Principles of Virtual-First Primary Care

JUNE 2020

Goal Depict the vision and experience for virtual-first primary healthcare for insurance members

Role Strategy and Research Lead

Client Fortune 5 health insurance provider / payer

Scope 3 months, $400K, 3-person team

Envisioning the front door of virtual first care

Envisioning the front door of virtual first care

 

Business Challenge

How can of one of America’s top health insurance payers realize the potential of virtual care for its commercial members while aligning with current operating and business model requirements?

Project Goals

  • Capture and articulate virtual-first opportunities for both business and members

  • Understand and envision the tools that deliver the right type of care, at the right time, in the right place, by means of the right person or resource.

Approach: Qualitative Design Research

Research plan for screener and recruiting for testing interviews.

Research plan for screener and recruiting for testing interviews.

Framing hypothesis for testing: what do members need to see and believe to build rapport and trust in a care system?

Framing hypothesis for testing: what do members need to see and believe to build rapport and trust in a care system?

 
 
 

LEARN & CAPTURE

Stakeholder and end customer interviews to understand the current virtual care experience through:

  • 14 remote, 1:1 member interviews

  • Across 4 regions of the United States

  • In 2 research and design sprints

  • 10 payer stakeholder interviews across enterprise

DISTILL & FRAME

Analysis of client market, competitor, pricing model data and insights from qualitative sessions to identify internal virtual care services/offerings that could help members access quality care while reducing costs and burden for providers and payer.

ENVISION & COMMUNICATE INSIGHTS

Informed concepts and journey that depict a compelling story of how the business will engage and interact with members in the future to help drive effective, efficacious virtual care usage and value for members.

Key Findings from Research

Opportunity to smooth the curve of delayed care: seeing a doctor is often the last line of defense.

Opportunity to smooth the curve of delayed care: seeing a doctor is often the last line of defense.

Members choose care paths based on urgency and familiarity.

Members choose care paths based on urgency and familiarity.

 
 

Insights that informed product decisions

Seeing doctor is often the last line of defense.

Ideal experience considers lower risk, lower cost* interventions earlier for members who are currently “sticking it out” until symptoms feel severe enough to see a doctor. (For members, cost is both time and money)

Urgency and familiarity of symptoms determine which care path members want to pursue.

Ideal experience provides members both asynchronous for and synchronous virtual care options to meet what they need for familiar (chatbot, speed to resolution) and unfamiliar symptoms (provider, diagnosis).

Members want care continuity on their issue whether it lasts hours, days or years.

Ideal experience ensures continuity across the experience especially if different care team members are involved.

Outcome

Excerpt from Member Ideal Journey

Excerpt from Member Ideal Journey

 
 
 

Impact

Client anticipates virtual care as a 2022-23 plan offering. Final deliverable is currently being socialized with both internal and external partners through a physical installation at headquarters.

Deliverables

  • Journey maps (un/planned care un/familiar symptoms, and chronic care)

  • InVision click-able prototype

  • Roadmap with vision statement

  • Above installed in a socialization room at Payer Headquarters

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