Overview

Mobile app delivering lab results to patients

Empowering patients on their healthcare journey by optimizing the tools they need to understand and take action upon their genetic test results, thereby increasing value and trust in our laboratory services

COMPANY

Invitae

PROJECT DURATION

July 2022 - March 2023 (8 mos.)

TEAM (LEAN)

2 designers (mobile app lead + me)
1 Project manager
2 developers

MY ROLE

As the designer in charge of creating the results experience, my role included researching, interviewing users, analyzing customer feedback, creating user flows and wireframes, protoyping, assisting with the launch and setting up performance metrics.

PROJECT SUMMARY

Our lab provides answers to people facing serious life events, including medical complications and interventions. This project was about delivering genetic test results to patients in a way that makes them feel supported and informed.

In the end, my team launched an MVP results experience in native iOS and Android. We expanded the Mobile app audience from one test-type to all test-types, and built a simplified approach for patients to share their results as the most critical next step on their journeys.

BUSINESS CASE

Employers offer our genetic tests as a benefit to their employees. By optimizing our patient experience, we could increase attractiveness to potential new employer partners, who prefer benefits that do not burden their internal support channels.

The majority of our patients (71%) were already accessing their test results on their mobile phones— but in a web browser unoptimized for mobile! By delivering test results natively in our app, we closed the loop on an end-to-end experience on a single platform.

patients on iPhone and Android in the web portal (unoptimized for mobile)

71%

current mobile app users

7.7k

potential new users, pending close on the next B2B contract

~132k

Research

Part 1: Initial discovery

Team Discovery workshop

In our Mobile app discovery workshop facilitated by another designer, my team identified the business problem, brainstormed solutions, prioritized an action plan, and ultimately chose the Results experience as our next big bet on the roadmap.

The team used a Lean UX Canvas to identify business problems, desired outcomes, problem statements and solution ideations.

Prioritization of ideations we came up to solve the business problem.

Mapping our questions and assumptions as high-risk uncertainties (to help inform next steps for the team).

Team members committed to an action plan for unpacking high-risk uncertainties.

The team identified the Results experience as a Next big bet.

We began to ideate on how to extend the patient lifecycle by helping them develop a health plan.

Competitor analysis and internal auditing

For a competitor analysis, I looked at healthcare and finance apps that tackle complex, personal subject matters. As part of my internal audit, I studied our customer satisfaction survey results and PDF reports.

23andMe walks you through complicated test results (on the web) in a user-friendly way.

MyChart (Epic) manages records and allows communication with your medical team.

Natural Cycles has great data visualization and other educational content.

OneMedical's platform is an easy way to navigate a complex ecosystem of patient care tools.

I started with the simplest use case: A negative result for our Genetic Health Screen test.

Part 2: User research

Recruitment and user interviews

I recruited users using a Google survey in our internal work channels. My interview guide had 3 segments:

What motivates people to get genetic testing? And what challenges did they face with the Invitae experience?
How do patients understand and assign value to their test results? How do we create a positive experience beyond delivering the test result?
What did users think of my first wireframe concept?

Four interviews were 1:1 with patients who had activated their Invitae employee benefit:

Vidya

Mike

Kara

Monica

Two panels were with 3-4 B2B customers. Attendees were patients, benefits coordinators, or both:

Annie, Omar, and Sandra

Victor, Louis, Paige, and Adrienne

Analysis and synthesis

I worked in Dovetail to form my research. The end result was a presentation to stakeholders which identified insights, barriers and opportunities surrounding the ordering, kit, and result experiences.

A slide from my insights deck, the final deliverable of my research

Analyzing transcripts in Dovetail, searching for impactful quotes and themes

Clustering quotes into themes in Dovetail

Design

Part 3: User flows and wireframing

User flows

The process of sharing results through the website portal was overcomplicated and inefficient. When we discovered that users were skipping the process entirely, and taking screenshots of their results instead, I decided to create an easier way for them to share their results securely.

"After" I landed on a simplified user flow for sharing results to give patients what they wanted the most.

"Before" The web user flow for sharing felt overly complex and outdated. There were too many steps, like creating an "address book."

Hand-drawn wireframes

Users were unsure about about next steps after receiving their test results and wanted to be contacted by somebody to explain their results to them.

My first sketches included concepts for messaging with a provider, managing and sharing medical records, and getting care.

