Trillium Line Finder
User Experience Design - Re-imagining the application for medical providers to be a smoother experience. With Centene.
Project Overview
Medical providers face a variety of challenges every day, and a confusing interface only adds to it. With every patient treated, providers need to check that the condition and treatment the patient is given, could be fundable. Throughout my summer at Centene, I worked alongside a fellow intern to re-design Oregon’s Trillium Line Finder - a product that had last been worked on in 2011 and suffered various security vulnerabilities and UX challenges. Our goal for the re-design is to ensure that the final product is accessible to those using assistive technology and efficient to all medical providers.
The State of Oregon produces a prioritized list of covered health services for Medicaid members. This list contains hundreds of lines of conditions with relevant treatments, and is critical to how Medicaid operates in the state of Oregon. Medicaid providers need to know whether these lines are considered a payable service, and to do so, the Oregon Healthplan (Trillium) created an online tool that allows a user to easily search the list of services to determine payability. Our team was brought in to enhance providers’ experience and re-create a tool that is usable, effective, and accessible to all. We tackled the question: “How might we change the current experience so users can navigate more effectively?”
Project Type: Internship [12 weeks]
Team: Pixel Perfect (Intern Team - 11 members)
Role: UX Designer
Before:
Before:
Before we start:
The medical field has an insane amount of vocabulary that can make the industry jargon hard to understand. To make it easier for you, here are some key vocab that our team focused on throughout this project.
ICD Code: International Classification of Diseases (ICD) are a set of designations used by healthcare staff to communicate diseases, symptoms, abnormal findings, and other elements of a patient’s diagnosis in a way that is universally accepted by those in the medical and insurance fields.
CPT Code: The Current Procedural Terminology (CPT) codes offer doctors and health care professionals a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency.
Line: A combination of ICD codes and CPT codes to register a diagnosis and treatment (based on ICD and CPT codes) to check if the diagnosis/treatment is funded by the state.
The Problem
The current tool contains many security vulnerabilities and maintains a variety of UI & UX challenges. The two most critical pain points we identified were the challenging search interface and the lack of accessibility to view the descriptions related to a line, especially since there can be hundreds of codes associated to a line. Some examples of confusions as you navigate the page:
The search function has multiple input fields at first glance, making a user think that you would need to fill out every single field before conducting a search. Moreover, the amount of options on the screen makes it confusing, increasing cognitive load for the user.
The search results are presented in an extremely confusing manner, with multiple tables populating the page (all directly related to each other, but violating the Proximity Principle).
Across the site, there is a lack of accessibility. Not only does the current site violate WCAG (Web Content Accessibility Guidelines), but users have a hard time accessing any information that they need.
The Solution
* as a note, this video only shows one way that the user can navigate across the application. Please reach out (sharonre@andrew.cmu.edu) if you’d like more info!
1 - Re-imagining the search function: Rather than the multitude of input fields on the default search, we devised a dropdown with three options to correspond to the three primary ways to search: by ICD and/or CPT code, by line number, and by guideline number. This dropdown offers a cleaner interface and reduces the user’s cognitive load, as search input fields are limited to those required for the selected type of search.
After:
2 - Ease of access to information needed: Not only did we aim to introduce a cleaner interface, but we aimed to provide easy access to all information and descriptions that might be necessary in determining fundability of a treatment. In the original tool, descriptions were only accessible if you searched the individual codes. With any associated ICD or CPT codes, the descriptions would not be visible until you conduct another search.
In a competitor’s tool, these codes were accessible via modal. These modals are pop-up windows that grey out and disable interaction with the main page until they are closed, which can be problematic for users with assistive technology, who may not have realized that they’ve opened a modal. Moreover, if modals are not properly coded, they cannot be read by a screen reader or exited via keyboard only, rendering them inaccessible.
Our alternative was to introduce descriptions within the table, beneath the list of codes when clicked. This addressed the accessibility concerts of using a modal, and kept information easy to access and in-context.
Key features
After:
The Process - Wireframes & Mockups
The iterative process throughout this internship was extensive - we revised and updated out designs to reflect the goals that we wanted to accomplish - continuously keeping our stakeholders looped in so that we could receive constant feedback as we continued. Feel free to peruse our design workspace if you’d like to explore the evolution of our design!
Usability Testing
The next step in our design process was to meet with super users & stakeholders to conduct a usability test of our current design. To facilitate testing, we created an interactive prototype for the user to click through to simulate the real tool. We also wrote user case scenarios, which prompted users to navigate to certain pages in the prototype so we could identify any pain points in the user’s journey that may have been overlooked in previous stages.
As we observed the user’s actions throughout each scenario, we saw that the user was able to quickly navigate to the necessary pages, which signaled to us that our design was intuitive thus far. We also received significant insights on how the tool is used by medical providers. For example, we know that lines are either fundable or not fundable. However, the users were able to clarify that these lines can only be fundable by Medicare if all associated guidelines and practices are met, as without it, providers may assume that lines are immediately fundable. This would ultimately lead to confusion and serious issues in medical practice.
Collaboration
In order to make more informed design decisions throughout our process, we often communicated with other teams to ensure that each design feature is not only feasible, but useful and accessible. We worked closely with the accessibility team to discuss any problem points for users with assistive technology, and ensured that no accessibility violations were present in our designs. If there were any violations or concerns, we made necessary changes to the design based on our team’s capability with the limited time we had remaining.
We also worked closely with the Product team to clarify MVP requirements and ensure that we were on track to meet any business requirements, and finally, with developers to share our design solutions and gather feedback to snake the feasibility of proposed features on their end.
Reflection
Throughout my 12 weeks at Centene, I engaged in multiple different aspects of design and creating/improving a tool, from communicating and collaborating with our product team and development team to clarify business requirements and developer abilities, to the accessibility team to have a conversation about any important points of improvement to allow for equal access. With the completion of this internship, something I want to continue focusing on and exploring throughout my career is the accessibility front and how to lift the barriers for those who have trouble with navigating websites and applications.