In this UX Ignite fireside chat, hosted by Kuldeep Kelkar, Senior Partner, UXReactor, Leo Frishberg, Director of User Experience at athenahealth, shares his journey and insights in the field of user experience. He discusses the importance of user experience in healthcare and how it impacts patient, provider, and doctor experiences.
Leo emphasizes the role of UXers as diplomats, bridging the gap between engineering and business. He highlights the power of storytelling in influencing stakeholders and shares strategies for influencing in hostile UX environments. Leo also emphasizes the importance of speaking the language of business and provides guidance on skills and attributes for advancing in UX leadership.
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Full Transcript
Kuldeep Kelkar
Today we have a special guest, Leo Frishberg, Director, User Experience, athenahealth. Welcome, Leo.
Leo Frishberg
Thanks, Kuldeep. How are you doing?
Kuldeep Kelkar
Good to have you. I’m good. Happy Friday.
Leo Frishberg
It is and it’s a new year. It’s very exciting.
Kuldeep Kelkar
Awesome. So tell us a little bit about your background, how you got started, how you got into the world of user experience.
Leo Frishberg
Yeah, so I’ve been in the job market now for 40 years. So that’s a long story. So I’ll keep it quite short. I was born very young. No, but I do like to say that even though I’m obviously a boomer that I was born digital. And the reason I say that is that my father was working as one of the first salespeople in the IBM Science and Technology Computing Group back in the 50s, when IBM was pivoting towards commercial computing. And so I grew up with computers in the house with terms being thrown about like ‘cybernetics’ and ‘black boxes’ when I was four years old. And so at some point when I was a kid, I decided I was gonna be an architect. And my dad said, well, by the time you become an architect, you’ll be using computers to draw and not paper. And by then I’d been on a key punch machine at his office. I really didn’t understand how I was going to type on a computer to get lines to show up on a drawing. Roll forward. I’ve now got my architecture license. I’m now working in a dark room late at night with a half million dollar computing machine in the basement, and I’m drawing CAD drawings. And so at age, whatever that was, 23, 24, I had actualized my father’s prediction, which was pretty interesting. But as an architect… Architecture is fundamentally about the experience. It’s about a lot of other things, of course, but we think of architecture as… parts of architecture are about experiencing the building, experiencing the views from a building, what is the feeling being in the room. So I believe that the experiential parts of UX I was already getting trained on in my architectural career. My sister introduced me to more of the usability side and more of the science and cog psych side. She was very involved in CHI, the ACM special interest group, SIGCHI. She said to me probably in the late 80s, you should really join this group because it’s all about making things more usable and user-friendly. I held off and I held off and I held off. And then at some point I was running my own business because architects are taught to start businesses. And so I was running my own business and I realized that I was working with a piece of software, a piece of CAD software that was fundamentally unusable. And so I had to rethink how to make this software usable for my own teams and for my customers. And that was my entry into what we would think of as UX. This was 1993, 1994.
Kuldeep Kelkar
Yeah, right about when the dot-com web started.
Leo Frishberg
Right, exactly. Yeah, and so I officially became a UXer by title in the early 2000s when I joined the first enterprise that I was part of, and I became the Principal User Experience Architect for a product line in a very high-tech electronic test and measurement company, Tektronix. And so at that point, spending eight years getting to the top of your individual contributor trajectory, where do you go in a company like Tektronix? There wasn’t a lot of space for my next step and so an opportunity to manage larger teams came up and I moved over to Intel where again I had responsibilities for driving user experiences associated with, in this case, Intel’s sales and marketing teams. I ended up having about 24 UXers that I was responsible for, direct management responsibility for. And then that opportunity went its way and then I joined Home Depot where again, I came in, there were four or five UX team members, but they really needed to grow the team and build a larger footprint within the organization and so I had the opportunity to grow that team to 12. And that brings me to Athena about four years ago where I had the opportunity to join athenahealth in a section of their product called clinicals, which is how you track all the information that you need… all the clinical information you have that you need to help deliver care to patients. And I was in a specific zone, a specific aspect of that product having to do with something called the longitudinal record. So you go to a doctor for 40 years, hopefully they know everything about you for that past 40 years. How do we keep track of that? How do we make that information easily available to the staff so they can know you over time? And since that time, they’ve… Athena’s reorg-ed and built new zones and new subdivisions. And I’m now leading a new subdivision that’s focused on really helping to re-envision American health care, which is a pretty bold statement. But we are one of the movers and shakers in the industry that might have a chance to actually have a positive impact on health care.
