Understanding where pharmacies fall off: before, during, and after launch
A service design study mapping the full pharmacy lifecycle with Nimble, from first sales contact to churn, to uncover where friction was costing us partners.
RoleLead UX Researcher
MethodsInterviews · Service blueprinting · Journey mapping
TimelineQ4 2025
PlatformCross-functional
The problem
25% of pharmacies launched in a quarter were churning. The reasons weren't visible in product data alone.
The outcome
Cross-functional problems surfaced and aligned with leadership, driving measurable improvements across communications, integrations, and patient adoption.
48hbug resolution + SLAs
+20NPS points
Reduce patient inbounds
↓Less integration churns
Background
Pharmacy churn was a symptom. We needed to find the cause.
NimbleRx grows when pharmacies stay active on the platform and process volume through it. But pharmacies were leaving. Some after a brief unhealthy period on the platform, others before they even launched. The pattern showed up in the data, but the data couldn't explain it.
Of the pharmacies launched in any given quarter, 25% were churning. Churn wasn't just happening at one point. The data showed the pattern but couldn't tell us why it was happening at each stage.
Research question
Where in the pharmacy lifecycle, from sales to post-launch, are the friction points that lead to low health scores and churn?
Customer journey
How pharmacies are meant to launch with Nimble
Understanding the intended lifecycle is key context for where the research uncovered friction.
The ideal pharmacy journey, from first contact to active partner on the platform.
Sales
Qualification & contract
Onboarding
Setup & training
Phase 1
Getting comfortable
Phase 2
Core product
Ramp success
Growth & retention
PMS compatibility confirmed
Clear expectations set
Integration runs smoothly
Staff feel confident and ready
Launches on a simpler product
Staff and patients adjust
A lighter entry point before the full product.
Moves to the core checkout product
Patients guided through change
Phase 2 is the full Checkout product, where real volume and revenue growth begins.
Fill volume grows steadily
Turns on features like refills
Research approach
Following the pharmacy from first contact to outcome
We recruited 12 pharmacies across four segments. Distribution was uneven by design. Reaching pharmacies that churned pre-launch was significantly harder, as they had already disengaged from Nimble entirely.
01
Segment-based recruitment
12 pharmacies across 3 churn segments, recruited with CS team support. Uneven distribution due to difficulty reaching pre-launch churns.
02
60-min in-depth interviews
Traced each pharmacy's full journey from sales outreach to their current outcome. Some sessions conducted on-site to observe the pharmacy environment and setup firsthand.
03
Journey mapping & blueprinting
Overlaid segment journeys to identify shared pain points and internal process gaps.
04
Cross-functional readout
Presented to Sales, Onboarding, Product, and CS to align on shared accountability.
We recruited across four distinct groups, including healthy pharmacies as a positive benchmark. Together they let us trace the full arc of the pharmacy experience and pinpoint where it diverged.
Segment 01
Launched, healthy
Pharmacies actively using the platform with a strong health score. Included as a positive benchmark to understand what good looks like.
Segment 02
Launched, unhealthy
Pharmacies that went live within the last 3 months but have a low health score. Still active, but struggling to gain traction.
Segment 03
Launched, then churned
Pharmacies that went live, used the platform for a period, and then disengaged or left entirely.
Segment 04
Churned pre-launch
Pharmacies that signed on with Nimble but never went live. The hardest segment to reach and the most upstream failure point.
Key insights
Many issues surfaced, but they clustered into three categories
Insight 01
Seamless integration is overpromised pre-onboarding, setting pharmacies up with expectations the product can't meet
·Payment reconciliation required running two systems simultaneously, creating double-payment risks and manual correction workflows.
·Workarounds pharmacies adopted to keep Nimble running ultimately negated the efficiency gains the platform was meant to deliver.
·Sales had overpromised on integration quality. Pharmacies arrived with expectations the current infrastructure couldn't meet.
·We were selling to pharmacy systems we knew had poor integration compatibility, setting up failures before onboarding even began.
191 hrsspent on integration-related inbounds in the last 90 days, the #1 CP inbound topic at 13% of all contacts
“
We could make Nimble work. But we then had to run it still through Pioneer. Seconds matter. We're that busy. It was too burdensome for our staff to make it worth it.
Ryan
Insight 02
Ongoing communication gaps across the lifecycle leave pharmacies feeling unsupported, eroding trust over time
When pharmacies can't see what's being done about their issues, and when their wins go unacknowledged, trust in the partnership erodes over time.
·We're cautious about raising potential issues around integration quality or patient adoption. While that makes for an effective sale, it irks pharmacies further when things go wrong.
·We don't follow up enough on issues raised: bugs, enhancement requests, or roadmap transparency. Pharmacies raised concerns and heard nothing back.
·When issues go unacknowledged, pharmacies feel like they're submitting feedback into a black hole, leaving them feeling unheard and eroding confidence in the partnership.
·There's an opportunity to highlight and amplify moments of success in the pharmacy journey. Wins are going unnoticed.
“
I had to keep calling and keep calling and be like ‘what's the update on the issue’, he said let me follow up. Everything was let me follow up, let me follow up.
