What is patient centricity, anyway?

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Healthcare often gets a bad rap for lagging behind commercial enterprises in areas like customer centricity and digital transformation. While plenty of reasons are given, it all comes down to the fact that healthcare is a different beast -- a massively complex ecosystem of players and data that all need to be connected in order for it to work more effectively.  

But here's what healthcare is doing right: it's ahead of the game when it comes to breaking down silos inside organizations, which is one customer-centric principle that most other types of businesses have yet to grasp. Mayo Clinic put integrated clinical practice on the map back in the 1920s, demonstrating that collaboration improves outcomes and lowers costs. Numerous studies since then have corroborated the benefits, and by the year 2000, there were 850 integrated healthcare delivery systems. 

So where do we go from there? It seems like every article and report on patient centricity focuses on the technology needed to match consumer expectations, including health apps, online bill pay, and personalization. Other articles are peppered with should's on business and operating models and culture, without much guidance on "how the heck will we do this?" All the advice floating around must be overwhelming to healthcare leaders. Where do you start? What fixes do you prioritize? 

A new definition of patient centricity

The plethora of advice is only matched by the plethora of definitions of patient centricity. Most definitions center on listening to patients and involving them in decisions, engaging, empowering, etc. I fear that this definition can hurt more than it helps, because a focus on thousands of individual patients is no focus at all; it amplifies complexity. While listening is critical, for which of these patients should you create your overarching patient experience? These definitions also leave out key elements of customer centricity that are essential to shift your organization to be more future-ready. 

I believe that top-down strategy is essential to minimize complexity and get laser-focused on what matters most. With that in mind, I'd like to add one more definition to the pot based on my definitions of customer centricity: 

  • Customer/patient experience is the sum of the interactions that a customer/patient has with your company... which creates your brand perception.   

  • Customer/patient centricity is a way of doing business that starts with your priority customer/patient and their desired outcomes, then reverse-engineering your experience, capabilities, competencies and culture in order to deliver that outcome.

There's a lot to unpack here; let's start with the controversial idea of "priority patient." 

Patient prioritization

I can hear it now. "But we serve all kinds of patients! There's no way we can prioritize!" Yes, I understand. But unless you know who you're designing your experience for, you'll continue to get tripped up with overwhelming complexity, and a continued inability to focus and align your investments where they'll pay off most. 

So how do you prioritize patients? I use a model called the Experience Portfolio™ to categorize and prioritize various types of customers. I developed it in response to the fact that there is no "one size fits all" experience design in sectors like B2B, healthcare, utilities, airlines and government that serve a complex medley of customers and stakeholders. 

As you can see in the 2x2 below, the goal to create quadrants that necessitate different experiences for each. It's a forcing mechanism to see the most important differences in your patient population that will impact your patient experience design. 

  • The vertical axis should be your definition of patient priority or value. This varies by sector and by company, but for healthcare I'd propose an index of variables like: Accesses higher-value care (specialists) vs. generalists, chronic care vs. 1-time treatments, low/high risk of non-payment, etc. 
  • The horizontal axis also varies by sector and organization, but Complexity is a good place to start. Does the patient typically require cross-department collaboration or not?  

Once you've created your categories, you can then define strategic goals, service levels and experience guidelines for each category. You'll also assign specific patients to each category, ensuring that the scoring is dynamically done in your database so that everyone knows what experience is needed by patient (understanding that patients can move into different categories, but this portfolio provides structure and guidance). 

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The ripple effects will ensure a greater ROI for initiatives in each quadrant. If you design your optimal experience for “A,” your investments in a more seamless experience will ripple to D; your higher-touch focus will ripple to B. Likewise, If you design your experience for "C" patients with the goal to lower cost to serve (usually through digital), your investments will also have ripple effects to patients in all other categories. So everyone benefits, but you also have clear guidance on how to achieve specific goals for each persona represented by each category. 

Patient Centricity - A way of doing business 

In my definition above, I include the 3Cs: capabilities, competencies and culture.

Culture: As everyone is aware by now, a big mindset shift is required to become more patient centric. Personas, well done and communicated, can help all employees orient themselves around your priority patient profiles. Other best practices include regularly sharing patient success stories in weekly meetings and rewarding patient-centric behavior in terms of recognition and compensation. 

