@ Amy Cueva

@ MadPow - Founder & Chief Experience Officer

@ HxRefactored - Chair of Design Track – April 5-6, 2016

CUSTOMER FOCUSED INITIATIVES

WHICH IS THE RIGHT ONE?

zzStrategy & Service Design

Behavior Change

Organizational Design & Training

Design & Implementation

Research & ValidationEMPATHIZE

ENVISION

MOTIVATE

TRANSFORM

EXECUTE

1.  Business Alignment2.  Experience Evaluation3.  Opportunity Prioritization4.  Experience Ideation and Validation5.  Experience Monitoring and Guidance

FOCUSING CUSTOMER EXPERIENCE EFFORTS

WHAT IS MOST IMPORTANT?

BUSINESS ALIGNMENT: 1

EXPERIENCE ECONOMY

IT IS AN

Increase top line revenue via: • Customer Attraction

• Competitive Differentiation

• Customer Retention

Increase bottom line revenue via: • Channel Migration/Self Service

• Informed Decisions

• Condition Management

BUSINESS OBJECTIVES

• Give me access to the best care.• Save me money.• Make things easy to understand.• Answer my questions easily and accurately.• Be easy to do business with. • Do the work for me where possible.• If there is something I should know, tell me proactively.• Keep up with my expectations for experience excellence.

CUSTOMER EXPECTATIONS

Explicit Intention: Figure out what is wrong with me.•  Initiated Interaction: Find a specialist.•  Motivation: Diminish anxiety. Feel better. Implicit Intention: Save money.•  Prompted Interaction: Review specific ways to save

money in the future.•  Motivation: Financial wellbeing.

EXPLICIT vs. IMPLICIT CUSTOMER INTENTIONS

SHARED VALUES + SHARED ACTION = SHARED PROFIT Cindy Gallop

(FINANCIAL & SOCIAL)

BIZ & CUSTOMER ALIGNMENT

Improved Rentention

Not having to learn a new plan

Satisfaction focused initiatives can yield loyalty and retention.

Decision support can deliver cost savings.

Business Customer

Cost savings via informed

decisions

Access to quality care with budget

in mind

SEGMENT ALIGNMENT

Health Status

Motiv

ation

Healthy & Motivated to Stay Healthy

No Conditions Yet but Little Health

Motivation – At Risk

Motivated to Manage a

Condition Well

Not Motivated to Manage Condition

Focus Initial Efforts Here

Masseuse

PCP

Support Network: Friends & Family

Pharmacist

Lawyer

Chiropractor

Health Coach

CSR

CSR

CSR

HR

Cardiologist

Nurse

Therapist

Weight Watchers

Gym

Lobbyists

Social Worker

Politicians

Lobbyists

Patient Advocate Translator

Financial Entities

Transportation Service

Heart Health Start Up

Hospital Network

Hospital

Cardiology

Lab

Pharmacy

Pharma

PBM Insurance Company

Insurer for Hospital

Federal Government

HHS

FDA

CDC

Legislature

Executive Branch

Employer

Condition Management Companies

Information: Google, Web MD, YouTube, iTunes

Condition Management Start Up

Walk in Clinic

Organizations & Non-Profits

Health Tech

Health Exchanges

State Government

Local Agencies

Health Communications

Patient Community

THE HEALTH ECOSYSTEM

JOURNEY ALIGNMENT

Brand Perception

Plan Exploration & Selection

Onboarding 1st Use Preventative Engagement

Episode Diagnosis Treatment Planning

Condition Management

Something Goes Wrong

HOW ARE WE PERFORMING?

EXPERIENCE EVALUATION: 2

Awareness of Health Problem Evaluate Whether or Not to Seek Medical Help Lab Test Sample Results and ResolutionWaiting PeriodSeek Health Care Solution

