What the Oscar team learned designing apps for healthcare

4 min read
Christopher Gillespie
  •  Aug 10, 2017
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What if you had to redesign your app to minimize the time users spend in it? That’s the conundrum that confronted Regy Perlera, Adam Karnas, and Gabe Schindler as they waded into the unfamiliar world of healthcare apps.

Regy, Adam, and Gabe are all designers for Oscar, the technology-focused health insurance company that’s busy revolutionizing a notoriously sclerotic industry.

Unlike its competitors, Oscar is fixated on its user experience. Where legacy healthcare providers still onboard new customers with reams of physical paperwork, Oscar uses super clean online questionnaires, friendly tutorials, and of course, an app. Yet because customers are only incentivized to use the app when they’re unwell, the company was hoping, for everyone’s health, that they’d do it infrequently.

“Healthcare should be a consumer product. To date, it hasn’t been.”

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For a design team accustomed to creating engagement-driven consumer products for Square, Amazon, and Motorola, Regy and the team had to flip what they knew about usage and learn to design differently.

Currently, healthcare systems keep doctors and patients from connecting

To say that the healthcare industry can improve is a vast understatement. It’s a politically charged topic but here are some bi-partisan facts: health spending in the US accounts for nearly one-fifth of GDP according to the World Bank—more than double the per-capita spending of the UK or Japan—and yet the US still ranks near the bottom on a list of global healthcare quality.

“It’s truly one of the few industries where people are used to paying a premium for poor service,” explained Regy.

How can this be? There are a multitude of factors but it’s often difficult for people to get through to a doctor. This prevents them from seeking early preventative care, which can be much cheaper.

According to a 2015 study by the US National Library of Medicine, 87.8% of people who avoid early care do so because of bureaucracy, insurance issues, and price. And even when they do get through, the complexity and lack of clear communication drive up costs.

Yet, there is a glimmer of hope. By connecting doctors and patients directly through services like telemedicine—a fancy word for talking via phone or text—healthcare providers can cut through bureaucracy and offer better care. Oscar is riding the crest of this wave.

With healthcare apps, less is more

For Regy and the team, the first step was learning from their users. Oscar had launched its first iOS app back in 2014 (its Android app followed in 2015) and had a substantial usage, but had also accumulated enough technical and design debt to justify a redesign.

Related: How to tackle design debt

“It was a chance to rethink it from the ground up, make it effective for all demographics, and get the iOS and Android versions back in sync,” said Regy.

“We consider ourselves successful if people are able to find what they need and then log out a few minutes later.” –Regy Perlera

Through focus groups and user interviews, Regy and the team got to know a different side to the consumers that they had built other technologies for. People use healthcare apps only rarely and might forget about them in between uses, so the new app would have to be more intuitive than innovative.

And because Oscar’s approach asked users to rethink medicine, it would have to be simple and not overwhelm them with documentation. This led the team to draw upon both traditional and non-standard design principles.

On the traditional side of the fence, they aimed for making the app simple enough to accommodate a wide variety of demographics.

“The average user may or may not be as tech-savvy as the designers and engineers working on it,” said Liz Robau, a technology communications manager at Oscar. “After our design team tested both a grid and a dynamic home screen using InVision, they found that users liked the tried-and-true sticky navigation best.”

They also stuck to the paradigm of introducing each feature as an icon paired with a title to teach users what to expect. This allows the team to easily introduce future features without undue confusion.

On the non-traditional side of the fence the team actively tried to limit in-app exploration by including very few navigational buttons.

“Because healthcare has so many disparate data points, it can be a confusing landscape,” says Regy. “Users require a more guided approach with contextualized information.”

They also embraced a principle that’s an anathema to normal designers: redundancy. According to Regy, “While many apps favor distillation over repetition, Oscar gives users the option to take the same action at multiple points in the app to help them understand when they should be seeking certain help.”

For example, the “talk to a doctor” option appears on both the app’s home screen as well as the care screen.

They were also forced to define success differently. Oscar wanted to help users find what they needed, log out, and not return, as this was indicative of a good health outcome. Regy and the team adapted by measuring engagement only with certain features rather than total time in-app.

This allowed them to polish users’ infrequent interactions and “improved the features available over time. We’ve found that engagement with Oscar’s key features such as Concierge, Care Router, and Telemedicine is up 35% year over year.”

This is no small feat in their industry—at the time of writing, 23% of Oscar’s customers now use telemedicine, compared with the national average of 3%.

Among their most popular features is one of their simplest: a digital version of the customer’s healthcare ID.

“People didn’t want to carry it with them,” recalled Regy. “It was so simple, but people felt like it was a huge convenience.”

The result of all this focus on design and technology was that the team opened up the door to more human connection.

The point of healthcare is connecting people

Oscar’s new app is crisp and simple and it’s hard to click anything without being directed to talk to someone—be that a nurse via text, a doctor via phone, or the concierge team via the app. And this is very much the point.

“People pay a lot for healthcare. They should get a great experience.”

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“Oscar is about connecting people,” says Liz. “All the technology, it’s just to facilitate that. And it should be easy. Healthcare should be a consumer product after all—it hasn’t been, to date—it’s been dictated by big healthcare companies, but we’re changing that. People are paying premiums and they should be getting a great experience.”

Oscar is growing. It’s now approaching 600 employees and like an organic, connective tissue, it’s healing its corner of a massive, underperforming healthcare system.

“For me the most exciting part is the prospect of how everything will eventually feed into each other,” says Liz. “We build tools for our members, but we also build tools for our providers. We help members see prescriptions, see survey results that they entered on their phone, and we can get that directly to their doctor. As a tech company we can connect them all.”

“And get them in and out of our our app,” laughs Regy.

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