Collaborative Design for Startups

Andrew Verboncouer:   You're listening to the Seaworthy podcast, episode 15, Collaborative Design for Startups. Seaworthy is a podcast about building successful software. Today we're talking about how collaborative design can push your product and business further with Kerem Suer of Carbon Health.  I'm excited to have Kerem on the show with me today. Kerem is a VP of design at carbon health, a company helping make patient centric world class healthcare accessible. Kerem has helped design experiences for companies like Fitbit, Dropbox, My Fitness Pal, Adobe, Zendesk, and more. Welcome to the show, Kerem. Thanks for coming. 

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Kerem Suer:  Hey, thanks for having me. 

Andrew Verboncouer:   How was your break? We're just recording here after the holidays. How was everything for you?

Kerem Suer:  Everything is good holiday break is good. I kind of you know unplugged a little bit you know, there was like some sickness on the on the kids and stuff running around but other than that it was it was fine. 

Andrew Verboncouer:   That's good, low key. 

Kerem Suer:  How was yours? 

Andrew Verboncouer:   Yeah most of the same you know we have, at headway we have a holiday refresh and so we're off between Christmas and New Year's and there's always the draw to work more. There's always a draw to, you know, side projects, things like that, but just really laid back barely opened my computer, which was great. But came back to a mountain of of emails after break, but that's how it goes. But yeah, you know, good. Good to refresh and recharge and just be ready for the 2020. 

Kerem Suer:  perfect. 

Andrew Verboncouer:   Cool. Before we jump in. Can you tell us a little bit more about you, your background and how you got into design? 

Kerem Suer:  Totally. Well, kind of boring, but I got into design through school, I started as a sort of as a computer science major. And, you know, shortly I discovered that, you know, computer science is not really what I was looking for. I always knew, you know, I wanted to do something with computers. And then my advisor kind of shifted me towards this new major in our school new program called interactive, interactive digital media. And that had you know, three different concentrations, computer science, visual imaging and then new media. And this is to kind of date myself this is way before you know, smartphones or any of these modern interactive devices. You know, so I started there as a visual image and concentration and that started with 2d design, print design, very traditional and went towards more interaction design, interaction as in you know, flash websites and you know, some HTML CSS here and there. But that's sort of how I got my I got my foot in.

Andrew Verboncouer:   Yeah, that's, I think, you know, the, the more I talk to other designers that have been, and design leaders and people that have been in tech for a while, you know, usually come up through the unexpected pathways, right, like you get into some, you know, you stumble into something like tangential or maybe you know, a lot of people got their start doing my space layouts. That's how I started learning HTML, CSS, you know, and then flashing and kind of snowballs into, you know, into a career that you find passion in and 

Kerem Suer:  that's right 

Andrew Verboncouer:   Yea, it can be really fulfilling. So that's, yeah, interesting to hear. 

Kerem Suer:  Totally. And, you know, like, what got me interested, obviously, like before school, you know, I was always interested in computers. I would, you know, play games. And, you know, as I started playing games, I'm like, oh, maybe like I can, I can create like a skin for this game. That went from that to - O, this wind app does music player. Let me just make this like new skin for it. And then I'm like, Oh, I'm actually really interested in this stuff. That's cool. And then I ended up kind of getting paid for this stuff. Which was great. 

Andrew Verboncouer:   Yeah, that's good. What keeps you busy outside of work?

Kerem Suer:  Outside of work, honestly, right now, I'm a dad of two. So and I guess like dad of three if you count my dog. So they definitely keep me busy. But yeah, I do a lot of kids stuff, a lot of family stuff. At some point, I started getting into woodwork, which was kind of fun. You know, um, you know, not not super sophisticated, wood work but I would start doing things like coasters or, you know, butcher block like cutting boards. You know, that kind of stuff really gets me excited, things that I can control and touch with my hands and create And I'm also a sailor. So, you know, I've been sailing since I was eight. So that has been a big part of my life. Less so in the last, let's say, like five years or so after the kids. But yeah, I'm getting back into it again.

Andrew Verboncouer:   Yeah, I mean, that sounds like sounds like fun outside of, you know, looking at the screen and one of the one of the things you said was wood working, cutting boards, different things like that coasters. I mean, what do you think that that does for, you know, just creativity in general? Like, is it you mentioned control as being one of those things like, Hey, I can control everything in this environment. Do you think...? 

Kerem Suer:  Totally. Yeah, I mean, it's, it's, um, for sure. Like, it's something you can like the physicality of it is something that's really interesting, you know, being able to cut I don't know tomatoes on it every day. You know, like looking at something that you create is pretty amazing. And, you know like to kind of pair that, you know, once we first bought our house, like everything I wanted to do myself, and I'm not a handyman at all, I was born in a really big city, where you hire a professional for everything. So I was not like part of this very cool suburban American culture where, you know, people actually build their own stuff, build their own decks and, you know, do construction in their houses or change their electrical outlets or whatnot. I've always been a part of a world where you know, you hire an electrician or like you hire a woodworker who would come in and or a carpenter who would come in and do this work. So I got really excited. And I started with like, rebuilding my deck and redesigning planters off the deck and this is like a fairly large deck. So it's it's definitely I did more than I was supposed to do I think there. But yeah, that you know, like functionality of things where I design and then you know kind of get to work on it and create it and then every day I walk on it and every day I look at it it's it gives you a little different satisfaction and maybe I'm so used to creating digital things, experiences, I guess and then like looking at them on a website. It is real but it doesn't feel real. And the physical products it's just so different. 