Kuldeep Kelkar
That is very interesting. I mean, I’m sure the healthcare industry in general needs a whole range of experiences, patient experiences, provider experiences, doctor experiences. And so much is digital these days and will continue to be in future that I’m sure there are a range of challenges. So that’s very interesting. And honestly, Leo, there are very few people who have a long history in the world of user experience. I mean, there’s potentially millions of people who are UXers these days. But many of them are in their first five years, 10 years, maybe 15, very few in the 20s. I know for sure very few in the 30 or 40, even before the dot-com. So it’s a pleasure to speak with you. But at a very high level, what does experience mean for you? What does even user experience really mean?
Leo Frishberg
Yeah, I boil it down to these three principles that a Roman architect established 2,000 years ago. Yeah, so the Vitruvian principles of architecture are economy, structure, and delight. I won’t use Latin. But the point is that you can immediately see how those three constituents have turned into what we call the three ring circus. I mean, the three pillars of current R&D and product development, right? Product, engineering, and UX. So those actually have their origins in the Vitruvian principles. And so I’ve approached my design practices, my businesses, my product design with those three principles in mind. Economy, which is the business concern, or we might even say it’s the engineering concern. How can we build this thing in the most economical way? Structurally, how can we build a business that is longstanding and has economic purposes? And then delight. How do we do this in a way that attracts folks to want to use it, seduces them if that’s the intention, engages them, mystifies them if it’s a game, but in any way addresses their needs and not simply the financial or engineering needs of the system. So those are fairly long standing principles.
Kuldeep Kelkar
Very, very interesting. I have heard a lot of people come up with a lot of analogies. I don’t remember having the architect’s point of view, which is very interesting. And so along those lines, what do you think UXers… And when I say UXers, I mean all the skills, be it a designer, visual designer, user researcher, copywriter or whatever skills that they bring… in general, what are UXers good at?
Leo Frishberg
So 10 years ago, I would have answered that question a little differently than I answer it today. I think it’s because of where I was and the kinds of organizations that I was in 10 years ago, which may still exist by the way. It’s just that my journey has moved, versus where I am today at Athena. So I’m going to answer it differently. I’ll answer it the way it was 10 years ago, and it’s very possible that’s the more usual way.
I really do believe that we are diplomats. UXers have to be diplomats. And that is, we have to be able to speak the language of engineering and we have to be able to speak the language of business.
We have to convert what our product partners are saying, the business needs and the market needs in a way that our engineering teams can actually make real and make manifest for the folks who are ultimately going to use these products. So that’s the way I would have answered that question 10 years ago because that was the role I was playing.
The other analogy is, and I’m trying to remember what the chemical name is for this notion of you have a molecule in one camp and a molecule in the other camp. You can mix oil and water because you have this ability to bring these two groups together. That’s really important, right? That’s an important skill and it means there’s a lot of stakeholder management and it means there’s a lot of code switching and there’s a lot of reframing and there’s a need to have a fairly good grasp of technical understanding from the engineering perspective, but you also need to have a pretty strong understanding of the product, market, customer perspective. Now, 10 years later, and again, either on my journey or because I’m at Athena, we have very savvy product people who actually know how to talk the language of engineering. And they actually also know the value and importance of user experience. And we have very savvy engineering people who actually understand the value of talking to business and also recognize that their work is driven by and ultimately measured by adoption. So whether that’s true everywhere, it certainly is now true of where I am. So what do UXers have to be good at now in this context? And one of the most important qualities that I am helping coach and trying my best to be better at is storytelling. We really need to be able to tell the user story.
We need to be able to tell our visions and the vision story that we have for the future. We need to be able to influence our peers in engineering and product, but also influence our folks up above who are gonna sponsor our work and pay for our work. And all of that requires crisp and delightful storytelling through words and imagery.
