Designing a better provider search experience
The struggle is real when it comes to finding a new doctor. It’s not enough to discover someone who treats your specific health issue and has an office close by. You also have to make sure that doctor accepts your insurance, takes new patients, and has appointments available sooner than six months out.
At Oscar, helping members find doctors and drugs that are covered is a core part of our member experience, one we’re constantly working to improve. Whether a member calls their Concierge team for help, or searches for care options on their own, we want to make it easy and painless to find the right resource at the right time.
Our product team recently spent several months overhauling the provider search feature in our mobile app. Let’s take a look behind the scenes at how business stakeholders, design, and engineering worked together to build a better way for members to find care.
Goals of the redesign
The project began with an internal working group that included participants from the Design, Product, Risk, and Network teams, as well as Oscar’s CEO. This group defined the primary goal of the redesign as making search results more useful for members who use our app to find doctors.
To achieve this goal, the team focused their efforts on revamping search results pages and doctor profiles on mobile to surface the most relevant doctor information, help members compare doctors, and reduce friction in the appointment booking process.
“What we really optimized for are the functional aspects of finding a doctor: Locating someone who treats your issue, has an office nearby, and has an appointment in the near future. These are the primary ‘jobs to be done’ from a product perspective,” says Lukasz Mosakowski, Senior Product Manager.
From an engineering perspective, there were two concurrent goals: Move to a new data ingestion system to improve performance, and rebuild the doctor search feature in React Native to streamline the development and testing process. Baptiste Truchot, lead Software Engineer on the project, says, “There’s a huge benefit of building all these things at the same time. Since we needed to write the new results pages from scratch anyway, it was a good time to migrate the backend components as well.”
Research and testing process
Earlier in 2017, Lukasz kicked off the research process by fielding some early interviews with Oscar members. Over the course of his conversations, he learned about what information is most valuable when evaluating a doctor. He also learned that the way people search for doctors is really inefficient, usually involving multiple rounds of googling, web research, and review site trolling.
This first round of user research informed the initial prototype that Gabe Schindler, Product Designer, put together. He and Sahir Jaggi, Product Manager at Oscar, then ran another round of user tests with members.
The main improvements included:
- The addition of doctor photos/illustrations, member ratings and feedback, and more in-depth booking availability.
- A more intuitive and explicit navigation between the list and map view.
- Doctor speciality and reason for visit information added to the top of the page to set the context for a user’s query and remove repetitive info on search results
- Surfacing the location of a query front and center in the list and map view to reinforce the user’s search context and allow them to easily edit it.
- Replacing specific (often inaccurate) cost estimates with a dollar sign system.
- New visual treatments for both the list and map view.
“We did a lot of testing to explore the best wayfinding visuals to help members quickly scan the page and internalize the information,” says Gabe. “It’s challenging to show all of this data without overwhelming users, especially on mobile.”
Through the user testing process, the team learned a few key things:
- Members care more about finding a doctor who’s nearby with availability than picking a “top” provider, at least for basic health care needs.
- Members like doctor ratings, but want to see specific comments from members as well.
- Members found dollar scale system to be a confusing indicator of cost, especially in health care. The team decided to cut this and revisit cost estimates in the future.
- Members like having a more flexible map experience where they can directly adjust their location and see relevant nearby results.
Iterative design & development process
For the new search results pages, the team decided to tackle mobile first since on average, 63% of Oscar’s weekly active users use mobile to access their account.
Gabe says: “We use a really iterative product design and development process. Every new feature we release gives us a stronger foundation to build upon. For example, we started working on our mobile provider search results after we rolled out updated provider profile pages so we could surface some of that new data. Now that our mobile provider search results are live, we can look at how members interact with the feature and incorporate those learnings into the desktop version.”
Working iteratively has also given the design team more time to thoughtfully incorporate new visual brand elements into the desktop and mobile member experiences. Instead of having to overhaul every area of the product at once, the design team has been able to incrementally update the iconography, styles, and UX to ensure that each new feature is optimal.
