Remedy



Empowering patients by providing them with faster access to health care.

Remedy

Empowering patients by providing them with faster access to health care.



Summary

Our parent organization, Two Point Conversions has been in the health care space for the last 30 years. While they have been serving large hospital businesses like Mercy Health, Bon Secours, etc. I was brought in as the company's first UX hire to help conceptualize a product that would be used by patients!


While we were aware that health care in the US was very unaccessible, we wanted to dive deep into the patients journey to figure out what all the pain points were and what needed to be fixed in what order.




Role

Product Lead reporting to the company’s Founder and President and is responsible for the engineering, design and business development (Sales and Marketing) teams.


Duration

June 2019 - Present


Process Overview


The Problem

Health Care in the US is not accessible

Patients in the US struggle to access health care. On one hand, the average wait time to see a doctor is 19 days. On the other hand, health care providers struggle with unfulfilled inventory as a result of issues like last minute cancellations, no-shows, etc.



Phase 1: Discover

Overview

The goal for the Discovery phase was to understand who our stakeholders were and to connect with them. We wanted to understand the part they played in the health care space, how they affected it and all the problems they had with it.

Stakeholder Map



Research Methods



Synthesis Methods




Co Design with Stakeholders

From our research, we learned that a patient's health care journey can be broken down into 8 stages, from before they fall ill to when they fall ill and eventually recover.

This information was consolidated into a user journey diagram, and we invited stakeholders (including health care providers, industry experts, receptionists and patients) to come help fill in the diagram with information that they thought we had missed out.

User Journey Diagram used for Co Design


We noticed that our stakeholders were brilliant people and experts in their field, but a lot of them were relatively uncomfortable with technology. The illustrations were added to help alleviate this issue and to make the co design exercise more accessible for our stakeholders. This worked like a charm! Our co design sessions were super immersive and we learned a lot. Here are some of our key insights.



Key Insights

From the User Journey diagram, it's obvious from the density of sticky notes, that our stakeholders' were experiencing the most pain around points 5 - Appointments and 6 - Hospital Visit.

1. A lot of processes are redundant

  1. "Forms are often repetitive. Some forms ask what conditions do you have and I don’t know."
  2. About follow up visits - "Don’t want to repeat the same information over and over again"

2. Appointment times

  1. "People generally visit the doctor at least once a year for an annual scheduled checkup as a habit. This generally happens between March and July"

3. Real time feedback

  1. "There are so many times when you go for appointment and you’re on time but the doctor is running from different clinics. My previous doc has 2 clinics and I’ve had to wait for a good hour."

4. Anxiety of waiting

  1. "There was this one time when I was VERY sick. I had a really high fever and I was weak and my vision was blurry, and I had to wait. I didn’t have an appointment and had to wait in a queue."

5. People love convenience even in health care

  1. "This is me being lazy. I like stuff being delivered to me."

6. Reminders are essential

  1. "I'm forgetful. I’d like to be reminded when the appointment is. I generally remember but on that one off-day I would like to be reminded"
  2. "Tell me what I need to bring with me. Do I bring so and so records or do I need to get my records transferred prior to my visit"

7. Health care is often for someone else

  1. "When parents have an appointment id like to know because they don’t speak english and I need to help them."

8. Minimize human interaction



Personas

Since, our previous co design activity proved to be so insightful, we decided to conduct another one with potential patients. We asked everyone to come up with an imaginary over the top health care experience that was so good, they would rate it more than 5 stars on Yelp or Google Reviews!

Provider and Patient Personas



The 5 Star Health Care Experience

Since, our previous co design activity proved to be so insightful, we decided to conduct another one with potential patients. We asked everyone to come up with an imaginary over the top health care experience that was so good, they would rate it more than 5 stars on Yelp or Google Reviews!