So I think it’s one of the skills that I knew was coming up. Years ago at Intel, we all took training on good storytelling. So I knew it was an important thing back then. But it’s one thing that I’m definitely seeing is an important skill. Among all the other skills, of course, synthetic thinking and visual thinking and all of the other things that distinguish us as designers, absolutely critical.
Kuldeep Kelkar
I literally jot down the term diplomat because of course I speak with a lot of people within the industry. I’ve heard about stakeholder management. I’ve heard about influence, but I don’t know that I’ve heard anyone describe it as a diplomat, which makes sense. So along those lines, I think every time I speak with people either who are new to the industry, or who are new managers, new leaders who understand that they want to influence their peers, their managers, their leadership, their executive leadership. But oftentimes, it is hard. It’s easier said than done. And there is no shortage of people who get frustrated. Either they believe that the executives or the engineers or the engineering leaders, or sometimes even the product or business leaders are not understanding what the designers, researchers are trying to say. So potentially it’s a lack of storytelling, it’s lack of ability to influence or something else. So two part question, have you seen that happen? And if that happens, what should a designer or a researcher or a UX leader do to influence more?
Leo Frishberg
Yeah, so I know you have a t-shirt that says “it depends”, right? So the answer to that question is very much contextual, right? It’s very much situational. I’ll start at various extremes because it’s a lot easier to talk about this in extremes. Let’s say you’re in an organization that’s extremely naive about the value of UX. One of the first things that I needed to do when I walked into an organization like that, they might be market driven, they might be engineering driven, but they aren’t user driven. And they certainly are not discovery driven, right? They are doing action, like take action, do, do, do, do. So one of the first things that I needed to do in that kind of situation was reveal to them the low cost effort to generate high value results. And sometimes that’s just not asking permission, but just doing something that maybe it only takes a few hours to do. So your boss isn’t gonna worry about it. But when you come back, you have a quick PowerPoint presentation or you have some kind of sketch that absolutely addresses core questions folks are having, that’s been reframed now in a way that makes them stop for a moment to think. And if you can do that with a relatively low level of effort, nobody’s gonna complain. They’re not gonna say, gee, why’d you take two months to go off and do this thing? It’s like, no, I did something small.
Kuldeep Kelkar
Yeah, what you’re describing is called the “show, don’t tell”. Show the value, don’t talk about it. Yeah, got it.
Leo Frishberg
Exactly, exactly, exactly. But how do you get there in a quick and dirty way? Good enough in order to tell your story. On the other extreme, you have organizations that are explicitly hostile to doing UX of any nature for whatever reason. And they may have all sorts of rational reasons for being that way, but they’re explicitly hostile. There are several options still available to us, aside from the one which says go find another job. Like that’s always an option, except in an environment today, for example, in early 2024, where the job market is quite challenging, still we should find ways to make it work. In this case, what I recommend is you find a leader who is open to the idea, a creative leader somewhere, somebody, and be able to work with them using that same approach, low cost, low effort, high value result, so that the leader now sees the value and they become your shepherd, your sponsor to move you further and further into the organization and work with them to help influence the naysayers and the ones who are hostile. I think it was, I can’t remember which of the UX leaders I heard talk at one of the conferences who said, look, nobody understood what I was supposed to be doing. And I was sitting there in the C-suite. I said, can I just do the PowerPoint presentation? Can I just build the PowerPoint presentation? And they said, yeah, do that. Well, that put him in a position of understanding everybody’s point of view. He suddenly became the nexus of all sorts of information where he could then very quickly say, oh, so-and-so is saying it this way. You’re saying it that way. Might we? And he worked his way into a position of influence through a very menial set of tasks. So there’s lots of entrees into that organization.
Kuldeep Kelkar
Great example, I mean, yeah, back to the “demonstrate value rather than just talking about stuff”, and I guess the key point there also was to find your executive champion. Find someone who can…
Leo Frishberg
Anybody. Doesn’t have to be executive. Could be your project lead. Could be somebody in another department who you respect. Find somebody to be your advocate.
Kuldeep Kelkar
And of course, if nothing works then there is always… do what’s best for you.
Leo Frishberg
Build your portfolio. Always build your portfolio. Have your parachute ready. Yeah.