Capabilities are the WHAT: What are you, or should you, be capable of delivering? In addition to what you're already great at (perhaps surgery or diabetes or heart health or...), put all those shiny technology-related initiatives here like personalization, patient portals (collaboration), health apps (transparency & control), etc. How do you prioritize these shiny initiatives? By your customer portfolio and strategic objectives for each quadrant. 

Competencies are the HOW, and what is usually missing in the discussions and definitions of patient centricity. These are the practices and processes that the organization does systematically and pervasively, and the required skills that are developed throughout the organization over time. These include:

  • Decision-making: How are decisions made, and what are they based on (includes prioritization)
  • Metrics: Departmental metrics that ladder up to shared patient perception metrics 
  • Voice of Patient: Ongoing listening that is strategic (not boiling the ocean) and helps drive everything else
  • Experience diagnosis and design: Includes tools like journey mapping, co-creation, innovation. 
  • Alignment/coherence: How well is the organization functioning as a system with shared priorities and outcomes
  • Strategy: Last but not least, the ability to set and maintain your strategic direction from the outside in. The best way to do that is to define how you want patients to feel when they interact with you. Emotion drives loyalty, and choosing a single priority emotion -- that spans all customer types -- is the best way to both align all departments and differentiate you from your competitors. 

What next?

1. I'd love a conversation around this topic, either here on the blog or on LinkedIn. Your comments and questions welcome!

2. If your healthcare organization is drowning in complexity and you're unsure where to start, schedule a call with me for a no-obligation consultation. I'm happy to advise you on what to tackle first. My specialty is simplifying complexity and getting everyone aligned around shared patient-centric goals...so that you can go farther, faster, together. 



A strategy without the right metrics is called a wish


I've seen a few posts recently arguing that the phrase "you can't manage what you can't measure" is a myth or bad advice. While the authors make some valid points, I worry that these articles diminish the importance of metrics in any transformation effort. 

what you measure reveals your priorities

Managing what you measure is a factual observation, like the sky is blue. Show me what an individual or an organization measures, and I will tell you their entire philosophy of life and success. What you measure is where your attention goes, rightly or wrongly. And you usually measure what you're focused on... again, rightly or wrongly. 

When an organization obsesses over customer acquisition metrics, but can't tell you customer LTV, I can predict that organization's profitability, growth rate and future prospects for staying in business (low). Those leaders are focusing on the wrong things if their goal is (I assume) to create a predictable revenue machine. 

Likewise, if an organization is drowning in a sea of metrics, it reveals that they have no strategic priorities.

"If you have more than three priorities, you don't have any." - Jim Collins, Good to Great. 

a strategy without metrics is a wish

When I ask clients how they're going to measure progress towards their definition of success, they often have no crisp answer. While the goal is usually measurable -- increased revenue and market share -- there can be a lack of clarity on what it's going to take to move the needle on those metrics. Which is a lot like a pilot who wants to fly from New York to Brazil without a way to know if he or she is flying in the right direction. 

I honestly can't think of a scenario in which the thing you need to manage is unmeasurable. There are ways to figure out metrics that are predictive of what you need to measure and manage. If you can think of any exceptions, please post them in the comments. 

So perhaps we should reframe this observation to be, "you can't manage what you haven't strategically decided to measure," or "you can't manage what you don't know how to measure." In my experience, a strategy without the right metrics is called a wish. 

Which begs the question...  

What are the right metrics? 

Right is, of course, a subjective term that depends on what you're trying to achieve. Let's assume your goal is to create a predictable revenue machine. There's a lot of talk about growth hacking these days, usually referring to marketing. But the ultimate growth hack is to fill the holes in your proverbial bucket so you don't lose customers out the bottom as fast as you pour them into the top. When you fill the holes by focusing on retention and loyalty, every new customer is additive instead of replacement. And these customers buy more from you and refer you to others. Ta da! Your predictable revenue machine, which costs a lot less than a sole focus on acquisition. 

So... how do we measure this? I won't go into too much detail here, but here's where I'd start: 

Strategy metrics.

Yes, I'd start with strategy, not with CX repair. I don't believe you should be down in the weeds of "find and fix" before you've set your future-state vision for your priority customer (which is, by the way, contrary to a lot of CX maturity advice out there.) Strategy helps you prioritize which holes to fix, for whom, and how to fix them in a way that is aligned to your strategy. 