- RESULTS

-MAILROOM

- RECEPTIONIST

- LABRECEPTION

- BILL

- RECEPTIONIST

- LABRECEPTION

-DOCTOR

- PATIENT’S ROOM

-DOCTOR

- PATIENT’S ROOM

- LAB TEST REQUEST

-RECEPTION

- CLINIC- PHONE

COPAYFILL

PRESCRIPTIONSCHEDULE

APPOINTMENTGET DOCTOR

EXAMRESULTS INTHE MAIL

WAIT FOR RESULTS

LEAVESAMPLEREGISTRATION

CHOOSE LAB TEST SERVICE

PRESCRIBED LAB TEST

GET DOCTOREXAM

REGISTER/ COPAY

ANXIETY & DEPRESSIONWORRY

SEARCH SYMPTOMS

SCHEDULE APPOINTMENT

EVALUATE MEDICAL

NOTES

SEARCHSYMPTOMS

NOTICES THEY ARE UNWELL

HAVING A LAB TEST

WAKE UPAT DAWN

DROP KIDSAT SCHOOL

JOURNEY MAP

TOUCH POINTS

USER JOURNEY

LINE OF VISIBILITY

BACK STAGE

FRONT STAGE

INTERACTION ZONE

DATABASE LOG SAMPLE

-TRANSMIT TEST REQUEST-PERFORM TEST-LOG TEST-REQUEST PAYMENT

I feel really dizzy. This isn’t

usual.

Better go see my doctor.

It’s probably nothing.

I hope... I have to get a lab test?

How long is this going to take?

Oh, these results aren’t bad.

Let’s see what the doctor has to say

about it.

What a relief! It’s not cancer

afterall.

Though I still have minor things to be treated for...

Oh well...

ADHERE TO TREATMENT

At least

everything is under control.

Adjudicate

PAYEREMR

- BILL

Adjudicate

PAYER

REQUEST PAYMENT

ACCEPT REQUEST

TRANSMIT RESULTSTAKE SAMPLE

REQUEST LAB TEST/PAYMENT

EXAMINE / REVIEW PATIENT

HISTORYCHECK-IN

SCHEDULE APPOINTMENT

Oh, what a beautiful morning.

Those kids sure

are a handful!

I wonder what I might have? Is

it serious?

Is this worth a trip to the

doctor?

Which lab

should I go to? Which is best?

Hopefully this is quick and

painless.

All done, now all I can do is hope for

the best.

- PHONE

SCHEDULE APPOINTMENT

-DOCTOR

- PATIENT’S ROOM

EMR

EXAMINE / REVIEW PATIENT

HISTORY

-DOCTOR

- EXAMROOM

MONITER PATIENT

CONDITION

-PHARMACIST

- PHARMACY

- PRESCRIPTION

Adjudicate

PAYER

RECEIVE/FILLPRESCRIPTION

-PHARMACIST

- PHARMACY

-BILL-DRUGS

SCENARIO

THOUGHTS

ALTERNATIVEPATH

TOUCHPOINT

STAGES EMOTIONS

PERSONA

TASK

BACK STAGE PROCESSES

CUSTOMER NEEDS

HIERARCHY OF

Trustworthy

Easy

Kind

Meaningful

Very Cool Delightful

Relatable

Functional

BECOME STUDENTS OF THE PROBLEM, INCLUSIVE IN OUR APPROACH.

Method Spotlight

Humans are complicated. The richness of detail in the story provides both information and inspiration.

ETHNOGRAPHY

Method Spotlight

Considerations: Hierarchy of Needs, Cognitive Load, Emotional Intensity, Explicit, Implicit, and Unmet Needs, Mental models, Intended Pathways, Intervention Perception

ETHNOGRAPHY

will tell us where we need to FOCUS, where we are DOING WELL, and where we need to IMPROVE.

EMOTION

A SPIKE IN EMOTION IS INDICATIVE OF AN UNMET NEED.

Method Spotlight

TRIADING

Go to my Insurance

Company’s Website

Call My Insurance Company

Ask a Friend or Google

How do you find a doctor? Why?

Method Spotlight

STAKEHOLDERS Involve Stakeholders: Immerse Employees and Decision Makers in Research. Use Rich Methods like Diary Studies & Secret Shopper.

Method Spotlight

CALL CENTER Observation & Associate Interviews: What is driving calls? Context? Channel switching? How can they be handled better or avoided all togther?

Method Spotlight

POST INTERACTION SURVEYS Measure efficacy of pivotal interactions, but don’t forget to measure interactions that couldn’t occur.

Method Spotlight

ANALYTICS Understanding Customer Behavior: “There is a fundamental different between what people say and what they do.”

Method Spotlight

DIGITAL MATURITY Can our customer access most needed features while mobile? Do we have the ability to personalize the experience and make anticipatory design a reality?

