Blue Shield of California —
Healthcare Marketplace / Digital Front Door

Imagine if Blue Shield of California and Apple computer had a baby, and that the baby had the business model of BSC, a vertically integrated insurer and deliverer of healthcare services, but with an intelligent, easy to use, frictionless consumer experience, and the brand loyalty of Apple. Employees across California would demand that their employers offer this plan, and seniors would choose BSC's Medicare Advantage plan without thinking twice.

PROBLEM

Blue Shield of California recognizes that their existing digital healthcare experience is rife with friction, accessing care and services is difficult, leading to poor engagement and dissatisfaction.  As an established payor, BSC saw an opportunity to increase customer satisfaction, dramatically improve access to care, a financial opportunity for the business, and the ability for them to create the conditions for better health outcomes for its members through a more intuitive and engaging experience. With that as a backdrop we asked ourselves: How-might-we create a human-centered AI driven digital experience based on a system of record, intelligence, and engagement providing users effortless access to care and services, and experiences that boost engagement, increases retention, builds loalty, and drives profitability.

CURRENT STATE

In the current state of the native mobile experience, members can to log in to their account, review their benefits, file a claim, check messages, update their settings, and profile information. In today's world, with a smart phone in everyone's pocket, users are still *not* able to find a doctor, access urgent care, schedule appointments, communicate with their doctors, fill and refill prescriptions, access their health records, exercise their transportation benefits and more. For these services they must make phone calls to find doctors who are accepting new patients, schedule appointments, and other secondary services.

DESIGN PROCESS

The goal directed design process runs from project planning, research activities, modeling, requirements definition, framework definition, prototype creation, testing, detailed design, through implementation and support. I believe that the best way to design and develop a successful digital product is by focusing on achieving both user and business goals.

DESIGN THINKING / SPRINTING

Once stakeholder interviews and user research was conducted, we gathered a small group of key stakeholders, leadership, and subject matter experts, we conducted information sharing lightning rounds, reviewed business and user needs, sketched out ideas, decided on which direction to explore, created prototypes, validated the concepts via user testing, with a focus on desirability, viability, and feasibility studies.

SOLUTION

Our solution was to create a data-driven personalized "Amazon" for healthcare experience that places members at the center of the experience. The marketplace platform would be designed and architected to help members discover and connect with health related services and information, allow them to, find-a-doctor, schedule appointments, communicate with their extended care team, close care gaps, refill prescriptions, file claims, pay bills, and a host of other related healthcare needs. The experience leverages member/patient data combined with human-centered AI, ensuring that each member's experience reflects their individual needs and preferences. The solution focuses on making Blue Shield of California's digital apps and services maintain a dialogue with our members, deeply understand their health condition and needs, and reflecting that understanding back to them, enabling each member to find and access the right type of care and services, on demand.

WIREFRAMES

HIGH FIDELITY INTERACTIVE PROTOTYPE SCREENS