Mark
Insight 03
At the phase transition, poor patient onboarding drives more calls than before, undermining pharmacy confidence in Nimble
·Great service is the number one goal of independent pharmacies. Negative feedback from patients, even a miniscule percentage, has a heavy emotional impact on pharmacy staff.
·Lack of adoption hurts pharmacies' bottom line (already under pressure) and works against realizing their revenue goals with Nimble.
·Bag stuffers are seen as mildly helpful but often arrive too late, are too generic, or there isn't enough time from closed-win to go-live to get them in patients' hands.
8–9%typical patient adoption rate in retail pharmacies, a low baseline that integration friction and poor messaging pushes even lower
“
If we have these flyers the first month that we launched, it would have been very helpful. We were told it was going to be a smooth transition and it was not.
Craig
“
This is becoming more of a problem than it's helping. Customers are getting frustrated. They got a text saying stuff's ready, but not everything is ready.
Ryan
Pharmacy lifecycle: before
Sales
Onboarding ★
Phase 1
⚡ Phase 2
Settles down
Churn risk
Journey
Pharmacy
Signs agreement
Smooth setup
Great CS support
Building volume
Staff training gaps
Phase 2 data exchange breaks down
Patients confused
Phone calls flood in
Calls die down
Volume recovers slowly
Bugs go unanswered
Revenue model unclear
Churns
Nimble CS
Account handoff
Proactive onboarding
Training & setup
Monitors health score
High inbound calls
No PMS visibility
Volume normalises
Can't triage bugs vs gaps
No triage visibility
Product
No PMS restrictions
Basic integration setup
Tracks Phase 1 metrics
Integration failures
No transition comms
Monitors Phase 2
No triage cadence
Bugs unresolved
Positive moment
Friction point
Churn risk
Standard action
⚡ High friction zone
What we changed
Each insight mapped to a cross-functional decision
Findings were presented to leaders across Sales, Product, Onboarding, and Customer Success. All four changes were actioned from the research.
Sales · Integration
Restrict sales to compatible pharmacy systems
Identified which pharmacy systems consistently produced poor integrations and built that into the sales qualification process, preventing a known source of early churn before it started.
Patient · Adoption
Deploy a patient education phase via text messaging
Introduced a dedicated patient education period triggered at the transitional phase where most confusion occurred. We used Nimble's existing text messaging infrastructure to guide patients through the change before they encountered friction.
Engineering · Integration
Invest in smoother integration infrastructure
Secured investment to build out more robust integrations for the pharmacy systems we do support, reducing the disruption that was undermining early adoption and eroding pharmacy confidence in the platform.
Product · CS · Communications
Establish SLAs for bugs and enhancement requests
Built out clear service level agreements. Product committed to reviewing and triaging all incoming requests on a defined timeline, and CS developed criteria to distinguish bugs from knowledge gaps, reducing unnecessary escalations and giving pharmacies visible acknowledgment that their feedback was being acted on.
Service blueprint
The pharmacy lifecycle after changes
How the full pharmacy experience looks with all four research-driven changes applied, from sales qualification through to a retained, active pharmacy.
Sales ✓
Onboarding
Phase 1
⚡ Phase 2
Settles down
Adoption grows ↑ (projected)
Journey
Pharmacy
Signs agreement
Smooth setup
Great CS support
Building volume
Improved staff training
Compatible PMS only
Patient SMS education
Fewer integration issues
Calls die down faster
Volume recovers strongly
SLAs for bugs in place
Revenue model explained
Features turn on
Adoption increases
Nimble CS
Account handoff
Proactive onboarding
Training & setup
Monitors health score
SMS education deployed
Reduced inbound volume
Bug vs gap criteria clear
Visibility into product queue
Product
Restricts bad PMS sales
Integration infra investment
Tracks Phase 1 metrics
Clearer transition comms
Fewer integration failures
Monitors Phase 2
SLA triage cadence live
Bugs actioned on schedule
Positive / improved
Change implemented
Friction point
Churn risk
Unchanged
⚡ High friction zone
Impact
Cross-functional problems surfaced, aligned, and acted on
The research didn't just identify friction. It created a shared language for problems that had been siloed across teams. Getting leadership aligned on the same picture was the first and most important outcome.
48h
Bug resolution + SLAs
Down from weeks. The product team resolved 200+ cases and maintained a fast resolution pace, directly reducing the black hole experience that had left pharmacies feeling ignored.
+20
NPS improvement
Pharmacy NPS improved by 20+ points following changes to communications and bug resolution.
Patient confusion inbounds
A dedicated education period reduced patient confusion calls during phase transition. Engagement and adoption also went up, with relative engagement reaching 70%+.
↓
Integration-related churn
Restricting sales to compatible pharmacy systems reduced churn from poor integrations.
A note on process
These improvements are meaningful, but they are the beginning of a longer journey. Fixing deep integration infrastructure takes time and continued investment. What this research enabled was prioritizing the actions with the most immediate customer impact first: clearer communication, faster bug resolution, and better patient onboarding.