Andrew Verboncouer:   Yeah, I've always been super interested in woodworking. I've never actually done any woodworking other than you know, shop class at school. But when you see somebody you know, I think there's a lot of people in design and just in tech that do like to disconnect from, you know, from the screen and do something with their hands, whether that's woodworking or knitting or sewing or whatever. It's just interesting to, to think about like the solitude that that gives you, you know, and how much we're inundated with other people's thoughts throughout the day. You know, in different messages on the screen. And advertisements and things like that, that, you know, would gives you the opportunity to do.  There's a, I don't know if you've come across it before, but there's a YouTube channel I started following recently actually about woodworking and the way that her videos are crafted, it's almost like an art form. And you can just tell, there's so much care, it's called Jen's Mistake. And she makes really mid century modern kind of furniture with just creative methods of using similar tools over and over again of ways of like cutting and stuff that you wouldn't really think of. And it's like therapeutic to watch. He has to like some lo-fi music and I'll send it along. 

Kerem Suer:  I'll definitely check this out. 

Andrew Verboncouer:   Yeah, it looks like a high high class finished piece at the end, which is awesome.

Kerem Suer:  Yea, I mean, I think like later in my career, I started realizing, I sound like I'm too old, like I'm done with my career. But later in my life, I guess I started realizing, you know, you know, design is just, you know, it's intentionally solving your problems. And I started realizing, you know, every object around like I always knew every object is designed obviously somehow by someone, but I started realizing all these little intentional decisions that people made designing this thing, intending to for me to use it and you know, either I use it the way that is intended or not it's a really interesting way of like communicating in a way.  And you know, like looking at like, I don't know, like looking at a let's say a boat, right like, I'm a sailor and it's like this beautiful like sailboat and looking at the way that they joined the pieces of wood, and engineered that, is it's now gets me an insane amount of satisfaction, even though knowing that I can't like probably make that you know, right away at least. But just like the attention to detail and you know, like to see like how far people have come to create these objects. And, and sometimes like in scale is also like a really interesting thought process like IKEA stuff I think, you know in the states like IKEA gets a gets a not a great credit but you know thinking about the scale that they create these objects and the simplicity of how they created them to to let like an average Joe assemble them. It's absolutely phenomenal. Like it's it's probably one of my favorite companies in the world. 

Andrew Verboncouer:   Yeah, I've never actually been into an Ikea if you can imagine that. 

Kerem Suer:  Oh my god, you're in for a treat. 

Andrew Verboncouer:   We just got one recently down in in Milwaukee, but yeah, the scale at which they do things and in the fabrication process and you know, there's the IKEA effect, right of allowing folks to connect things and set up and I think part of that definitely goes into into product design.

Kerem Suer:  And the stores as well, by the way. 

Andrew Verboncouer:   yeah. 

Kerem Suer:  Once you go into the store, you'll see it's just the way they tailored these stores and create these like mini experiences. It's just unbelievable. 

Andrew Verboncouer:   Yeah, I'll add it to my list to do coming up here this month. 

Kerem Suer:  All right.

Andrew Verboncouer:   So let's talk a little bit about product design. Let's talk about your experience. You know, where was your first job? You know that you were employed to do design and kind of how has your career evolved from one to the next? 

Kerem Suer:  Yeah, I mean, I have not started as a product designer and product designer the title may have been around but not for digital designers for a long time. It's a fairly recent I think, maybe like within the last five, seven years maybe. But um, I started as a graphic production artist. And what that means is you know, I designed by now and download now buttons in Photoshop, you know, making them shiny and really clickable. 

Andrew Verboncouer:   Really glossy. 

Kerem Suer:  Yea, really glossy. And then, you know. 

Andrew Verboncouer:   Or leather, did you ever make leather buttons?

Kerem Suer:  Oh my god yes, I like feel like I'm a I'm a professional at it almost. And you know, like that started there and then you know went towards you know landing pages went towards a little more functional pages more than marketing pages and then you know, my first job was at a gaming company. So, you know, I would not design the games, but I would design the the marketing assets and the graphics and everything to promote these games and to you know, make people buy them. And then I kind of got enough of that and you know, quickly realized this is not what I want to do for life, and then I got a job at this super small startup called Fitbit. And back then this is, you know, less than 10 people or so, you know, when I joined the team, my technical title was interaction designer, I think like senior interaction designer or something like that, um, but then we would basically design these beautiful web product at first and then, you know, we would go as far as you know, like, I'm not sure if you know, the very first Fitbit product that was this little clip and that had at this monochromatic display. Like I think an eight bit display actually. And and we would design these like little icons that would go on them on the displays, and then the first iPhone came out, and then that kind of totally, you know, changed the game for me at least. So, you know, I designed the very first iPhone app for Fitbit, and and that's where I started, I'm like, Okay, cool. Some of these, like little decisions that I make, actually, you know, tie pretty nicely with the business. And that's sort of when I discovered, okay, so these intentional design decisions, they're not just, you know, design decisions, they're actual business decisions. And I think once you understand the link between them, I think that's when you're like, I don't care about you know, the official titles or whatnot. But, but I think that's how product designers are defined as you know, once you understand the business goals, and tie some of your intentional like design decisions with these skills, and you see results, then you're like you get excited. And you know, if you're lucky enough to you know, be a part of a rocketship good company that's just taken off. That experience is kind of fast forwarded, you know, you get to make so many decisions super fast. And you know, some of them fail, some of them succeed. So that's sort of how I got my got my foot into the product design roles. But yeah, I mean, I worked with you know, for a long time, I actually was self employed. So I got to work with in San Francisco, a lot of, you know, really small startups, probably like 99% of you guys have never heard of,  went probably belly up. It's before product market fit startups. 

Andrew Verboncouer:   Yeah. 

Kerem Suer:  But you know, some of the big guys like Dropbox and Pinterest and My Fitness Pal and Zendesk and you know, some of the guys that are very big now, but back then was really small.

