Background:
In redeveloping the care quality improvement platform serving 2 million Medicare members, I focused on harnessing advanced analytics for personalized member engagement and aiding health plans in boosting profitability through higher star measures. This initiative unfolded through an iterative design approach, encompassing multiple sprints, extensive user research, and robust cross-functional teamwork.
Thoughts:
I worked on a multidisciplinary team to design Audi select’s consumer platform. Audi select is a monthly subscription service that gives members access to a selection of Audi vehicles for a flat monthly fee.
Role:
Worked within a team comprising two Product Managers, eight Engineers, an Engineering Manager, a Design Manager, a Product Marketing Manager, and a Product Educator.
Collaborated effectively with a Copywriter, Data Analyst, Business Leads, Brand Designers, UX Researchers, and the Customer Support team.
Challenge
Our task was to develop a solution enabling health insurance plans to engage Medicare users in health actions, while also increasing profitability through improved star measures. HealthMine aimed to replace the outdated Risk Manager with Opportunity Manager, a new platform. The existing features and user experience of Risk Manager were not suitable for companies with large memberships.
Approach
In the project's initial stage, we, alongside Zach, conducted interviews with internal stakeholders due to research limitations. This approach emphasized insights from stakeholders and plan leaders with extensive domain knowledge. These interviews helped us refine Opportunity Manager's feature scope, removing those of minimal value. Subsequently, we progressed to developing low-fidelity wireframes.
Outcome
1 - The MVP of Opportunity Manager markedly reduced pain points for plan leaders, analysts, and customer managers and representatives.
2 - Medicare plan members reported improved communication with customer support and enhanced self-management of health actions.
3 - This resulted in a 33% increase in NPS score and higher engagement from plan leaders, contributing to a rise in star level.
Discovery & Goal Setting
Discovery of User Pain Points
We initiated our process by posing critical questions to comprehend the purpose and development objectives of Opportunity Manager in relation to Risk Manager.
Key Questions:
What are HealthMine's business objectives, vision, and strategy, and what do internal stakeholders aim to achieve with Opportunity Manager? To what extent does the information architecture in Risk Manager present challenges? Does its navigation and visual hierarchy facilitate or hinder user workflows? How can we improve this for existing users? In what ways do different users engage with Risk Manager? Are there specific user permissions? Do users find all necessary features available to complete their tasks efficiently?
Product Importance and Impact
The platform encourages plan members to engage in health actions, enhancing their health and providing preventive care.
Target User Bases:
Plan Analysts/Leaders - Utilize the site for measuring star levels, monitoring compliance, accessing reports, and managing contracts. Occasionally, they interact directly with plan members.
Customer Support Representatives - Access a limited view of Opportunity Manager, mainly addressing plan members' complaints and reminding them to undertake health actions.
Medicare Plan Members (Indirect Users) - While not direct users of Opportunity Manager, their daily health actions are crucial in powering the platform.
Research
Methods Considered
Subject-Matter Interviews: Conducted to understand user perspectives on the topic. These interviews varied in structure.
Contextual Inquiry: Semi-structured interviews conducted in the user's work environment to gather insights that may not emerge in a standard interview.
Process
Lacking access to end users and plan leaders, we turned to internal subject-matter interviews with stakeholders experienced in health insurance management. Their insights guided our decision-making.
Interviewees: Ashan - Director of Market Intelligence, Jason - VP of Technology, Chris - Chief Technology Officer.
Key Challenges:
01. Site Navigation: Users needed comprehensive data and reports to assess star level compliance and inform actions.
02. Information Accuracy: The system often displayed unreliable health member information, affecting record management and adjustments.
03. Member Engagement: It was crucial to activate health actions in members through varied communication methods, including email, mailers, phone calls, texts, and push notifications.
Contextual Interview & Inquiry
We conducted a contextual inquiry with stakeholders using Risk Manager in their work environment, uncovering insights not revealed in interviews.
Interviewees: Nick, Director of Client Relations; David, Customer Support Manager (Indonesia).
Main Pain Points:
01. Risk Manager's slow performance and frequent crashes forced users to restart complex processes.
02. Design inconsistencies across the platform; different methods required for identical tasks on different pages.
03. Insufficient features for scaling to multiple health insurance plans, leading to incorrect information on member profiles.
04. Users, including customer support reps, analysts, and plan leaders, found the application confusing and inconsistent, with limitations in viewing plan contracts or reports.
Synthesizing and Definition
Affinity Diagram
Through affinity mapping, we identified recurring insights and pain points from stakeholder and subject-matter interviews, leading to the formulation of key problem statements:
01. Home/Starting Page: The current starting page inadequately serves diverse user groups like plan leaders, analysts, managers, and customer support representatives. Each group requires a customized viewing experience for seamless interaction.
02. Search-ability: Plan leaders, analysts, and customer service representatives struggle to locate specific information on members, contracts, or reports promptly.
03. Navigation: The application's multi-level navigation is challenging and non-intuitive for users, affecting areas such as member details, contracts, reports, and engagements.
04. Star Measure Visibility: A critical issue is the inability of plan leaders and analysts to view and delve into underperforming or successful star measures.
Opportunities Identified
During the discovery and research phase, we identified several distinct opportunities. Plan leaders and analysts primarily focused on dashboard and report functionalities, whereas customer support managers and representatives concentrated on member profile pages, highlighting their unique use-cases.
Ideation
Brainstorming Process
We initiated our brainstorming process by exploring solutions for the five identified problem statements. This phase involved key stakeholders, engineers, and product managers, with a focus on including engineers early to ensure feasibility.
Brainstorming Solutions:
01. Implementing top-level navigation for Dashboard, Members, Reporting, and Admin, with plans to add Engagements/Campaigns later.
02. Introduced card sorting to clarify the scope required for the top navigation pages.
03. Recognized the increasing need for user permissions to enhance product usage and efficiency.
04. In a future version (likely V2), we plan to enable detailed analysis of members who are not engaging with their health actions.
Card Sorting Exercise
Uncertain about feature classification for top-level navigation pages, we employed a card sorting research method.
Insights from Card Sorting:
Features like Overview, Health Actions, Stars, Rewards, Health Records, Campaigns, Tickets, and Recent Activity are allocated to subpages. This includes areas managed by customer support representatives.
Voting Exercise
Following card sorting, we identified 15-20 potential features to enhance Opportunity Manager. To prioritize, we conducted a vote, supplemented by feedback from internal stakeholders who had the final decision-making authority.
MVP Phase 1 Features:
Dashboard, Member, Contract, and Reporting Pages
Recent Activity Tracking for user logins on the mobile application
MVP Phase 2 Features:
Direct Chat: Allows Medicare plan members to chat with customer support representatives in the app, bypassing the need to call for ticket creation
Engagements: Develops customized campaigns based on plan members’ preferred contact methods, encouraging health actions
Note: The Admin Page was deprioritized later in the development process.
Rapid Prototyping
Prototype Testing
Following multiple iterations, I refined my wireframe sketches to detail interactions and components. This process culminated in a flow ready for feedback. Over eight weeks, we developed and shared various versions of Opportunity Manager with internal stakeholders for their input.
User Feedback & Design Response:
Customized dashboard design for plan leaders and analysts, with customer support reps integration in phase 2.
01. Development of a “Recent Activity” page for tracking member logins, health actions, appointments, and support chats, scheduled for phase 2.
02. Enhancement of search functionality with shortcuts for name, member ID, or birthdate.
03. Advanced filtering options to sort members by ID, birthdate, health actions, NPS scores, among others.
Testing and Validation
Methods Considered
A/B Testing - This would give us the opportunity to test multiple variations of the same product. We decided not to move forward with this option as the CSR had been de-prioritized by stakeholders MVP release 2.
Methods Considered
System Usability Scale - A simple 10-item questionnaire scored on a 101-point scale and provides a measure of the CSR’s perception of the usability of Opportunity Manager.
System Usability Scale
Knowing customer support representatives would be the primary users for Opportunity Manager. We wanted to make sure a lot of the work we had designed was validated before we began the hand off process with engineering.
Through Zoom & InVision, we conducted a system usability scale test with 9 customer support representatives and 1 customer support manager from our remote call center site in Indonesia.
Usability Scale Questions
System Usability Scale Questions:
I think that I would like to use this dashboard frequently.
I found this dashboard unnecessarily complex.
I thought locating, verifying, and updating member information was easy to learn and use.
I think that I would need to retrained to be able to use this dashboard.
I found the recent activity function in this dashboard to be beneficial when working with plan members.
I thought there was too many inconsistencies throughout this dashboard.
I found creating tickets to address customer issues easy to use.
I found this dashboard very cumbersome/awkward to use.
I felt very confident using this dashboard.
I found the member profile page easy to understand.
Implementation
Visual & Interaction Design
Since implementing the MVP of Opportunity Manager, there's been a notable reduction in pain points for plan leaders, analysts, and customer managers. Feedback from Medicare plan members highlights enhanced communication and improved self-management of health actions. This has resulted in a 33% rise in NPS score and increased engagement among plan leaders, contributing to a higher star level.
Information Arch & Visual Hierarchy
To optimize functionality, our information architecture was tailored for customer support representatives. Key priorities included:
Shortcuts - Representatives can swiftly locate members using member IDs instead of names or birth dates.
User Permissions - Different access levels were established: representatives access the members' console for security, analysts view reports, and admins have full control.
Engineering Involvement & Handoff
From the outset to completion, engineering played an integral role in our design process. Regular meetings were conducted to discuss feature requirements, allowing engineers to address technical aspects influencing design choices.
Upon completing engineering tasks for design-involved features, we conducted spontaneous visual QA sessions to ensure adherence to visual and interaction design standards.
Takeaways
Learning & Looking Back
In future updates, we'll focus on enhancing admin engagement with unmotivated and uninterested members. Since Opportunity Manager's initial release, here are key points:
01. Adhere strictly to the MVP to avoid scope creep and ensure timely delivery of a quality product.
02. Involve engineering early to understand technical constraints, minimizing rework and shaping the design strategy effectively.
Measuring Success
Since implementing the MVP of Opportunity Manager, there's been a notable reduction in pain points for plan leaders, analysts, and customer managers. Feedback from Medicare plan members highlights enhanced communication and improved self-management of health actions. This has resulted in a 33% rise in NPS score and increased engagement among plan leaders, contributing to a higher star level.