Patient Engagement Platform
I led the design of CareMessage's patient engagement web application, which enables FQHCs and free clinics to communicate with their patient population at scale and ultimately improve the health outcomes of underserved populations.
Project Overview
Client
CareMessage, a B2B SaaS nonprofit, which aims to leverage technology to help safety net organizations fulfill the essential needs of underserved populations.
Challenge
Design a web application tailored to clinical use cases that allows clinic staff to quickly and easily communicate essential information with patient cohorts.
My Role
Lead Product Designer
Timeframe
18 months
Problem
Clinic staff spend hours manually calling patients about upcoming appointments, referral follow-ups, and other health information. They need a more efficient and scalable way to communicate with their patients.
Solution
CareMessage's web-based application enables clinic staff to quickly and easily communicate essential information with patient cohorts via text messaging. Instead of spending hours calling individual patients, users can communicate the same information in just a few minutes by scheduling and sending text messages at scale.
Messaging Tailored to Clinical Use Cases
Clinic staff's most common messaging use cases became CareMessage's core features. Using clinical use cases to drive action makes the app feels more natural and intuitive for clinic staff to use.
Communicate at Scale
With just a few simple steps, users can send a single message to a targeted cohort of hundreds or thousands of patients. This enables clinic staff to communicate more efficiently and strategically and ensures patients receive relevant information.
Message Customization & Personalization
Users can choose from a variety of different message types and scheduling options to tailor their messaging to their preferred workflows. Message tags can be inputted to provide specific and personalized information to patients.
Monitor Patient Responses
After sending messages, users can monitor patient responses and see key information at a glance. Follow-up actions are easily accessible from the same screen.
Analyze Response Data
After a message or campaign has been sent, users can view data and graphs summarizing key metrics and patient responses. This helps users see which types of messages their patients respond best to and gives users further insight into their patient population.
Design Process
User Research
I began my design process by developing a deep understanding of the users who would be using the application. This research helped guide the goals for the overall design of the app to ensure it was meeting user needs. The main takeaways that influenced the application design were:
1. Users had varying levels of technical savviness.
While some CareMessage users were highly technical, others were less tech-savvy and were apprehensive about integrating a new software into their workflow. To ensure the app was accessible for all users, it needed to be easy to use, regardless of one's technical proficiency and familiarity with similar types of software.
Design Takeaway: Ensure the app is intuitive and easy for anyone to use.
2. Users were very busy.
CareMessage users were often juggling multiple tasks at once and had huge to-do lists. This meant that, no matter how beautifully the app was designed, they would likely not be spending a lot of time experimenting with features or trying new functionalities. It was more important for users that they could accomplish their goals quickly and efficiently and move onto the next task as soon as possible.
Design Takeaway: Design with the goal of saving time and improving efficiency.
3. Users were constantly changing.
Healthcare in general has a high turnover rate, and many staff, especially at free clinics, were mostly part-time or temporary volunteers. This meant the app needed to be easy to learn, since there would often be new people using it, sometimes without anyone within their clinic to help train them.
Design Takeaway: Ensure the app is easy for new users to learn and requires minimal training.
User Personas
These user personas help explain how the app's utilization differs depending on the type of customer and their patient population size. Some users prefer a "set it and forget it" approach, while others prefer to be more engaged day-to-day and want to actively monitor patient responses. I used these personas to ensure my designs were effective for all users and their preferred workflows.
Define User Needs
Further research into the specific messaging concerns and use cases that clinic staff wanted CareMessage to solve helped create the user needs that guided the individual features that make up the app.
Reduce Appointment No-Shows
•  Users need to remind patients to schedule appointments to see a referred specialist.
•  Users need to remind patients to attend their scheduled appointments.
•  Users need to ask patients if they will be attending their upcoming appointments.
•  Users need to see patient RSVP data.
•  Users need to follow up with patients who RSVP'd "No" to an appointment.
Optimize Patient Communication
•  Users need to communicate with patient cohorts (1:many messaging).
•  Users need to communicate with individual patients (1:1 messaging).
•  Users need to see all patient responses from an individual message.
•  Users need to see all messages from an individual patient.
Improve Health Outcomes
•  Users need to keep patients engaged in their heath long-term.
•  Users need to send targeted health education to patients with specific chronic diseases or other conditions.
•  Users need to evaluate which health education messages were most effective with their patient population.
Information Architecture
The user needs outlined the main use cases for the app, which helped guide the structure of the application. To ensure the app's navigation made sense to users, each clinical use case that was identified became a distinct feature. This way, it was very obvious to users which feature to navigate to based on what they wanted to accomplish.
Interface Design
The UI and UX design of CareMessage's app was heavily influenced by the user research that was initially conducted. I focused on making the app easy to use and understand while optimizing workflows to save users as much time and effort as possible. When designing interfaces, I tried to imagine how it would feel to use if it was my first time using the app and I had no idea how each feature worked.

