Why User-Centered Design Is Crucial to Member Engagement

A new normal has ushered in a new reality for health plans — necessitating member-facing tools that mirror the experiences consumers have elsewhere in their lives.

This clarion call from healthcare consumers is by no means new, but demand increased significantly amid a pandemic that has turned day-to-day life on its head. Payers increasingly realize that significant change is necessary to bolster their member engagement efforts during and beyond COVID-19.

And an obvious starting point is mobile.

"Health technology didn't leverage mobile technology and the ubiquity of mobile devices as much as other sectors pre-pandemic," says Wellframe Chief Technology Officer Mohammad Jouni. "Consumer markets have become mobile-first, and the health sector hasn't yet caught up. Due to the realities of COVID and the dynamics that emerge, the best opportunity for engagement is through the mobile device — it’s available and accessible to many."

However, a modern approach requires modern infrastructure, which many health plans have tried and, in many cases, have been unable to adapt to the current moment.

"Many organizations have to take their technology and somehow fit it into a web-first or mobile-first experience, and the experience suffers from that. In many ways, it's broken," Jouni maintains. "Just look at the App store reviews for typical health plan apps. In some ways, the experience is broken due to trying to adapt those technologies to the new realities."

Inherent complexity already defines healthcare. Introducing more fragmentation simply compounds the situation. Now is the perfect moment for payers to go back to the drawing board and consider member engagement and experience from the end user's perspective to identify and develop new ways for helping individuals navigate the healthcare system.

"Plans and providers realize they need to rethink the digital experience from first principles and closely scrutinize the investments they're making to pivot to more of a digital-first experience. And they are poised for success because this is what consumers are asking for," Jouni adds.

For many health plans, the infusion of new ideas will come about by partnering with a third-party specialized in developing user-centered solutions.

"The challenge is to be able to build an organization that has in its DNA a user-first experience. It typically is not a skill set that payers have — not because they shouldn't and they haven't, but because it wasn't a necessity for them," adds Jouni. "By rethinking and bringing in more design thinking into the organization, some are better able to engineer their own solutions on their own while others will benefit from partnering with vendors who can bring in that expertise internally."

When the perspective shifts to the member, solution development becomes much more straightforward. It's not about what the technology can do; instead, it's how the tool is structured to assist an individual on their health journey.

"When we approach member engagement, we think about the jobs to be done for the member based on a hierarchy of needs," Jouni says.

"For example, someone coming out of a surgery has jobs to be done that are different than someone who has a chronic disease," he continues. "An effective member engagement solution must be able to tackle these two individuals and give them what they need to navigate their health and care. The next step focuses on outcomes. Next, we move to optimization — how does the solution help bridge the gap between where members want to be, where they are, and how they get there."

The approach is heavily influenced by behavioral economics and understanding why individuals come to make their choices and encourage more desirable decision-making.

"Individuals sometimes struggle to recognize the incentives personally that will lead them to the intended result. Our job is to think about capturing that psychology and enable the staff to engage and reach out to the member," Jouni reveals.

Key to advancing the development of member engagement solutions is interoperability. Numerous systems contain data and information on a member, but they are not integrated in such a way as to create a more comprehensive picture of an individual's health.

"For the industry as a whole to get better at serving the member, the industry has to invest more in interoperability standards like FHIR," Jouni explains. "It makes it easier to have this ecosystem where people can plug in and create innovation. If a health plan creates a FHIR endpoint to see a member's history, any number of vendors could come and add value for that organization. And over time, both the payer and the member benefits from the seamless integration."

By adopting user-centered design principles and investing in interoperability standards, health plans of the future will be able to meet members where they are and help them get where they need to be.

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Wellframe partners with health plans nationwide to reimagine member relationships. With solutions for care management and advocacy, the Wellframe Digital Health Management platform empowers health plans to become a trusted advocate for all their members' health needs. Learn more at wellframe.com.

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