Jobs to be Done in Healthcare — The Case of Surgical Vision

Much of the writing about the notion of “Jobs to be Done” revolves around consumer products. This makes sense — these are simple examples that everyone can relate to. But, reading all these pieces, you’d never guess that healthcare is the biggest industry in the U.S. economy. There are few healthcare examples in my book Jobs to be Done, so the purpose of this piece is to provide a straightforward example for that huge yet neglected sector.

Let’s use an example based on a real problem we’ve encountered in our healthcare work — obstructions of a surgeon’s view. The surgical field is often blocked by complex anatomy, bodily fluids, and — for endoscopic surgery — a limited number of ports into the body through which to insert surgical instruments including optical scopes. A poor view can lead to guesswork, imperfect suture lines, and accidental nicks to parts of the body best left un-nicked. It’s a real problem.

Now imagine that a company has invented a significantly better way to visualize things (this example is disguised to protect client confidentiality). We have several questions to resolve. What surgical procedures should it target first? What sorts of hospitals should be the lead customers? What benefits does it need to prove for sales (as opposed to regulatory approval) purposes? How should it sell this? What should it charge? ​

A wonderful aspect of Jobs to be Done is that it provides a cohesive way to view market demands across stakeholder types, in a way that won’t change year-to-year based upon whatever new feature a competitor happens to introduce. It provides a way to address the expansive list of questions above.

​To do so, we need to use a tool, the Jobs Atlas, which is laid out in our book. The Atlas comprises eight parts, as shown below. The steps work best when followed in order:

1. Jobs to be Done — What are surgeons seeking to get done, and how might our product be relevant? Speaking with them, you’ll find that there are a host of functional jobs that might be relevant, such as connecting two ends of a blood vessel with 36⁰⁰ sutures that need to extend behind where a surgeon can see. These functional jobs will vary by surgical procedure (e.g., prostate gland removal occurs very close to key nerves that can be accidentally severed, resulting in incontinence). But don’t ignore emotional jobs. These matter in almost any industry — even in surgical equipment. One example is that some surgeons care about demonstrating proper technique to surgical residents, and they’re frustrated when some of their finest handiwork can scarcely been seen. They take intense pride in their craft and want to show just how skilled they are. And other important stakeholders may also have jobs that need to be addressed. For example, the head of a department may have distinct managerial jobs. And insurers may be pushing hospitals to assume the costs of post-operative complications to stabilize their liabilities.
2. Job Drivers — What leads certain jobs to be prioritized? This can vary by individuals’ attitudes as well as context. Attitudes can be personal (e.g., openness to new technology and tendency to get frustrated during a procedure). They can also be institutional, such as willingness to let surgeons experiment with new equipment. Context is also micro and macro. On a micro scale, it might matter whether a surgeon is rushed to free up scarce Operating Room resources, or whether a certain type of surgery is more challenging for visualization purposes than another. Looking more macro, hospitals that put more of their health insurance reimbursements at-risk depending on surgical outcomes might be more inclined to try new ways of avoiding mistakes. And some contexts will impact specific jobs — teaching hospitals will care more about demonstration of surgical technique than community hospitals where fewer people are observing a procedure.
3. Current Approaches and Pain Points — Many market research efforts conduct journey mapping, but if there is no understanding of underlying jobs the map lacks “why” explanations. Also, the wrong set of journeys might be mapped; the company may focus on how surgeons try to avoid unplanned events, but it may omit looking at how they try to instruct their residents. Knowing the jobs and job drivers ensures that you can examine current approaches, and their associated challenges (pain points), in the proper light.
4. Success Criteria — While Jobs to be Done is a solution-agnostic approach to understanding marketplace demands, it helps to have a clear view of how a new solution will be assessed. Metrics in this case might include time to complete a procedure, or a high-risk step within a procedure, as well as rates of post-operative complications.
5. Obstacles — The medical device industry is chock full of great ideas that never became popular. Find out what can impede people from “firing” old solutions so that they can “hire” you to get their jobs done in new ways. In our example, obstacles might include reluctance of surgeons to train on new equipment, or fear that something will go wrong with life-threatening consequences.
6. Value — How should we price this innovation? While competitive benchmarks always matter, it’s very useful to know the value of executing a job to be done. Perhaps better visualization enables surgeons to save 5 minutes per procedure, and avoid 5% of complications. Numbers can be placed on those outcomes, as well as on softer ones such as attracting desired staff.
7. Competition — Strategy involves competitive analysis, of course, but too often the competitors are selected too narrowly. What really competes for accomplishing key jobs to be done? For our example, the competition isn’t just makers of optical scopes like Olympus, but other ways of shortening procedures, reducing complications, or satisfying picky surgeons. Knowing the key jobs to be done enables you to select the right competitors that have to be beaten.

The Jobs Atlas framework allows companies to look at opportunity areas holistically, while avoiding bias toward specific solutions. The Atlas plots the overall landscape without dictating the route the company will take. This perspective enables a company to grasp the full opportunity that its innovations can seize. Moreover, knowing this Atlas for the range of stakeholders served (here, we’ve focused on hospitals) enables the company to compare benefits across stakeholder types in an apples-to-apples manner, looking objectively at where it may struggle and excel.

Healthcare is inevitably a complicated business. But even in a field as complex as surgical equipment, the Jobs Atlas provides a detailed yet expansive view of how to plot a route to success. As with our example innovation, perspective provides clear vision.

Learn more about Jobs to be Done thinking in practice at www.newmarketsadvisors.com!