By JONATHAN BUSH

One of our account managers sent me a link to this open letter written by a high-level employee to the leadership of Research in Motion or RIM, makers of the BlackBerry, laying out their concerns about the company. The company faces stiff competition in the smart phone market and recently announcedplans for 2,000 layoffs.

The account manager thanked me for what I have done to lead us in a way that has avoided this fate for athenahealth. So, thanks to him.

HOWEVER, I don’t think we are totally free of all eight concerns rattled off by one anonymous OG RIMMER. Here are some of her/his pleas to management and some of my thoughts on them as they apply here at athenahealth. (If you could see our internal blog version of this post, you’d see more than a dozen thoughtful comments from athenahealth employees on how they think we can learn from this story.)

1. Focus on UX! Well, our UX team is less than three years old. Most of that time they’ve spent working on making new features usable and deeply understanding our clients’ needs in health care. They started with a beautiful vision, like our UX prototype of 2009, but they needed to understand our Software Enabled Service model better and figure out how to get changes through our development cycle first. What they haven’t come back to yet is setting that beautiful vision and then fitting what we build into it. In my perfect world, we have important enough art that we can build our house around it. Not so today. What can we do to get there? Should UX go first or last in determining what we build?
2. Recruit the very best leadership for our future: In the RIM case, they want to attract people from software companies now, rather than telecom types. What are our target sources of leadership? We try to make a lot of internal promotions, but when we go out, where are the best places to get people? Where should we look to find leaders who would really make you wake up and listen?
3. Cut project list to the bone and then CRUSH the ones we choose:This, of course, is our strategy…but how much is it our practice? How much of our UX or development work is associated with a “contractual commitment”? If it is, but we can use it broadly, how disciplined can we be about building it as a public piece of the network? For examples, what percent of athenaClinicals is functionality that is global in nature, and what percent is LOCAL in nature? That is, how much of it could we change, nationwide, with a single line of code versus how much we would have to go client-by-client across hundreds of table spaces and TALK them into a switch?
4. Become friendly to their ecosystem of independent developers: Ah, well, we don’t have one because we do all our development in-house. Any concerns with building an ecosystem of outside developers?
5. Serious marketing punch to create user desire of what makes us unique: It is a LOT easier to market in a language the market is already speaking than to market in a language that only applies to you. How many of our demos and presentations use the word “EHR” or “EMR”? They are nouns and we sell verbs (i.e., services), right? Or has our desire to be like other EHRs led us to have software talk leading to software features leading to…well…software…rather than networking across the cloud, which is our vision. It is our vision, isn’t it? Would any of our employees ever consider working for one of the EMR companies? If not, why? Then why do we let ourselves slip into looking and acting like them? Let’s stay right in our own unique briar patch where none of them could ever go (even if they wanted to, which they don’t seem to). Then let’s MARKET that. Salesforce.com came up with the cloud, not software, thing that’s now their logo. What’s ours? Is it the beast? I love the beast, but it seems that we are still advertising the symbol of the problem. Our next thing needs to be about the solution.
6. Getting rid of underperforming employees: Well, we do that and we measure involuntary turnover.
7. Humility with the press and investors: We are using the press to get attention right now since awareness is our biggest growth obstacle…but at what point does my class clowning turn around and bite us? I like our investors and I read their stuff. I even like the guys whose mission is to talk trash about us. In order to keep our product relevant, we must expand what it does every year. Ironically, if we take a year off of this important work, many in the market would LOVE us for our higher profit levels. BUT if we did not reinvest, we would work ourselves into obsolescence. Get it?
8. Founders should engage and interact with employees and encourage ground-level input without repercussion: Okay, fine, I am not on the floor enough. I will spend August in Maine and will go to Belfast to get out on the floor. How much? I don’t know. A day? A month? A day a week? But I feel guilty doing it sometimes because I feel like I should be “getting work done.” But maybe that IS my work?

Thankfully, athenahealth does not feel like what the anonymous letter writer describes…but unlike RIM there are no iPhones shooting us out of the sky right now either. We are being hard on ourselves while we are flying high…rather than sorry for ourselves later.

Jonathan Bush co-founded athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. He obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.