Fidelity's Approach to Making Health Care Easier for Everyone
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Fidelity wanted to create a small business health insurance marketplace and used design thinking techniques like design sprints and co-design to do so rapidly. They established a problem statement focusing on providing employees an intuitive experience that helps them choose a health plan they understand and feel confident about. Through design sprints and co-design sessions directly with users, they generated ideas and tested prototypes to learn what would meet user needs. Their approach helped them design an admin experience meeting employer needs and an employee experience focused on choice, understanding, and confidence in selecting a plan.
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Fidelity's Approach to Making Health Care Easier for Everyone
- 1. What’s Worse: A Root Canal or Selecting Health Insurance? Fidelity’s Approach to Making Health Care Easier for Everyone @beckymin@nancy_emerson44
- 3. Fidelity wanted to create a best-in-class service that delivers small and mid-size employers the right health coverage for their employees.
- 4. Rapidly launch a health benefits marketplace, building a minimal viable product to service small businesses in under a year. GOAL
- 5. But it’s healthcare, which means: equal parts complex problem and significant opportunity.
- 6. Employees Employers Brokers Insurance Carriers Medical Dental Vision Life Disability
- 7. Minimal Viable Product Rapidly launch a health benefits marketplace, building a minimal viable product to service small businesses in under a year. GOAL Employees Employers
- 8. Employees Design Sprints Co-Design Today we’ll spotlight these portions of our work: Employers
- 9. Design Sprint Design Thinking Agile Today we’ll spotlight these portions of our work:
- 12. Establish a common understanding of the problem we’re tackling. Determine where we’ll focus our efforts. Generate a bevvy of ideas via rapid sketches, critiques. Select the ideas & treatments that we’ll prototype. Move from detailed storyboards to stand- alone prototypes. Prep the guide. Evaluate hypotheses and get feedback on treatments, from would-be customers. Recap findings, set next steps. Understand Diverge Decide Prototype Validate Five Steps to a Design Sprint
- 13. …Plus Two Hidden Steps… Prep Kick-Off Meetings • Cast the team • Source the nest • Commit to and book the time • Set expectations • Loop in extended stakeholders Understand Diverge Decide Prototype Validate • Identify key user insights (user interviews?) • Source competitive, comparable inspiration • Define respondents, recruit them • Kick the tires on sensitive topics • Identify any essential constraints
- 14. Must Haves Designer(s) Business Lead Strategist/researcher Facilitator Nice to Haves Strategist/researcher Talent that adds to the solution mix Help with food (fuel!), photos Don’t Need (& Must Exclude) Spectators of any stripe Feasibility fanatics Be Ready to Address Senior stakeholders seeking to “dip in” Casting Tip: “Just Enough” Participants to Explore Desirability
- 15. Lessons Learned
- 16. Set clear expectations for everyone involved. Clearly articulate the needs for which you are designing. Stay true to your problem statement. Watch for your Frog Prince: great ideas in shabby sketches. Design Sprint Tips
- 17. • Identify a small group of 4-6 participants. (Remember, no spectators.) • Clearly articulate what’s required from everyone. • Give pre-assignments so folks can be ready and raring for day one. • Help everyone adhere to the daily agenda (hint: a timer & strong facilitation). Set Clear Expectations for Everyone Involved
- 19. Clearly Articulate & Explore the Needs You Are Designing For • Focus on what your users are doing rather than who they are. • Consider a Value Proposition exercise to unpack behaviors and motivations. • Identify opportunities by turning the Journey into an exercise. • Spark fresh thinking via competitive and comparable examples.
- 20. Value Proposition Canvas Credit: Strategyzer.com and Strategyzer AG
- 22. Watch for Your Frog Prince: Great Ideas in Shabby Sketches • People who can’t draw well can contribute in a big way. • (But you need to help uncork their self-expression!) • Anonymous sketching + dot voting + discussion = a key play.
