NaviNet Value-Based Programs Application Design

Every year, NaviNet puts aside a few days to allow all employees to exclusively work on concentrated innovation projects. The event is called “Off The Grid” (OTG), and it is an opportunity for everyone to work on something fun, creative, and beneficial that does not necessarily have anything to do with their typical day job (i.e. official role in the company). Participants come up with various ideas and then form teams to work on them. Everyone takes two days to build their projects (e.g. proof-of-concept, prototype, business plan, etc.). Then, on day three, we all get together and show each other what we’ve built or learned. The company’s senior executives act as judges, and their top picks are launched as actual development projects.

Our CEO recruited myself and one of our engineering directors to work directly on an OTG project with him. The project was based around a product idea he had been mulling over for a long time. It involved an application that would enable administrative provider office staff to reach out to patients, in an effort to close care gaps and meet quality care incentive program requirements. Such shared-risk contracts are becoming increasingly prevalent between providers and health plans, as they slowly shift away from the traditional fee-for-service payment model. The goal behind our proposed value-based network application was to support these emerging, performance-based reimbursement and patient care structures.

After an intense couple days, as well as some sleepless nights, we rapidly designed our proposed, productized application. I constructed a fully interactive prototype of the application, basing my user interface on the latest dashboard best practices and an innovative gamification strategy.

Our presentation was a big hit at the Off the Grid event. The executives eventually used my prototype to shop the idea around to a couple of our big customers. These clients were impressed and excited by the concept, and thus the application was considered for our future product roadmap.

Client: NaviNet

Industries: Healthcare, Insurance

Demonstrated Capabilities: Creative Direction, Gamification, Interactive Prototyping, Process Improvement, Product Definition, Storyboarding, User Interface Design, Wireframing

Tags: Accountable Care Organization (ACO) / administrative staff / contracts / incentives / metrics / patient outreach / PCMH / PCP / preventative screenings / provider office / quality care / value-based programs

The Project Story

Prioritized Payer Programs Provider Office is Enrolled In

The initial screen shows a list of payer programs that the provider office is enrolled in with various plans that they contract with. Each of these incentive contracts are prioritized by the office’s program manager. This application is specifically designed for front desk admin staff, to help deputize them, and get them involved in patient outreach efforts that will ultimately lead to fulfillment of various program requirements. These efforts will also greatly benefit high-risk population patients and ensure that they are receiving the proactive care they need to in order to avoid experiencing acute, critical health problems.

Payer Incentive Program Dashboard

When a user clicks on a specific payer incentive program, she is brought to a metrics dashboard with a number of graphical dials. Each dial represents one of the program’s quality care measures (e.g. breast cancer screenings, HbA1c tests for diabetics. They show, at a glance, how many care gaps have been fulfilled to date, as well as how many are still needed to reach the required target. Rolling over a dial reveals more information about the measure, including comparative performance metrics across time and between offices. This helps users determine how well they are handling these activities from month-to-month, or in relation to other PCP offices that are enrolled in the same value-based care program.

View a Particular Measure Across All Payer Incentive Programs

Users can also view a particular measure, such as breast cancer screenings, across all payer programs that the office is participating in. This is a very powerful feature, as it allows users to see, within a single view, the thresholds they need to meet on a particular measure in order to fulfill requirements for each program. Today, each health plan mails separate reports for every program, and there is no easy way for office staff to see such an aggregated meta view.

Patient Call List for High-Risk Population with Built-In Gamification Mechanisms

Clicking on the “Call Patients” button brings up a list of high-risk population patients who are enrolled in the care program and still have not had the care gap addressed. Contact information is provided for each patient so that the user can immediately pick up the phone and start making appointments. On the right sidebar, users can see how many care gaps they have completed that day and how many more are required to meet the required target. The sidebar also contains a detailed description of the measure.

Interactive Patient Action Checklist

If users need more guidance, they can click on a specific patient and view a straightforward checklist of actions that must be taken in order to reach out to that patient. As each action is completed, they can be crossed off. Additional care considerations are also displayed so that the staff member is able to address all of the patients needs in one single call. As they close out patient care gaps, staff are continuously encouraged with positive feedback messages.