Reimagining the Health Insurance Member's Online Experience

By: Perry Carbonell December 2012

Table of Contents

1 Background ............................................................................................................................................................................................................ 3

2 Purpose .................................................................................................................................................................................................................. 3

The WHAT section

3 Design Concepts ..................................................................................................................................................................................................... 3

3.1 High Level Concepts ......................................................................................................................................................................................................... 3

3.2 Principles and Criteria ...................................................................................................................................................................................................... 9

3.3 Design ............................................................................................................................................................................................................................... 9

4 User’s Journey ...................................................................................................................................................................................................... 17

4.1 Initial Journey ................................................................................................................................................................................................................. 17

4.2 Subsequent Use ............................................................................................................................................................................................................. 19

4.3 Specific Features ............................................................................................................................................................................................................ 20

The HOW section

5 Nuts and Bolts ...................................................................................................................................................................................................... 23

5.1 Architecture ................................................................................................................................................................................................................... 23

5.2 Considerations ............................................................................................................................................................................................................... 26

6 References ........................................................................................................................................................................................................... 32

1 Background United Health Care’s (UHC) product and service offerings are extremely broad and have various touch points across the health industry. A key

challenge for the business is integrating these components to make the online business function as one. Solvers have been invited to come up with

innovative ideas to make the online experience simpler, more usable and personalised to it’s members.

2 Purpose The object of this exercise is to redevelop the online site in a way that engages the member to not only use the online offering once, but

encourages return visits and promotion to the broader community.

3 Design Concepts This section articulates the proposal for a fresh innovative approach to UHC’s online experience.

3.1 High Level Concepts Generally speaking, people intend to live long and healthy lives. We go for medical assessments to understand our health with the intention of

improving our current state. This entire process of checking your health is the backbone of Check Yourself; an application that checks the

member’s health in an interactive and playful way where users can measure their health against others and against medical facts. The assessment

provided empowers them to make informed decisions which integrates to the system’s main component – the Wellness System. These ideas are

graphically represented as follows:

3

Check-up

Pre check-up expectation

How did i fair?

• Own expectation

• Against others

Decision

Monitoring

4

1

2

2

3

5

The components of Check Yourself

5

Input

Processing Output

Interact

Checking

..translated online, these concepts will

appear as follows:

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An extended view of the new online world will have these additional components.

Dashboard

Wellness System

These components are the

backbone of the Wellness

System; a new system rich in

features and functionality.

Targets &

Schedule

Plan

Products &

Services

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And both systems have the core function of sharing. This function ensures members can share information with

people they know and trust.

From UHC’s perspective,

sharing ensures it stays current

and relevant with the times.

UHC is already information-rich. The challenge is to organise the information in a manner that engages the customer with an experience that provides

leading answers to questions. The tool therefore:

1. Creates a personalised interaction with the user

2. Drives the user to supply information they care about

3. Provides the user with (a) information based on their inputs and (b) information against other people with like characteristics

4. Provide the user with capabilities to create health targets and a schedule

5. Provide the user with capabilities to select a better insurance plan

6. Provide the user with services; such as monitoring their health and sending alerts

7. Provide the user with capabilities to share the information with other policy holders.

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And it has a lot of fun features!

3.2 Principles and Criteria

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Dashboard

Easy and can

be shared

Simple

Simplicity

Relevant

Personalization

Interactive

Engagement

Companion Frequency of

use

Easy

Services

Health Impact

Our Design Principle

UHC Project Criteria

3.3 Design

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s

Keep things Simple

People want tools and resources that are simple. The last thing people need is another complex tool to integrate with their busy

lives. What is required is therefore a simple and intuitive tool that is usable for all.

Check Yourself, a very basic

design with lots of space

Joe is male. UHC has this on record.

Updates are based on user credentials.

Perspective area

Demonstrates that we know the member

The # of people provides Joe with some perspective of

where he sits in context of the overall population.

These are conceptual designs that form the basis of end screen designs and IT development.

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Easy and can be Shared

The interaction with the user must be easy to encourage present and future use.

The concept of sharing leverages the current trend where people are allowed to share information with others they know and trust. The underlying premise is that if you don’t have time to check yourself, then others might just have the time to do it for you.

Joe’s last health records which he can change

quite easily.

The share function here allows Joe to share his

records with his daughter Ann. If Joe grants

access to Ann, then Ann can prompt her dad to

either take a new check-up, consider a new health

plan or even remind him to stick to his exercise &

diet plan.