- 25. The problem statement sets the stage for all your efforts during the sprint. A good one is: • Purposeful and concise • Targeted to your audience • Inspiring To craft a problem statement, use the framework: • how might we… • so that… • in order to… Stay True to Your Problem Statement
- 26. How might we design an intuitive, frictionless experience So that it: • Delivers me a good plan that I understand • Gives me the best plan choices for me • Gives me confidence in my decision In order to help me choose a plan that I feel great about selecting. Problem Statement for the Employee Experience Sprint
- 27. A Few Hard-Earned Do’s and Don’ts Do… • Pursue sprints with client partners who are ready to play along. • Follow a highly planned, yet improvisational approach. • Rejoice in rapid, evidence-based conclusions. Don’t… • Set out to crack version 1.0 of your product (you’re not!). • Believe 5 days is a magic number. • Overlook looping in your extended team and stakeholders before & after.
- 28. Boost the success of your solution via ideation with actual users. Our partnership with HR execs helped us design a simple admin experience to meet their needs. Co-Design
- 29. Clearly define the purpose and outcome of your sessions. Remember your participants are your partners. Keep learning by refining your direction session to session. Co-Design Tips
- 30. • What hypotheses are we looking to investigate? • How should we prep the participants? • What activities should we include? • What stimulus would be helpful? Determine the Purpose and Outcome of Your Sessions
- 32. • Recruit a range of users. (Consider extreme use cases.) • Give them something to work with. • Let them show you in their own words. Remember Your Participants Are Your Partners
- 36. • If you’re not learning and adapting along the way, you’re missing the value. • Allow space for debriefing and modifications in your schedule. • Park questions/ideas to explore further, prioritize what’s essential to address. Keep Learning by Refining Your Direction Session to Session
- 38. So, How Did We Do? And, What’s Next?
- 39. How might we design an intuitive, frictionless experience So that it: • Delivers me a good plan that I understand • Gives me the best plan choices for me • Gives me confidence in my decision In order to help me choose a plan that I feel great about selecting. Problem Statement for the Employee Experience Sprint
- 40. Get in touch. Currently hiring a UX Strategy intern. becky.minervino@beamland.com @beckymin nancy.emerson@fmr.com @nancy_emerson44 Thanks!
Hinweis der Redaktion
- I suspect that many of you have selected health insurance at one point either through your employer or even directly from an insurance carrier or public exchange. So, I’ll ask you: what was worse - a root canal or selecting health insurance? How many say a root canal? (raise of hands) How many say selecting insurance? One of the most surprising, yet sad, statistics is that in a recent survey, 60% of people said that they would rather have root canal/tooth pulled than enroll in their benefits. I’ve heard that root canals aren’t quite as painful as they used to be….and we are trying to make selecting health insurance less painful too.
- I’m Nancy Emerson and I’m responsible for customer experience at Fidelity Health Marketplace and my job is to make the selection of health benefits easier and help people feel more confident about their decisions. Being that we are only about 1 year old, I often get “who is Fidelity Health Marketplace”? We are a private health care exchange focused on offering small and mid-sized employers - and their employees – an easier, simpler way to administer and enroll in health insurance. And, as you may (or may not ) have guessed, we are a Fidelity Investments company. Typically the next question is: “Why is Fidelity getting into the health insurance business?” When we ask our customers what makes them nervous about the future – health care costs typically lands as either the #1 or #2 concern. We all feel it – the crunch of health care costs. This crunch may have lasting effects on your financial health (how munch money you are able to save). At Fidelity, we have the privilege of servicing millions of participants and we see the extent that rising health care costs have had. In fact, 19% of our 401k participants have had to take out a hardship loan to pay for medical expenses – and with a hardship loan, you cannot pay yourself back. We believe that we need to bring the world of health and financial planning together to help customers navigate these complex areas - to help them in the near term and longer term. One of the obvious places to start this journey is with the health insurance selections people make once a year during their annual enrollment. As a new business we set our sights on providing a best-in-class solution for small/mid-sized employees easing their admin burden, while also guiding employees to the health coverage that best met their needs.
- We have what we think is a great goal, and we wanted to get out into the marketplace as soon as possible. Our plan was to launch a product to a set of pilot clients to continue to learn and refine. So, we set up some time parameters and agreed to go out with a minimally viable product. And although this sounds easy, for a big company like Fidelity, we had to stay focused on being nimble --- which, as you might imagine, is not always that easy. To help us meet our aggressive goal, we partnered with BEAM.