Andrew Verboncouer:   Yeah. What are some of the core tenants that you think those companies had? Obviously, this is a loaded question. And there's a lot of companies that you named, but maybe is there is there a theme of why you think some companies took off? And some didn't? Some were able to reach product market fit faster than others? Or maybe at all?

Kerem Suer:  Yeah, I mean, it is a really loaded question. So I think I'll speak for for Fitbit, I think. I think that that has, you know, when I first joined actually, I'm not even certain we hit the product market fit. We definitely we had products that were super backordered. But you know, more than half our time was still persuading people what step tracking is and why people should care. And what is like 7000 steps, what is 10,000 steps,

Andrew Verboncouer:   Like a double sale almost, hey, you have this problem and we also have the solution to help you figure out if you're solving it or not. 

Kerem Suer:  Right, and there was almost no inspiration in the market like that. I mean, I'm trying to think like, there's Nike fuelband came after a while. And that was very interesting, but they had their, like own formulas, rather than just steps. Like, like field formula, basically. And then, you know, there are a few products but it was never like, super prominent, and I think Fitbit was early enough that it created their own community. And I think the community aspect of Fitbit is still like, you can still see it and you know, when you go out, just yesterday, I interviewed a brand copywriter who, whose boyfriend works at Fitbit right now and, and even her like she was saying, it's like, I'm wearing a Fitbit, you know, not an Apple Watch. You know, it's it's they created this community where, you know, they're kind of proud of what they're wearing and tracking their steps and the leaderboard. And I think that community aspect was was really strong. And I think like, sorry, the long answer is like I think the community is, is what made Fitbit, what it is right now is they created this this competitive but not super exclusive community. And that kind of drove the company to success.

Andrew Verboncouer:   And in the time that you joined Fitbit to remember, do you remember what year that was? Is that maybe 2011 or something? 

Kerem Suer:  Yeah.

Andrew Verboncouer:   I remember at the time when Fitbit came out, I didn't work at a big company, but my brother was working for a big printing warehouse company here doing some XM pi on some codec presses and stuff like that, but they would, you know, all of the employee engagement and health care, you know, incentives and stuff were tied to this little tracker that you don't really,  you never got a report on whether or not you're hitting steps, but it was this tracker that, you know, you'd walk through the front door and they had these RFID readers set up and it would pull the chip count from it when you you know, got there. But really, you know, not giving the people who are who would use that information to be motivated to do more the tools they need to actually say like, yeah, I should go for a run, or I should go for a walk or I want to hit this goal. You know, I think that's part of the the traction, just looking back that I saw Fitbit kind of take off as like, get the hands or get the, the tools and decision making power back into the users who are actually wearing them, you know, more of a personal tool rather than a corporate engagement strategy.

Kerem Suer:  Totally. And it was it's, it was all about the behavior change as well, right? Like, I mean, pedometers existed for a while. Yeah. Generally for old people. But you know, it's, you know, the reason for a pedometer is the doctor would say, hey, you need to get some activity and you need to like know how much activity you're getting. And to create that behavior change you need to kind of create this loop of giving feedback as well. So for the pedometers, the feedback I think was was not existent. So, you know, you would still get, you know, you would still see the number of steps you stepped. But, you know, no one is telling you you actually hit your mark or no one is telling you, Hey, you know what - Susan also hit her mark, or, you know, you want to step 10 more steps from her or something. So that gamification also kind of worked. I think at that time.

Andrew Verboncouer:   So was your role after Fitbit, did you go to Omada Health shortly after that, or were you kind of in between?

Kerem Suer:  I didn't, so that there was um, I did work with Omada right after Fitbit, but right after Fitbit, basically, I started you know, the company started taking off big time. And even though I was not the only designer, I was one of three designers there. I kind of was associated with as like the Oh, this is like the Fitbit designer. So I would get in Silicon Valley at least like I would get a lot of hits on my emails inbound for, for customers, clients. And at some point I decided I'm going to do my own thing, you know, I'm gonna have my own studio, I'm going to work on my own, you know, always wanted it. So I kind of took the leap, and, you know, created my own little studio just by myself. At some point, I hired a few designers with me. But um, then, you know, omada health was one of those, one of my very first clients as a self employed person. And, and they, they were back then at least, like maybe three, four or five people in like a co working space. So that was that was pretty fun.

Andrew Verboncouer:   Yeah. Any key learnings from your work at Fitbit that kind of tied into the work you're doing at omada health?

Kerem Suer:  Oh, for sure. You know, just just so people know, so omada Health basically creates these online programs to prevent chronic diseases and the first one first chronic disease we worked on was pre diabetes. So we basically create this like 16 week program where people would log into their accounts and there will be a health coach on the other end. And, you know, they would actually get a pedometer, they would get a weight scale and, you know, they would basically follow their progress. And within this program, the 16 week program, they would hopefully, you know, get back get their life back into shape and, and not have prediabetes anymore. So the experience that Fitbit obviously worked for me there because well first of all, all these like sort of like dashboard-y interfaces that you know, I've been designing, definitely work there. But also, you know, some of the learnings on you know, how behavior change works, you know, how after each action, you need to give feedback to users, and this feedback should be in a calm tone, it should never be super alerting, even if they do something wrong, you know, it should not be super alerting. So, a lot of these learnings I think, played into it, but you know, I also learned a lot that's at Omada. And to the point actually later on, I joined omada health, you know, when they grew into this large company of like 100, 150 people, then I joined the team to to lead their design org of like nine or so designers. 

