A discovery into care management

Introduction

Care management is an activity where a patients health barriers are solutioned by a team of nurses, service associates, doctors. they make sure a patients needs are addressed at right time with right care. As this is a service managed by insurance companies, the team's target is to provide best possible care, suggest health programs for those who opted into their health insurance products. The range of benfactors covers all ages.

I worked on a part of this solution which is it's backstage. It involves creating data driven systems with detailed business regulations that shows sensitive information to users who communicate with members of healthcare firm. 

Problems and Challenges

The project had a large team with multiple stakeholders including VPs, subject matter experts. Many modules of this project where standalone products before.

It had all the flavors for a UX Designer's nightmare. So Did me and my team overcome this? Not quite...

But we have paved a path for ourselves to slowly integrate ourselves into understanding the product, define our scope and identifying actual problems of the current system.

Teams structure

Timeline

Because of timeline crunch, we were expected to come up with solutions even before completely understanding the domain. So we took it upon ourselves to define immediate scope and create a timeline. As we understand the domain with user interviews and stakeholder discussions, the team will be equipped to solve complex problems and deep dive and suggest structural workflow changes to the platform. Till then, we can work on heuristics and known issues to develop solutions for immediate problems with 2 week sprints. 

The Platform

The care management platform is a unified interface where trained nurses becomes case managers and talk to member(insurance payers) about their health problems, barriers and solves them. The user calls the member or vice verse and the interaction is initiated. Each issue will have their own workflows and order of the actions performed depends on the phone interaction. The process seemed highly organic and data privacy, process compliance drive processing time further.

Understanding the domain and workflows

As a starting point, we started with desk research to find information on care management, competitors and old interview files. 

We confirmed our insights and findings with system analysts who has technical knowledge of the system. They also shared insights from survey platforms like medallia for us to come up with a list of opportunity areas.

Now we have to be sure that user opportunities align with our findings 

Rather than settling on business ideas and technical requirements, our questions and doubts were backed by initial research was presented to business. This approach helped us set precedence that users need to be involved before making a revamp.


User interviews and insights

With our intents to share with users, SMEs and researchers conducted exploratory interview sessions and shared recordings with our team.

Next was creating insights and deciding opportunity areas to work on

Apart from technical limitations pointed out by users, 3 major themes emerged from insights

Personalization

Users expect the system to configure for their specific use cases and reduce their manual effort. 


Effective communication

The users expects the product team to communicate all features and help them understand how it can help in their workflows.


Minimalism

The data heavy nature of the platform is giving too much cognitive load. User like to focus on tasks with zero distraction


with insights from research, the team started ideation on features around emerging themes mutually agreed by business, dev team and SMEs based on user needs and feasibility.

Feature Prioritization

Based on ideations showcased with SMEs and business, two major ideas evolved.

So a layout was suggested and shared with users.

First Iteration samples

With the direction confirmed, first iterations were showcased to user.

We noted that users like to focus on a single task , but they reference while taking notes. 

We also found opportunities to connect Member overview (right) to multiple workflows within page to all the tasks that they have to complete.


Revised Iteration samples

With the direction confirmed, first iterations were showcased to user.

We noted that users like to focus on a single task , but they reference while taking notes. We also found opportunities to connect Member overview (right) to multiple workflows within page o all the tasks that they have to complete.

The current technology couldn't automate and customize tasks for the user, so we enabled a way to let users customize it themselves to a particular task.

Review and Reflections

With new changes that support user's workflow, the suggested features were well received in initial usability review and planned for future releases.

The current case manager workflows is greatly impacted by technical limitation. Because of the complexities and compliances involved, a change in the product is looked upon with lots of skepticism.

With our first successful design interventions, the team gained confidence in helping out the users and got a chance to look further into the case manager workflows...