Aetna

Until you work with insurance, there is no way to understand the complexity of this industry. And that doesn’t count healthcare. Yes - medicine is different from insurance. A great realization is that, most users don’t separate them. Logic may dictate that, “if I pay for insurance, healthcare is included.” Doctors have a different perspective, patients, pharmaceuticals, outpatient, wellness, different state laws, regional segments, etc - everyone has different complex needs.

Our job at Aetna was to turn a 200 digital property company into a single customer facing app. Aetna is becoming a software company.

Throughout my tenure, we redesigned the majority of this application across iOS, Android, and 3 web view sizes, 4 times. That’s 20 final iterations, if you’re multiplying correctly.

I lead Symptom Checking, Insurance Coverage, Doc Finding, Wellness and Rewards, Appointment setting, Telladoc creation, and an unannounced feature called “Just 5 Things” for preventative health.

 
 

Problem: How Do We Present Meaning?

Symptom checkers aren’t new. But they aren’t easy. Many times designers assume simple means better. John Maeda’s Laws of Simplicity state otherwise. Hiding complexity is better and in the case of healthcare, communication is also better.

On the left is a Google-like search bar. On the far right is more granular categories of things to search for.

A known of our users is that they don’t now what to search for. When is a “Headache” a Condition or a Symptom? We tested for granularity. And it won.

What you see is what you get.  This was the test for this UI.  User are concerned with the Google results page - too many options for things they don’t know about.  So I wanted to show them as they use our app.

Users can trust that we are finding BETTER answers for them - and less of them, more relevant answers, to get them to care.  This was the winning design of another 3 more being tested, all against the control example of WebMD+Google.

FUN NOTE: 2 years after this research and me leaving Aetna, this design is being implemented. w00t!

Health Tracks

This was the magic our president asked for - a concept - then came Apple’s Apollo project as an outcome.

But before that, this was the start of a design that tried to answer the question every user always has - “what do I need to do today?”…fill in the blank, to make me healthier, to manage my child’s care, to lose weight, to run errands.

Just 5 Things -OR- Next Best Actions

This is my tipping point.  I wanted something cliche, “an apple a day keeps the doctor away.”  Sounds silly, but it’s the best way to describe preventative care WHILE forming better habits of users.

Things is, users don’t know what they need to create a better habit and the healthcare system is sorely miscalculating the importance of personal effort vs. practicing standard of care.  One is for a user the other is for the doctor.

Remember that neural net of search - I asked to put it to creating an algorithm - based on search, medical records, and personal input - to generate things a user needs to do.

Some of these tasks are standard - such as annual physicals, eye exams, etc.  Others were based off a surgery you’ve had, or perhaps about your children’s health.  Aetna new all this.  Why would I hide it’s value from the user!

This earns trust.

There is no silver bullet

So besides the tasks, our amazing search algorithm was always available.  The more a user interacted (which was a success metric), the smarter our math got.  I need users to do a little work and I never overwhelmed them with learning.

 

Because I had the information for them - I put the medical practices in front of them.  This makes for less patient questions and even better - it makes for more relevant questions at the point of care.

Next Steps

Each step can have micro lessons associated.  A health track or pathway.

Why?

Users shy away from action because healthcare is so complex.  But now, there’s no guessing or at least, there is much less guessing, equaling confidence + trust.

Aetna

Productizing conditions or scenarios (cohorts) can start building a larger content bucket filled with more personal ways to engage for best outcomes.

Episodes of Care + Apple

This is how I got Aetna and Apple to play together.

Episodes of care are the most costly parts of an employers healthcare package as well as the difficult times for producing good patients.  Good patients are defined by how well they follow a doctor’s instructions.  HINT:  we all mostly suck at it, and not because we don’t care or are stupid. :-)

I asked our data scientist, if most businesses try to develop for the masses - is the 80/20 rule actually backwards for Aetna.  Turns out that hunch was right - and with some really cool research, I learned that 2% of patients make up 80% of Aetna’s waste.  Think of big surgeries with older patients.

