Brian Scalia
Director of Product Management, Patagonia Health
Join Product Director Brian Scalia as he discusses how Patagonia Health's EHR product team stays agile, prioritizes user feedback, and navigates regulations to deliver impactful updates. Gain insights on balancing innovation, staff training, and optimizing workflows for better patient care.
Introduction
Welcome to the Patagonia Health Healthcare Solutions podcast. My name is Denton, and I will be your host for today.
Today's topic is how to stay updated with healthcare regulations and critical system updates, and we have a very special guest. I'm going to go ahead and let him introduce himself and talk about his role.
My name is Brian Scalia. I'm the Director of Product Management here at Patagonia Health. I joined in 2025, so I’m new to the company, but not new to the space.
I've worked with EHRs and healthcare technology for the last 20 years. Prior to Patagonia Health, I was with about three other EHR companies—some notable ones that people in the industry would recognize.
I’m very passionate about healthcare, improving the systems that support clinicians and patients, and product management itself, which I know we'll talk more about today.
How does the Product Management team ensure EHR solution updates align with user needs?
Great question. Just to step back a bit—in product management, our role is to represent the voice of the customer.
We’re kind of the middleman between our customers (and potential customers) and our development team. Feedback comes in from numerous sources:
- Direct customer submissions via portals, email, and phone calls
- Conversations, user groups, and other touchpoints
We collect and prioritize that feedback, and then pass it to the development team for implementation.
How do you determine which product updates are prioritized and which can wait?
Yeah, that’s the secret sauce of product management, right? We all know we can't do everything.
With several hundred customers and thousands of users, everyone's needs are different. But there’s often a lot of overlap—between users, roles, and job functions (clinician, front desk, biller, etc.).
We prioritize based on a few key factors:
- Pervasiveness – How many users have this problem?
- We use a tool called Aha!, which allows customers to submit and vote on enhancement requests.
2. Severity – How critical is the problem to a particular user or workflow?
We score and rank all these inputs, using both objective data and subjective context. Some problems are urgent—“stop the bleeding” issues—while others are longer-term strategy moves, anticipating future public and behavioral health challenges.
Are there any standard goals set for each update? How do you measure success?
Generally, yes. We track several goals across releases:
- Smoothness of delivery
- Defect count and resolution time
- Customer adoption of new features
One of our challenges is that our users are extremely workflow- and process-driven. Even positive changes can disrupt established routines.
Each release has a theme, and each feature within that release has its own KPI (Key Performance Indicator). For example:
- We might aim for 80% adoption within 30 days
- We may measure how much a new feature reduces the time it takes for a clinician to perform a step
We collect both quantitative data (telemetry, usage stats) and qualitative feedback to measure impact and iterate on improvements.
What does it take to find a healthy balance between innovation and simplicity?
This is one of the hardest parts of product management—especially in healthcare, where workflows are tightly structured.
We gather ideas from various sources but can’t talk to every user. So we use data, surveys, and internal assessments to estimate impact.
One approach we take at Patagonia Health is releasing features that are off by default.
- We include the feature in the release notes
- Customers can request to enable it after understanding the benefits
- We offer training materials and support before activation
The downside is that customers may not be aware of available updates. That’s why we work closely with marketing, support, and sales to ensure communication is clear.
The goal is to maximize value and minimize disruption—but it’s a tricky balance, and sometimes we have to explain changes after the fact.
Can you walk us through the rollout process of an update?
Our primary tool is the release notes. We follow a six-week release cycle.
Here’s how the process works:
- Features are selected for a release
- Our business analysts start compiling highlights and updates
- A couple of weeks before release, we conduct an internal review with subject matter experts
- We send a draft of release notes to customers in advance
- Final release notes are sent out at the time of release
In addition to release notes, we also do:
- Semi-annual updates
- User group meetings to reinforce awareness
This year, we’re adding more visibility into our product roadmap. Not just the next 6–12 weeks, but a broader view of the next year.
While we remain agile, we also aim to be more strategic—showing customers our direction and giving them an opportunity to weigh in before features are finalized.
Do these roadmaps help users see the bigger picture?
Absolutely. There's a concept called a feature factory, where you're just churning out small changes.
A roadmap, by contrast, is about strategy—a path to your product vision, incorporating feedback and aligning releases around user personas (clinicians, front desk, billers, behavioral health).
By theming releases around specific users, customers can more easily identify which updates are relevant to them.
What are the best practices for users to keep their internal teams trained on system updates?
It’s definitely something we’ve learned a lot about over time.
Healthcare organizations differ greatly, and the tech landscape has evolved a lot over 20 years. When I started, only 20% of practices used EHRs. We had to sell the value—now it's essential.
To stay current:
- Read the release notes
- Pay attention to Patagonia Health communications
- Ask questions
- Leverage our idea portal – You can vote, comment, and track suggestions
Internally, organizations should designate a product champion—someone who becomes the voice of the organization to us. I’m actively looking to engage with those champions.
You can always contact me at bscallia@patagoniahealth.com. I welcome feedback—good, bad, or suggestions.
How important is it to stay agile with new healthcare regulations?
Extremely. All industries face regulation, but in healthcare, it's the price of admission.
Security and privacy are non-negotiable. Data breaches can destroy trust and even companies.
We adhere to programs like HIPAA and HITECH, and we stay close to:
- Industry associations
- Regulatory updates
- Medicare/Medicaid policy changes
Often, we get a heads-up years in advance, like a 2028 change—but it sneaks up. There’s a draft > feedback > final rule > implementation process, and if you’re not ready, it’s too late.
That’s why we bake flexibility into our development cycle. Even if something is last-minute, we’re ready to pivot quickly to protect customer funding and compliance.
Have you ever had an unexpected user reaction—positive or negative—to a system feature rollout? How did you handle it?
Yes—this happens quite a bit.
Despite our best efforts with data, internal reviews, and training, users often find their own way of using the product. And that means a change—even a good one—can disrupt established habits.
To reduce this:
- We have a QA and UAT process
- We monitor post-release feedback
- We communicate directly with affected users
- We offer webinars, training, and documentation
If necessary, we can even roll back code partially, or work 1:1 with customers to support a smoother transition.
It’s a combination of science and art—balancing innovation with user expectations and experience.