Strategy metrics are outcome-based.

They're anchored on what outcomes your priority customers want you to help them achieve, which are both emotional and tangible. Yes, emotional... even in B2B. How do your customers want to feel when they do business with you? This is the #1 outcome you're aiming for, which guides your brand, business and CX strategies. And remember: there's no and in brand. You have to pick one emotion or mindset that is highly motivating and differentiated enough to aim for, and that is linked to driving business outcomes (for example, feeling in control, successful, confident, a sense of belonging, important, etc etc. Every great brand anchors on an emotion, which is what we built our Value Archetypes to inform.) 

They focus on the why.

All the analytics in the world won't tell you the why behind win/loss. And they won't define the overarching why you're in business and the value you should create. You have to get that understanding up front, use it to set your strategy, then use your strategy to inform metrics and everything else (and continue to listen for the why to fill in your journey- or touchpoint-specific knowledge gaps.) 

They can help you manage an emotion. 

You can reverse-engineer everything you say and do from the emotional outcome you deliver and value you create. I call it "getting all the wood behind one arrow." What experience and business model is required to deliver that outcome? When you do this correctly, you can back into a very short set of perception metrics (7, to be precise) that are predictive of attracting and keeping customers -- and these metrics are shared across the entire business to create alignment. Then you can define the descriptive, operational and department-level metrics that will guide you on closing the gap between current-state and future-state experience. Which then guides your repair metrics and focus. 

PS. Note that strategy metrics are NOT oriented around you, and what you make and sell. Your customer is the only one who can decide whether you're creating sufficient value -- on their terms -- to justify giving you value in return.

PPS. This is all included in customer strategy: the organization-wide blueprint on how to attract and keep customers. I'll be covering this topic in my next White Board Wednesday. To get it in your inbox, click here

Repair metrics 

You are probably doing some form of this, but let's get strategic instead of boiling the ocean with a lot of repairs and metrics that may not actually be the right ones.

For which customers?

First, we have to know which customer groups are most important to your success. And yes, these are defined up in your strategy. If you're losing unprofitable customers, no big deal... which is yet another metric you should be tracking by segment, but knowing how to segment and prioritize customers isn't always straightforward in a complex business. I'll save this for another post. 

Which issues?

Identify where the holes in your bucket are for these customers, and how much revenue is flowing out of each of them as they move through the conversion lifecycle (ie. at what stage do they drop out and why).  Journey mapping is another essential tool that can help diagnose which issues and why, along with more sophisticated methods like analytics and regression modeling to understand what's driving customer win/loss.

Now let's filter these holes by how essential they are to your future-state vision. Let's say your future-state is all based on, say, helping customers feel more in control... which means you need to provide tools, information and resources to empower them. And let's say one of your holes to repair is the lack of easy information and guidance. Boom. Put this in your higher priority fixes. 

How do we measure?

Lastly, identify descriptive metrics that are linked to those holes and those positive, differentiated perceptions that we want to create. A descriptive metric for tools and resources might be how often customers access a tool, how much time they spend with it, and whether increased use of the tool helps improve their perception metric of feeling empowered and in control. 

Your navigation system: Strategy, metrics and governance

Oooh, the "g" word. I know governance is a term a lot of people don't like, so let's reframe it as "how we make decisions." If... 

  • you have numerous strategies sitting in silos like marketing, digital, IT, service, product, etc.
  • you are drowning in an ocean of metrics, none of which ladder up to shared goals and outcomes, and
  • your decision-making across the organization is also fragmented and based on different criteria....

... then hoo boy, you're in a world of hurt, as they say back in my hometown in Texas. 

I like to call the intersection of strategy, metrics and governance as the organization's navigation system. It's how effective leaders, like pilots flying an airplane, know the flight plan and the associated metrics to mark your progress. Which then allows you to more effectively make decisions, because your flight plan and dashboard are tightly integrated and boiled down to the essentials that you need to know to reach your objective. 

If these three aren't basically the same thing -- across your entire organization -- well, there's your biggest opportunity to accelerate your growth. 

We'll dive deeper into this topic on next week's White Board Wednesday. Stay tuned. 



Why B2B buyer personas are a massive waste of money (and what to do instead)


If you're in marketing, it's likely that you've created buyer personas. If you're in B2B, then the number of those personas are probably proliferating due to all the variations like role/title, vertical, size of company, relevance to various products or business units, etc. 

