Every organization I’ve worked with has a version of the same story.
A message gets approved. The legal team reviews it, the compliance lead signs off, the communications director sends it out. By every internal measure, the job is done. The message is in the world.
And then it doesn’t land.
Not because the content was wrong. The content was right — carefully written, reviewed, cleared. It didn’t land because the person on the receiving end got it in a format that didn’t work for them. A wall of text sent to someone who processes information visually. A PDF sent to someone who was going to read it on a phone while waiting for a meeting to start. A written summary sent to someone who needed to hear it explained before they could take it in.
I spent years as a Bloomberg News Bureau Chief watching exactly this failure play out in high-stakes environments. The problem was never the journalism. The problem was always the gap between what we produced and what actually reached people in a form they could use.
The format gap is not a technology problem
For most of my career I assumed this was a resource problem. Organizations that could afford to produce content in multiple formats did. Organizations that couldn’t, didn’t. The gap between a message that lands and a message that doesn’t was a budget line item.
That turned out to be wrong.
The real constraint wasn’t resources. It was governance. In regulated environments — healthcare, financial services, pharmaceutical companies — you cannot just reach for any tool to solve a format problem. The tools that make multiformat content creation easy are consumer tools. They are built for speed and flexibility. They are not built for environments where a message has been approved by legal and compliance, where every version of that message needs to be traceable to the same approved source, and where a regulator may one day ask exactly what was distributed, in what format, to which audience, under whose authorisation.
In those environments, the format problem has always been unsolvable with available tools. So organizations did what organizations do when they can’t solve a problem — they worked around it. They picked one format and sent it to everyone. They hoped it landed.
What comprehension actually requires
The research on this is not ambiguous. Approximately half of US adults struggle to understand complex information when it arrives in a single written format — and that figure is not a reflection of intelligence or education level. It is a predictable consequence of delivering nuanced content through one channel to people who are often busy, stressed, or processing competing demands at the same time.
A frontline nurse absorbing a new clinical protocol during a handover shift is not in the same cognitive state as a hospital administrator reviewing the same protocol in a meeting room. A patient receiving discharge instructions while still processing the anxiety of leaving a hospital is not reading that document the same way a care coordinator filed it. A prescribing physician scanning materials between consultations is not engaging with approved clinical content the same way a medical affairs team produced it.
Format is not a cosmetic consideration. It is a comprehension prerequisite.
The same message in the wrong format is not the same message. It is a message that will not be understood, or will be partially understood, or will be understood differently by different people — none of which is what the organization intended when it spent time and resources getting the content approved.
Why now
Two things changed in the last few years that made this problem both more urgent and more solvable.
The first is that generative AI made content creation fast and cheap. Organizations that previously couldn’t afford to produce content in multiple formats now technically can. But the tools that make that possible were not built for regulated environments. They produce content quickly. They do not produce governance. The gap between what can be created and what can be safely distributed in a regulated environment widened, not narrowed.
The second is that the expectation of evidence increased. Regulators, accreditation bodies, and legal teams are asking harder questions about communication. Joint Commission accreditation standards, CMS documentation requirements, and SEC disclosure rules all create specific obligations around how communication is delivered, to whom, and under what authorization. Most organizations cannot answer those questions cleanly. The record either doesn’t exist or requires weeks of manual reconstruction to produce — work that happens at the worst possible time, when a reviewer is already asking.
The infrastructure argument
Conforma is not a content tool. I want to be specific about that because the distinction matters.
Content tools help you create. Conforma takes what you’ve already created and approved, and ensures it reaches every audience in the format that works for them — with the governance record that proves it did.
One approved source. Every format your audience needs. The record exists before anyone asks for it.
That is the infrastructure regulated organizations have needed for a long time. We built it because we couldn’t find it anywhere else.
— Sophia Pearson is Founder & CEO of Conforma
Health literacy figures referenced in this article reflect published research including the National Assessment of Adult Literacy and subsequent peer-reviewed health literacy studies. They do not represent Conforma platform outcomes.