Moving to React Native
“React Native allows us to build one shared codebase for iOS and Android. For new features, this saves us a ton of time because we don’t have to build everything from the ground up twice,” says Baptiste.
While React Native isn’t the best solution for everyone, it was a fantastic investment for Oscar. Since the data within our apps is so complex, we’ve chosen simple design approach that focuses on usability. Our team doesn’t need a lot of the platform-specific bells and whistles that other consumer apps often employ.
The other benefit of moving to React Native? It allows the engineering team to be much more flexible in terms of assigning and owning projects.
Baptiste says, “Our desktop product is already written in React. Now, we can assign any engineer to work on a feature across both desktop and mobile, instead of having three different people working on the same thing in three different ways. This allows us to move from platform ownership to feature ownership.”
The team has a long-term vision for the Oscar doctor search experience. This iteration focused on conveying functional information, convenience factors such as availability and location, and member ratings. Going forward, they’ll continue to build on the foundation they’ve laid with cost, clinical quality and additional qualitative member feedback.
A few of the big-ticket items on the docket for Q4 2017 and early 2018 include:
- Search results sorting. Members will be able to sort their search results by relevance, ratings, and distance. “Sorting will help members conduct searches in their preferred ways while also allowing us to be more transparent about how we’re surfacing doctors,” says Lukasz.
- Cost estimate ranges, revisited. “While we know cost is an important decision-making factor, we can’t add this information if we don’t do a good job of simply articulating what cost means to a member in a health care context, which is actually quite complicated,” Lukasz says. The team will be testing a few different ideas in Q4 to figure out which approach is most helpful to members.
- Appointment availability: The team is working to introduce appointment availability estimates into the app for more doctors.
- Reviews: Member reviews will be surfaced in individual doctor profile pages to provide concrete feedback and additional social proof.
We’re always working to improve the experience for our members and make health care less of a hassle with our technology. Stay tuned for more updates in 2018!
No longer can healthcare practices rely on the single appointment and waiting room process. Managers of healthcare practices of all sizes and types increasingly recognize that effective patient flow is key to increasing revenue and improving efficiency for the practice and providing a positive experience for the patient. As the business manager of a fast-growing orthopedics group explained, “We have to get this right.”
In our increasingly busy lives, the experience of going to the doctor or treatment center is no longer simply making an appointment, and waiting to see a provider. Attention needs to be paid to how patients can move seamlessly from check-in to clinical practice areas to check-out, so that providers can operate efficiently and maximize time with patients.
When patients are treated in facilities and practices that minimize undue waiting, make destinations apparent and transitions comfortable, they feel respected and cared for. The result is happy, well-treated patients and enhanced practice revenue.
Here are five guidelines, developed from our experience, for ensuring good patient flow:
1) Clearly define patient destinations
Signage is the key. It may be as simple as lobby or parking lot signs directing patients to the correct floor or door. It may be signs within a practice clearly distinguishing check-in from check-out, or segregating patients by type of service needed.
A suburban specialty practice group with four locations found that its patients prefer visiting their doctor at an older, smaller facility rather than the central office. According to one of the senior physicians it is because “they know just where to go. It is less stressful.”
2) Avoid bottlenecks
The most common bottleneck is at the traditional check-in counter. Operational and architectural changes can solve this.
Know your providers’ capacities and schedule accordingly. No matter what technology or floor plan you adopt, if your practice overschedules providers, patients will sit in a waiting area and fume.
Consider the strategic use of exam rooms. Know how many exam rooms a provider can typically handle at the same time. For many, it is two or three. Plan accordingly, then consider “swing” exam rooms—extra rooms allocated among several practitioners to absorb patients at times of high demand. These may be used to enable a patient to see a doctor on schedule, when another patient with a complex visit would otherwise cause a back-up in the schedule.
Be careful not to over-use extra rooms. Parking patients in an exam room and making them wait does not enhance flow.