Andrew Verboncouer:   Yeah. A lot of a lot of healthcare, a lot of startup experience kind of leading you to, you know, your path today at carbon health, but we'll talk about that in a little bit. One thing I wanted to chat through is just some pitfalls you've seen, you know, startups have and designers specifically at startups and their design teams and how they, they organize - one tweet you had and I'll just read it off, not the whole thing. But maybe we can chat a little bit more about it but - "Have been an inter-disciplinary designer at startups for over a decade now. Here are a few things I've learned." And then you kind of go on to list a few really, really great tenants that you know, we definitely believe in here. And I think that it's, I don't know if there's one that sticks out to you specifically, we want to talk about, or we can just kind of go down. But yeah, the first one is fast iterations over pixel perfection.

Kerem Suer:  Yeah, for sure. I mean, honestly, like all of these, let's read them. And I believe them kind of equally. And these are sort of, it was like, I think one of these nights it was like a tweet vomit, or tweet storm, I guess. It just came out because, you know, and this is the time I actually I was actually still at carbon health too. You know, one of the common themes that I see is, you know, a lot of people obviously have experiences and a lot of a lot more experienced people than I am out there. And, you know, people write books and blog posts and everything. But what's real is, you know, every company is different, you know, every company has a, has a different team that's driving the company. And those teams have different DNAs in them. And so I guess, like, what I'm trying to say is, these are the things like, regardless of the DNA of the company stuck out for me, um, and and these are the things that, you know, makes me a little more successful, I think, at what I do, or let's say, if you set a goal of shipping a product or, you know, doing a marketing campaign, these are the things that kind of pushed me towards doing doing a better job. And to be honest, like these contradict with what I had been saying in the past. And I think as I've gotten more experience that I started seeing the bigger picture a little clearer, for example, like fast iterations over pixel perfection. So my very first website and maybe like a couple first websites, portfolio sites, my tagline was pixel perfection. Like literally it was just like pixel perfection, and I really believe that this craft of creating this pixel perfect interfaces, and, and this this kind of slowed me down like everything started being about that pixel perfection like everything is about picking on my front end engineers on Oh, this is off, this is off, you know, this doesn't work this is you know the letter line height is not good and whatever. But the reality is, you know, we're designing something and and I'm basically trying to communicate what I have in my brain into a display. And the final medium is, is a display, it's interactive, and everyone have different display sizes, different devices. So it is about you know, you know, have a guideline and and look good, but you know, pixel perfection is really not like one of those things and iterate that's the that's the beauty you know, that pixel perfection maybe belongs into print design or something but um, but not interaction design.

Andrew Verboncouer:   Yeah, something more eternal. I think I can resonate with that a lot early on, you know, especially in Photoshop before you had pixel perfect tools that would snap and vector based, you know, they mean you if it wasn't pixel perfect in Photoshop where you spent the time to line it up and, you know, you're at like 10,000% zoomed in, making sure everything's perfect, you know, according to the grid, like, then you develop, you know, it's hard to detach the eagle from that, because you spent so much time in every single corner of that design making it perfect. Now you want to see that through versus like the tools I think today help you move a lot faster. And those things are kind of given, you know, those are granted to us - where back, you know, back in the day, I guess not not too long ago, seven years ago, maybe we're, you know, still working in Photoshop. It's, it's hard to detach from that when you spend so much time on that craft part. Right? We talked about woodworking and just seeing someone honing their craft. It's that feeling that like I own this and like I've been able to bring this up like we should see this through, but realizing that whether it's pixel perfect you know or the same at every screen size doesn't really matter to your user, right? At the end of the day, if you don't solve a valuable problem, they're not going to care what the line height is, or that the font on this is bigger than the font on their iPad, if it's a companion app or something. There's just aren't details that most people care about. And it's hard to being a designer, it's hard to detach from that sometimes.

Kerem Suer:  Right? Right. I mean, I guess we're dating ourselves with like, how many hours that we spent on App pixels right? Just like the goddamn half pixels, it's just not working. This icon does look blurry on every screen. Now, I think it shifts towards different things like it shifts - for designers jobs are shifting towards you know, now you need to document a little more I think that's becoming more important, you know, you need to create almost like a blueprint for for a product so so people can understand your your decision making rather than just you know, fixing the half a pixel that's almost like expected from the software now.

Andrew Verboncouer:   Right, right. And those are things that it's, you know, it's taking off of your plate. But if you know, like the one man, one man band where he's playing on - I don't know if you've ever seen one of those are playing like 10 instruments at a time, you know, imagine you had somebody come up and join the band and he handed one off but picked up another instrument at the same time. It's kind of the role of designers where we're handing off these lower level value things to software to technology to things that can take it and hopefully climbing up the chain and getting closer to that business value. You know, where we can actually get closer to the business we can prove out really do a 360 on the product and how this is gonna improve behavior and improve change and provide us outcomes. Not so much about I'm just a visual designer, I'm just a graphic designer I think, you know, those are two two ends of the spectrum that you can fall into and it's not bad if you are you know, if you are a graphic designer and that's your job but if you're trying to be a you know, digital product designer, need to be a little bit more comprehensive and understand what - where's that craft within context, you know?