Joe’s last check-up displayed online

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Relevance

The information presented to the user must demonstrate that we know the member at every point of the customer journey and

that we present information back that is relevant to them. This ensures engagement (a project criteria).

Health projections presented to Joe as a result of Joe

entering information online and based on UHC records.

Projections of the population are also provided to give Joe

context on how he stacks up.

These statistics provides Joe with some perspective

on how he measures up against people like him.

Targets are health goals for tracking progress

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Interactive

A good way of engaging the user is by making the system interactive. The design allows the member to make updates to their

information and allows UHC to capture the latest member records.

This allows updates to medical conditions for the user

Perspective area dynamically updates

based on user input

Joe can change information based on latest records

The member has no known medical condition recorded in

UHC database

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Companion towards better health

The new system partners with the member in their journey towards better health. It has features and functions that encourages

repeat visits. Additionally the online design has web and smartphone components to make it truly mobile; the member now has

access to check his progress at any time.

Joe can adjust his schedule on the fly.

Joe can adjust his alerts using a smart device.

Additionally his daughter Ann can also remind him

about his alerts (if Joe grants her access).

Joe can check his longevity projections using this

functionality

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Provides Services

There are numerous services by which the member can be rewarded for using UHC. The system integrates all tool and resources

UHC has as base and adds a new platform where all services are integrated and provided to the user.

Joe’s Diet schedule which he reminds him of

what he is allowed to have.

Joe’s exercise schedule where he can track

projection from actuals.

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DRIVERS. In order to persuade users to use the online system, the question from a user’s view point is “What is

in it for me?” Let’s try to test this.

The User

What’s in it for me?

UHC

Note that a user can either be a member or a visitor. Users must be registered online to have access to

the Wellness System. In contrast, anyone can access Check Yourself.

What’s in it for UHC?

User receives a simple, easy and interactive tool that

provides personalised information based on inputs and

past records. The user also receives relevant information

such as a comparison tool which they can measure their

health in context with medical facts and population

statistics. Another key feature is that they can share

information with people they are close to in order for

those people to receive alerts on their health.

These alerts are leading indicators; it provides health

projections to help keep the member honest. All these

features combined will encourage repeat visits and have

a positive health impact as UHC becomes a partner in the

member’s journey towards better health.

Promotes use of their system with member by:

- capturing latest records of members without delay;

- encourages engagement and repeat visits;

- sharing promotes interaction and therefore activity;

- recommending others has the potential to

accumulate new members;

- offering relevant products, services and advice.

4 User’s Journey This section details the user’s journey throughout the initial and subsequent use of both systems.

4.1 Initial Journey Check Yourself application is open to both members and visitors. However visitors will have to register to access the Wellness system.

Check Yourself application provides the use with the ability to check their health against UHC ecosystem of tools and resources. As UHC will have

more information stored for its members, the assessment results for visitors will not be as comprehensive1.

The Wellness system will provide the member with one central point to manage their health. The system will be feature-rich centralised on the

member’s relationships and the sharing function which allows one member to share their information with people they know and trust. The

underlying premise here is that if the member does not have enough time to check their health, then maybe a person they know and trust does.

1 No pre-population of data based on past results.

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Check Yourself and Wellness System map

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4.2 Subsequent Use There will be certain features reserved for subsequent users based on the concept of time; as time psses, UHC will be in a position to provide the

registered user with a better service. For example, automatic reminders can be pushed out to Joe if UHC does not have any new information in 6

months:

All features for subsequent users are reminders based:

Alerts for time lapse during a competition;

Reminders for keeping track of their diet and health schedule;

An alert for a new message posted on the board etc.

In general, registered users can always check themselves at any time and access any of the Wellness System features.

Auto reminders to alert the member (Joe)

Refer to the MS Excel file of the same name to have a look at the detailed wireframe models. 19

4.3 Specific Features

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Pre-populated for the member based on last records

Auto calculation of the BMI based on Height / Weight inputs

Perspective provides the member

with a measure against others

Check Yourself

Results provide the member with

a medically accepted range

UHC leverages of their propriety information to present

dietary considerations

The ability to create new Diet or Exercise routines

Medical Services that UHC may be able to explore

based on their own resources

Time scrubber allows the member to move forward in

time. This function automatically updates the

longevity table which provides projections of the

member’s health.