 

Gamifying and Personalization

Showing a user that Aetna is always working safely and securely with their sensitive data.

Problem: Making Every User Feel Important

The good thing about data is that it’s fast - it doesn’t really take much time to calculate or gather a user’s health data.

To help the user feel important as though Aetna was doing “a lot” for them, I wanted an on boarding process that gave them time while showing them it’s secure.

 

Problem: Starting Tiny Habits with Choice

Before you can simply “give” someone a goal, they need to feel like it’s part of them.

I start with asking a question and while the user tells me personal information, they are rewarded - always feeling important and progressive.

 

Problem: First Time User Experience

I wanted to the user to feel in control and productive.

Making sure they see what kind of user they chose and prime them with a small modal as to what they can do vs. taking over the screen - which can feel daunting.

 

The Bell and The Drawer

A system of communication through 4 design patterns. Making our app consistent and simple.

Problem: Stop Making The User Think

The Navigation system I created at 4 parts.

Each part is designed to nothing is in the way of the user, they don’t have to ask, “Where am I?” or “How do I find that?”

Masthead is to show a user there is something to do, but they can make the decision.

Notify is to give a user information in realtime without covering the screen or looking like system prompts that always get ignored or closed.

Learn is a small window that is used to prime a user for something they can do or not.

Act is a large window to give the user context without having to go pages deep into an app.

 
 

Problem: Covering and Uncovering without transitions

I didn’t want a bunch of screen transition, having users use back buttons all the time.  Or have them remember “where am I?”

These modals swipe up and down for context based on the screen underneath.

 

Problem: How does a user know what action to take?

Some parts of the healthcare system require specifics, and this helps us create streamlined flows for users.

This also allows us to step a user through that system, without having to guess what information is needed or when it’s needed.

The questions of WHAT and WHEN are quite important in healthcare systems, more than HOW and WHY.

Anyone know why?

 

iTriage - purchased by Aetna

Mission = to save the ER costs by $750MM per year by getting patients to the right level of care at the right time.

Left is FROM and right is TO.  But it was the first time the design team was able to change the culture.  (No small task)  We brought design thinking and multi-scrum-team support to the front lines and produced something we were proud of, on a deadline of course.

I lead all user testing and research, design sessions, speed sketching, and stake holder communications, design review and design to development maintenance.

Simplifying Home

At first there were too many options to a user and user was hidden at the top.  We simplified a user's options from 7 options to 2 - both of which are our core compitencies.

 

Grouping Results

Not only does scrolling through hundreds of results, a user doesn't know what they are looking at or for.  Grouping results by medical types make it easy to understand which is most relevant.

 

Digestible Information

Clicking back and forth to read important medical content is not optimal.  So with a simple scrolling card view, a user stays within the medical context while the Find Care option sticks to the top - this way, when a user believe this may be the condition worth checking out, they can find a provider at any time and get care.

 

Maps and Lists

Bust lists are hard to read.  And users, sometimes, need to make a decision quickly.  We added a map and simplified list items making it easy to understand the best choice compared to where the user is on the map.

 

Getting Care

Getting care is the most important function of iTriage.  How does a user know a green check is good or red X is bad?  I still don't know what they mean.  So, we re-categorized care options so a user can understand what's best and compare costs.

 

Beautiful Homepage

I love big web.  

We needed a user to understand there were two very distinct functions of the site and they were just 1 click away from either.

Simple choices to understand how to find care, quickest.

 

Almost copied Google

We needed a big map and a long view for lists.  

We looked at Yelp, Zillow, Google, and Apple.  

We still don't have it all right.  But this map makes finding a doctor much easier than no map at all.

The scale of the list allows us room to add pricing and other insurance information relevant to a patients needs. The trick is finding a clean database with said information…surprisingly tough in the health insurance industry.