Challenge

Optum’s products are fragmented, and data about their Members is spread across multiple places, making it harder for Care Providers to serve them. The result is that the quality of care their Members receive suffers, which can make Optum’s business costs rise.

Actions

We had already been working with Optum for several years so we had a solid understanding of their goals to boost efficiency and enhance the ‘Member’ experience by creating better tools for care providers. This included their work on a Design System Library to improve overall product consistency and various overlapping initiatives across business units to improve their respective “patient profiles”. Sensing an opportunity here to remove some redundancy, I encouraged my colleagues to suggest to Optum that we consider extending the Design System to include “templates”, starting with a “Member Profile” template, which we could create. (Adding “Templates” to a Design System gives it an additional level of structure, making it easier to apply across products.)

After consideration, they decided not only to let us create this “Template” but also to eventually build it as an individual product, which they would roll into the solutions they sold. (We were pumped about their “yes, and..” response!)  

Adding to the excitement of the project, our group discussions aligned on the idea of extensively using AI to streamline workflows. This would involve providing useful insights, inferences and suggestions to ease user workloads and combat the “burnout” reported by over 50% of Providers.

But, despite our familiarity with Optum’s various users, their workflows, and tools, we still needed to define precisely whom we were designing for in this project. Our main client stakeholder agreed, and instructed us to focus on the Care Manager role, which is responsible for coordinating and improving patient care and is critical for Optum in terms of risk management—particularly in reducing costly readmissions to hospitals or facilities.

 “If we do the Care Manager journey right, that should cover something like 75% of the needs of all the other user personas…Care managers typically handle 100 – 500 patients, and have 6 -9 minutes to review each case…Profile has traditionally been a “data dump”, but it should also be something they can easily take actions from too, to make things faster.”
– Client

Now we had our primary user and a time-per-case we could aim to reduce, but – plot twist – we soon learned from our key client stakeholder that other groups were competing for ownership of this project at Optum!

Since we were now racing to be the first ones to socialize a new Member Profile concept across the organization, we were directed to move as quickly as possible and focus on showcasing the most cutting-edge features of the concept instead of focusing on illustrating a full user story for a Care Manager and bubbling up functionality around that. We were sad to lose the big “story” but still very excited about the work itself, so we charged ahead.

First, we revisited our existing User Research, which had been conducted with Care Managers during our earlier Clinical Manager project. We also reviewed earlier competitive landscape work we had done and looked more closely at direct competitors, specifically Google’s CareStudio and Microsoft’s Dynamic 365.

Next, to understand the existing content and data, we quickly captured the current versions of a “member profile” that we could access across the Optum product ecosystem. We found nine versions of the Member Profile, containing fifty-five different modules.

Most of these examples were part of legacy platforms, which existed as steps in “pogo-stick” workflows, where users were forced to move across several tools to accomplish a task. We wanted to fix this by keeping workflows centered around an individual Member within a single intelligent and predictive context.

After this discovery work, we articulated our Product Vision…

The Product Vision

Next, we unpacked it into “Principles” to guide our design teams toward success…

Experience Principles

Streamline
Provide Meaningful Context
Design for Action
Effortlessly Personalize
Intelligently Notify
Humanize (“Person” not “Case”)
Support Collaboration

We added “Clinical” principles as well to make sure everything was connected to how modern medicine is practiced…

Clinical Principles

Improve Patient Outcomes
Value-Based Care
Engage Patients as “Partners” in Care
Promote Effective Communication and Coordination of Care
Fight Clinician Burnout
Evidence-Based Solutions
Mindfully Follow Fundamentals & Cognitive Frameworks of Modern Medicine

We shared this strategy, as well as a few early tactical ideas we had for the framework, with our client partners.

Framework

Intelligent Consumable Dashboard
Bring the Human into the Chart
Patient is the Navigation
Self-Configure by User or Visit Type
Drag & Drop Modules for Clinical Comparisons

After everyone was aligned, we started to design! The UX team focused on exploring ideas for the overall structure of the experience and condensing the modules. The Visual design team jumped into exploring look and feel concepts. (The device we targeted was a tablet because that’s what most of our Care Managers used since portability is key for their work, which takes place across multiple locations – facilities, hospitals, patients’ homes, etc.)

Very rough early UX

Visual Explorations

Plot twist – During this time, Optum pulled the trigger on a rebrand of their visual identity. We were told at first to ignore the rebrand, but (you know where this is going…) we wanted to make sure we could easily adapt if they changed their mind. 

In order to do this, we made all of the modules and core page elements into components, which mapped to styles we could quickly update if needed. (And later there was “need” when we were told to reflect the rebrand in the designs – ha.)

As we worked, the Health Innovations Director and I designed the content for all of the modules together in order to have the most clinical relevance to real workflows. We used AI whenever possible to help users:  Switch contexts – ex. “What do I know about the member I’m reviewing now?”,  Discover insights – ex. “Help me see connections I might not know about, like possible comorbidities or the meaning of symptoms”, And, Take action – ex. “Help me create my clinical summary update (aka “SOAP”) as quickly as possible.” 

We also fought hard to “humanize” the whole experience. Too often, members are treated like “cases” and not like real “human beings.” This feels rude and impersonal AND ironically ends up costing healthcare companies more in the long run because they often miss important lifestyle and environmental signals that could help them avoid serious and costly health issues down the road. (This is why we are seeing a movement towards “value-based care” in America, where providers are paid based on how healthy they keep their patients, as opposed to the traditional “fee-for-service” model.)

To address this, we included more lifestyle-related data in the Profile –  things like SDOH (“Social Determinants of Health”, ex. Does this person have economic stability? Are they unhoused?), ADL (“Activities of Daily Living”, ex. Do they use a cane?), and Social History (ex. How many drinks do they have a day?). We also included powerful communication and collaboration tools to ensure the entire Care Team would see each other’s actions, impacts, and notes. And, keeping with general digital trends, we explored how medical at-home connected devices could factor into the equation through features like “Live Vitals” and “Missed Medication” alerts.

Some of the modules

Result

Once we had alignment on the key modules, screens, and interactions, our client stakeholder shared the designs with her inner circle. After some light revisions, we moved ahead and created a showcase video for her pitch!

Despite the jargon-y script, this won our client ownership of the project!

🏆

UPDATE: Full disclosure – I was worried this might have been just a concept piece that would never go into production, but that is not the case! I recently learned that the product has been built and was so successful internally that it’s been white-labeled and is being sold externally now as well!