Sr. Design Strategist / Consultant, AWS WWCO ProServe, Gen AI Specialty Practice
Sr. UX Consultant, TATA Consultancy Services
McKesson Pharmaceuticals
Concentra
Redesigning case management systems to enhance efficiency, unify disparate systems, and break down monolithic architectures for improved performance.
This initiative with Concentra aimed to modernize their outdated systems by dismantling old monolithic structures and fostering a more streamlined architecture for enhanced system communication. Anyone familiar with medical billing understands the longstanding challenges of maintaining consistent and accurate patient data. The project, demanding robust security and heightened system availability, was no minor undertaking. To conceptualize the new design, we initiated the process with a comprehensive 3-day onsite workshop. During this intensive session, we delved into the specifics of four critical systems: Occusource (patient admission), billing & finance, patient checkout, and referral management. Through a series of journey mapping and feature-defining exercises, we engaged key stakeholders who brought deep knowledge of each system, ensuring a well-rounded and informed approach to the redesign.
The screens displayed below are the culmination of weeks of dedicated effort in identifying the essential requirements of the system and arranging them in a logical flow. This meticulous process was aimed at effectively narrating the sequence of actions within the system, ensuring that each step is clearly understood and efficiently executed.
With McKesson Pharmaceuticals, the project scope was similar but the design challenge was significantly greater. The existing system was notably unstable, and caseworkers had resorted to creating numerous workarounds to manage daily system challenges. Its outdated interface resembled something from the Windows '95 era, with certain functionalities buried under up to seven layers of parent-child relationships necessary to access critical data points. As we embarked on redesigning the system from the ground up, one of my core principles was at the forefront: maintain a sense of familiarity for the users. It was crucial to ensure that the new system did not stray too far from the user's scope of familiarity, as doing so could risk them reverting to old habits. The goal was to introduce a system that felt familiar yet significantly easier to use, smoothing the transition away from their cumbersome legacy systems.
The introductory screen featured above has been designed to facilitate easy access to patient data for case reviews. A notable enhancement I introduced is the tabs at the top of the screen, which allow users to have multiple cases open simultaneously. This capability was not available in their previous system and represents a significant improvement, offering increased efficiency and flexibility in managing patient information.
The next logical step in the workflow is to access the Physician details related to the case. This section consolidates all relevant information about the healthcare provider, ensuring seamless integration and quick access within the overall case management process.
This is the clinical section of the case management system, which outlines all pertinent details regarding procedures and tests recommended by the physician. It serves as a centralized hub for all clinical data, ensuring that healthcare professionals can easily access and review necessary medical information to make informed decisions.
When you click into one of the case files, you are presented with a comprehensive array of details about the patient's case. Previously, this information was not centralized but scattered across different parts of the system. This dispersion led to inefficiencies and considerable time wastage, as patients waited while case managers navigated through the system to gather necessary details. The new design consolidates all relevant information into a single, accessible location, streamlining the process and significantly reducing wait times for patients.
This section serves as a comprehensive repository for all documents related to the patient's case. It features an intuitive system that allows caseworkers to seamlessly integrate and associate documentation with specific case details. This functionality enhances the accessibility and organization of related data, making it straightforward for caseworkers to retrieve and review documents pertinent to each case.
The Patient Assistance Program is an initiative either operated directly by or in collaboration with pharmaceutical companies, designed to offer medications at no cost or at a reduced price to low-income individuals who are not eligible for other forms of insurance or assistance, such as Medicaid, Medicare, or AIDS Drug Assistance Programs (ADAPs). Although this stage of the process is optional and tailored to individual patient needs, it is a crucial component that must be addressed before a case can be officially closed. This ensures that all potential aid options are explored to support the patient's healthcare needs effectively.
In conclusion, the projects with Concentra and McKesson Pharmaceuticals represented significant strides in transforming outdated systems into modern, efficient case management solutions. For Concentra, the redesign focused on decoupling monolithic structures to foster better system communication, while McKesson faced a more extensive challenge of stabilizing an unstable system and centralizing fragmented data. Both initiatives involved crafting user-friendly interfaces that retained elements familiar to users, preventing a revert to old habits. These efforts not only streamlined internal processes but also substantially improved the user experience for caseworkers, enabling them to provide faster, more reliable service to patients. The success of these projects underscores the potential of thoughtful system redesign to enhance operational efficiency and patient care in the healthcare industry.