- With anything that needs solving, it’s typically not solved because it’s, well, not that simple. And healthcare certainly meets that description. There are lots of moving parts with healthcare - lots of rules, regulations, emotions, players. But, that also makes it ripe with opportunity.
- To give you a sense of the health insurance world, let’s review the major players. Employees – they typically engage only when they need to enroll, have some sort of family change that makes them reconsider benefits, or have some health situation that makes them take a long, hard look at what they selected Employers, particularly Health Benefits Administrators worry about benefits all the time: it’s a yearly process that isn’t just about planning for open enrollment. There’s dealing with preparation, renewals, integration with payroll, making sure they are following the rules, fielding benefit questions, keeping on budget and... Brokers (the salesforce for the carriers) must keep up-to-date on health insurance options and keep up to date with compliance and changes in health care laws at both federal and local levels. And, keep their clients current. And if that’s not complex enough, let’s add some more. Imagine the differences in employers (from the law firms to the manufacturing firms) and the differences in their populations. Then, the employees themselves - young and single, married, married with kids, empty nesters, approaching retirement, dealing with health concerns. Everyone wants a suitable health plan for their individual needs. How do you break up the general population and provide each of them with the right health benefits? How do you build a solution to meet these different goals in under a year? We knew that it was totally unrealistic to meet everyone’s needs – so what was the right amount to address?
- So our goal was to tackle two areas first. #1 - the employees. We needed to build out a simple easy enrollment process that guided people to the right fit. Then, we wanted to focus on the employers to give them the insight and oversight into their employee population. But the challenge is to get a product out into the market as soon as possible – so what does minimal viable product look like? So to tell you about our approach, I’ll turn it over to Becky.
- For today, we’re going to focus on the end users Nancy just talked about (EMPLOYEES and EMPLOYERS) Going deep in these two activities: DESIGN SPRINTS and CO DESIGN I’M INTERESTED IN KNOWING How many folks have heard of design sprints? Participated in one? And how about if you’ve participated in co-design?
- Lately Design Sprints have started ramping up to full-blown trend status, thanks to the work of folks such as Google Ventures, including their work last year and the Sprint book and activities they launched this spring (by Jake Knapp and John Zeratsky) The O’Reilly Design Sprint book (written by Richard Banfield, C. Todd Lombardo and Trace Wax: http://www.designsprintbook.com) The short hand is design thinking meets agile development. It’s a rapid appproach to investigating IMPORTANT and UNFAMILIAR points about your product ir experience. We utilized design sprints to define our solution for both employee and employers.
- To understand the value, consider the traditional design process
- A design sprint is designed to help increase the rate of learning, helping you go from ideation to actionable findings – without investing time and money in building and launching.
- Classically there are Five Steps to a Design Sprint -- basically taking all the crucial steps for good design decisions, but condensing them to focus on a specific problem. [Explain the 5 very topline] However, to our mind it’s a mistake to think five steps means five days. We’ve found through trial and error that this doesn’t work very well for our team and particularly our team when we’re working with clients. While adhering to the core time-boxing principle, we like to air things out, usually around 8 days, but for very specific questions we collapse to 3. (We have tried one and that was too extreme) The other reason is that there are key steps that preceed this… Provide a quick overview to remind/educate the audience on what a design sprint is – could use a better graphic
- Classically there are Five Steps to a Design Sprint -- basically taking all the crucial steps for good design decisions, but condensing them to focus on a specific problem. [Explain the 5 very topline] However, to our mind it’s a mistake to think five steps means five days. We’ve found through trial and error that this doesn’t work very well for our team and particularly our team when we’re working with clients. While adhering to the core time-boxing principle, we like to air things out, usually around 8 days, but for very specific questions we collapse to 3. (We have tried one and that was too extreme) The other reason is that there are key steps that preceed this… Provide a quick overview to remind/educate the audience on what a design sprint is – could use a better graphic
- Who you cast and how many folks is a function of the problem you’re tackling. However, from this experience with Fidelity health and other activities there are a few tips I can say You want “just enough participants” to explore desireability” – In terms of roles this means… Must haves... Nice to haves + Talent that adds to the solution mix – this could take many forms. On our EE sprint, it included our tech director, not for his tech skills per se, but because he’s great a concepting Don’t need No Spectators (including project managers, relationship managers – folks who might contribute to your overall project’s success but aren’t primed to dive into concepting Anyone who is ONLY focused on feasbility. There’s space for those considerations, but someone who only keys into feasibility is going to hinder your progress. We had this experience and it was hard for everyone involved, as well intended as the input was. Watch out for Senior stakeholders who dip in. You should try to avoid this but it may not be possible. When your CEO is excited but not available for the duration, you want to take advantage. Do your best to explain the mechanics and then make the most of the time you have together. Understand and Diverge are better days to “sample” – and having an extended team involved in the read out is actually a great move. We still debate this, sprint after sprint. We had 11 in this first forray and we paid for it in terms of fatigue and some wasted effort. (Though we probably did gain something in terms of alignemtn.) Just wrapped up a sprint with 8 and it still felt slow. Colleagues says 4-6 is a magic number, but it’s admittedly hard to winnow to that.
