Noah Waxman of Cactus: “RE-INTRODUCE WONDER”

The human body is a breathtaking marvel. How has healthcare drifted so far away from helping patients see this wonder? Healthcare should inspire, shock and awe you like the very best documentary film or museum exhibition. But unlike films or museums, healthcare’s job should be to tell you the story of your own individual body […]

Thrive Global invites voices from many spheres to share their perspectives on our Community platform. Community stories are not commissioned by our editorial team, and opinions expressed by Community contributors do not reflect the opinions of Thrive Global or its employees. More information on our Community guidelines is available here.

The human body is a breathtaking marvel. How has healthcare drifted so far away from helping patients see this wonder? Healthcare should inspire, shock and awe you like the very best documentary film or museum exhibition. But unlike films or museums, healthcare’s job should be to tell you the story of your own individual body and mind. When something is broken, let’s move beyond thinking simply of how to fix it, and instead dive deeper into why it is ‘broken,’ various routes to fix it and ultimately provide preventative solutions so it doesn’t keep happening. Beyond treating symptoms, let’s elevate our expectations. The biomarkers in your blood, the unique makeup of your microbiome, the results of diagnostics, etc.; these should be connected to the story of what makes you who you are. This is an excellent role for technology and content to play.


The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Noah Waxman, Head of Strategy for Cactus.

A natural born disruptor, Noah is an entrepreneur, experienced brand strategist, award-winning consultant, connector of ideas, and intuitive problem solver, who has spearheaded global brands including Casper, Mount Sinai, MillerCoors, Canyon Ranch, and The Gap. Drawing from over 20 years of deep expertise in technology, healthcare, hospitality, and retail, Noah combines an artful perspective with practical, functional strategies that set clients up for greater impact and long-term growth. His extensive track record of client success continues at Cactus, where he has led the development and strategy for cutting-edge health & wellness brands (CLMBR, Mount Sinai, Ever/Body), entertainment & retail ventures (Color Factory, Rise Nation), and product launches (MIRA, Cubic Sky).


Can you share the most interesting story that happened to you since you began your career?

We started Cactus with a business plan and a vision for using cutting-edge technologies to create wild, different, futuristic experiences in retail, entertainment and cultural settings. Soon after starting out, we crossed paths with a visionary doctor who inspired us, and ultimately hired us, to think about applying our expertise and vision in healthcare. It was a curveball, but it quickly became clear that the combination was magic. We began developing what would become Lab100, an ahead-of-its-time clinic and UX research lab at Mount Sinai Hospital in New York City. The work was a success and made waves in both the medical and design communities.

This experience with Lab100 was also one of the most profound a-ha’s in my own career. I found the work challenging in all the right intellectual ways and discovered that I could have a huge impact with relative ease. By applying the same principles that I had been living and breathing — user-centric design, rapid prototyping, surprise and delight tactics, frictionless UX — I could have a huge impact because this kind of thinking was (and still is) really lacking in healthcare. I found that Cactus was able to really move the needle in a space that benefited humanity in a meaningful way. All the right pieces were in place, and we have never looked back since. At this point, about 70% of Cactus’ work is in health and wellness.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

We rented a pretty wild space in Brooklyn for our office when we initially started out. It was a former Pfizer R+D lab complete with old bunsen burner hookups and emergency eye wash stations, and was completely unrenovated when we moved in. It felt like a real mad scientist’s lab with all the hardware and prototyping equipment. I crack up every time I think back to that, because there were several times when we invited clients into space way too early, before they understood how buttoned-up we really are. We definitely freaked a few of those clients out, thinking they’d hired a bunch of rag-tag hackers. I miss that amazing (and hilarious) office!

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Ask for forgiveness, not permission.

Generally speaking, the magic of our business is being able to come into complex situations, which are often scenarios where there are various stakeholders, legacy systems, layered operations, etc. We get asked to imagine a better way. My philosophy is to ‘go big, fast,’ and propose solutions we believe in — even if they’re risky or bold. That way, either we will have a big idea or we’ll know we are wrong, and we’ll know it clearly and quickly and have the feedback to try again.

Are you working on any exciting new projects now? How do you think that will help people?

Yes indeed! I will offer up two in different spaces:

We have been working with CLMBR for several years now and they are about to go to market with a new connected stationary climbing machine that we helped design and build. I believe it’s going to be really successful. CLMBR’s at-home unit is a super fun, super challenging alternative to a traditional spin bike or treadmill, burning 60% more calories in less time. At Cactus, we’re excited to use technology in thoughtful ways to help people get motivated, create and maintain good habits, and explore new ideas for advancing their health.