Kuldeep Kelkar
I love that. So in my conversations with research leaders in particular, but also design leaders or new managers and aspiring managers, a part of that influence story is also a deeper understanding of KPIs or metrics or understanding the business language, understanding the levers that need to be pulled. And there are several. So any thoughts around speaking the business language, how to do that, how to grow in that effort, because I generally feel that people have intention, they’re not always sure how to move the needle for themselves in that direction.
Leo Frishberg
Yeah, I’ll tell you a little bit about my journey on that one because I definitely continue to struggle even after 40 years, although less today, thankfully. One of the ways is to start your own business. As soon as you start your own business, suddenly you have to deal with all of those things that the business people care about. Again, as an architect, I was taught to start my own business. So I had a lot of that infrastructure in my professional training. But then throw all that away when you suddenly become a consultant, like practical things like bookkeeping and keeping track of receipts, just logistics or how many times did I call that prospect before they became a customer? You begin to really think about your time as really valuable and how do you measure or improve the efficiency of your work? All of those become KPIs within any business. Those are operational concerns of any business. We are the most expensive part of a business. The human in the labor equation is the most expensive part of the business. So almost every business process is around reducing the cost of labor, see generative AI. So that brings it home, right? What can I do to understand what my work costs is the first way to start thinking about speaking the language of business. If somebody says to me, or somebody said to me back in 2006, hey, we want to get this result. What’s it going to take to get there? I should be sufficiently comfortable doing some kind of time and motion decomposition of doing that work. I think it’s going to take me 12 hours to do this piece. I think it’s probably going to take me 30 hours to do that piece. That is a huge way of speaking the language of business, as a beginning, kind of Lego block step.
When I moved into more of a managerial position at Intel, most of my stakeholders were working with P&Ls, profit and loss statements, for their divisions. They were held to account, they had a million dollar budget, they had this many expenses, they had to show a profit at the end of the year, they had to show this in something called a profit and loss, a P&L. I actually dug into understanding what their P&L looked like and really understood what those line items meant. And then when I presented back to them, I could show the value of the work I was going to be doing and how it hit either their top line growth or bottom line cost savings so that they understood how my work integrated into their bottom line literally. And that was the only way I could convince them. We were an in-house consultancy. The only way I could convince them to use my team is to show that spending a million dollars on my team over the next two years was going to save them $6 million of development costs or $4 million of external consultancy costs. And I needed to make that a case. So, do I like that? Is that something I enjoy doing? I have to tell you, it’s about as far away from design as one can get. But there are aspects of it that I truly love. When I started my design business, doing a full time and motion study of all the parts and pieces, I actually really liked that. I thought that was really fun. Like, oh, how could I shave more time off of that and not reduce quality? How might I make that easier for somebody else to do so I don’t have to be spending high cost resources? So I think there are some design problems inherent in the language of business.
Kuldeep Kelkar
Yeah, fantastic. I mean, over the number of years, given that you have been an individual contributor, a designer, and been involved with research, you have now managed teams for a while. What are some of your recommendations for someone who wants to become a leader or is a manager but wants to become a senior manager, is a senior manager wants to become a director, and I don’t necessarily mean by job profile and here are the step by step. I mean this is a generic question, what skills, what attributes do you think folks should focus on?
