The client
A seed-stage health startup running a two-sided marketplace that connects healthcare professionals with patients. The product was already live, with an established onboarding flow, and the team counted eight people across product, design, development and growth.
In a marketplace, value doesn’t come from completing a setup. It comes from a successful match between a patient’s need and the right professional. That made the first days after signup decisive: the product had to show it could deliver that match before the user’s initial motivation faded.
The challenge
- Users completed onboarding but left before experiencing the first moment of value.
- Abandonment was concentrated in the first 72 hours: the team needed to understand what happened between signup and initial usage.
- Unstructured feedback diverted the roadmap towards individual requests rather than the main problem.
- The team lacked a shared metric for understanding whether users reached product value.
Diagnosis
Completing onboarding did not mean finding what the user came for. The flow guided patients through a sequence of steps, but it did not help them reach a first useful outcome: identifying a professional who offered the service they needed.
The information existed on the platform, but a newly registered patient could not easily find it. Services were hard to locate among the available professionals, and the steps required to get there were unclear.
Users completed the setup, hit this friction at the moment of real intent, and left. Meanwhile, the team lacked a common criterion for separating recurring feedback from isolated requests.
Strategic approach
I started with one question: when does the patient understand that the platform is useful? In the marketplace, the answer is the moment they submit a booking request to a healthcare professional who offers the service they need.
- Identify the true first value moment: analyse the behaviour of patients who stayed to find the action associated with continued use, and confirm that the first contact with a professional was the turning point.
- Simplify onboarding around the user’s intent: the flow now captured the service the patient was looking for and, based on that request, suggested professionals with that service clearly highlighted. This removed the need to search the directory unaided and shortened the distance between signup and contact.
- Align the team on one primary activation metric: the share of newly registered patients who submit a booking request to a healthcare professional within 72 hours of signup. It became the single reference for product decisions and roadmap priorities.
- Structure feedback through the same lens to distinguish recurring signals from isolated requests.
I set up event tracking and monitoring in Mixpanel, built dashboards to follow the key metrics, and compared cohorts by patient type to see where each group dropped off. I complemented the quantitative work with 10 user interviews. Onboarding was reduced from 10 steps to 5.
Results
- Activation up 35% relatively over eight weeks: from 20% to 27% of newly registered patients, a gain of 7 percentage points, measured by submitting a booking request within 72 hours of signup.
- Lower early abandonment: new patients not returning after their first session within 72 hours of signup went from 70% to 58%, a decrease of 12 percentage points.
- A stable, value-oriented roadmap: three shared initiatives tied to the primary metric, with mid-flight priority changes falling from six to two during the observation period.
What the client said
“We used to look at how many users finished onboarding. Now we know that what matters is a patient sending a booking request, and we use that same reference to decide what to build and what to leave out.”
Founder, seed-stage health startup