Find Care — Steven L. Caldwell

Who was the customer?

BlueCross Blue Shield is the only South Carolina-owned and operated health insurance carrier, we have been offering security to Palmetto State citizens for more than 70 years.

What was my role and responsibilities?

As the customer project lead I worked directly with the I/S team (developers, engineers, designers) with planning and managing the build out process. This was an agile project managed in Jira. Through weekly sprints I recommended which task would be worked on weekly.

As lead UX Designer I worked with the designing team designing the prototype for the application (mobile and full site) that was used in the first phase usability testing. As UX designer I also led a monitored usability study including developing the task and developing the summarization for our senior level staff.

The Challenge

Prior authorization is the process to approve services before using your benefits. Through the process, there will be a review your benefits and the clinical information related to the services requested.

Prior to developing the prior authorization tracker members were only able to track the status of their prior authorization by either calling in to customer service or awaiting their results by mail.

This caused a problem for members because of the delayed notification of the status. Members must wait for the approval to have procedures done or be able to pick up medicine.

This delay caused members to miss dates for procedures and lapse in getting their prescriptions filled.

The Design Process

The project started with an ideation session which included meeting with over 30 members of staff including customer service, providers and various line of business members. This was a two-day session during which we created 4 different low fidelity prototypes using Poster boards and markers.

We then narrowed the prototypes down to 2 prototypes. As the project lead I worked with a team of designers in iterations to design and build out a function prototype via Adobe XD. This process was done utilizing the agile method and weekly sprints to keep watch over the process.

After meeting with senior staff and performing walk throughs of the prototypes and discussing how it works I took their feedback and readjusted the prototype and started the usability testing.

Based on the ideation session and using the results of the usability testing I created a first phase design utilizing a mock up created of the application.

Using this first phase design I worked directly with Subject Matter Experts throughout Blue Cross Blue Shield on completing demos showing how the application enhancement will function in the real world.

Through these demos we were able to use the research obtained from these focus groups to fine tune the application design .

DESIGN CHANGES

There were no critical, show-stopper findings which prevented users outright from completing tasks.

However, there were several elements which severely hampered the participants’ ability to carry out ordinary

tasks:

Hard-to-read authorization numbers
A confusing list presentation of authorizations
Confusing statuses
Unknown acronyms
Confusion about the tracking bar colors and progress

Conducted June 18, 2019 at the Percival Road facility

Five participants were recruited; four had previous experience with authorizations

Four females, one male
Two African-American, three Caucasian
Ages: 23, 25, 46, 52, 55
Income: four in $25-49,000 bracket; one in the $50-74,000 bracket

With the results from the usability study we decided to make changes to the application to make it easier for the users to use. These changes consisted of a more organized filter feature which will allow users to filter by member and authorized status.

We also updated the cards to follow a more consistent standard with sizing of icons and styles used within the icons.

To compensate for the issues of unknown acronyms and confusing list of authorizations we removed acronyms from the application and instead used real worlds in all places including the forms details.

Update Colors to match MHTK
Decrease status title
Update font selection to match MTHK
Update filter

Usability Study

In conclusion the MyHealthToolkit application was launched for 150,000 customers using the MyHealthToolkit app. These users now have access to track prior authorizations and view details including the doctor details directly in their device. This upgrade will help members enhance the overall user experience when going through health issues.