A Conversation with Jay Gerhart: Guiding Innovation Teams with JTBD

JTBD Toolkit
7 min readApr 8, 2023


Jay Gerhart is Healthcare Strategist at Atrium Health, the 5th largest nonprofit integrated health system in the nation with approximately 150,000 teammates. He works on the corporate innovation team in Charlotte, NC called the Innovation Engine.

Business model innovation is a key focus area in his project work, as well as teaching their innovation process to teammates, called Design for Impact. JTBD plays a large role in their overall approach.

Jay Gerhart, Healthcare Strategist at Atrium Health and JTBD enthusiast

Jay also produces and co-hosts “A Sherpa’s Guide to Innovation” podcast, which now has 114 episodes. Jay was our guest on “JTBD Untangled” where he talked about how he guides and leads his teams to success with JTBD. Jim caught up with him afterward the session for this interview.

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JIM: How and when did you get into JTBD?

JAY: I spent the vast majority of my career at Atrium Health in strategy and planning. In 2016, I was working with colleagues to better define and deploy a consumer-focused strategy for the system. This was very different work from what I was used to. We were thinking about a new type of primary care product and we realized that we didn’t really have a product development process. However, we did have an innovation team, so I started learning more about what they did.

Two teammates on that team, Ann Somers Hogg (now with the Christensen Institute) and Will Behrmann, had recently taken a course by the late Dr. Clayton Christensen at Harvard Business School. They learned about JTBD theory and were eager to learn more about how to apply it. One of their instructors recommended Bob Moesta.

To make a long story short, the team I was working with joined forces with Ann Somers and Will to hire the ReWired Group to conduct JTBD interviews in the area of on-demand care. We had a dual purpose — (1) inform our consumer strategy work and (2) teach us how to do JTBD on our own. Needless to say, working side-by-side with Bob was an incredible experience.

It’s not an exaggeration to say it was life-changing. We were all hooked on JTBD from that time on.

JIM: Amazing that you got the opportunity to work directly with Bob Moesta. Sounds incredible indeed. How have you used JTBD in practice? Can you give an example?

JAY: Our team’s business model innovation process is called Design for Impact. One key element is obtaining a strong Customer Understanding. JTBD is the foundation of that, providing the mindset, language and methods we employ to understand our customers. So JTBD is present in some way in each and every body of work we carry out.

One recent example was in the area of primary care. The physician executive over our primary care division asked us to perform interviews to better inform some of their ongoing work from the consumer perspective. We conducted two parallel interview streams: (1) Switch interviews to understand what causes people to hire or fire primary care, and (2) what we call “standard” JTBD interviews to understand functional, social, and emotional jobs that people have related to their health and wellness.

As part of the second stream, we learned what pains and gains people experienced when trying to fulfill these jobs, what solutions they hired and fired, and how context might impact these elements.

This turned out to be one of our most extensive customer discovery efforts we’ve ever conducted, and we expect to be leveraging the insights for years. Another aspect that we enjoyed about the work is that two members of the primary care division participated in the interviews and analysis — one a care provider, another an administrator.

Furthermore, the physician executive took our findings and summarized them from his own perspective to communicate across the division. Partnering with our business owners is really important to our team, so this was an exciting step in helping our organization become more JTBD-centered.

JIM: Great example — thanks for sharing. How would you summarize the impact of JTBD on your team’s work? What business impacts have you seen from JTBD?

JAY: It’s been transformational for our team — we’re still on the journey of making it transformational for our organization, as it is a very large and growing organization. But that is our aspiration. As I mentioned earlier, JTBD provides the foundational mindset, language and methods for our innovation process, Design for Impact. We integrate it into Alex Osterwalder’s Value Proposition Canvas and Business Model Canvas.

Taken all together, these frameworks provide a structured understanding of our customers and our business models. As we discussed during JTBD Untangled, we continue to build out our JTBD toolkit to match our project needs — essentially identifying and fulfilling our JTBD for JTBD! Is that too meta?

Back to your question. Our team has articulated four key elements of our innovation mindset: Empathy, Curiosity, Collaboration, and Action. JTBD is like a channel for the first two. The method we learned from Bob is grounded in Empathy and Curiosity.

