A managed care company had an aging claims processing system used by many internal employees and wanted to find ways to improve user experience and increase efficiency.
- Co-design workshops
- Contextual inquiry
- Persona and journey mapping
- Usability test
- Web app design and development
- Data science, AI, and event-driven architecture
- Reduced number of clicks for CSRs to find answers to member questions from 23 to just 3
- Increased ease of use and non-duplicative member data
- Optimized APIs to deliver results instantaneously and reduce user wait time
- Built internal alignment and ownership among stakeholders and users in a consolidated solution
The Challenge: Many Roles, One App
A managed care organization had one application that was used by several different roles within the company including healthcare referral specialists and customer service representatives.
With high burnout rates and turnover in these roles, the company wanted to provide a more personal user experience with better workflow management, alerts, and automation for their users while meeting stability, scalability, and integration requirements.
The Solution: Redesigned Bespoke Solution
The company partnered with 1904labs to redesign the one-size-fits all system to make it more specific to the roles using it day to day. Built a decade ago in Flash, the system struggled to keep pace with the massive growth of the organization and the number of users who were being added. We worked closely with stakeholders, users, and the client’s teams to redesign the application for their individual purposes and redeveloped it in Angular.
The entirely new modern, cloud-enabled solution was developed as microservices with data science, AI, and event-driven architecture built in. With a unified approach to each user persona’s activities, the web app was built to scale as the managed care organization continues to grow.
Our Process: Human-Centered Design Agile
Many of the system users were brought into the company through acquisition and spread across different states. Leveraging our HCDAgile process, we engaged in extensive employee research activities, allowing us to identify employee personas and observe how they accomplished their tasks within their real-world environments. We conducted extensive interviews, contextual inquiries, co-design workshops with users, and iterative design feedback sessions working with twelve different development teams across multiple locations within the company. Through these activities, we built alignment around a consolidated solution and gave more visibility and ownership in the final outcome.
For example, customer service representatives were using the app to answer questions from plan members and would spend over a dozen clicks across multiple systems and several minutes getting to the right answers. We worked with the CSRs to identify the most commonly asked questions and centered the redesign around the key answers they needed most, focusing on helping them get answers as quickly and accurately as possible to serve their members’ needs to the next call.
The Outcomes: Improved Efficiency, Ease-of-use, and Employee Experience
A tailor-made solution
We delivered a robust native web and mobile application We redesigned the application to fit the needs of the employees, focusing on minimizing their pain points and maximizing features that help them do their jobs better. The evolved product had a completely refined and simplified workflow, reducing redundant interactions, and eliminating the need to use spreadsheets and other peripheral applications alongside the system to augment data.
Enhanced speed and efficiency
With over 800 CSRs on the system alongside nurses, doctors, data entry, and more, optimized APIs deliver results instantaneously and reduce wait time. For CSRs, the new app reduced the number of clicks to find answers to member questions from 23 to just 3 (87% reduction in clicks).
The HCDAgile process brought users (CSRs, doctors, nurses, referral specialists, others) and stakeholders across the company together to better understand one another’s roles, challenges, and needs. Though each role had differing end goals, we worked with them to create ownership in and alignment around a consolidated solution, enhanced visibility across teams, and improved internal communication.
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