Each feature needed to feel distinct while still ensuring they all looked and worked similarly. I used a design system with components and modals that could be applied across features to ensure a consistent user experience throughout the app.

I created hundreds of interfaces for the different pages and states of the CareMessage application. Below are some examples of the design principles and usability heuristics that guided my work.
Optimizing Interfaces for User Goals
When users click into a feature, they usually want to scan through the recent responses they received and see if any patient responses require follow-up.

Thus, each feature's main screen lists the most recent patient responses with the ability to see additional details and take appropriate action, all on the same page.

This makes it is easy for users to accomplish their goals while reducing their cognitive load and number of clicks.
Using Empty States to Improve Learnability
When users first visit a feature, they may be unsure about the best way to use it and the appropriate next step to take. To improve the app's learnability (the user's ability to use an interface they have not seen before), I used empty state pages to explain the purpose of each feature and the recommended action to take next. This helps guide the user, ensuring they will understand and begin using the app sooner while getting the most out of the available features.

Guiding Users with Suggested Use Cases
To help users get started with messaging, each feature comes preloaded with messaging templates and suggested use cases. Offering these suggestions helps users understand the best way to use each feature and allows them to feel more comfortable using the product.
Flexible Message Creation Forms
While preloaded messaging templates help new users get started, more experienced users may wish to customize their experience by creating their own reusable templates. Users can determine the number of messages included within a template as well as the content, format, and scheduling of each message. Allowing users to customize the product to best align with their preferences helps ensure that they successfully accomplish their goals.
Actionable & User-Friendly Insights
The main messaging metrics users are concerned about are the results of an individual message (i.e. what % of patients responded Yes/No to a question) and the number of messages sent to a specific patient (to ease concerns about over-messaging a patient). Thus, I designed summary pages to highlight those key metrics and make it very easy for users to find the data they care most about.
Designing to Prevent User Error
The ability for a clinic staff member to message thousands of patients with the click of a button means a small user error could be very consequential.

To help mitigate these risks, I designed interfaces in ways that prevent user errors from happening. One example of this is using design friction to force users to slow down and confirm consequential actions. Identifying potential errors and proactively trying to prevent them helps mitigate risks and makes users feel more at ease.

More about this:
Designing to Prevent User Error
Visibility of System Status
To import data into the CareMessage app, users can upload spreadsheets through the file center. This is a multi-step process, so I used a progress bar at the top of the page to ensure users know what step they are at and how much longer they have to go before they are done. Despite being only 4 steps, the file upload process can be a bit cumbersome, so reminding users that they only have one or two steps left increases the likelihood that they will complete the process.
User Delight
No matter how beautifully designed an app is, there are some things that will always be a bit frustrating to users. Waiting for something to load is one of those things. When frustration was inevitable, I tried to bring joy to users with amusing illustrations, like an illustration of a file waiting in a VIP line when it is queued for upload. Once a file is successfully uploaded, that file illustration is relaxing with a cocktail.
"CareMessage's clean, intuitive UI makes rollout a breeze with minimal training."
- Tracy A., Chief Medical Information Officer & CareMessage User
Result
Using CareMessage's web app, clinic staff are able to successfully send important health information to their patients in an efficient, scalable way. This functionality became especially useful during the COVID-19 pandemic, as the app enables clinic staff to communicate with patients about telehealth appointments, updated clinic protocols, vaccination information, and more.

In my time working on CareMessage's app, the average number of unique patients messaged per month grow from ~200,000 to over 2.5 million and the number of individual app users grow by 350%.