STRATEGIC PARTNERS

PEOPLE

FAMILY & FRIENDS

SOCIAL MEDIA COMMENTATERS

WELLNESS SALESPERSON

STATE/FED LEGISLATION

STATE/FED REGULATORS

HR BENEFITS ADMIN

CONTENT CREATOR

INTERNAL SALES DTF/DSPOC

COMPANY CONTACT

UCCIIT

OFFICE ASSISTANT

3RD PARTY VENDOR

OTHER PATIENTS

GOVN’T ADMIN

BLOGGERS RECEPTION BROKER

HYGIENIST

DENTIST STATES VS. OVERSEAS

CONFERENCES

AT WORK

AT HOME

BENEFITSFAIR

MILITARY EVENTS

PROVIDER OFFICE

EXAM ROOM

WAITING ROOM

PARKING LOTS

COMMUNITY OUTREACH

TRAVELING

ONLINE

IN CAR

REMOTE VS. POPULATED AREA

CO-WORKERS

DEPENDENTS REPORTERS

RECOVERY

KIDS BEGIN DENTAL CARE

USE MYDENTAL BENEFITS

UNDERWRITING

ONBOARDING

CHANGE PLAN

CHOOSE DENTAL

TREATMENT

EMERGENCY PROTOCOL

BENEFITS SELECTION

ACCOUNT INSTALLATION

MEMBER REGISTRATION

MAKE AN APPOINTMENT

SUBMIT A CLAIM

INQUIRY

REFERRALMAKE A PAYMENT

HOME CARE & MAINTENANCE

ONLINE REGISTRATION

CAN CREATION

ACTIVE DUTY ACTIVATION

TRAVEL TO DENTIST

COST-ESTIMATOR

AUTHORIZATION APPROVAL

LODINJURY

STRATEGIC PARTNERS

INFO STORE

AUTHORIZATION SUBMISSION

LOD APPROVAL

MILITARY INSTALLATION

GRIEVANCES

SUBMIT AN APPEAL

AUDITS

GO TO DENTIST

FIND A DENTIST MOVING

PLAN/PRODUCTS

OPINIONLAB

NEWSCOVERAGE

COMPUTER

BILLS

COVERED SERVICES TABLET

EMPLOYER WEBSITES

PROVIDER AMENITIES

BENEFITSGRID

MY DENTAL BENEFITS

WEBSITES

MONEYPHONE

LETTERS (WEB APP)

MARKETING MATERIALS

CHOMPER CHUMS

PREDETERMINATION

GOOGLEMAPS

ID CARD

MEMBERAPP

SOCIALMEDIA

MOBILE APPS UCD WEBSITE

ENVIRONMENTS PROCESSES

DENTAL SUPPLY REP

PEOPLE

ORAL SURGEON

OTHER DENTISTS

PHARMACY

LAB

INSURANCE COMPANY

FAMILY

OFFICE MANAGER

HYGIENISTS

SPECIALISTS

RECORD KEEPING

TRAFFIC

PARKINGLOT

ADMINSPACE

OPERATING ROOM

LOCATION

WAITING ROOM

OFFICE ASSISTANT

RECEPTIONIST PATIENTS

SENDING EMAILS

FILINGCLAIMS

SCHEDULINGAPPOINTMENTS

FACILITY MAINTENANCE

GREETING PATIENTS

CREDENTIAL-ING

OBTAINING LICENSING REQ

CLEANING TEETH

BILLING PATIENTS

CONDUCTING PROCEDURES

BEING ON-CALL FOR HOURS

CONDUCTING EXAMS

PHONECALLS

ORDERSUPPLIES MARKETING

FAX

WEBSITE

MY PATIENT BENEFITS EMAIL

PRACTICE MANAGEMENT

SOFTWARE

MAIL

DENTAL EQUIP-MENT/TOOLS

PHONE

COMPUTERS NETWORK

ENVIRONMENTS PROCESSES ARTIFACTS

BANKING

PEOPLE

PARTNER ENROLLMENT DEPARTMENT

PARTNER SALES REP

TPAS

OTHER EMPLOYEES

DENTAL ELECTRONIC

SERVICES

IT SUPPORT

OTHER CARRIERS

PARTNER ACCOUNT

INSTALLATION

TRADEEVENTS

PAPER

HEALTH & BENEFITS FAIRS

OPEN ENROLLMENT

BROKER OFFICE

PRIVATE EXCHANGE

MOBILE

PUBLIC EXCHANGE

ACCOUNT INSTALLATION

MEMBERSHIP AND BILLING

PEGA SYSTEM ANALYST

OPEN ENROLLMENT

ENROLLMENT PROCESS

PERFORMANCE GUARENTEE

RESEARCH ON AN EXCHANGE

REVIEW CLAIMS EXP.

