An Exploration of Care Management
Introduction
Care management involves a team of nurses, service associates, and doctors working together to address patients' health barriers. They ensure that a patient's needs are met at the right time with the right care. Managed by insurance companies, the goal is to deliver the best care possible and recommend health programs to those enrolled in their health insurance plans. The beneficiaries span all age groups.​
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I worked on a part of this solution that focuses on the behind-the-scenes process. This involves creating systems that use data to follow business rules and show sensitive information to the users who communicate with the healthcare company's members.
Problems and Challenges
The project involved a large team with several stakeholders, including VPs and subject matter experts. Many of the modules were standalone products before.
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We had to navigate a platform filled with vast amounts of data and outdated research.
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The project lacked a clear timeline and scope.
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New branding guidelines had been introduced, but no clinical usability checks had been performed.
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It was a perfect storm for a UX designer’s nightmare. So, did my team and I manage to overcome it all? Not exactly...
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However, we've laid the groundwork to gradually immerse ourselves in understanding the product, define our scope, and pinpoint the actual issues within the current system.
Team Structure
Timeline
Due to a tight timeline, we were tasked with delivering solutions before fully understanding the domain. To address this, we defined an immediate scope and created a timeline ourselves. ​
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As we gained deeper domain knowledge through user interviews and stakeholder discussions, the team became better prepared to tackle complex challenges and recommend structural workflow changes to the platform. In the meantime, we focused on addressing heuristics and known issues, developing solutions for immediate problems through two-week sprints.
The Platform
The care management platform serves as a unified interface where trained nurses act as case managers, engaging with members (insurance payers) to address and resolve their health issues and barriers.
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Interactions are initiated either by the user calling the member or vice versa. Each issue follows its own workflow, with the sequence of actions determined by the phone interaction. The process appeared highly dynamic, with data privacy and process compliance further influencing the processing time.
Understanding the Domain and Workflows
We began with desk research to gather information on care management, competitors, and past interview files.
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To validate our insights, we consulted system analysts with technical expertise, who also shared survey data from platforms like Medallia. This helped us identify key opportunity areas.
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Next, we need to ensure that user opportunities align with our findings.
User Interview and Insights
To engage with users, SMEs, and researchers, exploratory interview sessions were conducted, and the recordings were shared with our team.
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The next step involved deriving insights and identifying key opportunity areas to focus on.
Instead of simply accepting business ideas and technical requirements, we presented our questions and doubts supported by initial research to the business team. This approach established the importance of involving users before undertaking a revamp.
Apart from technical limitations pointed out by users, 3 major themes emerged from insights
Personalization
Users want the system to adapt to their specific use cases and minimize manual effort.
Effective Communication
Users expect the product team to clearly communicate all features and explain how they can enhance their workflows.
Minimalism
The platform's data-intensive nature is causing excessive cognitive load. Users prefer to concentrate on tasks without any distractions.
Using research insights, the team began ideating features based on emerging themes that were mutually agreed upon by the business, development team, and SMEs, considering user needs and feasibility.
Feature Prioritization
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Allow users to filter and customize their workbench to suit their specific use cases.
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Enable users to select the necessary member details to minimize cognitive load.
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Simplify navigation to user tasks for greater efficiency.
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Introduce dictation functionality for long forms.
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From the ideations presented to SMEs and the business team, two key ideas emerged:
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Allow users to create a personalized workspace using a split-screen approach, enabling them to work on two selected tasks side by side.
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Since users were already using split tabs in their browsers to reference information while working on tasks, this behavior could be leveraged into a design solution.
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A proposed layout was created and shared with users for feedback.
First Iteration Samples
With the direction finalized, the initial iterations were presented to users.
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We observed that users prefer to focus on one task at a time but frequently reference information while taking notes.
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Additionally, we identified opportunities to link the Member Overview (on the right) to various workflows on the page, connecting it to all the tasks users need to complete.
Revised Iteration Samples
With the direction established, the initial iterations were shared with users.
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It was observed that while users prefer focusing on one task at a time, they often reference information when taking notes. Additionally, we identified opportunities to link the Member Overview (on the right) to various workflows on the page, connecting it to all the tasks users need to complete.
The existing technology couldn't automate or customize tasks for the user, so we provided a way for users to customize it themselves for specific tasks.
Review and Reflections
The newly introduced changes designed to support user workflows were well-received during the initial usability review and have been planned for future releases.
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However, the current case manager workflows remain heavily affected by technical limitations. Due to the complexities and compliance requirements, any proposed changes to the product are often met with skepticism.
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Following the success of our initial design interventions, the team gained confidence in addressing user needs and was able to explore the case manager workflows more deeply.