- Identify a small group of active participants. No spectators. Small is relative. We have learned from practice that more than 8 and you hit rapidly diminishing returns. << could insert a photo of the work session to dramatize this >> Be ruthless here. Use the kick off and the read out to loop in extended members of your team. Clearly articulate what’s required from participants and give them clear directions before the workshop. (Kick-off meeting.) Give pre-assignments so everyone can be ready and raring for day one Help everyone adhere to the daily agenda (hint: a timer & strong facilitation). If you’re new to the process, engage an agency partner ir an experienced consultant (e.g. Keith Hopper) Emphasize throughout the workshop that everyone is valuable and necessary
- Structure + Flexibility is key We worked to build in flex time – see for instance the decision to give us lead time for Diverge And since this engagement we’ve experimented with a range of durations From 2 days to 8 days You need to take stock in the nature of the problem you’re going to tackle, your team’s flexibility, and what cadence works best for you For meatier problems, we now prefer to purposefully kick off late in the week (weekend off), and to build 3 days into prototyping. Balance of the intensity of timeboxing with downtime/flexibility …it looked like this (though that’s not the way it went down – if you remember the first week of February 2015 you could guess why.)
- <<Best title? Elevate further – needs + ways in?>> << Add this idea about exercises ir park elsewhere: Leverage design exercises that make participants focus on sequence and flow Focus on what your users are doing rather than who they are. This will keep you focused on designing solutions for their needs
- The Value Proposition Canvas focuses on what jobs your user is doing, what pains they have and what gains they are hoping for. From there, you can determine how to meet the needs of your users through pain relievers and gain creators that will drive design towards products and services. <<Add framework version for slideshare>> Here’s what our canvas looked like after going through the exercise for Employer
- For employee we interviewed folks who had recently gone through enrollment – this was essential I'm the biggest stumbling block to the process; the mechanisms that are in place are straight-forward and easy to use so far. I could have had it all done in an hour, but I had to build a spreadsheet and crunch numbers and talk to my family and over think it and drag it out. -- Mike B. We shared insights from those stories and tapped the collective experience in the room through a journey mapping exercise. Making the journey into an exercise helped us visualize the issues and sort out where we most wanted to focus Consulting on needs Providing options tailored to their input Friendly tips before, during and after the “moment of sign up” <<Add notes about what the swirl was Read Research Ask others Make a decision?
- People don’t have to be able to draw to contribute in a big way (But your facilitator needs to help uncork this self-expression) Show them examples. It’s easier to feel confident when you know what is expected of you. (Plus you can see a range of “talent.”) Help them warm up (crazy 8’s ir 6-ups are good warms-ups. Never shared with anyone…) Anonymous sketching + dot voting + discussion = key play
- Here are three responses to the same storyboard exercise On the left, a detailed sketch by our Director of UX Design (formerly a medical illustrator – basically the nightmare arrangement for people with sketch stage fright On the right, in the middle – a sharp contrast. Perhaps too much exposition, but they expressed some ideas And on the far right, no one is going to win any sketching competitions, but those ideas had merit (stickers) They all express something…
- And you find this out through the combination of independent thinking and DOT VOTING Not only a feel good thing (democratcy in action) – it actuall helps you identify where the value lies and establish consenus moving forward
- BAD problem statement might be: HELP PEOPLE MAKE CHOICES It is a goal… But no insights
- You’re not building 1.0 of your product sprints are about concentrated focus. Scope creep fragments your attention and undermines that value. you'll be tired and crazy Sprints are a great learning tool – but not a means to short circuit a full product development process (And Embrace time boxing – it’s scary but freeing)
- The value of Co-Design is to increase the success of a solution through concept ideation with actual users. We conducted co-design sessions with HR Benefits Administrators to explore how they manage benefits and design an adminstrative experience to meet their needs.