Alerts keeps the member focussed

Wellness System

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Creating a Dare is creating a challenge with other

people. It is a fun and interactive way to get a larger

community involved while keeping healthy.

Alternatively, the member can attempt to beat their

own personal record as part of Target feature.

A Challenge in action! The Pilates challenge here has 3 participants and

the community has the ability to post some friendly fire via The Board.

This Board has some social media components such as Like, Comments

and Messages.

And it can be shared.

Wellness continued..

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5 Nuts and Bolts This section articulates the architecture and considerations that UHC must understand and answer if they are to proceed with the proposal.

5.1 Architecture The real world representation of relationships within the system is as follows:

Members

May have an existing product / service arrangement with UHC but may not necessarily be registered to use

online facility (Check Yourself and Wellness).

e.g. Joe has a policy with UHC but has to register with UHC online to access Check Yourself and Wellness

Visitors

An individual who does not have

access to the online chAnnl and

does not own a policy with UHC.

e.g. after Joe registers and has

access to the online chAnnl, he

invites Mark to participate in a

challenge.

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Policy Holders

In this example, Joe and his family have a UHC policy for a Life

Product. They all register to use the Check Yourself and

Wellness System.

Users

Under this model, Joe grants access to Ann to use certain

components of the system. Ann can now do certain things

according to the entitlements granted.

Rob however, cannot as he has been limited to the Group

component of the Wellness System.

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Sequence Diagram. Simple sequence displaying Ann logging on and receiving alerts (on Joe’s targets).

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Scenario: Joe grants Ann access to his records. Ann subsequently receives alerts regarding Joe's performance against his Targets.

Sequence Diagram displays processes working in order with one another. It is an interaction

diagram that forms part of Unified Modeling language (UML).

5.2 Considerations There are 3 key questions that requires further analysis and agreement. The answers here can be used as a guide for further work.

Where can we source the information for Check Yourself?

A large component of Check Yourself is presenting statistics back to the user in context of each input variable e.g. the 1st screen presents the

member’s gender which is male. For UHC member’s this data item can be easily pre-populated on-screen but for visitors, the screen design must

present Male – Female and prompt the user to select one. As soon as a gender is

selected, the “perspective” area dynamically updates and presents the number of

males (in our example) to Joe.

Sourcing data will get trickier as the application goes through the cycle. Smoker

status may be challenging to source and likewise Body Mass Index, Medical

Conditions, Exercise patterns and Diet. As Check Yourself presents 2 layers of

perspective – a personal perspective where the user is compared to internal

records and macro perspective where the user is compared against US population

– sourcing the data will need to combine records captured internally, data from the

bureau of statistics and other data sources.

The value presented to the user here is immediate engagement as it provides

contextual information on how they measure up against their own expectations

and against others.

Alternate screen in the instance the user is visitor and

UHC does not have the user's identity.

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How will sharing work?

Sharing in general

Sharing for the purposes of the Wellness system is defined as a UHC member granting read-access to another UHC member which allows view

certain components of the system. With this in my, our member Joe has the power to grant access to either his with Jane or daughter Ann to view

his records. His ‘records’ in this context includes:

Results from Check Yourself His Targets from Wellness System His Schedule from Wellness System His Plans from Wellness System His Products/Services from Wellness System His Alerts from Wellness System His Reminders from Wellness System His Groups from Wellness System (refer to Groups, below)

Within that high level grouping, Joe should even be granted access at a component level e.g. allow Jane to view his Plans only and allow Ann to view

his Targets and Schedule (if he so desires2).

Similarly the reverse is true; Jane (or Ann) can grant Joe access to their records too. This sharing function allows all members to proactively care

about others in their community (a family member or a friend).

Sharing Levels

As we attempt to mimic the relationships in the real world, it is important to distinguish between the different levels of relationships we have with

others. Different levels of relationships may translate in to different levels of sharing depending on user configuration.

As soon as we grant access to an individual to read our records then the expected system behaviour is to determine the relationship this person

has with you. Usually, relationships are already recorded in the system i.e. Jane = “wife”, Ann = “Daughter”.

If the relationship is not explicitly provided or if Joe grants access to a non-UHC member3, then the default relationship label for this person is as a

“friend”. Joe can change this setting at a later stage.

2 From a system’s perspective, this is nothing more than an administrator granting access to individuals to read certain components.