Additionally, another project in the works is an innovative in-home geriatric primary care project that I am particularly excited about. Gerontology is woefully stuck in the past. People think older adults cannot use technology. I completely disagree. In my opinion, there has largely been a failure of imagination in the design of products and services for this population. Having recently watched as my grandparents struggled through illness and the burden of trekking out daily to various medical offices, the Cactus team and I are excited to help design and build more compassionate, personal and hopefully more effective care models for our elders.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider is anyone that can honestly say that they are putting patient experience and patient empowerment — not just patient outcomes — above all else.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

I think we are far behind in terms of applying the technology that we have access to for improving patient health outcomes and caregiver satisfaction and efficacy. The clunkiness of the legacy systems that are still in place in so many instances are slowing progress towards the experience that we know patients and caregivers want. The main way we can combat this is to continue to replace these systems with those that prioritize the actual users (both patient and caregiver).

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

There are several examples here — caregiver and front-line workers certainly rose to the occasion in an incredible way. To me, from a product and design perspective, the big story here is the rapid acceptance of alternative care models, especially remote virtual care, in-home care, and systems that combine the two. I am proud of how many health systems have innovated here, and how quickly. One example in our work is a new acute-care hospital that we have been designing with a major California health system. That hospital will be entirely in-home and will cover dozens of in-patient conditions. They will be able to show equal or better patient outcomes while letting patients stay home. It is not true for everyone, but for a wide swath of the population, being treated at home surrounded by family, friends, pets and belongings will allow a sea change in patient satisfaction. In California today, it costs more than 5 million dollars per bed to build a new hospital room, on average. The economics of at home care are also a huge driver, but it took a global pandemic to force this obvious change to move into rapid adoption.

Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system?

  1. RE-INTRODUCE WONDER.

The human body is a breathtaking marvel. How has healthcare drifted so far away from helping patients see this wonder? Healthcare should inspire, shock and awe you like the very best documentary film or museum exhibition. But unlike films or museums, healthcare’s job should be to tell you the story of your own individual body and mind. When something is broken, let’s move beyond thinking simply of how to fix it, and instead dive deeper into why it is ‘broken,’ various routes to fix it and ultimately provide preventative solutions so it doesn’t keep happening. Beyond treating symptoms, let’s elevate our expectations. The biomarkers in your blood, the unique makeup of your microbiome, the results of diagnostics, etc.; these should be connected to the story of what makes you who you are. This is an excellent role for technology and content to play.

An example of re-introducing wonder and storytelling into healthcare is a new project we are building for a hospital center in Florida. We’re developing content — video, interactive, written, audio, etc. — to ensure that for every medical procedure, there is a rich and complete context. Some patients will choose to just lean back and have a more traditional experience, but for those who want to know more, they will be able to lean in and “pull” more of the story of the biology, technology and integrative elements of what the doctors are doing.

2. PUT DESIGNERS IN CHARGE.

As a designer it amazed me to learn how decisions within the world of traditional medicine are made. For decades, the interests of hospitals, networks, insurance companies, pharmaceutical companies, large employers and the Electronic Health Records (EHR) software providers have been elevated above the interests of the actual patients and caregivers who use the spaces, places, technologies and equipment. This has meant that engineers, accountants, lawyers and business people have been put in charge and designers have not had a seat at the table where decisions are made. I see today’s low patient satisfaction and dangerously high doctor burnout rates as direct results. Now, we see early breakout successes from smaller companies, usually startups, that have UX design in their product from the beginning. I think of Oscar in healthcare, Parsley Health in primary, and Oath — a company we worked with at their outset — in pediatrics. There are dozens more examples of this new breed of innovators, but they still represent a drop in the bucket when you look at healthcare overall. This is going to change rapidly in the years to come — and we’re excited to be a part of that change.

3. TURN DATA INTO A CAPTIVATING NARRATIVE.

The goal of healthcare providers should be to move from treating sickness to preventing it. But how do you do that? A lot of it has to do with interpretation. We are at the very beginning of an explosion in bio-data and health metrics — but nobody is turning your data into a holistic, digestible picture of one’s self. The companies that can connect your actions to your desired outcomes will be the ones who rise to the top — because they’ll be providing actual value on an actionable level for patients. On days you drink, you tend to eat junk food. On days you hike, you feel a greater sense of purpose. On days you sleep 9 hours, you run faster, etc. Creating this sort of narrative will become more possible and also vastly more important as we all encounter more and more data about ourselves.