Kerem Suer:  and I think, you know, this kind of, is a good segue to the next two, you know, prototypes over mock ups and collaboration over redlining. You know, these are, you know, the reasons the core reasons for for prototypes is, you know, it's the cheapest way to actually test your product in a way, right? Like, not with users, but you know, like, let's say, the interactivity of a product, it's, it's the cheapest way to kind of play with it, and give it to your engineers and the people in the company to, to kind of get a feel of like, what what it's really gonna feel like, and the collaboration over redlining, like, I'm not sure, I'm sure you've done it as well. But, you know, in the past, we've, we've been designing things and we would be literally red lining up like, Oh, this is gonna be a seven pixel space, this is gonna be a 10 pixel to the right. You know, I would rather sit literally next to an engineer and talk about it. And, you know, kind of collaborate over it and and other amazing tools out there. You know, there's a, you know, there's the figmas and Adobe extees and, you know, all these tools are going towards, you know, real time sort of designing together collaborating. And it's been amazing because because this is the collaboration also opens a lot of doors like, I mean, this is like maybe a blanket statement, but there are a lot of designers out there. Like, it's not only the people who have the title, you know, designers are, you know, there's a your CEO is a designer, they are engineers aren't designers, maybe not the title, but, you know, they are intentionally solving problems. And then people have a lot of ideas. So it's kind of your job to capture these ideas. And then, you know, we should document them take notes, and do prototypes and, you know, kind of give them what comes out of this as like an entirely collaboration, collaborative process.

Andrew Verboncouer:   Yeah. No, I think that's important too, in collaborating from a sense, you know, as you said. So we work with a lot of companies that are, you know, startups, they don't have have a product yet. So we, you know, kind of have this jumping off point design system, where it's not so much redlining individual things, but, you know, your things are becoming more componentized, you know, in design as they are in code. And that helps, I think, make that translation. And that's, you know, one of the other instruments that technology takes over as we don't have to recreate buttons over and over again, or different components and patterns and things, we can rely on that and then focus on creating prototypes, you know, much faster than doing design from the ground up, which is really important for a product team to move fast and learn enough together, so. 

Kerem Suer:  yeah, I mean, the engineers are probably laughing at this because, you know, that is how engineering works. Yeah, I mean, from the get go, right, like before design systems or whatnot. You know, the website has a stylesheet. Yeah. And the cascading style sheet is done for this. So you don't have to repeat your code. 

Andrew Verboncouer:   Right. No inline, no inline styles? Yeah. Um, let's see one of the other ones...more notes. Yeah, maybe jump ahead to more design crits. 

Kerem Suer:  More design crits, yea. 

Andrew Verboncouer:   It's part of part of the collaboration.

Kerem Suer:  Totally, I mean, I think we've all done it, probably. But now, you know, as I've gotten older, I feel more uncomfortable, you know, when I'm just designing by myself. You know, even if your team is really small, even if you don't have a design team, I think just like showing your designs, walking people through your thinking process, and not just showing visuals, because you know that is easy, obviously, right? Like, you can just take a screenshot and send to people and people can give you their aesthetic reviews. But more so you know, if you're solving a problem, you know, walk people through, what you were thinking, what the problem was, what your solution is, and how you think it's gonna solve the big problem. And I think, and the idea exchange there is, is what kind of makes you better and makes you a little more vulnerable. And that's obviously, one thing that designers are constantly working on to, you know, kind of unpair from their work as their craft. Because because technically it's just you know, they're finding solutions and and work always gets better solutions always will get better. Well, when you think like, you know, if you think about design as art, you know, this, it's, if you think about it, your solution itself expression, let's say, you know, it doesn't really get better, it's subjective, it's like you get attached to it, but, you know, the more design critiques you do, the more you unpair from your work and and understand that this solution actually has many more options that you can you can work on and sometimes, you know, like that's capturing that is what really matters. 

Andrew Verboncouer:   Yeah, it's very easy to, to focus on, you know, your work and be attached to it. You talked about that a lot, but it's much better to see that traction and be a part of a team that's that's growing, then be defensive about a product that's growing and solving a problem, then be defensive about, you know, certain things that don't matter. It's just trying to understand the nuance of that. Where, when does when does it make sense to be perfect and when is progress enough?

Kerem Suer:  Right. Yeah, I mean, honestly, speaking, like, you know, designers - we're drivers at some point, right? Like, we're, you know, we can't just drive by ourselves, but we need to we need to kind of we're, I mean, I guess like not a driver but like a vehicle right? Like, you know, we're carrying these solutions to the final points and and we need to kind of get directions from other people as well at the same time.

Sponsorship:  This episode is sponsored by Headway. Headway helps startups and corporations bring entrepreneurial ideas to market and keep them there. Whether you want to bring a new idea to life, or improve the one you already have, headway can help through product strategy, design and development. For more information, you can head to our website at headway.io. Through this podcast headway is excited to give back to the community because we all know a rising tide lifts all ships, so go forth and make waves.

Andrew Verboncouer:   So let's talk a little bit about carbon health.

Kerem Suer:  All right.  

Andrew Verboncouer:   So when did you join the carbon health team?

Kerem Suer:  I joined I believe about eight months ago now. So early 2018. 2019 sorry.

Andrew Verboncouer:   2019. Yeah, so what kind of stuff have you been working on lately?