BILLING PROCESS

MEMBER COMPLAINTS

BROWSE ON THE WEBSITE

REVIEW OF LAWS

BILLPAYMENT

REVIEW NETWORK

SUFFICIENCY

DETERMINE FUNDING

NEED FOR INSURANCE

ONBOARDING EMPLOYEES

REVIEW OF COMPETITORS

FINALIST PRESENTATION

DETERMINE BENEFIT

BUDGETS

REQUEST A QUOTE

GEMUS

ERROR REPORTING

PREMIUMFILES CERTIFICATIONS

E-DELIVERY (ENROLLMENT)

SHARPOINT (MAINT. FORMS)

POLICY DOCUMENT

AGL (INSTALLA-TION & MAINT.)

DEMO-GRAPHICS CARD

SALES BROCHURES

GPA (POLICY) COBE (INSTALLATION TOOL)

GEO-REPORT

PRIVATE EXCHANGE

ELECTRONIC FORMS

ADMIN KITS GLI E-QUOTE

ACCOUNT MANAGEMENT

PORTAL

E-BILL

INVOICES

ELECTRONIC COMMUNICATION

PAPER ENROLLMENT

ENVIRONMENTS PROCESSES ARTIFACTS

DENTAL SUPPLY REP

PEOPLE

ORAL SURGEON

OTHER DENTISTS

PHARMACY

LAB

INSURANCE COMPANY

FAMILY

OFFICE MANAGER

HYGIENISTS

SPECIALISTS

RECORD KEEPING

TRAFFIC

PARKINGLOT

ADMINSPACE

OPERATING ROOM

LOCATION

WAITING ROOM

OFFICE ASSISTANT

RECEPTIONIST PATIENTS

SENDING EMAILS

FILINGCLAIMS

SCHEDULINGAPPOINTMENTS

FACILITY MAINTENANCE

GREETING PATIENTS

CREDENTIAL-ING

OBTAINING LICENSING REQ

CLEANING TEETH

BILLING PATIENTS

CONDUCTING PROCEDURES

BEING ON-CALL FOR HOURS

CONDUCTING EXAMS

PHONECALLS

ORDERSUPPLIES MARKETING

FAX

WEBSITE

MY PATIENT BENEFITS EMAIL

PRACTICE MANAGMENT

SOFTWARE

MAIL

DENTAL EQUIP-MENT/TOOLS

PHONE

COMPUTERS NETWORK

ENVIRONMENTS PROCESSES ARTIFACTS

ECOSYSTEMS

MEMBER

PROVIDER

EMPLOYER

BROKER

ECOSYSTEM AUDIT Evaluate each touchpoint against hierarchy of needs.

WHERE SHOULD WE FOCUS?

OPPORTUNITY PRIORITIZATION 3

STRENGTHS & WEAKNESSES What are the biggest experiential strengths, weaknesses, opportunities which represent current gaps and unmet needs?

EXPERIENCE QUALITY & FREQUENCY

Experience Frequency

Expe

rienc

e Qua

lity

Strong: Frequent Experience Contributor

Weak: Frequent Experience Detractor

Weak: Infrequent Experience Detractor

Strong: Infrequent Experience Contributor

PATTERNS Do the strengths and weaknesses manifest around a certain persona or intention, a particular part of the journey, a specific channel or tool?

FOCUS DEFINITION What tool, segment of the journey, or personas are our focus? What are criteria for measuring the success of those experiences?

WHAT EXPERIENCE WILL WE DELIVER?

EXPERIENCE IDEATION & VALIDATION 4

COLLABORATION

Diversity of participation helps form focus, iteration helps refine that focus.

CONCEPTUALIZATION Envision the journey and micro-interactions keeping customer intentions and needs in mind.

VALIDATION Will the design perform as we intended?

HOW DO WE ENSURE IMPROVEMENT OVER TIME?

EXPERIENCE MONITORING & GUIDANCE 5

is a byproduct of how we are organized internally to deliver it.

THE EXPERIENCE

THE MATURATION OF EXPERIENCE DESIGN INSIDE ORGANIZATIONS

Pretty Stick

EXPERIENCE PRINCIPLES

GUIDING

Trustworthy

Easy

Kind

Meaningful

Very Cool Delightful

Relatable

Functional

Consider how business decisions will impact the customer through a gut check or more involved surveys and analysis.

How many members will be effected, and how often?

Positive

Neutral

Negative

BUSINESS DECISIONS GUIDING

THANK YOU.

@ Amy Cueva

@ MadPow - Founder & Chief Experience Officer

@ HxRefactored - Chair of Design Track – April 5-6, 2016

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HotSeat

HOTSEAT tackles sitting disease through behavior change and game design

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CVS

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Molding Technology to Match Clinician Workflows