Buyer personas are based on the enormous fallacy of something called the purchase funnel. Spend a lot of resources generating awareness and consideration among the greatest number of prospects, and then convert them to purchase. Job done, right? 


It's time to start thinking quality over quantity. When you think with the end in mind --  what are the right products, services and experiences required to keep and grow our most valuable types of customers -- then everything changes. 

See, your product teams can't build as many variations of product to match the variety of customers you're pulling in the door. Nor can your organization build an infinite number of experiences. This is why the trend of data-driven personalization is a band-aid. Sure, it can drive top-line revenue... but how in hell is the rest of the organization going to deliver on 100 different promises? Ending your funnel at purchase is taking care of you, but alas, not helping the rest of the organization. 

Reframing your job

Marketing is the tip of the spear. You're the group who is best poised to understand your customers and prioritize them for the entire organization. You're the only group who can do it. And when you start helping the entire organization attract, keep and grow your most valuable customer types -- which boosts brand reputation, accelerates business growth and decreases inefficiencies -- you win major credibility points with other departments and in the board room. 

Instead of a purchase funnel, start thinking conversion lifecycle: a combination of 'conversion funnel' (ie. from awareness to purchase to loyalty and advocacy) with the major lifecycle stages including, for example, installation and getting support. It doesn't make sense to have two different models for different reasons. 

When you think about who is moving through that entire lifecycle, it's a single human (or group of humans.) There's not a set of buyers who suddenly turn into a different set of customers... which is an artificial distinction created by internal silos, represented by different metrics, goals and funnels. You likely have different personas proliferating around the organization that are built by different departments for their own ends.

With this in mind, your job should be focused on understanding how many and which customers are moving (or should move) past the purchase stage. Your ideal customers may be pouring out the holes in the bottom of the bucket faster than you can keep it topped off -- which happens when your organization isn't aligned on the same customer priorities and takes an all-things-to-all-people approach in a helpless response to customer complexity.  

Throw away your buyer personas

... which are no good to anyone in your organization except for sales and marketing. Instead, build a limited set of priority customer personas, linked together by a differentiated psychographic and mindset, that guides the actions and priorities of the entire organization. Show how each priority role moves through the entire lifecycle, and what experience is required to attract and keep them. NOW you've got the right information to inform your "marketing module" -- how to get these people in the door in the first place. 

"Deciding what not to do is as important as deciding what to do." - Steve Jobs

I've seen too many buyer personas with a laundry list of possible mindsets, needs and motivations. They were built in a bottoms-up fashion without a top-down strategy to guide all employees on the single most important customer outcome that everyone should be aiming to create.  

How to fast-track the right answer

You may be thinking, "Of course, Jen, I know that we need to do this. But I don't have the time or resources to dedicate to a big strategy project." 

Yep, exactly. I know the feeling. I'll let you in on a little secret that consulting firms and agencies don't want you to know (or maybe they don't know it themselves): This process is way simpler than it looks. Why? Because human nature is... well, human nature. It doesn't change. And there are only so many customer variables with which you can build a successful brand. 

After nearly 30 years in the business, I've packaged up all the repeatable shortcuts and frameworks that I built for my own use as a consultant, and I'm making them available to you. It's time to take the know-how and short-cuts out of the minds of consultants and put it where it belongs: in YOUR teams. 

Join us for our upcoming webinar: The Shortcut to Defining Prioritized, Impactful B2B Personas. I'll share my 3-part recipe for getting to the right answer fast. 

Click to register. 

Like this article? Might your teams and peers benefit? Please share! 


What's a B2B Persona Platform, and why do I need one?

Does your business deal with a Rubik's cube of enterprise customer complexity? Verticals, titles, sizes, geos, channels, psychographics and mindsets.

Layer on all the various departments and business units that might be building use-case-specific personas for marketing, sales, products, services and experiences, and you've got an explosion of complexity on your hands. 

While marketers can create an infinite number of personalized messages for an infinite number of customer segments, that's taking the easy way out. You're not helping the rest of the organization, since your product, service, and experience groups don't have that luxury. 

It's essential to prioritize and focus on your best-fit customer... then create a very small number of personas that every department can build on. 

