Redesigning how we access healthcare
Connecting patients and physicians in 90 seconds or less with a HIPPA compliant secure messaging app.
Summary
The healthcare industry has done a great job of putting walls between patients and providers. Because of this, we have a struggling system that alienates physicians and patients. CirrusMD was built to break those barriers and to reconnect patients and providers in 90 seconds or less. CirrusMD is a virtual care solution that uses text as a modality to solve 80% of the acute care needs of member populations.
I joined CirrusMD pre-Series A and helped lead the charge for a better-designed product. Post Series B, a lot of my work has continued to establish a better design strategy. In this time, I've contributed to the company seeing $25M in funding, 12 large-scale healthcare customers, 40 employees hired, and $400k in MRR gained.
Building Foundations
Previously to my time at Cirrus, all of the design work was outsourced. Innovation and advancements were limited and restricted by hourly costs. After diving into the product, and breaking down the business context, nuances of the healthcare industry, and team dynamics I began building a process for design. At this point, the entire product, design, and engineering team for iOS, Android, and the web was six people. One design, one product, one iOS, one android, and two web engineers.
I set up a delivery workflow to redirect UX focus and began making many design changes in the product. One was to bring more clarity and brightness to the product with a significant feature in the product called white labeling. We offer this for our larger customers like Kaiser, and we needed to build a better design system to support the efforts for white labeling. Through this process, I created a robust design system that enabled better design and engineering efforts by refining UX features in the app. As a part of this process, I had to make changes to the color system in the product, which built some rather impressive accessibility features into the app.
Refining Process for Design
I walked into a green design system and process and had to get a few essentials off the ground with design software, prototyping, user testing, design documentation, project management, roadmap planning, and OKRs.
With a suite of tools in place, which didn’t happen overnight. Some were easy to get into play, and others took considerable time. User testing was one I was chasing the longest. Since we’re in the healthcare space, there are a lot of rules of how we can user test and record the results. If it has personally identifiable information, I needed the recording platform to be HIPPA compliant. That’s a tall order to fill and was never going to happen. But it turns out there are few ways around all of the security checkboxes.
The other extensive tool, design documentation, was more of an evolution than a precise tool match. Much of the design process with screen design tools and rapid prototyping communication breaks down, when we transferred work from design to engineering a lot gets lost in translation. This is where design documentation was born and became a critical component to building a successful product. We needed a way to ensure context was intact for engineering. Design Documentation was much more than a tool. It was a log of decisions and a record of the things that we created. Often we would work on stuff in the design phase, and then we wouldn’t touch it for many months, and often the context would be lost when engineering picked up the work. Other times when we wanted to build a feature in phases, the framework would get lost in the game of telephone with different departments and stakeholders in the company. Design documentation became the needle and thread that held everything together.
Leveling up with Accessibility
Accessibility has become a hot subject in the design industry. When we first began work with designing the early stages of the service, we were a little naïve to the sheer scope of ADA compliance. As I begin to dig into WCAG, I started to uncover aspects that I couldn't ignore. The deeper I got and the more we understood the more I knew we had to change. As I was building our product and trying to establish a solid design system there were aspects of accessibility that we needed to make core to our product if we wanted to succeed. To be honest, we needed to make that core to the company.
As I began to dig into WCAG there one aspect that I couldn’t ignore, our brand colors. We had a color system comprised of three colors primary, secondary, and tertiary. The three colors were an analogous color scheme with light blue, medium blue, and dark blue. With those three colors, our product was designed with a specific color hierarchy, and when it came to white labeling, this became increasingly difficult to try and fit our customer’s brand colors in our color structure. Most often when we put our customer’s colors into a theme the outcome was pretty bad. Often times customers had complementary colors and when we put these two colors together in the product the effect in the UI system was not always great.
As we dug deeper with the colorwork, we created something pretty rad; we created a solution we call Color Math, and we were able to take a customer’s primary brand color and dynamically with code and math create a dark and light version of the customer's primary brand. Doing this enabled us the capability to have the product look as we intended. Another byproduct of this color math was that we had greater control over hues. We built math that would dynamically in the code augment colors via HSL so that we could ensure that customers' brand colors would meet WCAG contrast ratio standards.
Advanced Provider Support
We use technology to analyze data, spot trends, and predict health issues with rich text data. We leverage physicians' finely-tuned medical judgment skills to deliver unparalleled care that impacts the bottom line, care delivery, and patient satisfaction. With technology, using prediction to enable lighting fast contextual care data on specific medical topics unique to each patient. The contextual care data is information that comes from past chats, in-person visits, clinical impressions, and long-term medical history. The visual example below illustrates how we use prediction combined with judgment to create action. The AI strategy is an enhancement of abilities, not a replacement. The goal of the product is to enhance existing clinical staff to drive optimal efficiency rather than claim we can replace doctors with technology to improve financial outcomes.
We are delivering healthcare in a modern era with a modality people want. People want freedom and flexibility to access care when they need it without the barriers of time or cost. This sample workflow example illustrates how we currently engage with patients via the CirrusMD Provider platform.
The provider feels out what the patient is experiencing — typical clinical discovery.
The provider digs in a little deeper and finds that the patient had a recent medical episode that changes the provider's scope and a path to problem-solving the issue at hand with the patient.
The patient is dealing with a more serious medical issue and needs to go to an ER to confirm the prognosis with in-person tests.
With Advanced Provider Support, we can leverage data from past encounters that will give the provider relevant information to exercise faster judgment. Using data will be done by displaying the prior context of the patient's recent hysterectomy, which was the inflection point of the encounter. The hysterectomy in itself is not the trigger, but the use of 'pneumonia' in the patient's first message. Pneumonia, combined with the recent hysterectomy plus additional contextual care data, the provider, can ask more informed and precise questions early on in the encounter.
Armed with relevant information, the provider can get to a faster 'aha' moment and use nearly 46% less back and forth Q&A. As a byproduct, speeding up the conversation, we create more productive connections with the use of informed expertise and instill deeper trust with the patient that they are getting the answers needed to resolve their issue in a little as time as possible.
Patient Starts Chat
Provider Digs In
Provider Explains
Provider Reassures and Confirms Urgency
Mobile SDK Kit
A significant part of the services CirrusMD offers is white labeling with SDKs. It's a great way to integrate into a flagship app for a big customer. But it has its massive struggles. With an SDK, your at the mercy of the host app's UX when it comes to navigation. Meaning the navigation bar is controlled by the flagship app, and UX needs to be pretty simple to work well. This SDK version of the app removes the dependency of the host's app navigation and builds a UX navigation that sits on top of the host app. One entry and one exit with control over the experience. When the user accesses the chat portion of the app and enters the CirrusMD experience, we can control the UX with a single screen that starts the interaction, the stream. The stream is a collection of past and on-going medical chat encounters with real doctors. When a patient creates a new chat or accesses an old one, the details would be displayed using the iOS modal interaction. Doing this gives us greater control over navigation and clear communication to the patient without sacrificing the quality of the UX we want with our experience.
Visuals demonstrate the integration into a flagship app like Kaiser. Color system is inherited from the host app.