Kerem Suer:  Yeah. I mean, carbon health is awesome. It's it's one of the not I mean, it's probably the best company I've ever worked with, or worked a. So it was a cool story. So I actually was self employed back then. And our CEO, Eren, kind of reached out to me to say like, Hey, you know, we had a mutual friend and we wanted to explore, you know, if I can do a project for them, project or two. And as he was talking about the products, the product and the entire market and how they're trying to solve some of these problems, I kind of shifted the topic I'm like, okay, cool - not to like change the topic, but are you guys looking for a full time designer? And, and he said, You know, they would be definitely interested. And we definitely decided there that I was going to join full time. And, and the reason for it is honestly, it's a, in a way it's a designer's playground. And you know, I'll talk about like the business and, you know, our mission and why carbon health makes the world a better place. But from a very pure like selfish design perspective, it's it really is a designer's playground. We have, we have digital products, we have physical experiences, we have physical spaces. And the physical spaces with technology is connected to the experience to the patient's experience throughout. And then when patients go home, there's another digital experience on their phones that they can get back to, and their countless interactions.  Hold on one second. Sorry, that was my dog walking in. He like learned how to open doors now, so.  Yeah, so there's like countless interactions with patients and these like meaningful interactions we get to kind of decide and, and from an engineering and design perspective, it's, it's a super tight knit team. We're really, really extremely small. To the point like we have three designers and one of them is like a lead marketing designer and the other two, including myself, are you know, product, and I get to kind of touch everything. And then we have very small engineering team as well. And, and we control a lot of the product and a lot of the experiences. So carbon health, kind of like roll back, and people are probably wondering what is this? So it's basically think about a health clinic that is built from ground up, you know, which means you know, it's not your traditional mom and pop health clinic, not that it's a bad thing. But you know, we actually look at a lot of these traditional health clinics. And, you know, we don't go in as a as a typical Silicon Valley way of like, we're going to redesign healthcare and we're going to redefine everything. But we actually look at how it's done right now. And we discover a lot of the inefficiencies in it. And this includes, you know, in efficiencies on the on the provider side on the doctors and nurse practitioners, nurses, you know, these are amazing that these are super educated people who have gone to amazing schools and, and studied, just studied enough to take care of people. So we don't believe they're bad. We believe that the systems that they use are bad. So we basically create efficiencies for them, we create, we created know from ground up the electronic health record that plays well with other systems. So you can - a typical example would be like, let's say you have, you have fever cold, flu, whatever you're not feeling well, if you're going to an urgent care. I'll tell you my experience. You know, I would go to an urgent care and they would say, Alright, cool. Do you have your health insurance card? So I would give my health insurance card. If I have it, if I don't have it, I would have to like look for and go on the healthcare site. And then, you know, they would sign me in and I would sign a bunch of stuff on paper, I would fill in forms and then they would ask me things, and I would just like fill that stuff up and answer questions. And then they will do like, let's say, a chest X ray. And after all of this is done, let's say they would prescribe some medication for me and I would have to like tell them which pharmacy I want it at and I would then have to go into the pharmacy. If I want to check out my chest X ray, I would have to like literally, like, in my very recent experience, they said, Hey, here's a CD for you. 

And while this is cool, maybe for 2000, I don't know 2006, you know, nowadays, you know, like if you want to see the stuff so with carbon health, this experience would be you would go into the clinic, which you can already book your appointment so you don't have to wait at all. And there would be an iPad kiosk and you would fill out that information, tap, tap tap very easily. You would sign your consent forms, and you would go into the room and the doctor would already know where you're coming from. Your your medical history he already has the documents on on their iPad on their or computers. And they will easily consume this. And within the exam room, there's an iPad, there's a Apple TV application, where you know, you would see all of this information very transparently. And they would assess you exam you, examine you, and then you would take the X ray. And literally as the X ray is taken, it goes into your iPhone app. So you can just tap and see your X ray results. And for your prescription as you're checking out. By the way, all the like health insurance card, you just scan your card on the app and it's done. And on your way out, they will say hey, you know, like, do you, would you like your prescription here? Or would you like, would you like us to ship it? And you don't even have to say anything. You can even go on your phone and say tap, you know, delivered to my home. And within two hours some places in San Francisco right now we're testing within two hours your prescription is at your door.

Andrew Verboncouer:   Wow.

Kerem Suer:  So, a lot of like inefficiencies, we can actually get it out of the way. And, and this matters so much on the patient side, but also on the on the provider side, you know, the one of the biggest problems in American, you know, doctors and nurses and nurse practitioners is burnout. You know, these people are charting, meaning, you know, they're there, they're taking notes about their patients a ridiculous amount of time, and for every patient and we're making that a lot easier for for doctors, and, you know, nurses and providers. So, so all of these kind of come together as an ecosystem of a healthcare like a health clinic, it becomes this really um, not really a bad experience. Yeah, you actually can can be like with no way you can go into urgent care, primary care, pediatrician and everything that goes on your phone. So it's like a caught up health clinic system that's kind of built for 21st century.

Andrew Verboncouer:   Yeah, well, like you said it's a designer's playground. You're really using that whole service design model to understand not only what are the problems here, but like, planning, follow up insurance, prescriptions. 

Kerem Suer:  Absolutely. 

Andrew Verboncouer:   You're, you know, you're bringing that together. Yeah, that's that's exciting. Now is this something where carbon health is, like a specific facility right now but maybe expands to be an offering and a model that other clinics could adopt, like the software and like, kind of like the SAS model and service model?

Kerem Suer:  Yeah, so we've tried that. And early on in our in the company's history, but um, the reason we kind of shied away from it is because the, the workflow and and all the connectedness of all of these touch points actually makes the whole experience. And, you know, once we give many of these touch points in the physical clinics to other other health clinics, staff, it actually affects the whole experience a lot. So we decided we're going to build our own health clinics. So right now we have close to 14 health clinics in the Bay Area and Bay Area, Reno and Southern California. And so this kind of differs, because, you know, we, we build our health clinics from ground up. But we also acquire health clinics that are in the same mindset as us.  And then they kind of go into our model and and we find the inefficiencies there, we create the efficiencies and install all of our services there, you know, kind of redesign their workflow in a way. And, you know, we're kind of planning to do maybe, like close to hundred new clinics over the next 18 to 24 months or so. So, so it'll grow. And we know that the current model for us works phenomenally, and from a business perspective as well. So we're excited. 

Andrew Verboncouer:   Yeah. No, that is exciting. So how do you measure? How do you measure success and like business goals. Obviously, you're setting up new clinics, you mentioned it, you know, it's a sustainable business model. It makes sense. From that standpoint. Convenience is a big factor. You know, you can measure that different ways NPS usability score, like all of these different things, but how do you measure success? You know, of what the design of what people, I guess the service design the entire experience with carbon health?