Additionally, what can we learn from technology outside of healthcare that’s weaving compelling narratives? One fun example the Cactus team has been very impressed by is Co-Star, an astrology app that clearly invests in outstanding copywriting so that your horoscope doesn’t read as generic, it reads as striking, relevant and personal. Regardless of your feelings about astrology, its specificity gets conversations going. Wouldn’t that be fantastic in healthcare? We think so.

4. TURN CAREGIVERS INTO NARRATORS.

Today doctors are overwhelmed by their technologies. It weighs them down. That’s because it’s not designed with their goals in mind. More often than not, it’s designed for the operations of the hospital and their billing requirements, etc. Doctors spend an average of 16 minutes and 14 seconds of active time per patient encounter doing data entry in an antiquated EHR interface. This pains me because technology should have the exact opposite role. When a doctor or nurse arrives in a treatment room, there should be technologies in place to help them tell you the story of your health and compelling distillations of how (and why) this is the case. We should be building up doctors to be able to better connect on a human-to-human level about what is going on with your body and what they think needs to happen next. At Lab100, we focused on building the systems so that all the collection of data was automated and in the background. The stuff that comes to the foreground, on-screen, faces the patient and doesn’t just live within the doctor’s computer monitor. The information chosen to be displayed is meant to spark conversation — helping the patient ask better questions and helping the doctor tell a better story.

5. DEMOCRATIZE ‘CONCIERGE MEDICINE.’

Today there are an array of high-end options for concierge (aka luxury) medicine, from the private GPs of London to destinations like Lanserhof Lans in Austria. They do an excellent job of giving patients undivided attention, building a holistic portrait of a patient’s health, and offering solutions across both traditional and more progressive disciplines. And yet, for most of the population, attention is scarce, health portraits are limited or incomplete, and solutions come from the disciplines you expect. How can technology solve the attention crisis and build trust? How can technology put people in control of their own health information and help them understand everything that’s going on with their health? How can technology point both patients and providers to ‘prescriptions’ that are outside of their direct realm of expertise (and not just kick the can to a specialist?). We think there’s a lot to learn in adapting this for the greater population, and not just have this type of attention available only for a small portion of the population.

Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?

I am no expert in this, but what I will say is, I think the issue of physician shortages is largely tied to burnout. Many of the systems and technologies that we make physicians use day to day are directly linked to such burnout, due to their design shortcomings. The statistics about EHRs simply make me sad. The amount of time doctors spend on data entry and administrative types of work is a waste of time, knowledge and resources. It is a failure on the part of the EHR companies. In order to address the problem of physician shortages, we must first address physician burnout. Designing easier-to-use UI is a crucial first step.

How do you think we can address the issue of physician diversity?

With exploring the future of healthcare design comes recognition of where current and past design patterns have fallen short. We feel that improving research and data surrounding physician diversity is a crucial first step to addressing this issue.

How do you think we can address the issue of physician burnout?

Anyone who tells you that EHRs have to be as complex and clunky as they are is simply bending the truth to protect their legacy relationship, or they are clueless about what well-designed software is capable of. We do a lot of collaborative work with some of the newer EHRs, (Welkin, Cerbo and DrChrono) trying to get a foothold in advancing this part of healthcare. If EHRs were better designed and more efficient, doctors would be happier and more mentally available to connect with the patients they committed their professional lives to helping. That’s a very good first step in the right direction to help with burnout.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

So long as individuals, corporations, communities and leaders remain concerned with tunnel vision on their own priorities, these changes will never come to fruition. The key to change is prioritizing the patient experience and caregiver experience, which can be achieved through putting design at the forefront of care.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

New technology is often overwhelming. When it is not intuitive, it can be incredibly frustrating. But new technology also has the power to unlock human potential, to make us better equipped to realize our dreams. So my movement would be a design-for-new-technology movement. The movement would combat systems that force people to conform to the system constraints and instead would be designed to fit perfectly into our needs and our usage patterns. Specifically, in healthcare that might manifest as using world-class interface design and cutting edge input/sensor technologies to bring health data and human psychology into concert.

How can our readers further follow your work online?

Find our case studies and more information about Cactus at our website: www.cactus.is

And give us a follow on Instagram! @cactus.is and LinkedIn

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.

    Share your comments below. Please read our commenting guidelines before posting. If you have a concern about a comment, report it here.

    You might also like...

    Community//

    Michelle Davey of Wheel: “We need to embrace value-based care”

    by Luke Kervin
    Community//

    Dr. Innocent Clement of Ciba Health: “Focus on Patient Engagement”

    by Luke Kervin
    Community//

    Dan Rubinstein: “Don’t forget the importance of the human connection”

    by Ben Ari
    We use cookies on our site to give you the best experience possible. By continuing to browse the site, you agree to this use. For more information on how we use cookies, see our Privacy Policy.