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Helix patient communications

Boosting revenue by ensuring at risk patients attend their appointments

Summary

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 (Designer), Shanthini Prassana (PM), Graeme McLaughlin (Solution Architect), Evon Dos (Tech Lead)

Automate processes

Safe and reliable experience

Drive revenue

My role

Solo designer (research, UX, UI, 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

Why patient communications is so important for practices

Medico-legal compliance

Deliver effective care

Communication channels

Patients rely on communications channels to schedule, confirm and attend appointments as well as to receive information and results

Burden of care

Practices have a burden of care to ensure that at risk patients attend their consults and can be liable if they don’t

Attending appointments

Ensuring patients attend appointments and avoiding no-shows maximises revenue and makes the most use of the scarce availability of doctors

Maximise revenue

User research

9

Participants

Youth Mental Health

Semi-structured interviews

General Practitioners

Overview

We wanted to dive deep into the attitudes, behaviours and goals of practices around patient communications through users interviews

What we wanted to understand

  • The reasons practices were contacting patients, at what point in the consult and what they were sending
  • Different requirements for general practitioners, specialists and youth mental health
  • When are practices sending messages to individual patients or groups

1

Hour

Specialists

affinity mapping of user research insights
flow diagram showing how communications functions in medical practices

Understanding the communications process showed areas to target for improvement

summary

Through user research, workshops and consulting with subject-matter experts, the process could be mapped out and key insights about the area could be established

A large amount of messages sent were tied to appointments

Booking an appointment, reminding patients of appointments and billing follow-ups are important patient communication occasions

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

Although tedious and time-consuming, ensuring it is done effectively has consequences for patient care and medico-legal obligations

Different patients groups require different levels of communications

Vulnerable patient groups such as those with chronic conditions or young patients require ongoing and detailed communications

user journey for patient communications
flow diagram showing how communications functions in medical practices

Where Helix was falling short

summary

Areas were identified where Helix was not adequate for practice needs. In the current state practices were resorting to calling patients manually, a huge administrative burden that’s difficult to document.

Dealing with high risk patients

For some practices ensuring patients were prepared for and attended the consult was incredibly important such as 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

Current system was too inflexible leading to low uptake

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

original design for appointment reminders
flow diagram showing how communications functions in medical practices

Design direction

summary

Speaking to our users there were three key flows when practices needed to communicate with patients that guided the design direction

Messaging groups

Appointment reminders

Messaging individuals

Three goals for design phase

  • Reduce time spent by automating and streamlining where possible
  • Messaging must accommodate when and how often practices could contact patients
  • Accomodate for flexibility
mapping out message flow
flow diagram showing how communications functions in medical practices
messaging from the appointment calendar
flow diagram showing how communications functions in medical practices
Dashboard for appointment reminders
flow diagram showing how communications functions in medical practices

Messaging groups of patients

summary

The appointment calendar was the ideal location to message groups of patients for unplanned events such as cancelled appointments or practice closures

Why it was placed in the calendar

  • Reception staff spend most of their time in the appointment calendar allowing easy access
  • Practices want to send things in one-off situations e.g. the practice is closed or sending information to group appointments
  • It can accommodate finding patients by appointment details rather than having to find patient names

Flow of sending a group message

summary

There were important considerations and design decisions at each step of sending a message to groups of patients

Search for patients from their appointment details

  • 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

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

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
SMS-modalSMS-modalsms-modal

Design challenges

summary

There were several challenges that needed to be addressed through ideation, prototyping and user testing

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

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

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

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

SMS-modalSMS-modalsms-modalsms-modal

Appointment reminders

summary

So much of what practices wanted to send was appointment based, so an automated messaging system for patients was created

Why appointment reminders

  • Tying messaging to patient appointments allows practices to “set and forget”
  • Customisation allows practices so send different messages based on appointment types and practitioners
  • Is a key way to ensure that patients attend consults
setting up a new appointment reminder
flow diagram showing how communications functions in medical practices

Appointment reminders dashboard

Provides overview of reminders that have been set and their details

  • When they are sent
  • Appointment types
  • Practitioners
  • If patient can reply
  • If it’s enabled or disabled

There are four categories of appointment reminders

  • Appointment status
  • Before appointment
  • At time of booking
  • After appointment
appointment reminders dashboard
flow diagram showing how communications functions in medical practices

Adding a new appointment reminder

sms-modal

When to send reminders

User research indicated three important situations for sending reminders

  • Before appointment
  • At time of booking
  • After appointment

Send for different practitioners and appointment types

This allows the practices to set up messages for specific scenarios and situations, allowing automation to a greater degree

Special case appointment reminders

summary

So much of what practices wanted to send was appointment based, so an automated messaging system for patients was created

sms-modalsms-modalsms-modalsms-modal

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

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

Did not attend

  • Triggered if a patient does not attend an appointment
  • Allows practices to follow up for a cancellation fee or re-book

Design challenges

Adding in ‘enabled’ checkbox

  • Practices wanted the ability to ‘turn off’ appointment reminders without deleting e.g. 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 accommodate this
  • For the final design only ‘Practitioner’ and ‘Appointment type’ remained
final dashboard design
flow diagram showing how communications functions in medical practices

Choosing between cards or table layout

  • 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
    sms-modal

    Outcomes

    summary

    This project was still in beta when I left the company so all outcomes are not available however many key objectives were achieved

    Prevented corporate client churning

    A large client received early access to beta and renewed their contract with the software due to the new funtionality

    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 utilising Helix messaging more with the new system

    Learnings

    summary

    This project was undertaken on short notice and was high priority so the project was adapted to these circumstances. This resulted in important learnings for this situation

    Importance of co-design

    Consistent contact with users through all stages of this project was essential for it’s success

    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 outcome

    Staggering design into stages

    Time constraints necessitated staged design phases, however this resulted in a less cohesive product in the end