Predicare
Enabling back-office nurses to perform patient triage operations with improved efficiency.
Healthcare
Enterprise App
Project Details
Healthcare
Enterprise application
Nov 2022 - Jan 2023
My Role
UX research
Analysis, Solutioning
Wireframing, Visual design
Team
Akash Raje (Lead)
2 Designers, 2 Developers
Software Architect, PM
Business analyst, SME
Deliverables
UX research artefacts
Workflow diagrams
Wireframes
Interactive prototypes
OVERVIEW
Predicare is a U.S. healthcare platform that empowers back-office nurses to identify life-threatening health issues early on, and enhance patient longevity through personalized care. It utilizes AI for health plan administration and fraud detection.
The design engagement involved 3 designers to revamp the outdated legacy system developed in the early 2000s.
This case study demonstrates the patient case creation process workflow within the application
PROBLEM STATEMENT
The application enables payers to facilitate savings through continuity of patient care after discharge, claims review, negotiation, and patient education. However, —
Due to the absence of team collaboration and an efficient case management process, the system requires extensive manual work and consumes considerable time to accomplish non-clinical tasks.
DESIGN PROCESS
Given the timeframe of 12 Weeks, the BA and I devised a plan encompassing —
User Interviews
Task Analysis
Ideation Workshops
SME Reviews
Hi-Fi Design
USER RESEARCH
The objective was to comprehend users' daily tasks, difficulties, and uncover their goals and motivations in relation to the system's behaviour.
Creating user interview guide facilitated the interview process and encouraged users to express their pain points with the system.
The major hurdle was to —
Understand the processes without being able to use the application due to privacy policies (HIPAA). To tackle this, I carefully analysed detailed walkthroughs and compiled a comprehensive report to align our cross-functional team.
ANALYSIS
Next, we created research reports to document our interview observations and categorized the information into key findings, system's pains and gains, and recommendations.
These artefacts alongside user personas were used to validate the reasoning behind our design decisions.
KEY INSIGHTS
The current process within the system isn’t a failure. However, its a great efficiency killer.
The system demands contemporary look and feel, and improvements in form and behaviour.
Users engage in mundane tasks and constant back-and-forth to navigate fragmented information.
IDEATION
Brainstorming workshops helped us to redefine the workflows to eliminate manual efforts. For e.g. we decided to automate data entry aspects of the case creation process, followed by employing predictive analysis to identify member's care gaps and preparing a care plan.
We collaborated closely with the architect, developers and BA to gain insights into technical restrictions and business perspectives.
After finalizing the workflow diagrams, we stitched a prototype with accurate data to effectively communicate the experience to our business partners.
Wireframes played a crucial role in conveying ideas and functionality to partners and SMEs during review-sessions. Following 4 iterations, we transitioned to the design phase.
#0746B2
#125C35
#E0092F
Following the engagement, the client's parent organization took over the second phase of development.
KEY SOLUTIONS —
Automating the calibration of data from various organizations to create a consolidated master report.
Transparent collaboration for efficient case assignments and quick access to extensive patient information.
Utilized predictive analysis to identify care gaps by analysing EHR data and propose unique care plans.
IMPACT
Automated 40% of non-clinical routine tasks while ensuring end-to-end HIPAA compliance
Reduction in cost by ~14% for high-cost claimants through plan refinements.
23% reduction in allowed medical costs through claim reviews for medical necessity.
KEY TAKEAWAYS
Conducting remote user interviews proved invaluable in identifying underlying pain points, though we encountered challenges with certain users reluctant to enable webcams, and it was difficult to establish their comfort.
It was the first opportunity for me to lead 2 juniors, that included managing the task assignments, design reviews and setup a visual direction.
The project was fast-paced, but it taught us how to function efficiently under time constraints and adapt processes as needed, all while staying focused on our objectives.