Kerem Suer:  Yeah, I mean, great question. So they're traditional ways of, you know, measuring the NPS is a good one. And we definitely, you know, look at them and, and we look at our reviews. The thing is, it's, you know, we're not really redefining anything, we're kind of not reinventing the wheel again. So for us, you know, one of the major things is to find areas to open clinics at and, you know, we tend to go for areas that you know, people don't have enough access to healthcare. Because, you know, our mission is to kind of create this very accessible healthcare system. And in for that, you know, our success measurement, I think is actually, you know, every every product has has a different measurement. So, for example, on our, you know, one of the numbers we look at is, you know, how many people are actually using our apps, because we believe really, you know, using an app is gonna change that experience for you. But then for health clinics themselves, there are different metrics that we look at. Um, you know, like, how long is the wait, how long did it take us to treat a certain condition? And obviously, like, the volumes for each clinic is different, right?

Andrew Verboncouer:   Real tangible, like measurable quantification. 

Kerem Suer:  Right? Exactly. And And honestly, like it's, it's a, it's really not as it's not rocket science. And once you go into bricks and mortar businesses, it's you kind of understand it's, it is real. And, you know, some of these metrics that on digital products we look at as it becomes like a little light lighter weight, looking at the physical places, but yeah, it's been it's been phenomenal. 

Andrew Verboncouer:   Yeah. I mean, yeah. Because you can definitely measure the admin staff in time to input notes and make charts and, you know, all of that is valued. I mean, it's somebody getting paid and all in hourly salary plus benefits, like you can really calculate that and understand how you're impacting.

Kerem Suer:  Yeah, and one of the like, the the metrics we actually tried to follow the most as, you know, the amount of time our providers spend treating people and charting. So we want to really reduce the amount of time charting so these providers can actually do what they signed up for, you know, taking care of people. So, so we're constantly working on to find shortcuts to find, find ways to shorten that time to chart and you know, strengthen them and make it longer to take care of patients. Person to person. 

Andrew Verboncouer:   Yeah. How do you? How do you prioritize, you know, whether that's new features or new offerings, you know, that you're bringing to, to your existing clinics, how do you priotitize what kind of gets built by your product team, what gets worked on by marketing? What are some of those leading indicators?

Kerem Suer:  That's, that is a great question as well. So because we're a super, super small, tight knit team, you know, we commonly we have meetings, like, let's say, last yesterday, we had this roadmap meeting, which we do every two weeks, and we meet our clinical staff. And, you know, we have, we all use this like very centralized documentation platform. And you know, everything gets documented every feature request counts. You know, honestly, my favorite people are the central support team. Because they they're like the face of Carbon health, they talk to patients every day all day. You know, talking to them and getting ideas out of them is is amazing. And not to mention, they also join our meetings as well. But then, you know, the clinical staff would come in and say like, okay, cool, you know, like, taking care of this procedure. It took us a little long, but if we did this, and this and this, it would be a lot shorter. What do you guys think? And, you know, we would come up with our own like technical, either there's a technical difficulty, but you know, on the software side, anything is possible. So, generally, the answer to them is like, Alright, you know, when should we build this, and then we actually have literally one product person, and that is like a half product person and half designer. And then we have our CEO who's also like a half of everything. So he's also very productivity. So we would all talk and talk shop and talk about priorities and what we should be doing. And we also have quarterly meetings. So you know, we have our okrs and roadmaps. And you know, like the company wide like broad objectives and sort of like a general paat that we want to go quarter. And you know, we run all of them together and we come up with the perfect formula of what to build.

Andrew Verboncouer:   Yeah. Good. Yeah. When you, it's always good to have that mindset of, you know, you're not recruiting doesn't seem like you're recruiting your users, the clinicians that are there are in the mindset of like, how could we make this better in the weeds? You know, so you're almost have like, this continuous ongoing diary study, you know, that you might run in other companies where, you know, we'll do that if we don't have access to people around the clock is like, keep track of what you you know, what you've done, what time it was, what do you think could be improved about that process, but you kind of have that baked in so I could see you being able to iterate really quickly and learn from what you're deploying that's, that's awesome. 

Kerem Suer:  Absolutely. Yeah, the close communication loop i think is one of our differentiators. And, and I often would say like startups or - startups and bigger corporations which you know, who we're against up to here. You know, they're two different vessels and because I'm a sailor, I like water. So you know, startups are like speed boats. And we can maneuver super fast because we're really really small. Wheras these big corporations even though they know the right answer. Sometimes their manuever is a lot slower. So, you know, we get to find inefficiencies and kind of react to them in a fast manner. 

Andrew Verboncouer:   Right. You almost imagine a speedboat running next to like a Carnival Cruise ship. Right where you one's slow moving but has a lot of momentum. But you know, can get a lot of people there, you know, and amount of time the other one you can get a short amount, you know, smaller amount of people there very quickly.

Kerem Suer:  Yeah, totally, but, you know, the carnival ship has, you know, 30,000 people on them. So, so we're gonna get there but you know, they're, they're definitely we're also looking up to a lot of our competitors and looking up to a lot of the existing systems. So, yeah. 

Andrew Verboncouer:   For sure. Any tools that you use internally at carbon health that you don't think you could live without?