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Any person that is given access to read member’s records is categorised under Inner Circles.

And yet another level of sharing is sharing with others outside your inner circle. This type of sharing is limited to individuals that the member invites

to participate in the Challenges feature. The default relationship label for these individuals are “friends” but under the Outer Circles category.

Sharing capability is detailed in the below table:

Level Category Relationship Example

1 Inner Circles Family Joe-Jane (Husband and Wife)

Joe-Ann (Father-Daughter)

Joe has granted access to both Jane and Ann to read all of his records

2 Inner Circles Friend Joe-Mark (Individual-Friend)

Joe has granted access to Rob to read his records including his Targets

3 Outer Circles Friend Joe- Rob (Individual-Friend)

Joe has granted access to Mark to participate in a Challenge

3 Outer Circles Friend Joe-Sue (Individual-Friend)

Joe has granted access to Sue to post messages on his message board

This is an important conceptual element to the system’s design as it can be used to control the behaviour of the system.

Note that Category of Inner and Outer Circles is limited to system design and is not made visible to the user.

3 A Non-UHC member can be allowed to read records of member’s if the member grants him/her access. This Non-UHC member must register to use the Wellness system

and may not necessarily have products/services associated with their access i.e. it is limited to the scope of access provided by the member that invites them to use Wellness system.

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What does the registration process look like?

Since Outer Circles are non-UHC members, they must register to use UHC online. The process is straight forward and should be limited to a few

steps at best to ensure take-up.

Typically registration follows the pattern below:

In the example above, Joe has invited Sue to join him as a friend in Wellness System. Sue accepts by registering and providing the details above.

Note that these are standard registration data items and it should comply with UHC’s security requirements.

What are Groups?

When a challenge is created where the member invites other individuals to participate4, a group is created with the name of the challenge used as

the label.

Joe can re-label this group if he so wishes and can add other people into a group without granting these people access to read his personal records

e.g. Joe grants access to Rob to join his Pilates challenge group but does not allow Rob to read any of his other records.

4 A member can challenge him or herself to beat their own record.

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Simple screen

designs required here

How will this make life easier for the member and for UHC?

A criteria for design is to make the online experience interactive and therefore engaging. UHC is not the first business to undergo this

transformation as there are numerous other sites that have been through the same transformation5. In essence, the Check Yourself tool allows

members to not only medically assess their health but it also provides them with some perspective on how they measure against a group of people.

By showing the user some perspective, it will raise awareness and promote better health.

The Wellness System on the other hand is feature rich with a lot of social components. Sharing information with others who can monitor their

health makes it easier for the member to keep track of their health and save time. Alerts have also been configured to provide a leading indicator to

the members by projecting their health in the future based on the inputs provided by the member.

This social aspect of the system will empower other members to be more proactive with the health of others.

In our example where Joe grants access to Ann to access his records, Ann will receive alerts on Joe’s progress with his new exercise routine. If Joe

fails to achieve a target of Pilates on Wednesday and Thursday, Ann will not only receive the alert after Joe enters in the actuals but Ann can send a

message to Joe about his failed accomplishment and suggest a better approach. This message will be posted in his groups as follows:

5 Refer to Section 6. References.

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Rob is invited to join

the group. Rob

registers and is part of

the Joe’s Pilates

Challenge Group

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Encouragement from a family and friends

usually brings the message home to the

member.

What better way to engage the member by

involving those closest to them!

..which highlights the value of

once again. Sharing

6 References There are numerous material in the online world used as reference to create the above such as:

People like U: A macro view that captures user inputs and presents back a view of how unique the individual is versus the population. Used as reference for Check Yourself;

Vitality: Wellness program big in life insurance. Used as reference for Wellness System; Covermore assessment: An online medical assessment tool for the purposes of travelling. Used as reference for Check Yourself; Netbank: Online Banking for customers. This is used as reference for Targets (Goals are the equivalent in the online banking space); FitFued: Online health competition. Used as reference for Challenges; Fleety: Online health competition focussed on mobile / smart phone devices. Used as reference for Challenges.

There are social features such as Like, messages posted to a Board, sharing, Doc’s Face time and others which has parallels to social sites such as

Facebook, LinkedIn and other social media sites.

The business domain may be different but the approach to interacting with an online user remains the same. These benchmarks have therefore

been used to create Check Yourself and Wellness System.

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Author: Perry Carbonell