Digital therapeutics often miss the mark when it comes to connecting with patients and meeting their expectations. To build and launch a successful Software as a Medical Device (SaMD), you need to know and leverage your unique advantages. In this article, we share why we think the Jobs to be Done (JTBD) framework provides a better understanding of what drives customer behaviour than the traditional market segments and demographic information. We’ll explain what the JTBD framework is, and focus on applying the Four Forces analysis to the SaMD market to address enablers and barriers to customer demand.

The conventional approach to customer discovery

The discovery phase of a traditional customer analysis begins by brainstorming personas of high-priority target customer groups and creating customer profiles.

Most organizations rely on proto-personas and secondary research to organize the team's existing knowledge (or best guesses) of who their users are and what they want. This method is often preferred to reduce costs and accelerate timelines, and avoid clinical research involving patients and regulatory restrictions. Unfortunately, the resulting customer groups and profiles are often biased and inaccurate.

Customer discovery with JTBD

In his original work about the JTBD framework, Clayton Christensen posits that customers buy products to meet an underlying need. Let’s take Theodore Levitt’s idea:

“People don’t want to buy a quarter-inch drill. They want a quarter-inch hole” — Theodore Levitt

Contrary to the conventional approach to customer discovery, JTBD does not ask ‘what type of drill would customers want’, but focuses on ‘why they want a drill in the first place' and thus encourages organizations to, for example, create shelves that do not need drilling at all.

The JTBD framework combines several principles, techniques, and frameworks to understand the underlying ‘why’ behind customer decisions to “hire” a certain product:

  • Willian Power’s hierarchy of goals: the types of goals customers have, how to prioritize the different types of goals, and in what ways the goals are interdependent
  • The principle of the “Switch” moment: learn from customers who recently switched to a competitor, so you can understand the sequence of events that culminated in the moment of their ‘switch’
  • Understand who (or what) your primary, secondary, and tertiary competitors are
  • Map milestones during customer interviews to understand product purchase decisions. The timeline leading up to the purchase reveals what customers value
  • Four forces: the emotional forces that generate and shape customers’ demand for a product and their decision to make a change

A core tenet of the JTBD framework is to get as close as possible to real customers. Whether you plan on conducting clinical research, collecting anonymized and aggregated patient data, or interviewing healthcare providers and patient representatives, the JTBD framework will guide you to actionable insights throughout the customer discovery process.

The heart of the JTBD framework: Four forces

The heart of the JTBD framework is the principle of the four forces that examine the forces of push, pull, habit and anxiety. People consume new products and services because they want to make progress, but often they don’t know how. When customers switch from one product to another, they do it because the forces of push and pull are greater than the forces of habit and anxiety of adopting a new solution. So the pull and push forces work together to generate demand and the habits and anxiety work together to reduce the demand. In the middle, you have your customer who is experiencing all these emotions at once.

Demand creation: Push and pull forces

The first step to shaping customer demand is understanding the forces that push and pull customers in your product’s problem space. Your customers’ pain points, frustrations, and needs comprise push forces. Their goals, desires, and expectations comprise pull forces.

What pushes customers away from the status quo must be matched with what pulls customers toward your solution. The point of convergence is demand. By synergizing push and pull forces, you can create demand for your product.

Consider the jarring juxtaposition of a frictionless television viewing experience with a fragmented patient journey. The frustration patients experience navigating a healthcare system pushes them away from what they have now and at the same time, their desire for convenient access to digital healthcare pulls them toward a seamless telemedicine product (read our case study about Hims).

Currently, in the health market, patient behaviours and expectations are rapidly changing, organically creating push and pull forces towards digital health products like telemedicine and SaMD.

For example, patients:

  • Expect patient-centric products and platforms
  • Are used to seamless digital experiences in other areas of their lives
  • Increasingly pay out-of-pocket for digital products and services that meet their needs
  • Are invested in wellness, wellbeing, and preventative actions

By understanding these forces, you can push and pull patients toward your SaMD products by:

  • Building digital products that meet their needs
  • Delivering seamless, patient-centric, digital experiences
  • Using data to personalize experiences
  • Offering evolvable digital solutions

Demand reduction: Habit and anxiety forces

To create market demand, you must leverage enablers and remove barriers to adoption. The JTBD framework conceptualizes two types of forces that reduce customer demand: anxiety (why customers might hesitate to try your product) and habits (why customers might want to maintain the status quo).

Let’s say your product helps patients with diabetes manage their condition by tracking their blood glucose measurements and providing insights about their diet to move closer to the therapeutic target they set with their physicians. Here are some examples of how you can mitigate forces that act as barriers to customers trying or sticking with your product.

What a customer might experience

Type of force

Solve for the underlying need

I don’t want to share personal health information.


Implement strong data privacy and security policies and procedures to address their anxieties; be transparent about what you do with customer data to build trust.

All of my data is already on another platform.


Make it easier for customers to make the switch to a new platform. For example, create a tool to migrate data from another digital platform or upload data from scanned journals.

I’m not sure this product will actually help me.


Educate your customers about how your product was designed to work and demonstrate real live usage and outcomes. For example, share data from clinical trials you’ve conducted demonstrating that your product is effective, or stories of individual patients who benefited from using your product. 

The key to mitigating forces that reduce demand is to proactively interact with your customers: iteratively build your product based on user feedback and data. Building a customer-centric product is hypothesis-driven, so your assumptions must be tested and evaluated based on how users interact with your SaMD product.


Understanding your customers' needs and creating a perfect solution for their problem space is essential for successful product development. Technological advances have already disrupted customers' lives in many areas and thus, organically created a huge unutilized opportunity for the healthcare industry, especially for the SaMD sector. As SaMD user groups are already managing their illnesses in a certain way, you will need to convince them to switch to your product. Therefore understanding all the expectations and emotional forces creating and reducing their demand for your SaMD product is crucial for your product strategy. We believe the JTBD framework, with special attention to one of its most important elements, the four forces methodology, provides the right mindset to create truly innovative products with built-in problem-solution fit.

Learn more about how Rangle builds SaMD products with our clients.