Most healthcare technology companies build in silence. They develop behind closed doors, launch with polished marketing, and reveal their product only when they are ready to impress. There is nothing inherently wrong with this approach — but at Welli, we have chosen a fundamentally different path, one rooted in transparency, accountability, and the belief that the best products are built in partnership with the people they serve.
Why transparency matters in health tech
Most healthcare technology companies build in silence. They develop behind closed doors, launch with polished marketing, and reveal their product only when they are confident it will impress. There is nothing inherently wrong with this approach — but we have chosen a different path.
At Welli, we are building in public. This means sharing our thinking, our progress, our challenges, and our mistakes openly as we develop a platform that we believe can meaningfully improve how people engage with their health. This post explains why we made this choice and what it means in practice.
The health tech trust deficit
The healthcare technology industry has a trust problem. After decades of ambitious promises — from electronic health records that would "revolutionize" medicine to wellness apps that would "transform" health outcomes — both patients and providers have developed a healthy skepticism toward health tech companies.
And they should be skeptical. A 2023 analysis published in JMIR found that only 7% of digital health interventions demonstrated sustained clinical benefit beyond 12 months, with the majority showing engagement declines of 60-80% within the first 90 days (Baumel et al., 2023). The graveyard of health apps is enormous — of the approximately 350,000 health-related apps available in major app stores, fewer than 5% have been validated through clinical research (IQVIA, 2022).
The root cause of many of these failures is not technical but philosophical. Products were designed to maximize engagement metrics (daily active users, session length, notification open rates) rather than health outcomes. They were built for investors' pitch decks rather than for the complex, messy reality of managing health over time.
What building in public means to us
Building in public is not simply posting progress updates on social media — although we do that. It is a foundational operating principle that shapes how we make decisions, design products, and engage with the people we hope to serve.
Transparent roadmap
Our product roadmap is public. Anyone can see what we are working on, what we plan to build next, and what we have decided not to build. This invites scrutiny — and that is precisely the point. When our priorities are visible, we are accountable for the choices we make about where to invest our time and resources.
We publish quarterly roadmap reviews that explain not just what we built but why we chose those features over alternatives. This practice forces internal clarity. If we cannot articulate a compelling reason for a product decision in plain language, it is probably not well enough thought through.
Open design process
Our design process is deliberately open. We share early wireframes, prototypes, and design explorations — not polished final products — because the most valuable feedback comes when ideas are still malleable. A design that has been refined over months is resistant to fundamental change; a sketch on a whiteboard is open to anything.
We conduct our user research sessions with full transparency about our stage of development. Participants know they are seeing early ideas, not finished products, and they respond with correspondingly honest feedback. The research on this is clear: participants provide more critical and actionable feedback when they believe their input can actually change the outcome (Spool, 2016).
Honest content
We are committed to publishing content that is genuinely useful rather than optimized for search rankings. This means citing primary research, acknowledging uncertainty, presenting counterarguments to our own positions, and being transparent about the limitations of our product and our evidence base.
The health information landscape is badly polluted by content farms, affiliate marketing disguised as health advice, and company blogs that exist solely to drive organic traffic. We refuse to add to this noise. Every piece of content we publish should leave the reader better informed than when they started — even if the information does not directly benefit our business.
The business case for transparency
Building in public is not altruism — it is strategy. We believe that transparency creates sustainable competitive advantages in several important ways:
Trust accumulation. In healthcare, trust is the most valuable currency. Patients are being asked to share their most sensitive information — medical histories, vital signs, mental health data — with a technology platform. They will only do so if they trust the organization behind it. Trust is not built through marketing campaigns; it is built through consistent, verifiable behavior over time. Building in public creates a public record of our values in action.
Better products. Products designed in isolation reflect the assumptions of their creators. Products designed with continuous community input reflect the actual needs of users. Research from the Harvard Business School has demonstrated that companies with transparent development processes produce products with 23% higher user satisfaction and 31% lower post-launch defect rates (Pisano & Verganti, 2008).
Talent attraction. The best engineers, designers, and clinicians want to work on meaningful problems with people they respect. Building in public lets potential team members evaluate our culture, our technical standards, and our values before they ever submit an application. This self-selection process leads to stronger cultural fit and lower turnover.
Community formation. Health is deeply personal but never truly individual — it is shaped by families, communities, and social networks. By building in public, we are not just developing a product; we are cultivating a community of people who share our belief that healthcare can be better. This community becomes a source of feedback, advocacy, and accountability.
What we have learned so far
Six months into building in public, we have learned several things that have surprised us:
People value honesty about uncertainty more than confidence. When we published a post acknowledging that we were uncertain about the right approach to medication tracking, the response was overwhelmingly positive. People are tired of companies that project false confidence. Admitting what you do not know is paradoxically one of the most trust-building things a health tech company can do.
The loudest feedback is not always the most important. Building in public generates a lot of input. We have had to develop frameworks for distinguishing between individual preferences (important to one person), common pain points (important to many people), and structural insights (important to the integrity of the product). Not all feedback is created equal, and responding to every request would produce an incoherent product.
Transparency requires courage. Sharing works in progress is uncomfortable. Admitting mistakes is difficult. Publishing decisions that you know some people will disagree with requires conviction. Building in public is not a strategy for the conflict-averse.
Looking forward
We will continue building in public because we believe it makes us a better company and produces a better product. We will continue to share our roadmap, our design process, our content philosophy, and our mistakes. We will continue to invite feedback, knowing that some of it will be difficult to hear.
Healthcare has been built in closed rooms for too long. The result is a system that often feels opaque, impersonal, and disconnected from the people it is meant to serve. We are building something different — openly, honestly, and with the understanding that the best products are built in partnership with the people who use them.
References
- Baumel, A., et al. (2023). Sustainability of digital health interventions: A systematic review. Journal of Medical Internet Research, 25, e42556.
- IQVIA. (2022). Digital Health Trends. IQVIA Institute for Human Data Science.
- Pisano, G. P., & Verganti, R. (2008). Which kind of collaboration is right for you? Harvard Business Review, 86(12), 78–86.
- Spool, J. M. (2016). The $300 million button: How a simple design change increased revenue. User Interface Engineering.