Helix patient communications
Boosting revenue by ensuring at risk patients attend their appointments
Overview
At Telstra Health I redesigned the patient communication system for the doctor’s practice management software Helix. This automated processes for practices, delivered a safe and reliable experience and drove revenue
Team
Hugo Dowd - User Experience Designer
Shanthini Prassana - Product Manager
Graeme McLaughlin - Solution Architect
Evon Dos - Technical Lead
My role
Solo designer
- Research
- Wire-framing
- UI Design
- User testing
Why this project was chosen for development
Major corporate client was at risk of churning
They were having trouble ensuring patients attended their appointments, as their practice’s dealt with at-risk youth patients this was essential for them
Customers were finding other solutions for patient communications
Our users were not using the native messaging system to send messages, rather they were either using other systems, or managing it manually. As practices pay per message sent, increasing the usage of the patient communication system drove revenue for the company
Aligned with product vision
A key market differentiator of the Helix product is it’s cloud infrastructure and automation capability in a market that is still primarily dominated by on-premises software
This project was an opportunity to modernise Helix’s communication system and drive revenue
Why patient communications is so important for practices
Deliver effective care
Patients rely on communications channels to schedule, confirm and attend appointments as well as to receive information and results
Medico-legal compliance
Practices have a burden of care to ensure that at risk patients attend their consults and can be liable if they don’t
Maximise revenue
Ensuring patients attend appointments and avoiding no-shows maximises revenue and makes the most use of the scarce availability of doctors
Understanding our users
Overview
We wanted to dive deep into the attitudes, behaviours and goals of practices around patient communications through users interviews
Interview structure
- Semi-structured interviews
- 1 hour
- 9 participants
Research goals
Understand
- Why practices wanted to contact patients
- At what point in the consult this would happen
- What they want to send
- When they send messages to practices or groups
- Different requirements for general practitioners, specialists and youth mental health
- When are practices sending messages to individual patients or groups
Who was interviewed
Included range of user roles and practice types
- Doctors, practice managers and reception staff
- Specialist, general and youth mental health practices
How patient communications was functioning for practices
To guide the design direction we needed to understand why practices wanted to contact patients, the content they were sending and when it was sent during the consult flow
A large amount of messages sent were tied to appointments
Practices wanted to message patients when they booked an appointment, when they needed to be reminded of an appointment or after an appointment for billing or reminders of medical care
Patient no-shows hurt practice revenue
Ensuring patients attend their appointments maintains practice revenue and avoids wasting doctor’s time
Patient communications is time consuming
Patient communications has important consequences for patient care and medico-legal obligations Ensuring it is done right is an important but tedious and time-consuming process
Different patients groups require different levels of communications
Depending on their specific needs the level of attention and detail varies Vulnerable patient groups with chronic conditions or young patients require ongoing and detailed communications
Where Helix was falling short
Dealing with high risk patients
For some practices ensuring patients were prepared for and attended the consult was incredibly important eg youth mental health practices with high risk patients
Dealing with appointments made far in advance
For specialist practices appointments were often made many months in advance and were difficult to reschedule, patients needed to be reminded at a longer timeframe to prepare and be able to keep a record
Uptake of the current system was low and it was too inflexible for what practices require
With only one text sent for all appointments, the current system didn’t have the flexibility to address all situations required of our diverse user base
Practices were resorting to calling patients manually, a huge administrative burden that’s difficult to document
Design direction to address Helix’s shortcomings
Speaking to our users there were three key flows when practices needed to communicate with patients that guided the design direction
Messaging groups of patients
There were situations when practices wanted to contact groups of patients for unplanned reasons
Messaging individual patients
Practices wanted to contact individual patients for unplanned reasons
Appointment reminders
A large amount of what practices wanted to send was tied to appointments
Three main goals emerged from user research that would guide the design direction
Reduce time spent
Automate and streamline messaging when possible
Address no-shows
Messaging must accommodate when and how often practices could contact patients
Appointment reminders
When one-off messages need to be sent allow easy access to it
Messaging groups of patients from the appointment calendar
The appointment calendar was the ideal location to message groups of patients for unplanned events such as cancelled appointments or practice closures
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A large amount of messages sent were tied to appointments
Practices wanted to message patients when they booked an appointment, when they needed to be reminded of an appointment or after an appointment for billing or reminders of medical care
Patient no-shows hurt practice revenue
Ensuring patients attend their appointments maintains practice revenue and avoids wasting doctor’s time
Patient communications is time consuming
Patient communications has important consequences for patient care and medico-legal obligations Ensuring it is done right is an important but tedious and time-consuming process
Different patients groups require different levels of communications
Depending on their specific needs the level of attention and detail varies Vulnerable patient groups with chronic conditions or young patients require ongoing and detailed communications
Why the appointment calendar?