... After getting back home the family has questions that you never thought of, and I give them them the notes that the doctor sent with me to address their questions. Anonymous, 5 Star Co Design
... On my first appointment with the GP, I got a message an hour before the appointment that the doctor was running an hour late, so I was able to use that time to catch up on work around the house instead of waiting in the waiting room. Anonymous, 5 Star Co Design
... I am a 45 year old man with a liver condition, a heart murmur, and type-2 diabetes ..... I was able to easily authorize coordination between the members of my team in advance, because communication between them is critical for a complex situation like mine. Anonymous, 5 Star Co Design
... After my last appointment, the app conveniently notified me of the results of my tests instead of having to go through the process of calling my doctor for the lab results and worrying if my condition has gotten worse or if the injections have had a negative affect on my body. Anonymous, 5 Star Co Design
... They choose to pay for their copay fee using Apple Pay through the same online portal to minimize human interaction. Less than a minute later, a doctor calls the patient’s name and their appointment begins. Anonymous, 5 Star Co Design


Design Ideas



1. HMW help patients be less forgetful?

2. HMW reduce time wasted?

3. HMW reduce patient anxiety?

4. HMW help patients trust the process?

5. HMW create 'coordination in care'?

6. HMW minimize human interaction?

7. HMW eliminate frustrating processes [like redundant medical forms]?



Concept Exploration

We then began rapidly ideating a number of concepts before narrowing in on a select few before creating user flows, user stories and storyboards to define user requirements. We voted on the concepts and decided to experiment with 2 concepts. This would give us enough breadth to experiment with ideas and interactions without straying away from the user problems we were solving for.


Concept 1: Appointment Scheduler - A mobile app that allows patients to book appointments based on real-time provider availability.

Appointment Scheduler - Initial Wireframes



Concept 2: Doc2Doc - A mobile app that allows patients to access and share their medical health information

Doc2Doc - Initial Wireframes



Needs Validation Process (Testing in low fidelity and refining)


While the Appointment Scheduler prototype tested well enough for us to receive valuable feedback to iterate upon, our testers found it difficult to understand the low fidelity Doc2Doc interface. We quickly decided to break the rules and create a digital (higher fidelity) version of Doc2Doc to fix this problem.



Doc2Doc - Digital Prototype

Doc2Doc - Initial Prototype



Doc2Doc - Key Insights

Our feedback, for Doc2Doc was generally very negative. We took that as great news and decided to purse the Appointment Schuler opportunity. We didn't give up on Doc2Doc entirely though - more on that a little later!

1. People visit the doctor very rarely - The Doc2Doc concept is relevant to a niche group of patients who visit the doctor periodically - based on old age, chronic illness, etc.

2. People don't want to think about their health - Very few people will wake up on a Saturday morning, open an app and fill in their medical information. People care about their health but don't want to think about it.

3. The healthcare paradox - People care about their health but don't want to think about it, until they are sick. When they are sick they are in no condition to do anything additional about it.

4. Medical information is sensitive - Healthcare practices are apprehensive about a third party handling their patients medical information, and being liable if anything goes wrong.

5. The competition - It's public knowledge in the healthcare space that massive players including Google and Microsoft tried building their own version of a centralized health system, and failed.




Phase 2: Define

Overview

The Discovery phase gave us clarity regarding, which opportunity to pursue. The goal for the Definition phase was to consolidate this information and use it to create measurable business goals to drive design, development and sales of our product.



OKRs

Create a MVP by June 2020. An MVP is the smallest version of our product that can validate our Growth and Value hypotheses, and be used by potential patients and providers unsupervised.

1. Value Hypothesis - Will patients book at least one appointment through Remedy?

2. Growth Hypothesis - Will health care providers recommend Remedy to their patients?



Go To Market Strategy - Google Design Sprint

We wanted to focus on a go to market strategy before design began, so that we could incorporate it in design and not have to build our strategy around design. We needed to answer questions regarding branding, colors, design principles and product voice and we wanted answers as quickly as possible. The solution was to run a Google Design Sprint.



Sprint Phase 1: Understand

Competitive Analysis

We analyzed other companies in the space in an attempt to find patterns in what they were doing.

Source: https://appinventiv.com/blog/cost-to-develop-doctor-appointment-app-like-zocdoc/


Secondary Research

We looked at analogous spaces to help influence our design thinking process. Here are some of the things we looked at for inspiration.

1. Hospital Waiting Rooms - Adding the perception of space by keeping things like cups and magazines in order, large lightly colored walls, etc. act as calming elements and help reduce stress.

