Context

Improving the customer experience for Medicaid members and enabling innovative mindsets within the health company

*Due to confidentiality, some details have been removed.

A health insurance company needed to augment their innovation team to develop the pilot of a new service for their Medicaid members. The previous team had completed extensive research with parents, families, and experts to create a big-picture strategy to better support their members and improve health outcomes.

The research team identified that individuals classified as “low-risk” were an overlooked population who needed additional support to navigate health systems and assistance solving social determinant of health challenges. By applying a family-centric and localized lens, we needed to develop the details of the pilot service.

I applied my service design and design strategy skills to help with the desirability and feasibility of this new service. Specifically, I needed to take a systematic and holistic approach to design interactions between internal staff for the omni-channel service team and design a customer-centric program that met the unique needs of the region. I worked with a fellow service designer to develop and execute a pilot plan.

Developing the Customer Experience

Co-designing with front line staff to break down silos and create a customer experience strategy

We needed to define the details and nuances, so to achieve the best result, we co-created the service with the front-line staff and experts working everyday to serve the users. We knew from the research that staff across departments did not communicate effectively, and customers were often directed to different departments. We created a cross-department team working collaboratively to solve customers’ challenges that were negatively affecting their social determinants of health.

We planned and facilitated a multi-day co-creation session to bring together siloed departments to design each aspect of this program and develop consensus among the stakeholders who would be running the pilot.

One idea that came out of the workshop was to create a telemedicine hub and partner with schools to reach our target users. Through the co-creation session, we learned that community schools already act as a resource to engage communities, and through this partnership, we could provide the missing healthcare resources. Telemedicine would deliver healthcare services to an area that has a shortage of doctors.

Workshop participants had diverse perspectives and priorities, and the next step was to develop an implementation plan for the new services.

Encouraging an internal innovation mindset and implementing a new customer experience pilot

After the co-design session, we needed to refine the details and organize logistics to turn the idea into a MVP pilot test. We needed to identify opportunities for unique collaborations and find a path forward for this initiative despite all organizational constraints, friction, and bureaucracy that are common in healthcare.

Through this process we refined and filled in the gaps in the service blueprints created by the front-line staff. We continuously involved the project leaders in the decision making and development of the pilot program.

During this phase of the project, I had to answer:

How do we encourage an innovative mindset in the community partners and other departments we work with? How do we break down silos?

Healthcare is a complex industry with many differing stakeholders, and throughout the process we often had to advocate for the benefits of a human centered design approach. By supporting departments to work in new ways, creatively problem-solve through challenges, and leading in a mission-oriented matter to improve healthcare access, we were able to forge new partnerships and build a coalition across over 8 departments for this pilot.

During this project we had to be creative to get wifi to support the telemedicine hub at the community center despite it being located in a digital desert. We navigated policies and formed a coalition to forge a partnership between the health insurance company and the community school that had never been done before.

How do we design a service that meets the needs of users and front-line staff?

Through constant co-creation, iteration, and communication we developed a pilot service that solved user challenges and improved institutional efficiency.

What is the user experience and journey of a user?

I intentionally designed each step of the user experience--awareness, initial engagement, participation, and continued support. With a human centered approach, we developed an ideal user experience as well as identified qualitative and quantitative data to inform decision-making and continuous improvement.

Piloting the new service

Launching the new service with partners in an initial target market

With many new collaborations and partnerships, we launched the new customer-centric service.

We partnered with community schools to host a kickoff event to showcase the new telemedicine hub. We brought in mission-aligned partners and wrap-around services that addressed the needs of the community including legal services, telemedicine, food, family games, and our customer advocate team was available to help solve health challenges for families.

After the kickoff event, the telemedicine hub continued to have a physical presence in the community school center, and the front-line staff used an internal data platform to execute a calling campaign to educate, engage, and problem-solve for families.

Outcomes

Improving internal efficiency and customer experience to help customers gain improved healthcare access

I was responsible for proving success of the pilot through qualitative and quantitative success metrics, refining requirements, and managing the data of the large-scale pilot test.

Lessons Learned

*Due to confidentiality, I can share limited results from the pilot. The project is currently under review for scaling beyond the pilot phase.

By breaking down silos, front-line staff felt more engaged when working collaboratively with other departments to solve customers’ challenges. When armed with data, these teams were also more efficient (reduced average handle time by 54%), and this concept could be scaled across the enterprise.

During our co-creation, we had learned that customers are nervous and skeptical about telemedicine. By providing hands-on demos and education during our kickoff event, it resulted in an 81% increase in customer confidence in telemedicine. Although we learned the effort to host a unique event is not scalable, hands-on telemedicine demos could be added to existing community outreach events.