As part of my series about the “How Businesses Pivot and Stay Relevant In The Face of Disruptive Technologies,” I had the pleasure of interviewing Nigel Misson.
Nigel has spent 20 years implementing Agile methods in both technical and business teams, enabling them to respond faster to an ever changing world. Most of the last 10 years have been in support of building systems for the healthcare sector, to support transformation of the NHS to paperless and enable efficiencies to improve front-line care.
Thank you so much for joining us in this interview series. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
During the first dot com boom, I was building Internet banking systems and working with Rational Unified Process in the late 1990s as a development methodology. While fantastically complete, it was a very heavy and bureaucratic approach, so I started exploring Agile processes like Scott Ambler’s Agile UP, which brought me into the work of user stories rather than functional spec documents structured around verbose use cases.
Alongside this, I was looking at ways to increase the reliability of how we built our system by introducing automation. I wrote my own build and CI framework, ported Kent Beck’s JUnit suite to Visual Basic, and bingo we were doing Continuous Deployment in 2001. Since then I’ve been finessing the approach and evangelising it to anyone who wants to listen.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or ‘take aways’ you learned from that?
Thinking that one process, if properly implemented, could work successfully every time. That’s not the case: varying business imperatives, organisational culture, and personal preferences all mean that there’s no such thing as a ‘one size fits all’ process. An experimental, magpie approach is needed and accepting a ‘try — monitor — fail fast — try something different’ approach helps to support accepting a lean agile culture organisationally.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story?
Many many people, but probably top of the list is David Putman who’s one of the best coaches in the business. He’s a great chap to have on your team and I’m glad to have worked with him several times. Rather than recite a story I’ll point you to one of his: the ‘f’ in framework.
Extensive research suggests that “purpose driven businesses” are more successful in many areas. When your company started, what was its vision, what was its purpose?
Our company vision was to improve the care of patients by delivering great software that empowers those who are caring for them. It still is today. That’s pretty powerful. We want to be profitable, but only as an enabler to grow our capacity to better fulfil our vision. We believe in mission over margin. I’ve written some pretty meaningless software systems in my time and it’s great working for a company with this vision, particularly in these times.
Thank you for all that. Let’s now turn to the main focus of our discussion. Can you tell our readers a bit about what your business does? How do you help people?
We make software that records clinical information about patients in hospital, so everyone caring for them has access to complete, correct information. However entering and finding this information has historically been very inefficient for clinical staff; we focus on usability to ensure that doctors and nurses can get the information into the system quickly and find it easily. That means technology like dictation and speech recognition rather than typing. It’s about a cohesive digital system to support a patient throughout their health journey, and to support healthcare professionals so they can focus on the patient, rather than the paperwork.
Which technological innovation has encroached or disrupted your industry? Can you explain why this has been disruptive?
Mobility. People are used to having the information they need in the palm of their hand and being able to respond to it in a couple of finger presses. That’s no different for doctors and nurses. Patient records are complex, satisfying the different needs of dozens of different roles. Creating simple task-specific applications gets difficult because of this complexity. Then add the challenges of patchy networks, disconnected use, and data security, and it becomes a real headache. Cracking this will truly disrupt how IT enables great healthcare beyond monolithic database systems.
What did you do to pivot as a result of this disruption?
Our product used to be a monolithic web application, deployed on premise. We’ve embraced service-oriented architecture, cloud, mobility, and responsive design to make it accessible anywhere, anyhow, from any device.
Was there a specific “Aha moment” that gave you the idea to start this new path? If yes, we’d love to hear the story.
Our product owner, Dr Adam Towler, has always had a long game in mind as far as design is concerned. Perhaps NHSX’s ‘internet first’ directive gave us the impetus to really embrace the cloud to enable our clients to also do so. As the NHS starts to embrace cloud and more mobile possibilities further, it becomes easier for us to implement those positive changes.
So, how are things going with this new direction?
Really well. We’ve got a series of exciting releases planned for 2021 to push our vision forward and have already transitioned one of our NHS Trusts into the cloud. We hope to have further cloud commitments signed up early this year.
Can you share the most interesting story that happened to you since you started this pivot?
I’m fairly new to Epro, so I bring lots of ideas about how things have been done in other healthcare IT and cloud companies. That stimulates a lot of debate in our team about what that looks like. It’s enthusing and energising. The whole company has wanted to learn about these, cloud in particular, and I’ve been inundated with requests for lunch and learns and other workshops both technical and non-technical.
There is something about this paradigm shift that gets people going that I’ve not seen with other technology changes. I think it’s the opportunity to learn something new, try something new or just change one’s view of the world. Hospitals are pretty conservative with technology but even they are interested to know how our approach supports their vision, and it all creates a powerful alignment.