3) Plan for logical traffic patterns with no crossed paths
Very often a patient checks in, sits in a waiting room, then must cross the path of new patients checking in on the way to an exam room. Plan instead for a traffic flow that moves patients sequentially through a visit without crossing paths or retracing steps.
Some practices now use “just in time” patient service. They have no waiting areas. Patients move directly from check-in to exam room; doctors enter the room from a separate entrance. Many more solutions are available depending on the size and configuration of the facility. Patients may move from check-in to financial consult to vitals to exam room to check-out without crossing other traffic paths.
In some practices, patients check in and check out at the same counter with the same staff members. Patients who have completed their visits often must wait while a staffer registers another patient. Departing patients do not appreciate this wait.
Moreover, if a patient must handle financial matters at check-out (or check-in), it can create an uncomfortable situation, and depending on the design, may violate Health Insurance Portability and Accountability Act privacy regulations. Use separate check-in and check-out areas, even if the functions are handled by the same staff members.
4) Consider internal traffic flow, including within the reception area
Provide touch-down stations where providers can write notes after a patient visit without going back to an office or nurses’ station. One practice prefers stand-up stations for doctors, located close to work stations where medical assistants can provide necessary back-up. These stand-up work stations keep doctors in the middle of the flow, enable them to complete notes quickly, view records, and then move on.
If you are in a multi-specialty practice, consider the hand-off between specialty areas. In some practices, patients must get dressed again, take an elevator between floors, and return to a public waiting area or otherwise disrupt their visit.
For one facility, the solution is a “warm hand-off.” A doctor walks with a patient transitioning from family health to behavioral health. The patient/doctor path is between two separate practice areas, but within the clinical portion of the facility. Thus, the patient perceives the transition as part of a single visit with no disruption.
The same type of transition can apply to patients moving from a clinical visit to physical or occupational therapy.
Let the movement of medical supplies contribute to a smooth flow for patients and doctors. Some practices prefer central
storage for medical supplies; some prefer that each room be fully stocked on a rotating basis so that every exam room or clinical area has all the supplies needed.
Some practices prefer carts, fully stocked, that are moveable to exam rooms as needed. There is no single correct solution. Focusing on how the availability of medical supplies affects provider performance and patient experience in the context of how your team functions will help create a solution that enhances workflow.
Consider pods, and reserved or rotating exam rooms. One practice uses exam rooms of various sizes, developed over time to fit into the facility and accommodate growth. One senior practitioner worked in only one exam room; others worked around him. Sometimes this creates a back-up—patients must wait for a room to open up.
Other practices prefer pods. Each practitioner has several assigned exam rooms close together. Generally, each pod is assigned to a single practitioner, but design is standardized, so substitutions are easy. Still other practices line up exam rooms along a corridor like beads on a string. Practitioners use any available exam room.
Many practices feel the pod solution is superior because it enables providers to work efficiently with multiple patients in a compact area and to have assistants working with patients close by. Some practitioners personalize their pods with color or thematic design—this also helps guide patients to their destinations.
5) Parking is part of patient flow
Parking is part of patient flow and can dramatically affect both patient satisfaction and revenue. One primary care practice took the extraordinary step of borrowing money to build a parking garage. In their small town, street parking was limited, and their parking lot could not accommodate all patient traffic.
Because patients could not find parking spaces, many were late for their appointments. Others gave up and became no-shows. Both practice revenue and patient satisfaction suffered.
In many suburban locations, the problem is not as severe, but is still chronic. Patients cannot find spaces or must squeeze into overly small parking spaces.
Another parking issue is an appropriate drop-off area. Can a family member pull into a covered space to drop off an elderly family member or patient on crutches? If so, you have enhanced patient flow and experience.
Whenever you are considering a new facility or improvements to an existing facility, consider parking carefully. You can be certain that your patients do.
Marisa Manley is president of Healthcare Real Estate Advisors (HCREA) in New York, New York. Send your practice management questions to [email protected].