2. Transparency - By letting patients see waiting times through wait-time boards, and doctor statuses helps reduce anxiety

3. Let in nature - A glimpse of the outdoors with windows can feel like a reprieve from the stress indoors. And as with artwork depicting nature and actual plants, it gives people something familiar to look at, and familiarity provides a feeling comfort.



Sprint Phase 2: Define

Product Mental Model

We used the above information to help guide our next phase - the Definition phase. We consolidated the information and built a word cloud with ideas using which people were defining the space.



Sprint Phase 3-5: Sketching to Validation

Sketches and Prototype - Iteration 1

Sketches and Prototype - Iteration 1


Sketches and Prototype - Iteration 2

Sketches and Prototype - Iteration 2



Sprint Phase 6: Validation

Key Insights

After Phase 4 or the Decision phase, we had two types of prototypes. The first one was a more rough, hand drawn version. We were really proud of this prototype because it was in line with all our ideas of creating a friendly, warm and approachable product and most importantly cost of development was really low.

Unfortunately, it didn't test as well as we hoped. Our users found it difficult to trust because it was perceived as too playful and childish.

So, even though the digital illustrations would cost more to build, we decided to go with it. We do only what our users want!



Design Principles

Aesthetic Integrity - Aesthetic integrity represents how well an app’s appearance and behavior integrates with its function. Remedy is used by people who are feeling unwell. Demonstrate respect and empathy for their time and attention through thoughtful and elegant craftsmanship.

Clarity - Eliminate ambiguity. Enable patients to see, understand and act with confidence.

Efficiency - Streamline and optimize workflows. Intelligently anticipate needs to help patients perform tasks better, smarter and faster.

Consistency - Create familiarity and strengthen intuition by applying the same solution to the same problem



Product Branding

This helped us answer questions related to branding, color palette, typography, illustration and iconography.

Remedy Branding




Phase 3: Design

Overview

The goal for the Design phase was to come up with a hi-fidelity mockup to hand over to the development team.



Recap of our Goals

Create a MVP to validate our Growth and Value hypotheses by June 2020

1. Value Hypothesis - Will patients book at least one appointment through Remedy?

2. Growth Hypothesis - Will health care providers recommend Remedy to their patients?



Design Process

We used the above information to help guide our next phase - the Definition phase. We consolidated the information and built a word cloud with ideas using which people were defining the space.



Appointment Scheduler - Paper Prototype

Appointment Scheduler - Paper Prototype



Appointment Scheduler - Medium Fidelity Prototype

We iterated upon the low fidelity prototype and built a medium fidelity (digital) prototype that we used for Expert Critiques with health care providers (dentists, chiropractor, anesthesiologist, clinical psychiatrist and medical intern) and medical practice receptionists.

Appointment Scheduler - Medium Fidelity Prototype



Final Design

We used the above information to help guide our next phase - the Definition phase. We consolidated the information and built a word cloud with ideas using which people were defining the space.

Remedy Hi-Fidelity Mockups



Feedback

We used the above information to help guide our next phase - the Definition phase. We consolidated the information and built a word cloud with ideas using which people were defining the space.

Search screens are not intuitive

  1. Search screens were designed assuming that our patients always knew why they were sick.
  2. A more intuitive information architecture was needed to help patients make their search decisions

Appointment screens are not intuitive

  1. It's not clear what happens after you book an appointment. Do you have to wait for someone to approve it, or does it happen automatically?
  2. Initial appointment screens allowed for patients to book only 1 appointment at a time

Quantitative Needs Validation of Doc2Doc Design Idea

We wanted to test our second design idea "Doc2Doc", without having to build the app.

  1. Added the option for patients to fill in preliminary medical forms, and at the same time store PHI centrally
  2. Added demand validation screen in app, to measure patient demand for this feature

Care Team

Based on feedback, we decided to scrap the 'Care Team' module. It was a nice to have, but we could validate our MVP hypotheses without it.




Phase 4: Build

Overview

The goal for the Build phase was to bring the design to life, and create a our technical MVP to be used by our users unsupervised by us.