What would you say is the most critical role of a leader during a disruptive period?
To articulate the vision and the paths that could get us there. To empower the teams to chart their own direction and get out of their way to allow them to make progress.
When the future seems so uncertain, what is the best way to boost morale? What can a leader do to inspire, motivate and engage their team?
I’m a great fan of Dan Pink and his ‘what motivates knowledge workers’ speech, and Servant Leadership. I already talked about Purpose, but Autonomy and Mastery are also important. Set stretching challenges for your team and support them to achieve great things.
Is there a “number one principle” that can help guide a company through the ups and downs of turbulent times?
Change is inevitable. Stop fighting it and adjust so you respond to it quickly and effectively.
Can you share 3 or 4 of the most common mistakes you have seen other businesses make when faced with a disruptive technology? What should one keep in mind to avoid that?
Emulation. Just copying someone else’s idea isn’t enough. By the time you have done it, they will have improved it and you’ll be forever playing catch-up. Aim to leapfrog.
Ostrich mode. Putting your head in the sand and ignoring it won’t make it go away. Get out there and understand it.
Invariable prediction. You’re not going to be able to guess how it will impact the future. Be bold — try different things and approaches until you find one that works. Preferably in parallel so you keep your options open until the direction becomes clearer.
Ok. Thank you. Here is the primary question of our discussion. Based on your experience and success, what are the five most important things a business leader should do to pivot and stay relevant in the face of disruptive technologies? Please share a story or an example for each.
Engage your people in the debate. A lot of your exposure to disruptive technology will come bottom up. Give your teams the time and space to play with it, share experiences, and suggest ways forward through things like 10% time and brown bag sessions. At several companies, I’ve provided time for people to come together and discuss things that are important to them or emerging at technical and non-technical levels, to bring techies and business people together around a common interest. Appoint a facilitator to organise these, buy the pizza / lunch and even consider opening them up to interest groups outside your company to help build your brand as an innovator.
Give people time, space, authority, and support to progress their ideas. That might mean supporting them through a change in role; today’s developer with a good idea is tomorrow’s product owner. We introduced ‘no planned work’ intervals between medium-term iterations (roughly every few months) to give people time to progress ideas in addition to the 10% undirected time in sprints which frequently got squeezed by business pressures. This provided slots to get things like hackathons organised to get people together to develop their ideas.
Focus on relevance. Keep your roadmap aligned with your ideas. Suggest ideas to explore for your people to generate ‘top down’ R&D projects that people can run, alongside testing the relevance of ‘bottom up’ ideas. Allocate project time to develop ideas once they’re through fast concept stages. Have a robust gateway to get on the list, but look actively for synergy between strategy and good ideas, and favour these when you’re selecting which ideas to provide time to develop further. Also review progress frequently — use Lean Portfolio Management techniques to review what each innovation project has achieved and wants to do next. Create a Dragons Den style ‘pitch day’ when everyone puts their plans forward to the board which approves what gets backed next cycle, and open pitch day shares the innovation knowledge and generates competition to execute it seriously.
Reward innovation as part of your performance review process. Setting SMART goals is fine but open ended, “So how have you used your time to benefit the company?” is better. Fold back some of the benefits of their work to the individuals, not just in monetary concerns, but with the autonomy, mastery, and purpose to continue developing their ideas. Paying back time to run with ideas is an excellent motivator so develop a backlog system when anyone has a chance to get their project on the roadmap, not just product and architecture. If you want to reward financially, I’ve been able to link returns from the idea as metrics for bonus payouts.
Remember there’s no single right way forward. Preserve options, and embrace variability using concepts such as set-based design. Robustly challenge options and eliminate the unworkable to keep the noise down. Run with the rest in parallel — that may mean doing multiple similar things. Generate competition but also foster collaboration — encourage multiple project teams to share ideas and come together on an agreed ‘best approach’ themselves.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My boss in my first senior management role told me that I was sharp and quick to forge ahead with new things but I needed to ensure I took people with me. The hardest part of leadership is when you look over your shoulder to check who is coming with you. Technology is great, but ultimately it’s all about people. Since then I’ve always focused on the “individuals and interactions over processes and tools” value of the Agile Manifesto. People talking to each other is so important. I used to try and get teams together in offices to facilitate that but disruptive communication tools like Slack have turned that on its head last year. Now every process and tool we have channels data through Slack to keep everyone informed and collaborating.
How can our readers further follow your work?
https://www.linkedin.com/in/nigelmisson/
