One of the biggest problems in American healthcare (besides cost) is the shortage of providers. From physicians to nurses to mental health professionals, it’s getting dire at every step — from finding a provider when you need one, to being able to make an appointment in a reasonable timeframe, to getting the treatment you need near where you live.

One of the most promising solutions is virtual care. It’s efficient, it keeps sick people out of public spaces, it addresses localized provider shortages, and it’s good business for healthcare — better access for more patients also means more patients seen and paying (let’s be honest, it is a business).

There’s at least one big barrier: A majority of patients still believe they have to see their doctor in person to get good care, even if it’s inconvenient and difficult for the simplest of conditions, like ear infections or dermatitis.

The truth is, about 80% of visits — particularly for common conditions treated by primary care, the entry point for all care in any health system — can easily be virtual.

No one should have to work that hard to get care or see patients.

Enter, Connect+

• The foundation to all virtual care ecosystem efforts created to compete with disruptors like Amazon

• A membership service, paid monthly or annually

• Access to 24x7 virtual care from a third-party provider following Rush protocols

• Access to chatting with a Rush scheduling and care support representative

• Mostly seamless integration with current Rush operations and systems

• A central piece of a strategy to attract new patients with convenience, serve them with easy access, and engage with them long term with referrals and specialists

Then, virtual first primary care:

• 2-3 days virtual, 2 days in-person appointments

• Primary care plus support for chronic conditions, like diabetes or obesity

• Staffed to address more holistic patient needs than typical PCP clinics

• Shorter appointments —> higher availability

• Use of patient-facing technology to streamline every visit

• An effort to attract new patients with convenience and easier access to providers

What do these services do?

Connect+ supports faster access to virtual care and direct communication with one of our most helpful and critical teams in patient support and satisfaction. As an MVP it had limited functionality and only preliminary aspirations, so this paragraph is shorter.

Virtual First Primary Care was already in pilot. This effort supports

• faster, more complete understanding by staff of what’s happening for patients, achieved by standards for consistency that support a cross-disciplinary care team

• chronic conditions treated in one clinic instead of through several specialist referrals, unlocked by having pharmacists, social workers, and eventually other specialists like mental health providers on staff.

• streamlined appointments focused on time with a patient, achieved by using patient-facing tech for tasks like check in, reason for visit, and check out

What I did to support them

For Connect+ it was …kind of a blur for 7 months. This is how things just are in healthcare and why everyone you meet in a hospital looks extremely tired. Everyone is overtasked, overwhelmed, and just trying to keep up with email.

Every now and then, I would design a screen or a flow to help the team understand what the service was. For example, after multiple unproductive rounds of discussion with a spreadsheet open on a conference call, I pulled together a “prototype” which was really a PowerPoint deck with everyone’s bits and pieces strung together. Apparently, this was revolutionary, but hey — whatever works to help people see.

I pulled that together because I cannot think of a worse way to gather requirements than to put 30 people on a conference call, open a spreadsheet, and instead of honestly gathering requirements, nudge people into commitments they were simply not aligned with. I was told that this is the way these digital transformation efforts generally go. (I didn’t see a lot of long-term success in working this way; I also noticed that people seemed to avoid my boss.)

For Virtual First Primary Care, I had the benefit of working with a fantastic physician who knew exactly what kind of experience he wanted to provide. He was running a pilot, so we were scaling and enhancing an existing operational model. I did the work needed to make sure we started off on the right foot for scaling on the software and change management side.

Holy cow, did I learn a lot about healthcare and the technology that sits behind it. It’s too much to go into here.

What I learned

1.Be careful what you wish for

Mostly I was hired to bring “consumer-grade experiences” into Rush because I had worked in big tech.

The problem with being someone who knows what consumer-grade experiences are is that I also know what they are for: to maximize consumption of a product or service.

I wanted to move into healthcare because I was sold (in the interview process) on the idea that I would be helping patients gain access to care by making the digital experiences better. There is a lot that can be made better.

What I was really doing: adding to the digital dysfunction and putting together services designed to make money for the health system.

2. As went early UX roles in the business world, so it goes in healthcare

I have no doubt that the people who wanted to hire a UX architect were convinced that’s what they needed. I brought decades of expertise and could do basically everything in a delivery process, so I seemed to fit the bill.

But what they really wanted was someone who was willing to open a spreadsheet with 30 people on a call and obtain commitments, and someone who was willing to put a product in front of patients when it was much too late to change it to simply say the voice of the patient had been incorporated.

As a designer, those weren’t skills I was keen to hone, so I left after 9 months.

Coda

Healthcare and its delivery in the United States is one of the most inhumane systems I have ever come across, which may seem an odd conclusion when this work was setting out to improve things for both providers and patients, and has a mostly decent model to achieve that goal, at least on a small scale.

What I mean is this: for a system that is supposed to be about providing human beings with care provided by other human beings, it is not built to support either set of human beings.

So much stands between both provider and patient, including

• linear protocols for diagnosing patients based on symptoms that don’t leave room for listening compassionately and treating holistically, making providers seem like automatons speaking a different language

• a business model that incentivizes quantity when its users (patients) need quality, while providers may well prefer to focus on giving higher quality care to fewer patients

• regulatory requirements that are well-intentioned but create a bureaucratic maze worthy of Kafka,

• extractive, exclusive health insurance (in the US), and

• financial barriers for patients, who bear the cost of a system that is so expensive to run