely on the following people:

• Developers build the product

• QA testers make sure a high quality product goes out the door

• Support and Service personnel share client feedback

• Tech writers provide the necessary user manuals

• Marketing and Sales to spread the word and keep the product profitable

Without my teammates support and advice, I likely would have our clients at our office door with pitchforks and torches (or dropping their subscription).

A good Product Manager knows they are not an island and don’t have all the answers. I was willing to listen to the feedback on design concepts, requirements, and launch strategies. I really believe the collaboration helped me build the best possible product possible.

To bring the point home, I really like the way Patrick Neeman recently summed up the importance of collaboration in product.

Bonus tip: Celebrate your progress

On any long journey, like running a marathon or building a product, it is important to celebrate progress along the way. It is easy to focus on what hasn’t been accomplished and get discouraged. But when a small milestone is met, I take a moment to step back and take note of the successes to get to this point.

These milestones can be the first line of code being written, seeing the first product demo, or having that first successful user test of your design. Acknowledge the progress, thank your team for the hard work, and then celebrate however you see fit!

In Conclusion

The clients will ultimately let me know whether the product will be successful. However, I’m feeling confident my marathon running experience and living these secrets have helped me successfully navigate a challenging product development effort. Setting goals, staying persistent and patient, and finding help allowed me to get to the finish line.

How to Design for a Crisis

I’ll just start by understating the obvious: these are unusual times. The COVID-19 crisis has turned our personal and work lives upside-down as we attempt to flatten the curve. We are all adapting to a new normal that involves social distancing, wearing masks to the grocery store, and seeing a lot more pets and children appear on our work video calls.

I personally dealt with mild symptoms of COVID-19 a couple weeks ago. Three days into feeling like I had a flu, I started feeling my lungs just walking my dog. It was the first time in my life where I could hear a rattle in my chest taking a deep breath. As the panic sank in, I immediately set up a telemedicine call. The symptoms were not severe enough and I wasn’t an at-risk patient…no testing for me. The recovery was a waiting game of rest, fluids, vitamins, and hoping for the best. I’m one of the lucky ones that had a mild case, but it didn’t make it any less scary.

Sheltering in place and fighting the illness gave me some downtime to reflect. I realized I have worked on the designs for a few products that are likely getting a lot of use during this crisis. I designed a “Simplified” UI for the Engstrom ventilator in response to the 2006 Avian Flu scare based on the use case that untrained users may be forced to monitor and maintain patients during an outbreak. I have worked on two different Infection Prevention surveillance tools that are meant to prevent hospital outbreaks. And just in the last few weeks, I’ve been part of the team that built a survey tool for post-acute providers to identify whether they will accept patients from hospitals recovering with COVID-19.

The ventilator and COVID-19 survey projects were especially unique because the primary use case we designed for were worst case scenarios. Usually a scenario like, oh you know…a global pandemic might be considered an edge case. Even though these two products are very different, I noticed there was a common design goal to reduce the users’ cognitive load. A crisis scenario is a stressful situation which makes it critical that any tool being used will not slow down users or cause them to make potentially fatal decisions.

The experiences from these projects helped me realize there are a few key product design strategies that need to be prioritized when considering crisis scenarios. In general, these are smart strategies to consider for any product design initiatives.

Make the design obvious

In a crisis situation, you can’t count on user manuals and training sessions for people to get familiar with your product. People are under a lot of pressure and need to act fast, yet still make good decisions with the information in front of them. A product needs to be very obvious and intuitive right away to support these high stress situations.

The goal for the Care Management COVID-19 survey was to help hospital discharge planners identify post-acute locations to potentially send positive patients. It is very important to free up beds in the hospital during the surge, but not everyone will be healthy enough to go straight home. Sending a patient with the virus to a nursing home that is free of the virus could end up becoming a deadly mistake.

It was really important to make the feature obvious for the users on both sides of the referral communication. For the post-acute providers, we provided a survey to allow someone to quickly indicate whether their site would or would not accept COVID-19 patients. We made the decision to display it as a modal as soon as the application was up. The screen shot below provides clear instructions, shows the current selections, and contains only 5 questions to allow a fast response. It is admittedly a very intrusive design, but the survey will not be missed and can be quickly dismissed if desired. On the main page, we added a banner with red, bold text that clearly states “Click here to take the COVID-19 Emergency Survey” if changes needed to be made to the answers:

The post-acute provider survey in a can’t miss modal. Notice the yellow banner in the background to re-open the survey to make quick updates. (Screen shot from CarePort Care Management)

The “make the design obvious” principle was also used for the hospital discharge planners that are performing searches. The search results can be tedious to navigate if there are a lot of results that appear. I advised the team to use bold, red text to highlight the COVID-19 answers and make them stick out. It may not be pretty, but it is obvious where to identify if the facility will take an infected patient.