Think of this "master set" of personas as a platform. They are linked together by a mindset, and provide high-level information on the messages and experiences that will drive repurchase and loyalty. Then each department builds on this foundation over time. How does Role A move through the lifecycle? What digital experience is the right one? How does it vary from Role B? 

Apple is a great example of focus. Their target? People who think different. How many unique personas do they need? Not many. Basically a couple variations on a single theme -- Apple consumers are also an enterprise's employees who demand that the IT department allow them to BYOD (bring your own device). That's what has fueled Apple's growth in the enterprise (40% YOY growth as of the last reported statistic in 2016). 

Apple's best-fit customer might be someone who buys Apple for themselves, and is also an employee of a large company, ideally one that has a design focus. They are both a user and an advocate. There's Role A. Role B would be the IT department who's responsible for either enterprise-wide technology purchases, or passing the rule that employees can use their own devices. 

From here, you can define each role's lifecycle -- the consumer who buys either online or in store, gets support at the Genius bar, etc. OR the enterprise IT customer who moves through a different, more personalized experience. And yes, there will be a lot of added detail and perhaps some variations... but Apple's laser focus on a mindset links it all together. 

But wait! (you might say)... Apple sells to a lot more types of people than these two! Yes, you're right. My 75-year old mother loves her iPhone. But we're talking "center of the bullseye" here. Against what type of customer will you design your end-to-end customer experience? If you get that right, others will follow. 

There you go. The first company to hit $1T in value and (I may be wrong, but) I'd bet they don't have more than 4 priority personas. 

Join our upcoming webinar

If you need to solve for an explosion of customer complexity, join us for our upcoming webinar. We'll go through our 3-part recipe for simplifying and focusing your efforts on your best fit customer. Click here to register. 


Three massive flaws in marketing "best practices"

If you're in marketing, advertising or lead gen, you know that what moves the needle is understanding customer mindsets, not demographics. What makes customers tick? What do they fear? What motivates them? Winners of the Effie Awards all know how to tap into emotion. The most successful brands in the world know how to build companies on emotion. Best practices, developed over decades, have told us exactly how to do it. 

The problems with "best practices"

Conventional wisdom dictates that this kind of psychographic insight requires months of up-front research and strategy work before launching a campaign to guarantee effectiveness. Building qualitative discussion guides from scratch, and then (even better!) convincing the client to spend 5-7 figures on a quantitative research project. And only then do you have the insights to create a creative brief and execute. For 25 years I served as an account planner, brand strategist, and management consultant; I've learned, practiced and taught these best practices while conveniently ignoring the problems, which include: 

  1. It takes too long. Best practices were born decades ago, back when there was more time to do everything. Clients weren't demanding results yesterday. Society and business has sped up considerably, and our practices need to evolve with the times.  
  2. It's not accessible to smaller firms. Most companies don't have (or want to spend) the money to do a 6-figure segmentation project. So you rely on existing customer knowledge (often lacking psychographic insights) or conduct a few interviews to make sure you're directionally on target. Or -- as I've heard from many of you -- you throw stuff against a wall to see what sticks.
  3. What customers say does not equal what they do. Now, this feels weird for me to write this. I mean, I've been doing research-based strategy work for decades. But the fact is, no matter how well-done the research, at the end of the day it's only directionally predictive of future success. And if you don't ask exactly the right questions, you'll miss the mark without even knowing it. Only actual behavior can be a better predictor of what's going to generate leads and new customers. 

Best practices were born decades ago before concepts like Agile and digital were a glimmer in some inventors' eyes. They're outdated. And, while still helpful, they aren't absolutely necessary. 

What's needed is a more agile approach to insights, allowing you to create hypotheses based on proven human nature and then testing those hypotheses with behavior (ie. clicks). The key here is "proven human nature." If you're guessing in a vacuum, you are likely to miss the crucial insight that is needed to capture attention and interest.

If your organization is being pressured to produce quality results faster, talk to us about our Value Archetypes, playbooks and coaching.  

How to link brand, CX and digital to drive measurable results

Now that we've reviewed the Value Platform and Value Archetype™ concepts, let's see it in action. I originally designed the Value Platform™ to address a common problem that I saw in the brand strategy world: the lack of connective tissue between the brand strategy and everything else. 

This post provides a sample framework to help you ensure that your brand promise can be operationalized. We help CMOs look good by driving measurable results from their brand work. 

