My technology career was born out of administrative heartbreak in a shared storage closet. That’s where I poured through cancer patient records to identify individuals who could participate in clinical trials. It was part of my internship at an oncology clinic.
I could spend one to two hours reviewing an individual patient’s chart, getting excited that they may be a candidate for a new therapy, until I found the one piece of data that disqualified them. It was heartbreaking, slow, there was potential for error as I became more and more tired over the course of a day, and there had to be a better way.
Despite this work seeming to be the perfect candidate for automation, it’s not mindless, and it’s deceptively complex. It takes a lot of effort to explain the complex oncology field at the administrative level, and the intuitive, and not-so-intuitive tricks born out of trial and error that allowed me to screen patients for trials well.
Over and over throughout what has developed into my technology career, I keep channeling those hours of tedious mental labor and stamina. I remember when I was trying to find a better way to parse dense text, charts, acronyms and numbers. I was working to more effectively and efficiently help the people who those pages of paper represented.
A lot of this kind of work is done by women. But most enterprise software intended to make that work easier and better is not designed by women. That may be a missed opportunity, or worse, that disconnection may be holding back enterprise software.
It’s estimated 36 percent of technology product designers in the U.S. are women. That is a higher percentage of women than in engineering and data science. But critics have suggested this imbalance in product design results in a blind spot when 50 percent of humanity are women.
But what if you are developing enterprise software for healthcare, insurance or banking? In most cases startups in these sectors are working to automate administrative workflows. And who has more hands-on experience with administrative workflows?
Ninety-four percent of administrative assistants and secretaries in the U.S. are women. Women are 91 percent of medical record and health information technicians. We are 88 percent of billing and posting clerks, and nurse practitioners. Women are 66 percent of diagnostic technicians, 65 percent of insurance underwriters, and 60 percent of accountants.
But are people in these roles equipped to lead tech startups? Maybe they’re too mired in a culture of following someone else’s process, and can’t be entrepreneurial?
Lisa, Kristen and Anita
Lisa Skeete Tatum is the founder of recruiting technology company LandIt, Kristen Sonday is co-founder of legal tech startup Paladin, and Anita Finnegan is founder of cyber security firm Nova Leah. Their experiences are instructive.
In addition to founding enterprise and business software firms that have landed on industry watch lists, the path each took to that part of their career included a stop in the administrative paper-shuffling guts of business or government. Tatum spent five years as a product supply manager and purchasing manager at Proctor & Gamble. She has said it was exactly her insights into how she was able turn her deep expertise inside a giant corporation into an entrepreneurial career path that has evolved into the product design that led to LandIt.
Sonday invested more than two years drafting hundreds of international arrest warrants as an international affairs specialist in the U.S. Department of Justice. Her experience here helped form ideas that would become Paladin.
Finnegan was a quality assurance inspector at a construction company, and then a quality manager at a design firm. These were engineering positions, but on the support side of each business where she saw gaps in medical device quality workflows that software could address. They all went on to contribute or lead the design of great software products.
In each case, they brought into their career direct experience with the repetitive tasks that make up the workflows of the industries they have gone on to disrupt, and the millions of little tricks frontline administrative workers absorb. Call them domain experts turned founders.
It is a truism that startup teams tend to find product-market fit by designing products that they themselves would use. It’s also a truism that users don’t use products that make their work more complex rather than easier, and worse yet when products appear to be designed to provide data to someone else so those other people can tell you what to do. Think electronic medical records.
Products that start by solving a problem the user has today, before worrying about other things, are the ones that get used more. You can’t get to addressable market until you have user engagement.
There’s not enough understanding of how work is actually done on the frontlines of insurance companies, banks and hospitals. Even brilliant physicians may not be aware of the labor and workflows that go into coding for reimbursement, scheduling, filling out electronic medical records. That may contribute to the frequency of health tech solutions that end up being more of a burden and distraction rather than a solution to problems engineers and even physicians can’t see.
Dr. Atul Gawande – now the CEO of a healthcare venture launched by Amazon, Berkshire Hathaway and JP Morgan – picked up early on how nurses can clearly see where workflow quality can be improved. If only they’re authorized to break through the hierarchy of operating rooms and speak up when a physician is skipping a critical step.
Gawande cited a policy at The Johns Hopkins Hospital in Baltimore, authorizing nurses to speak up when they spotted problems in the workflow, as contributing to a reduction in infection rates from 11 percent to zero.
How do we do it?
If women have potentially unique insight into organizational workflows, how do we get them into product design. Given the potential, it is surprising that women still make up only 36 percent of product development roles, and most of that 36 percent are not in senior level positions. A tiny percentage are founders and CEOs. It shouldn’t be that hard.
It may be, we just need more women startup founders and CEOs like Tatum, Sonday and Finnegan. For fans of Virginia Woolf, you could call a solution, “setting up more rooms of one’s own.” Enabling and funding space for women to solve enterprise scale problems from the frontlines up.
Look at the largest ethics and compliance software company in the world, NAVEX Global. It started as a spinout from a giant law firm with about five people led by Shanti Atkins, an employment lawyer who saw the pink collar work of human resources and compliance professionals and realized there was a better way.
Dru Armstrong is the CEO of property tech company Grace Hill which is taking a ground up approach to customer service and talent in the real estate sector, pushing forward artificial intelligence in property tech. Sheila Talton at Gray Matter Analytics is taking a hard look at data operations and multivariate analysis in hospitals, and talks about the inspiration she gets from the movie Hidden Figures, about women who stepped up from background roles to help the U.S. get to the moon.
This may be where the next wave of enterprise technology emerges, from domain expertise that develops as close as possible to the frontlines of big industries.