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
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.
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.
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
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