Leo Frishberg
Yeah, so these are conversations that I have with my team members monthly, right, intentionally. We all are supposed to be able to ask and answer the question, what do you want to be when you grow up? And that’s a perfectly reasonable question that I hope somebody asks me today. The answer to that question will define the next steps that somebody needs to take. So why do you want to get a promotion? What are you looking for? Are you looking for more money, or are you looking for more footprint? Are you looking for more influence? Are you in a company that requires that cohort in order for you to be accepted as a power dynamic? Let’s get to the bottom of that desire. There are folks I know who would just be happy doing what they’re doing, and promoting is not in their… And that’s fine too. Like, let’s understand that. But once we understand the drivers and the motivations, then I have a 45 skill matrix that I have folks go through. And they self-evaluate on these 45 skills. And I evaluate them on these 45 skills after I get to know them. And then we compare. We do a little calibration. And then I say, okay, so you’re at a senior level and you want to move into a leadership level. Great. Here are the rough numbers you’d expect to need to have for each of these skills. And it’s a range, it’s never a hard number, but if you’re in a range of one to two over here, we wanna get you into a two to four over here. If you’re pretty far away from all of those things, great, then we know what we need to do. We just generally need to get you upleveling those skills. If you’re close… If you’re really close and you’re probably there for a lot of those skills, but there’s several in which there’s gaps, great. Let’s give you jobs within the organization that help you up level. Now out of those 40 some skills, there are probably 15 that are soft skills. And these are stakeholder management, time management, data management, storytelling, meeting management, communication, equitability, diversity, and inclusive language. Like these are all soft skills. And so leaders are expected, the higher you go, as you suddenly get up into VP and higher, many of the technical skills become less interesting. And a lot of those soft skills become things you need to be masterful at. So that’s the easy answer, right? Just self-evaluate on these 45 skills, and then figure out what you need to do and go do them, right? I make it sound… it’s not as facile, right? I don’t mean to make it sound like that.
Kuldeep Kelkar
No, no, I’m impressed because again, in talking with a range of individuals, this answer is more on the scientific approach, on the engineering approach of, no, let’s just talk in general terms. No, no, let’s have a structure, 45 questions, each on a one to five point range or seven point range, and then talk through examples and identify opportunities to demonstrate some of them. Sometimes in my experience, people have gone through that process and realized that they are more comfortable in the… they thought that they wanted that, and they realized that they don’t. Yeah.
Leo Frishberg
Exactly. Well, and this is a conversation that I have with folks who are thinking they want to get promoted. We saw this at Intel quite a bit. So Intel uses this grade system 6 through 12. And individual contributors are at the top of their trajectory at grade 7, roughly. And to move in grade 8, you need to start, you know, the T-shaped person, you need to start moving into the crossbar of the T. And it is a very difficult transition to make, because…
Nothing you’ve learned on the upright of the T [T-shaped skills] tends to help you with the crossbar of the T… We shouldn’t be focusing only on the upright. We should always be talking about the crossbar, even as a junior designer coming on board.
So we found that a lot of folks moving into grade 8 were failing. They weren’t prepared for that transition. We had not done our job as managers to help get them ready for that crossbar move. So I took a lesson from that and said, okay, that’s wrong. That’s the wrong thing to do. We shouldn’t be focusing only on the upright. We should always be talking about the crossbar. Even as a junior designer coming on board, those 11 soft skills are still a requirement. We just don’t expect proficiency and mastery at a vice president level for those. But we certainly expect proficiency at a junior level. So what does that look like? And then we move. We just keep moving folks up that thing. So the point is, I say very intentionally and very self-consciously to my team members, be very careful what you wish for. If you really want to move into that position, the work you’re going to do is going to look very different from the work you’re doing today. If that doesn’t look good to you, you’re not going to be happy. I want to give them opportunities to try those things out and say, ooh, yeah, no, really? That’s what that’s about? I don’t want to do that.
Kuldeep Kelkar
Yeah. I mean, grass always appears greener from this side to look at that other side. But when you are on that other side, you see a lot of patches of brown. And so, yeah, I’ve had similar experiences as well.
Leo Frishberg
And I’ve even talked to leaders, peers of mine, who have decided to move back into individual contributor positions because they really do want to do more design work and they want to stop doing whatever it is we do as directors.
Kuldeep Kelkar
Yeah. Fabulous. I mean, Leo, this has been very inspirational even for me. I’ve been doing this for a couple of decades, and I learned things. So thank you. Thank you very much. I know the listeners are going to be very appreciative of all that feedback. And not everyone has the opportunity to always connect with people who have been in the industry for 40 years and practicing UX for 20 plus years. Thank you for your time. Thank you for all the nuggets of insights that you had to share. Appreciate you being on this show. And thank you to the listeners. We’ll have this recording on all podcast channels, as well as LinkedIn, YouTube, Twitter, everywhere where podcasts are available. Thank you, Leo.
Leo Frishberg
Well, you’re entirely welcome, Kuldeep, and I appreciate everybody else. It’s quite a privilege and an honor to be able to talk about my journey.
Kuldeep Kelkar
Thank you, bye bye.