The post-acute provider search using bold, red text to make the COVID-19 status stand out. (Screenshot from CarePort Care Management)

Just days after launching the survey, we had 3500 post-acute provider facilities answer the survey and 174 hospitals did a COVID-19 referral search. Those are incredible usage numbers in a short period of time for the product, and they have continued to grow. The “in your face” obviousness of the design was a factor in the high usage.

Prioritize what is most important

In order to reduce the cognitive load in a crisis, there needs to be a focus on what is the most important information someone needs to see. Searching for information only adds more stress to an already difficult situation. This principle is used in the COVID survey with the modal presentation and the red, bold text.

This prioritization focus was also critical in the Engstrom Simplifed UI project. The main use case to consider was the situation we are currently in with COVID-19. What if the normal ventilator operators are overwhelmed and sick? Caregivers that do not normally operate a ventilator may be asked to do so. Not only did we want to make life easier for the novice ventilator users, but we also had to consider viewing the display from a distance in an isolation room. That meant seeing less data on the screen.

While in the conceptual phases of the project, I had an opportunity to interview a couple pulmonologists that were experts in mechanical ventilation. The question was difficult but straightforward: “If you could only have 6 numeric data points what would they be?” The doctors understood their feedback had to highlight the most crucial data needed to assess and maintain a mechanically ventilated patient. The answers were fairly consistent, and I was able to confidently cut the data that would be displayed in half:

The normal Engstrom ventilator user interface versus the “Simplified UI” that was designed by prioritizing the most important clinical data needed to maintain a ventilated patient.

The normal Engstrom ventilator user interface versus the “Simplified UI” that was designed by prioritizing the most important clinical data needed to maintain a ventilated patient.

The final design testing validated the prioritized data points. The users we brought in were able to quickly and successfully assess the “patient” after a quick 5-minute training. The testing results showed the focus on prioritization also helped make the design obvious.

Know your users

This will seem like obvious advice to any designer. But it amazes me how many times I hear about critical steps in the user research process being skipped. It is really important to understand the day to day life, tasks, and goals of someone using your product in a crisis situation.

Even though I relied on ventilation experts to inform the design for the ventilator project, I couldn’t recruit the normal set of users I was familiar with for design testing. I had to recruit healthcare professionals that are not normally in the ICU. We brought in nurses from a variety of backgrounds, and even had a paramedic come in. The whole point was to test whether the new design was intuitive for someone that didn’t normally operate a ventilator. Knowing their background and medical knowledge (or their lack of ventilator knowledge) was key to understanding whether we were hitting our design goals. Testing with ICU nurses and Respiratory Therapists would have defeated the purpose, and would not have provided the proper design insights.

The Care Management COVID-19 survey was different because it was geared toward our normal user base. The strategy of knowing our users still applied. We already had strong knowledge of the daily workflows, goals, and challenges for both discharge planners and post-acute nurses. We knew they wouldn’t take the time to take a lot of extra steps to update company profiles or provider searches to get their patients placed in the proper locations. The knowledge that comes with years of working closely with our users allowed us the benefit to skip right to product design, which in turn led to a very fast time to market. I wouldn’t normally recommend skipping early conceptual research, but this was an exception we were able to make because of our past focus on understanding our user base.

Bonus tip: Do the best you can testing

It is very difficult to match a real world crisis situation when design testing a product. There is only so much stress that can be artificially created in a controlled environment. The testing for the Engstrom project was done in a lab setting; there wasn’t a critically ill patient and only had one other medical device alarming as a distraction. The COVID-19 crisis was such a distraction for our Care Management clients, that the best we could do to get feedback on the concept was a focus group. Neither situations were close to the ideal, but any feedback is better than none.

In these less than ideal situations, try to simulate as much as you can to the real world scenario. Identify where the limitations are in the testing, weigh out the potential risks of those limitations, and then mitigate the known risks.

Final thoughts

Hopefully this provides insight and helps guide design and product strategy when unique crisis scenarios need to be considered. It helps to write down the design goals early, and then revisit them in the middle of a project to make sure the final product doesn’t stray too far from the original intent.

The realization knowing that multiple products I worked on are being used in the current worst case scenario has been surreal. For all the focus that went into a pandemic situation for the ventilator project, I never really expected for it happen in real life. But here we are. Meanwhile, the last few weeks have been wild with the effort to push the COVID-19 survey out the door while adjusting to our world turning upside down.

I know I haven’t been alone. I have seen a lot of other solutions getting released to help address the crisis. I see the stories of how people are addressing the ventilator and PPE shortages — whether it’s increasing manufacturing or making at home masks. The creativity and empathy on display has been such a bright spot.

Keep innovating…but after you wash your hands!