- What hypotheses are we looking to investigate? This drives all the other decisions. How should we prep the participants What activities we include and what stimulus would be helpful In our case, we suspected that there were pain points in the pre and post-enrollment experience. Benefits are one of many systems that administrators have to “deal with” – our hypothesis was that this was a major issue. We also understood that pre-enrollment (plan design) was a confusing period. We wanted to explore what activites Benefits Administrators were doing before and after enrollment, not only during enrollment. To investigate this and other and points, we created a loose model of what we knew and asked admintrators to bea it up [next slide] They described the activities and exercises they were performing and what pain points they had with each.
- …We walked through our model of the activities PRE, During and POST enrollment, AND asked the administrators to beat it up They refined this AND described the activities and exercises they were performing and what pain points they had with each. However, we were surprised to learn about how vast they were Each organization had a different set of problems: dealing with classes (i.e. part-time, full-time) having to addresses different ways to consolidate payroll dealing with education prepping for the new year. Bottom line: we found there was a lot more we weren't aware of around pre and post-enrollment.
- Who you involve greatly influences your outcome. A range (and maybe a purposefuly set of contrasts) is instructive. In our case, for our Employer work we talked to companies with 5 people and with 2000 people law firms and food service companies with manufacturing plants Benefits administrators and HR directors Something to work with means sufficient fodder for discussions. You do this for a living but your respondents don’t. Set the stage for them to jump in –show you in their own words [NEXT SLIDE]
- We did a simple affinity diagram exercise to understand activites and items they felt were important
- And we asked folks to show us how they manage their process today Here are examples of the gymnastics that one of our Benefits Administrators does to consolidate payroll and benefits data and ensure deductions were being made. << how did we respond to this in the design>>
- Finally, we also conducted a concept walktrhough And prototype testing to determine what information they wanted to see during all phases of enrollment (pre, open and post.)
- <<Add notes about how specifically our schedule allowed for this>> Our schedue was 70 minutes where we: Provided the participatns with our understanding on our mental model for pre, open and post-enrollment Had them articulate what current issues they had with the process Walked through some concepts around reporting and dashboards to understand what data points they needed to see Testing with ER prototype to get more detailed feedback on what worked/what didn’t
- In our initial prototype (on left), we assumed Benefits Administrators would want more data points around completion but found that instead, they wanted less. However, they also wanted the ability to drill down to find specific information from the main dashboard (right.)
- As a recap, we were looking to build (as the first starting point) a easy employee experience. - We launched the product and had our expected number of pilot clients use the platform for 2015 enrollments. We’ve conducted a number of focus groups afterward to understand how well we did. Overall the feedback from employees (conducted through focus groups) was very positive. People thought it was simple, easy and people felt that they understand what they were selecting. However, we still have more to do. One learning – we solved for the more complex offering, where employers offered their employees 3-5 plans. We had a couple of clients only offer their employees one plan. The work we did on guiding people to the right decision was lost – as there wasn’t a decision to be made. This means that we need to design change that accommodates those situation. We also have some higher-order goals to continue to work on (i.e., getting people more confident about the decisions they are making.) We have learned that people like to see the “best fit” but they really want to understand why it is the best fit. The tool inherently knows, but we need to present it back to the user. How about the co-design session result? We don’t know yet. The product gets deployed next month, so we are anxious to see how real people use the experience in a real environment. We are happy with how quickly and far we’ve come. With any product release, we had to make concessions to meet our timeline, but we feel like we made the right ones. This is a multi-chapter book, and we’ve completed the first chapter. I expect the following chapters will be equally as interesting and rewarding.