Kerem Suer:  Yeah, I think notion is one of them. You know, we use notion for literally every single thing. And I am you know, like sometimes in companies these tools can become problematic because, you know, the sales team might come in and be like, Hey, you know, we only use Microsoft Excel, and PowerPoint and so I tried to kind of brainwash everyone, every new employee of like, Hey, we live and breathe in this tool and document everything you do. So it's been pretty great. I think it could get better but you know, that's one tool we can't live without.  On the design side we're - in a polite way- we're like a sh**show, we use every single tool. And this started with you know, we're traditionally the carbon health was using sketch for example, and then you know, when we, when I first started, I'm like, you know, sketch is cool, but you know, have you tried figma? And then we started trying figma and then we tried figma and like, you know, figma is cool, but, you know, I can't design offline. You know, should we try XD? So now we're like trying XD you know, counts also like all the prototyping tools of like framer and principal and invision so we use every single tool and, and honestly, because the team is small, we kind of like it. So you can find like, one file for a single product on sketch, and the next version could be in figma. And the next version could be in XD and we all know are capable of using these tools. They're fairly similar. I'm not sure if engineers like it, but designers that - we like using every single tool 

Andrew Verboncouer:   Did you check the prototype? No, the other prototype. Yeah. 

Kerem Suer:  Exactly. I mean, just yesterday, I was like, Hey, have you where's this like, new file I'm like, um, should be on sketch or figma or maybe XD, I don't know. 

Andrew Verboncouer:   Check all three and come back. Yeah.

Kerem Suer:  Yeah. 

Andrew Verboncouer:   So you mentioned carbon house looking to expand, you know, the next 18, 24 months, that sort of thing. Anything else next for you and the team at carbon health?

Kerem Suer:  Yeah, I mean, so I'm actually not even sure if I'm supposed to talk about this. But um, so we have these physical experiences are great. But it's also a little harder to scale. Because you need to kind of build and get permits and kind of building a health clinic from scratch has been a learning experience for me for sure. But we also want to, we're exploring this, traditionally called telemedicine, what we call virtual care for now and named TBD, sort of, but we're exploring these virtual products where basically wherever you are, you can you can tap a button and be able to talk to your doctor. You know, let's say or talk to your health team. And and we're trying to stuff in different verticals as well, which has been super exciting. So you know, one of them I'm fairly passionate about is pediatrics. So being able to talk about saying like, you're a new mom or dad, and your kid has fever, you know, being able to connect to a pediatrician, right then we believe can be really powerful. We don't believe, you know, necessarily virtual products is the answer to healthcare. But we think like it can be a really complimentary experience where, you know, you actually get a lot of value as a patient, and also a model where we can actually scale that a lot faster on the software side. So that's definitely something I'm very excited about. We're fairly close to shipping our first first sort of like data product, and then you know, we'll we'll work on work our way towards the other verticals.

Andrew Verboncouer:   Yeah, the the virtual doctor visits is actually on the homepage right now. And I clicked into it and I can schedule a virtual Urgent Care session in about 25 minutes. That's pretty...

Kerem Suer:  right.  That's, that's pretty good, right? I mean, and this is, it's only gonna get better. It's 25 minutes actually is kind of like, within our metrics, it's fairly slow. You know, you should, you should, you know, our goal is to do like, within five minutes, you need to be able to connect to someon, your health team.

Andrew Verboncouer:   That's pretty. I mean, that's the difference, you know, for a lot of people for virtual urgent care is going from, do I need, is this something I need to worry about? Hey, I just, you know, saw this or noticed this, or I'm feeling this, like, do I need to come in? Like, should I should I handle this right now? You know, just getting that opinion.

Kerem Suer:  I mean, or, like, you know, we believe like, you should have your primary care physician, you know, and let's say like you have your go to Urgent Care place, but let's say you're traveling and you're in Los Angeles, and you know, you are not feeling well you have fever, you should be able to connect to the health team that that you were seeing before and get quick answers instead of just googling what fever is? And, you know, that usually doesn't turn out? 

Andrew Verboncouer:   Yeah. What advice would you have for startups or designers looking to really reach that next level of growth or, you know, go beyond product-solution fit? 

Kerem Suer:  Yeah, I think, um, you know, I see prototyping as an extremely important tool. And this is not just like, prototyping internally, but, um, you know, creating prototypes and putting them in front of potential customers, patients. I think it's super powerful and undervalued in a lot of startups that I have worked with. So that that is one. On the engineering side, you know, I, I stuck to this quote from from one of my, one of the co founders, I worked with, that, you know, the market doesn't wait for your re-factor, you know, and, and and this kind of counts for design as well as the market doesn't really wait for you're design, like your, if you're solving a real problem. And if that problem if that solution doesn't include the the beautiful aesthetics or the amazing back end code, put your product out there, and and start solving the problem right away and then work your way. And at least on the software side, you know, for us, it's slightly different because we have the physical aspect of things as well. So everything we do has to be worked into a workflow with real people and real, you know, experiences. But you know, get your product out there. It can be a small thing. It can be a big thing, just get it out there and then work your way into iterations, making it perfect and maybe not pixel perfect, but you know, making it to the way that you intended to design it. 

Andrew Verboncouer:   Yeah. No, that's great advice.Where can people find you online and follow more about you, your journey, Carbon? 

Kerem Suer:  Yeah. So carbon is easy. Go to carbonhealth.com, and people can follow me. I'm fairly active on Twitter just watching you know the weirdnesses happening in our worlds and commenting on them on Twitter. You can follow me @kerem. K-E-R-E-M. And you can also go to kerem.co. And that would be my website. 

Andrew Verboncouer:   Awesome. Well, thanks so much for being on the show. It was great talking and learning more about your experience, how you're changing healthcare at carbon health. Appreciate it. 

Kerem Suer:  Cool. Yeah. Thanks for having me. It was fun.

Andrew Verboncouer:   Thanks for listening to Seaworthy. Connect with us and ask questions on Twitter @SeaworthyFM. Make sure you subscribe and if you enjoyed it, leave a review on iTunes. Sail forth and make waves.