As we’ve expanded our JTBD toolkit, learning from thought leaders such as yourself and ODI practitioners like Scott Burleson, we are sharpening our skills in articulating jobs, pains and gains — key elements of the Value Proposition Canvas. The different methods and tools give our team a more robust portfolio of ways we can approach business problems and opportunities.

JIM: How do you begin to assess the impact of JTBD on the organization?

JAY: I’ll share one simple way we measure the impact of JTBD.

Outside of our group, we consider it a win when our leaders use the mindset and language, unprovoked. Some months ago, I was in a meeting with medical group leaders talking about our various digital pathways to our services. The dialogue was mostly in the supply-side realm, using Bob Moesta language. A senior physician executive spoke up and said something to the effect of “Wait, let’s look at this from the Jobs to Be Done perspective.” That warmed my heart!

I know it may not sound like much, but instances like that are a big deal, particularly in health care, which is heavily expertise driven. The conversation then tilted more to the demand-side, and people started thinking more from the perspective of health care consumers — which we all are.

We have some pockets of physicians and administrative leaders who use the words in a way that reflects the mindset — the way of seeing, as you put it in your book. Changing the conversation is meaningful.

JIM: I’ve always said that one indication of success is when others start using your language, so that makes total sense.
What advice would you give someone looking to get started with JTBD?

JAY: You’d think this would be a simple question for me to answer, but the reality is that it depends. It depends on your context and desired progress. So first, you should explore your own Job to Be Done for Job to Be Done.

Also, there is a growing body of helpful resources on a range of JTBD methods. So, I’ll offer a menu of suggestions for the reader to select from:

  • Competing Against Luck is a good starting place for a high-level overview, more of a strategic perspective. A bit of a shortcut would be reading the September 2016 Harvard Business Review article “Know Your Customers’ Jobs to Be Done” by the authors Dr. Clayton Christensen, Karen Dillon and Taddy Hall. However, this won’t equip you to start applying JTBD deeply to your work. One benefit of the book is that it may equip you to better explain to executives in your organization why they should hire JTBD.
  • One option is your book, Jim. The benefit of the JTBD Playbook is that it covers the full range of JTBD perspective and methodologies. The reader can then start working with the methods that resonate with them, fit in their context, and meet their objectives. However, there is some risk of becoming overwhelmed with what methods to select and where to start.
  • Alternatively, someone starting with JTBD could select between Switch and ODI. For Switch, the book Demand-Side Sales is a great practical start. And Bob has many podcasts and YouTube videos to support learning.
  • For ODI, you have excellent content in your book on creating Job Maps as a starting point. I created my first job map with your interview guide. I also find that Tony Ulwick’s Medium post “Outcome-Driven Innovation: JTBD Theory in Practice” is a good starting point for ODI.
  • These are all good potential starting points, but I’ll offer one more that is highly accessible — David Duncan’s The Secret Lives of Customers. Most of the book, Part 1, is in a highly entertaining narrative form. Part 2 is a concise explanation of how you get started as a “Market Detective.” The method is not as rigorous as Switch or ODI, but it’s quickly actionable. If you or your team want to “get out of the building” and start uncovering jobs quickly, David offers a highly accessible framework. You can read the book in a sitting or two.

JIM: That’s a great list of resources. Are there any practical steps you’d recommend folks take to get started using JTBD?
JAY: Reach out to friends or connections who are JTBD practitioners to get their perspective. I am happy to connect with your readers and talk with them to better understand their context and desired progress, and to offer any guidance I can. I find that some folks are intrigued by JTBD but struggle to start.

The range of approaches and different voices can create anxiety around hiring JTBD. The important thing is to start. Start building the JTBD muscles in your personal life — think about what jobs arise for you each day. Interview yourself about them. Maybe interview friends or family — but don’t drive them crazy with it!

Lastly, I would be remiss not to plug my own podcast, A Sherpa’s Guide to Innovation. JTBD has been a topic of numerous episodes, and we have been fortunate to interview many JTBD thought leaders, including yourself.

JIM: Thanks, Jay!



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