Architecture Summary

We used the above information to help guide our next phase - the Definition phase. We consolidated the information and built a word cloud with ideas using which people were defining the space.

Remedy High Level User Navigation



Programing Language

Some of the Frameworks we explored included Native, Flutter, React Native, Ionic and Cordova.

We decided to go with React Native. The variables that influenced our decision making could be categorized into User-Centric and Team-Centric. Some of these variable included:


User-Centric Variables

  1. Maintaining a native look and feel
  2. UI consistency across iOS and Android
  3. Time to market

Team-Centric Variables

  1. Learning curve for developers and development costs
  2. Total number of code bases to manage
  3. Available online documentation
  4. Competitive Analysis - What do other companies do?


Communicating Design to Developers

To enable effective and efficient communication between developers and design, all mockups were designed around an 8 unit spacing guideline framework.

Every element on the screen would be spaced and sized in numbers divisible by 8. By implementing this in the code itself and writing the application around it, we would be sure to decouple development and design.

Spacer Guidelines - Examples



MVP vs Product - Lessons Learned

The Onboarding Flow - Lazy vs Traditional Registration

Somewhere along the line I forgot that we were building a MVP and not a product. One example of a module, that I would have designed differently is the Onboarding Flow

The Remedy App, used Lazy Registrations for Onboarding. We allowed new users to experience the app, and book an appointment before having to create an account. The reason? Lazy Registrations provide a better UX and we would definitely see as good or a better onboarding success rate. What I didn't take into account - Lazy Registrations require you to store different user states and so, is more costly to develop.

The flaw here is the MVP should have been designed ONLY to test our value and growth hypotheses. What if a traditional registration had delivered a good onboarding success rate as well? We'll never know.


Concierge MVP - Appointments Backend

We decided that since we would be working with a small number of early adopters only, after launch - we could get away by replacing the entire Appointments backend with humans. Every time we received an appointment request, I would manually call the medical practice, book the appointment and change the required attributes in the backend, manually. This would bring down engineering time by 3-4 weeks, and we would still validate our MVP hypotheses.


Designing Workflows in Small Batches and not Large Batches

When we first began work we worked in large batches. for example, I would work on hi fidelity screens and hand them over to Dev and then they would begin working on the front end, and once that was done, backend work would begin.

This was a very costly process. There were instances when I would fail to communicate design effectively and we would only realize this once front end work had begun. As a result, we would have to stop front end, and I would have to go back to square on, re-do my designs and re-submit to the development team. This is one of the reasons the spacer guidelines framework was even built!

We changed our entire workflow to e completed in smaller batches - where work happened in parallel. We began to do work "just-in-time". In case an error was detected, we could detect it a lot earlier and there would be less waste.




Phase 5: Sell


Stakeholder Value Proposition Matrix

We estimate customer (patient/provider) willingness to buy by plotting target persona vs target persona action.

Willingness to buy criteria:

  1. Not usable
  2. Usable but with no obvious benefits
  3. Nice to have. The end user will appreciate these benefits although they are not strategic to the organization sponsoring the purchase
  4. Should have. The end user receives strategic benefits, although these benefits can readily be achieved by other means as well
  5. Must have. The end user receives benefits that are strategic to the sponsoring organization and cannot be achieved by any other reasonably comparable means.

Stakeholder Value Proposition Matrix

Value Propositions Results

Use the following value propositions in sales pitch depending on campaign

Campaign targeting Providers and Patients - "Receive appointment reminders"

Campaign targeting Providers - "Strengthen online presence"

Campaign targeting Patients - "Receive appointment reminders"



Pricing

Pricing will be based on value to the Practice. Value is determined by estimating the net increase in revenue a new acquisition brings through our app brings to the Practice, and the LTV of that new patient. This ensures that we receive the greatest possible revenue for our product, to counter our high CACs.

In the long run,

  1. We can charge patients based on storage space utilized for storing medical records (Enterprise revenue)
  2. We can charge providers for new patient acquisition (Subscription revenue)
  3. We can charge providers for higher ranking in the search screen (Ad revenue)

Price Simulation Model for Small Practices



          

© Aroon Philip Mathai 🐶