Easy access for reception
Reception staff spend most of their time in the appointment calendar allowing easy access
Sending in one off situations
Practices want to send things in one-off situations eg the practice is closed, sending information to group appointments
Leverage appointment details
Finding patients by appointment details rather than having to find patient names
Flow of sending a message
Search for patients from their appointment details
Search by
- Appointment day
- Appointment time
- Practitioner
- Appointment type
Automatically brings in details from calendar
The selected days, practitioners and appointment types from the appointment calendar will be autofilled when sending a message
Selecting recipients
- Returns a list of recipients that fit the search criteria
- Displays information about the recipients
- Warn user about recipients that don’t have a phone number on their record or haven’t consented to SMS correspondence
Writing a message to the recipients
Start with a template or free-type a message to the recipients
Fields can automatically fill in patient-specific details
Placeholders such as the patient’s name or the appointment time can be automatically filled in from patient information
Design challenges
Preventing patients not receiving the message
To prevent errors the patients that didn’t have a phone number listed or didn’t consent to receive SMS correspondence were surfaced to the user
Warning users that patient wouldn’t receive message
If they were selected and the user went to sent it another warning would on pop-up, providing two warnings to the user
Selecting patient details fields
We gathered the information that could be used based on the patient and appointment details and included it in the fields
Ensuring patient details would be available
By basing the search on appointments ensured that the details would be available for the message when it was sent
Sending messages faster with message templates
What practices were sending to patients was often similar so templates were utilised so practices don’t have to write the message from scratch
Combining free-text and templates
Allowing users to select a template but also edit it in the modal balances speed with flexibility
Restricting template edit access
User testing suggested that practice managers wanted control of templates for error prevention and medico-legal risk so it was placed in the settings
Appointment reminders
So much of what practices wanted to send was appointment based, so an automated messaging system for patients was created
Why appointment reminders?
Automate processes
Tying messaging to patient appointments allows practices to “set and forget”
Allow customisation
Send different messages based on appointment type, practitioner
Ensure patients attend
Allow practices so send more messages to patients at different points in the consult flow
Appointment reminders dashboard
Overview of appointment reminders that have been set and their details
- When they are sent
- Appointment types
- Practitioners
- if patient can reply
- Enabled/ disabled
Four types of appointment reminders
- Appointment status
- Before appointment
- At time of booking
- After appointment
Adding in a new appointment reminder
When to send reminders
User research indicated three important situations for sending reminders
- Before appointment
- At time of booking
- After appointment
Accommodating when practices wanted to send reminders
Send the message based on the appointment types and practitioners to allow customisation and automisation for the practice
Four types of appointment reminders
- Appointment status
- Before appointment
- At time of booking
- After appointment
Special case appointment reminders
Additional appointment reminder triggers were added after feedback from user testing
Rescheduled appointment
- Sent when an appointment is rescheduled by the practice
- Informs patients of the updated details
Declined appointment
- Sent when the patient declines the appointment
- This is to confirm that the patient will not attend the appointment
Did not attend
- Triggered if a patient does not attend an appointment
- Allows practices to follow up for a cancellation fee or re-book
No patient reply
- Sent if a patient hasn’t responded to a previously sent reminder to confirm an appointment
- Feedback from users noted this as a particularly important situation for the practice
Design challenges
Choosing between cards or table
- Tables presented were more information dense and are better for comparing values
- Cards allow user to see info for a single reminder easier which was more appropriate for this situation so this was chosen
Determining card design
- The card component in the design system had limited options
- Many iterations of the cards were made to determine how best to display the necessary information
- Listing the number with icons meant that the cards were easily scannable
Adding in ‘enabled’ checkbox
- Practices wanted the ability to ‘turn off’ appointment reminders without deleting eg vaccine reminders during flu season
- The ‘enabled’ checkbox was added to accommodate this
Simplifying information architecture of fields
- Multiple iterations of the number of fields and their relationship to each other were tested with users
- Having more, interconnected fields was confusing for users
- For the final design only ‘Practitioner’ and ‘Appointment type’ remained
Outcomes
This project was in beta when I left the company so only limited outcomes are currently available
Prevented corporate client churning
A key client renewed their contract with the software due to this project
Positioned Helix as market-leader in automated messaging
The newly built messaging system allowed messages to be sent out in more situations with more customisation than our competitors
Higher usage of messaging system
Beta customers reported that they would utilise Helix messaging more with the new system
Learnings
Importance of co-design
Consistent contact with users was essential for the success of this project
Pushing to address design debt
Working around design debt and legacy design systems made design significantly more difficult - dedicating time for this would've improved the outcomes
Staggering design into stages
Time constraints led to staged design phases, resulting in a less cohesive final product