Atul Gawande, the American surgeon known for his book “Better”, wrote an article in this week’s New Yorker called “Slow Ideas: Some innovations spread fast. How do you speed the ones that don’t?” He describes the challenges faced by healthcare institutions all over the world: despite the advances in research, the most difficult part of improving care isn’t availing doctors and nurses to these breakthroughs, but changing their behavior. Some doctors simply won’t wash their hands no matter how many times they are told it reduces infection rates.

While the stakes in technology adoption are less dire, changing user behavior is just as challenging for information workers as doctors. Startups may research the market, understand customer use cases, solve the users' problems on paper, but unless they change behavior, their efforts are no more useful than the healthcare research trapped in a doctor’s file cabinet or email inbox. Insights and tools must be put to use.

That’s why I think there ought to be an additional step in the Product Market Fit process, the image at the top of the page. This step begins after Customer Validation and before the scaling of the sales and marketing teams in Customer Creation.

This step should be called Customer Engagement. The goal of this step is to develop a process to drive product adoption and behavior change within an organization. As Gawande writes:

To create new norms, you have to understand people’s existing norms and barriers to change. You have to understand what’s getting in their way.

Eliminating obstacles to change and understanding how to motivate new users to adopt the tool repeatably are essential to deploying a product. The current PMF framework emphasizes finding value proposition fit with each customer segment and then optimizing sales efficiency. But sales without engagement leads to high churn and the mirage of product market fit that will vanish when it’s time to renew customer contracts.

Understanding customer needs and building the product to solve those needs are critical. But so is developing a process to destroy the inertia of doing things “the old fashioned way” and catalyze users to change their workflows to enact change. That’s the only way to speed the adoption of change, whether in medicine or in technology.