1- Results summary with new message banner; 2-Results data visualization; 3-Message inbox with provider; 4-Document center; 5-Share results

1- New message from your provider banner; 2-Results summary; 3-Next steps; 4-Bottom navigation 1st concept; 5- Appointments scheduling; 6-Upcoming appointment

1- Results landing page with new message banner alert; 2- Bottom navigation 2nd concept; 3- My health for medical record keeping; 4- Get care for next steps; 5-Messaging with provider

Medium-fidelity wireframing

I became interested in healthcare and fintech apps that employ data visualization and other interactive features to educate their users. I thought it would be smart to leverage content from Invitae's many existing result guidelines to minimize our need for medical writers, plus legal and regulatory reviews.

But when I shared my first idea with users, they said they were confused and felt overwhelmed by the complicated subject matter.

Patients wanted to know: What is my result? What does it mean? Why does it matter? And what should I do next?

Based on the mobile team’s initial feedback, I toned down the “textbook” level of content by removing “Positive result” and “Risk guidelines.”

It quickly became clear that users needed results explained to them. Even language in the result banner was confusing them.

Phrases like “lifetime risk” and "genetic illness" could cause undue stress if taken out of context.

There was far too much cognitive load for someone dealing with new test results.

Prototype v1

New plan! For my first prototype, I pivoted away from the educational experience and prioritized funneling users directly to speaking with a healthcare professional. Features included:

Messaging with a provider, managing/sharing medical records, and getting care
A simple result summary card (and no more long scroll of data vis)
Banner alerts, new message notifications, action item cards, and due date tags to create urgency
A bottom navigation to allow users to flow through all of the new features

Part 4: Prototyping

Part 5: High-fidelity

Making a mobile design system

In separate effort, the app’s style was being redefined. I started making Invitae's initial mobile design system to make collaboration easier with my design partner. This way the results experience would have better cohesion with the rest of the app.

Prototype v2

At this point, the company saw a major shift in priorities. We needed to shorten the timeline on this project, but still hoped to get something out the door. Revisions included:

Designing a “Talk to a Genetic Counselor” flow which exactly mirrored the web-version
Striking “Messages,” “Get care” and “My records” pages to eliminate timeline extensions
Removing the bottom navigation because it was no longer needed.
We're including a feature that lets users easily share their results with providers and family members, while also giving them a privacy warning for added safety.

Part 6: Final MVP

The mobile team wanted to launch an MVP. We asked, what is the minimum we can ship to responsibly deliver test results? Final revisions were:

Removing the results summary page
Opening the PDF report directly from the test card on the home page
Removing the ‘Talk to a Genetic Counselor’ flow
Adding a floating action button for sharing

Conclusion

Key outcomes

Providing our patients with a end-to-end experience on one platform for both Apple iPhones and Android devices.

Expanding the mobile app audience to ALL patients (by offering the results experience for all test-types)
Giving patients the #1 tool they use to see their genetic healthcare journey through to the end: native sharing!

Metrics

Data retrieved from Amplitude at three months post-launch:

organic users viewing results natively in mobile in the last 30-days.

749

increase in users viewing results over the first 3 months of production.

62%

average number of users sharing their results monthly via top 30 share actions.*

120

*Top 5 sharing actions over were: 1. Message in iPhone (~21.5 per mo); 2. Save to files in iPhone (~11.5 per mo); 3. Print in iPhone (~8.1 per mo); 4. Mail in iPhone (~7.8 per mo); 5. Gmail in iPhone (~3 users per mo)

Challenges

Making compromises without sacrificing user experience.

Responding to newly released federal regulations, which disrupted the core Results experience I was in the midst of working on.

From my user research, I learned healthcare providers are strongly motivated to choose labs that emphasize the patient experience, especially when it comes to test results. Receiving positive results can be stressful and scary for patients, and providers want to control when those results are released, so they can offer timely support. In the past, we offered providers the ability to configure settings to delay the release of their patients’ results, until the provider had time to review.

In 2020, that all changed. The 21st Century Cures Act mandated laboratories could no longer delay the release of lab results to patients, regardless of the ordering provider’s wishes. Our lab had a legal responsibility to disclose health information immediately to patients, despite the fact that doctors may not have a follow-up appointment set up yet, or may not be available to pick up the phone at the exact moment patients received results.

This change alienated some of our providers, whose utmost concern was their patients’ health and safety. We used to offer the ability for providers to control the “release of report,” but now those controls were going away. We were in a bind because the law favored the patient’s right to timely, easy access to their health information.

Ultimately, we had no choice but to follow this federal law governing laboratories. The responsibility would have to fall on ordering providers to communicate the importance of patients to wait to review results with a healthcare professional. My job was mentally prepare the patient for any outcome and provide them with the tools they need to get answers. This is why we included the “Important message” on the results landing page, to urge patients to wait to review results with their doctor.

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