Value Platform Example: AirBnB

Previously I shared the Value Platform model plus the eight human-centric Archetypes -- one more more of which can serve as the differentiating central idea or organizing principle for your entire business. The archetypes should anchor on a core customer need, since customers are the ones buying your product and paying your bills, but should be relevant across stakeholder groups. 

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AirBnB provides an excellent example of a company that is built around a customer-centric idea, Belonging... which happens to be one of our 8 archetypes. 

In the AirBnB blog in 2014,  Brian Chesky wrote: 

Joe, Nate, and I did some soul-searching over the last year. We asked ourselves, “What is our mission? What is the big idea that truly defines Airbnb?” It turns out the answer was right in front of us. For so long, people thought Airbnb was about renting houses. But really, we’re about home. You see, a house is just a space, but a home is where you belong. And what makes this global community so special is that for the very first time, you can belong anywhere. That is the idea at the core of our company: belonging.

I encourage you to read the whole post, as it provides great context for how they think about the business within this customer-centric context. 

Below you'll find a draft of AirBnB's full Value Platform and operating model in grid form. It's based on secondary research currently, but we'll be validating with the company directly. 

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  • Value Platform Archetype: While Belonging is the central idea, the marketplace concept wouldn't work without delivering on certainty/trust. Freedom in its various flavors (adventure, empowerment) shows up in the internal culture as well as the actual travel experiences. These archetypes inform the rest of the platform. 
  • Purpose: Belonging is infused in AirBnB's mission statement of "helping create a world where you can belong anywhere" and it's brought to life in a marketplace-based business model which inherently brings this concept of belonging and connection to life. 
  • Who we serve and what we offer: The team at AirBnB has worked to pull the "golden thread" of belonging into the employee and partner experience. They've also prioritized the impact on the broader ecosystem, translating belonging into a CSR platform of non-discrimination. 
  • How we work: AirBnB's operating model is highly team-centric and self-organizing. They strike a good balance between top-down guidance with empowered, bottoms-up decision-making. While the structure is still functionally based, they've used the culture and processes to ensure that they all drive towards bringing the customer outcome to life. They even hired a head of Diversity & Belonging. What I didn't find, but would recommend, is having an outcome-based perception metric of "feeling a sense of belonging" -- as well as identifying drivers of that perception (similar to NPS driver analysis) -- to better guide the organization and resource allocation. 

Hopefully this example demonstrates the outside-in, customer-centric approach to business strategy that serves to break silos, unify departments towards a shared outcome, and strongly differentiates the brand. As always, questions/comments welcome. I'll highlight a B2B example next. 


Applying the customer lens to organization design

Recently Strategy+Business published the 10 Principles of Organization Design. Overall some excellent information here. I'd like to add my 2 cents based on what I know about customer-centric organizations, and how this outside-in perspective can better ensure success. 

In point #1, Declare Amnesty for the Past, S+B highlights the importance of reconnecting with your sense of purpose, what will differentiate, and what capabilities will help you deliver on your value proposition.... 

Why your transformation effort is likely to fail

Why your transformation effort is likely to fail

There’s a lot being written about digital transformation. Customer experience transformation. Future of Work transformation. Oh, and let’s not forget innovation. No matter the type, they all seem to be failing. McKinsey reported that "just 26 percent of respondents say the transformations they’re most familiar with have been very or completely successful at both improving performance and equipping the organization to sustain improvements over time" in 2015; two years later, they found that "companies are no more successful at overhauling their performance and organizational health than they were ten years ago."

I'll share my theory, formed after countless conversations with senior leaders over the years and numerous customer-journey/root cause analysis projects....

The Value Platform Archetypes

In the last post, we discussed the purpose of a value platform: to serve as the customer-centric beating heart of an organization’s strategy, informing everything it does in order to bust silos, boost efficiencies, and (most importantly) drive revenue and growth. 

Grounding the Value Platform are the Value Platform Archetypes™, which have emerged over nearly 30 years of customer-insight-driven strategy work. What I noticed after a few years of conducting bottoms-up strategy projects is that we always surfaced variations on the same themes. The first emerged from a brand strategy project for a B2B technology company back in the early 90’s. After numerous 1:1 interviews with technology decision-makers, we noticed three primary needs that drove decision-making: