Four systems, one patient.
Designing a user-centric telemedicine app connecting insurance providers, healthcare providers, pharmacies and patients, improving the end-to-end healthcare experience.
Four parties, no shared view.
The American healthcare system is made up of doctors, patients, insurance providers and pharmacies, and every one of them has needs the other three cannot see. How might we improve communication between distinct healthcare stakeholders, enhancing the overall healthcare experience?
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Patients
Want one place to raise an urgent or minor concern, order and refill a prescription, and make, reschedule or cancel an appointment.
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Doctors
Want the same digital route to a patient for urgent or minor concerns, and need to hear from a pharmacy when a medication is out of stock.
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Pharmacies
Hold the medication inventory a patient cannot see, and need anything touching it to be secure and HIPAA-compliant.
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Insurance providers
Hold the in-network pricing for prescriptions and appointments that patients want to see in real time.
The goal was to put appointments, prescriptions, pricing and the consultation in one place, so that coordinating care stopped being the patient's job.
From secondary research to high fidelity prototypes.
Secondary research and 24 user interviews were conducted before the first wireframe was drafted. The home screen was then iterated across five versions based on user testing.
- 01Discover
Secondary research and user interviews
- 02Define
Affinity mapping, personas and feature synthesis
- 03Develop
User flows, wireframes and the design system
- 04Deliver
User testing and high fidelity prototypes
01Discover
Conducting secondary research and 24 user interviews.
Secondary research was conducted to understand the present adoption of telemedicine, the healthcare use cases it covers and which solutions in the market best facilitate telemedicine features.
User interviews were then conducted with 15 healthcare consumers, 8 medical workers (2 licensed physician assistants, 3 medical doctors and 3 pharmacists) and 1 insurance provider. Participants were drawn from diverse backgrounds.
- 24User interviews
- 15Healthcare consumers
- 8Medical workers
- 1Insurance provider
Strengths
Internal, helpful
- A reason to try the appTelemedicine was still new to most patients during the research. The technology itself was recorded as a reason for patients to try the app.
- Designed from the researchThe product was shaped by 24 user interviews. Each feature traces back to a need recorded in those sessions.
- Four services in one appAppointments, prescriptions, pricing and the consultation are offered in one place. Existing solutions in the market offered each of these separately.
- Consultations inside the appProvider partnerships allow consultations to take place inside the app. Further partnerships were recorded under Opportunities.
- Real-time in-network pricingInsurance integrations provide real-time in-network pricing for prescriptions and appointments. Integrations were also recorded under Weaknesses and Threats.
- Secure handling of health dataSecure, HIPAA-compliant handling of health data gives patients and providers a reason to trust the app. Data security was also recorded under Weaknesses.
Weaknesses
Internal, harmful
- A new name in the categoryThe category is led by insurers, hospital systems and pharmacy chains. ScheduleSAFE enters as a new name without an existing user base.
- Costs before the first patientIntegrations, compliance and clinical staffing are all required before launch. The product depends on pharmacy and insurance partners being in place from day one.
- Required before launchHIPAA requirements must be satisfied before any feature ships. Regulation was also recorded as regulatory compliance and under Threats.
- Licensing and prescribing rulesLicensing, prescribing rules and state boundaries differ by location. This was recorded as a weakness because it is work the product team must complete.
- A different API for each partnerEach insurance, provider and pharmacy partner exposes a different API on its own timeline. This is the build effort behind the integrations recorded under Strengths.
- Security work before launchSecurity for health data must be designed, built and audited before launch. The same item was recorded under Strengths for the trust it earns once that work is complete.
Opportunities
External, helpful
- Rising adoption of telemedicineSecondary research showed adoption of telemedicine increasing across the market. It was recorded as an opportunity because the trend belongs to the market.
- Care where providers are far awayIn healthcare deserts, distance to the nearest provider is the main barrier to care. Remote consultations remove that barrier.
- Users already manage health on mobileMany health consumers already track and manage their health with apps. These users arrive familiar with the behavior the app relies on.
- Room to add providersAdditional provider partnerships expand the care available in the app. Current partnerships were recorded under Strengths.
- New marketsThe app could be offered in other countries. Each new market adds to the compliance work recorded under Weaknesses.
- Continuous health dataWearable devices that patients already own produce continuous health data. An integration would let the app surface when care is needed.
Threats
External, harmful
- Rules that change after launchRegulations can change in markets where the app has already launched. These changes sit outside the product team's control.
- Breaches of health dataA breach of health data would remove the trust that patients and providers place in the app. This is the external side of the data security items.
- Trust in remote careSome patients doubt that a remote consultation is real care, and some providers resist adopting another system. This informed the focus on building user trust through visual design.
- Platform updatesThe underlying technology will require updates while the integrations are being built. This effort was recorded as a threat to the delivery timeline.
- Dependence on partner decisionsA partner can change an API, raise a price or sign with another product. Features that depend on that partner are affected.
- A crowded categoryThe growth of telehealth recorded under Opportunities also attracts competing products to the category.
02Define
Organizing insights with affinity mapping and personas.
Interview insights were organized using affinity mapping. Personas were then developed from interviewee demographics and responses.
The research identified three primary user groups impacted by telemedicine applications: patients, doctors and pharmacists. The insurance provider was a source of pricing information for the other three groups and not a daily user of the product, so it informed the features without becoming a persona.
02Define
Synthesizing six primary features.
Synthesis produced six primary features. Each feature consolidates and simplifies healthcare processes and systems that are traditionally confusing and disconnected.
Select a figure to change the view.
Telemedicine
Patients and doctors want a digital solution to discuss urgent or minor health concerns.
Prescription management
Consumers want a mobile solution to order and refill prescriptions.
Appointment management
Consumers want a mobile solution to make, reschedule and cancel medical appointments.
Insurance partnerships
Consumers want to view in-network pricing for prescriptions and appointments in real time.
Pharmacy partnerships
Consumers want to view medication inventory at selected pharmacies, with stock outages communicated to their physician.
Data storage and security
Doctors and pharmacists need the app to be secure and HIPAA-compliant.
Ten candidate features were then scored on two axes: customer importance and business impact. The five features that scored high on both axes became the MVP.
- Highest on both axesUsers asked for real-time in-network pricing on prescriptions and appointments. This pricing is only available through an insurance provider integration.
- Requested by patients and doctorsPatients and doctors both asked for a way to discuss urgent or minor concerns without a visit. It scored lower on business impact than the three integrations because it is built in-house.
- Required for every consultationEvery consultation requires a provider on the other end. The SWOT analysis recorded provider partnerships as both a strength and an opportunity.
- The consultation itselfCustomer importance was scored high. Business impact was scored lower because this is delivered as part of telehealth functionality.
- Inventory and stock outagesUsers asked to view medication inventory at selected pharmacies and to have stock outages communicated to their physician. Both require a pharmacy integration.
- Wanted by patientsPatients wanted a profile that holds their health history. It scored low on business impact because it has no partner dependency, so it was planned after the integrations.
- Wanted at the time of scoringCOVID exposure tracking was wanted by users when the features were scored. It scored low on business impact because no other feature depends on it.
- Requested by the businessReviews give users a reason to return to the provider directory, which gave them a business impact score. They were not among the six features identified in the research.
- Dependent on appointment managementAppointment management was identified in the research and reminders were not. Reminders build on scheduling, so they were scored low on both axes.
- An enhancement to schedulingThe calendar view is an enhancement to appointment management. It was scored low on both axes and placed after the five MVP features.
The five features that scored high on both customer importance and business impact became the MVP.
Insurance provider integrations
Real-time in-network pricing for prescriptions and appointments.
Telehealth functionality
A digital route for patients and doctors to discuss urgent or minor health concerns without a visit.
Healthcare provider integrations
A healthcare provider available on the other end of every consultation.
Realtime communication with a provider
The consultation itself, delivered as part of telehealth functionality.
Pharmacy integrations
Medication inventory at selected pharmacies, with stock outages communicated to the physician.
Three of the five MVP features are integrations with outside parties. Integrations were also recorded as a risk in the SWOT analysis.
Insurance providers
Supplies real-time in-network pricing for prescriptions and appointments.
Healthcare providers
Connects a patient to a provider for every consultation.
Pharmacies
Supplies medication inventory at selected pharmacies and communicates stock outages to the physician.
03Develop
Mapping user flows before designing screens.
A Pew Research study shows an increasing share of health consumers using mobile apps over desktop to connect with providers and manage health data. The work was scoped to a mobile application on that basis.
Feature prioritization and user story development followed, and user workflows were then defined through flow mapping.
Interfaces were sketched on paper and in Balsamiq. These rapid prototypes guided the low fidelity and mid fidelity wireframes in Figma. Multiple variations were explored, and the most promising elements of each were merged into one set.
03Develop
Guiding the visual design with color theory.
Nosocomephobia, the fear of hospital environments, is driven in part by the color associations people hold with sterile clinical spaces. The palette was built from a mix of whimsicality, tranquility and urgency where needed, in place of the institutional blues and whites common to healthcare products.
Design research also indicates a positive correlation between user trust in medical settings and a non-institutional, playful design aesthetic. Illustration was added to the interface on the basis of that finding.
04Deliver
Testing three tasks with the wireframes.
The first wireframes placed the six features on a home screen, prioritized by user need, with navigation to the patient dashboard, appointment management and the user profile. Participants were then given three tasks to complete with the wireframes.
The test sessions identified two additional user needs: a dedicated button for prescription maintenance and search across the whole app.
- 3Tasks tested
- 2Additional user needs
- 5Home screen versions
04Deliver
Iterating the home screen across five versions.
Both user needs were added in the second version, and the home screen was then iterated through three further versions.
The structure of the home screen, with six features prioritized by user need.
A prescription maintenance button and search across the app were added from user testing.
Visual weight was added to the calls to action and fields to mark key interaction points.
Illustrations were added to direct users toward the zones, buttons and fields each workflow requires.
The remaining feedback was incorporated and the visual elements were polished.
Four parties, one place they meet.
The first flow connects the patient to the doctor, the insurer and the pharmacy at sign up. The next three each put the patient in the same place as one of them. The fifth makes the consultation readable as well as audible. Every flow is shown on the iPhone beside its Apple Watch companion. The watch came from the research: participants already wore one, and wearable integration was named as an opportunity in the SWOT analysis.
Every party connected at sign up.
The interviews showed the patient was the only link between the doctor, the insurer and the pharmacy. That link is made once, during first launch. On the iPhone, an account is created and insurance is connected before the dashboard tour.
On the watch, no password is typed on a small screen. Sign-in is handed off to the iPhone, and the profile syncs with each of the three providers checked off. Reminder and Health permissions follow, and the ScheduleSAFE complications are added to the watch face. The next visit, the day's doses and the refill count are visible from day one.
An urgent visit, from symptoms to follow-up.
Doctors in the interviews asked for a digital route to their patients. On the iPhone, the patient's location is confirmed and the nearest in-network urgent care partner is matched before the call is joined.
On the watch, the intake form is replaced by symptom chips and a started-when control. The place in the queue counts down from 3rd to 1st on the wrist, and a haptic signals when the doctor is ready. The visit summary closes the loop. The prescription is already sent to the pharmacy, and the two week follow-up is added to the calendar. Passing the prescription along had been the patient's job.
Coverage, known before the visit.
Insurers held the in-network information patients wanted in real time. On the iPhone, the insurance card is scanned, the insurer is connected and an in-network care provider is selected. Every provider after that is shown with its coverage attached.
On the watch, the insurance card flips to show the member, policy and pharmacy numbers. A full-brightness QR code is shown at check-in, so neither the phone nor the wallet comes out at the front desk. Each provider is marked in-network, and directions to the clinic open from the same screen. Coverage is confirmed before the patient arrives.
A refill caught before it runs out.
Pharmacy stock was out of the patient's view, and an out-of-stock medication was found out on arrival. Testing also showed prescriptions needed a dedicated button. On the iPhone, a prescription is chosen and the insured and self-pay prices are compared at each pharmacy before the refill is ordered.
On the watch, a low-supply alert arrives with 1 day left, and supply bars show every medication's remaining days. The nearest pharmacies are listed by distance, and the lowest price is tagged. The refill costs $4.12 with insurance against $14.50 self-pay. A pickup alert arrives after 4 PM, and code RX 7419 is scanned at the counter.
Captions sized for the wrist.
Patients with hearing or vision needs were planned for from the first version of the consultation. On the iPhone, live captions are switched on, the caption text is enlarged and high contrast is applied during the call.
On the watch, captions appear word by word under the speaker's name. The Digital Crown steps the caption size from Medium to Large, with a live preview of the change. High contrast moves the captions onto a solid black panel with a yellow speaker label. Earlier lines are reviewed by scrolling back through the transcript with the crown.
Six needs, one application.
The six the research produced (telemedicine, prescription management, appointment management, insurance partnerships, pharmacy partnerships and HIPAA-compliant storage) arrived in one place, rather than spread across the four parties a patient had been holding together themselves.
Tested, then drawn again.
Three tasks put in front of participants surfaced two needs the six features had not covered: a dedicated button for prescription maintenance, and search across the whole app. Both went into the next pass, and the home screen was redrawn five times rather than defended once.
Accessible by default.
Robust closed captioning provides real-time, accurate transcriptions of medical consultations, designed as part of the product rather than retrofitted once somebody raised accessibility concerns.