Nirali Shah

Ascension is one of the nation's leading non-profit health systems, spanning across 19 states and the District of Columbia, serving millions annually.

At Ascension, I am part of the appointment scheduling team, where appointments are central to all consumer engagement touch points. My role was to improve the patient-facing appointment scheduling experience with primary care and specialty care providers.

My role to create an end-to-end appointment scheduling experience for authenticated and unauthenticated users, designing intuitive interfaces across different platforms.

Team

Team of 2 Product designers, 1 UX Researcher, 1 Product Manager, and 4 Developers.

Role

Senior Product Designer

Deliverables

Responsible for creating an end-to-end appointment scheduling experience focusing on increasing digital bookings and enhancing usability.

Timeline

5 months

Context

Ascension Health is a healthcare organization that has multiple partners and internal solutions, each with its own user experience and separate data systems. Among these solutions is a third-party scheduling vendor, InQuicker, which facilitates appointment booking without requiring users to log in.

Despite the availability of online appointment scheduling, a significant portion of appointment slots (10-30%) remain unfilled, with nearly 20% resulting in no-shows. Patients also face an average wait time of 18 days to see a provider. Interestingly, while users visit the website to search for providers, many prefer to call rather than use the existing online scheduling system.

Business Problem

The primary challenge with the current scheduling experience is that patients frequently resort to calling to book appointments due to dead-end scenarios encountered in the online experience. Additionally, a substantial number of users access the site via mobile devices, where the scheduling process is not optimized, presenting a cumbersome experience. Mobile users encounter lengthy forms that are difficult to navigate.

User interviews have revealed that many users schedule appointments not only for themselves but also for family members. However, the current system only allows guest scheduling, requiring users to input redundant information for each appointment. Users express a desire for a more streamlined process where the system remembers their details and pre-fills forms on their behalf, reducing redundancy and saving time.

On the provider side, there is a reluctance to fully open up availability online. Providers prefer to display only a limited number of appointments online, as they often encounter incorrect bookings when patients schedule appointments themselves. This leads to inefficiencies, with clinicians needing to dedicate significant time to verifying appointments and potentially rescheduling patients to prevent backlogs.

Business Solution

To address a problem, Ascension has made a decision to switch from using InQuicker's solution to an internally developed user interface (UI) that utilizes InQuicker's API to provide a more personalized and improved experience to users.

The transition also presents an opportunity to introduce an authenticated experience to eliminate the need for users to repeatedly fill out information.

Business Requirements

1. Finding gaps in the current forms and implementing a better-unauthenticated experience
2. Creating an authenticated experience
3. Making it mobile-friendly

Step 1: Evaluating the Current Form

We identified several UI/Visual and functional issues that affected users' ability to schedule appointments efficiently in the current scheduling form.

UI/Visual issues:

1. Disabled Appointment Dropdown - The appointment dropdown appears disabled, causing users to overlook it and resulting in incorrect appointment selections.
2. Unusual Form Hierarchy - The form prompts users to input their reason for a visit before their name or date of birth, causing disorientation among users.
3. Stretched Input Fields/Dropdowns - The form features elongated input fields and dropdowns that do not match the content within them, creating confusion for users.
4. Lack of Progress Indication - Users are not provided with any indication of how many more steps remain to complete the appointment scheduling process.

Functional issues:

1. Missing Validation States - The form lacked proper validation states and feedback, leaving users uncertain about input accuracy and hindering form completion.
2. Dead-End States - Users encountered dead-end states during scheduling, resulting in frustration, delays, and abandonment due to a lack of clear guidance.

Step 2: Comparative analysis

For competitive analysis, we examined other healthcare services (Zocdoc, Piedmont, Scripps, Zoomcare, and Stanford Healthcare) and digital scheduling experience.

Major takeaways

1. Use a progress bar to guide users - Introduce a clear progress indicator at the top of the scheduling flow, guiding users through each step and providing a sense of direction.
2. Collect information in stages to prevent user overwhelm - Divide the scheduling process into distinct stages, focusing on collecting specific sets of information at each step to prevent user overwhelm.
3. Keep provider details visible - Ensure provider details remain visible throughout the scheduling journey, fostering trust and familiarity with healthcare professionals.
4. Streamline the data input process - Streamline the data input process by breaking it down into manageable sections, minimizing the cognitive load on users, and optimizing for completion.
5. Allow users to review and edit information before finalizing - Allow users to review and edit their information before finalizing the appointment, reducing the likelihood of errors and enhancing user satisfaction.
6. Offer flexible account creation options - Offer users the option to create an account for future convenience while also providing a guest checkout option to accommodate those who prefer not to register.
7. Seamless Insurance Integration - Integrate insurance information seamlessly into the scheduling flow, making it easy for users to input and reducing friction in the process.

Step 3: Design iterations

Pain point 1: How can we make it easy for the user to choose the correct appointment type?

Iteration 1: Visually Enhanced Dropdown Placement

• Pros: Improved visibility of the appointment dropdown, reducing the likelihood of users overlooking it.
• Cons: Users were confused due to similar appointment names, leading to incorrect selections as they were drawn to clicking on timeslots instead.

Iteration 2: Implementation of Multi-Page Question Flow

• Pros: Multi-page question flow ensures users choose the correct type of care and reduces inaccuracies.
• Cons: It requires users to navigate through additional steps instead of a straightforward dropdown selection.

Pain point 2: How can we make the forms more mobile and user-friendly?

Iteration 1: Grouping Input Fields under Sections

• Pros: Provides visual structure to the form, enhancing clarity and reducing cognitive load. Users can easily locate required information, improving organization.
  • Offers flexibility to toggle between pages based on user authentication status
  • Incorporates progress indicators for users to track their completion status, minimizing frustration.
  • Early validation prevents users from completing unnecessary sections and rerouting ensures accuracy.
• Cons: Increases completion steps but prioritizes accuracy and usability.

Iteration 2: Implementing Multi-Page Workflow

• Pros: Breaking sections into individual pages enhances user experience, making form completion more manageable.
• Cons: One long form may necessitate scrolling, presenting challenges for mobile optimization.

Final Solution

Our unauthenticated experience went live to the public in January 2024. Since the launch, we have noticed significant improvements in several crucial metrics, indicating a positive impact on our users:

1. Month-over-month, online appointment bookings have increased by 80%, indicating a growing preference among users for the convenience of self-service scheduling
2. Within the first quarter of implementation, there has been a 25% decrease in incoming calls related to appointment scheduling, freeing up valuable resources and allowing staff to focus on delivering quality patient care
3. We've observed a 20% increase in slot utilization rates across our network of clinics, ensuring that more patients can access timely care
4. Our data indicates a 70% reduction in abandonment rates since the launch of the new experience, indicating greater user satisfaction and engagement

Along with this we recently launched our authenticated experience (Ascension App) to the public in April 2024. For now, we are collecting feedback through user surveys on the new experience.

• Monitor metrics and find areas of improvement in the authenticated experience
• Implement this new scheduling experience for location-based services