Julia Hana Pak

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Julia Hana Pak

Activehealth: Streamlining Medical Preauthorizations

OVERVIEW

As the sole designer on the team, I helped nurses and doctors transition from fax to a paperless system for insurance authorization of medical procedures. My role encompassed user research, usability testing, and UI design, with a strong emphasis on accessibility and compliance with PHI regulations. Collaborating with engineers, I ensured that the tool not only met functional requirements but also adhered to best practices in accessibility.

ROLE

UX Designer

TEAM

1 designer, 4 developers, 2 QA, 1 Business analyst

TIMELINE

2018

Background

This project focused on developing a preauthorization tool for medical professionals, enabling them to submit patient procedure requests for insurance approval. This project aimed to modernize the workflow by developing a digital tool that allowed nurses to submit and track procedure requests more efficiently.

Problem

Nurses faced inefficient workflows and struggled with complex documentation processes like faxing forms, leading to delays in patient care.

Solution

I designed a simplified interface from the ground up that allows for a quick input of patient information and procedure codes, streamlining the approval process.

Results

Improved Accessibility: The portal’s accessibility score increased from 65 to 90.

Streamlined Nurse Workflows: Post-launch user surveys revealed a 40% reduction in manual paperwork and faxing, enabling nurses to spend more time on direct patient care.

Operational Efficiency: Preauthorization requests are now processed faster and with fewer errors, reducing back-and-forth communication between clinics and insurance providers.

Positive adoption: Within the first 3 months, over 80% of nurses migrated from paper-based requests to the digital portal.

Improved Accessibility: The portal’s accessibility score increased from 65 to 90.

Streamlined Nurse Workflows: Post-launch user surveys revealed a 40% reduction in manual paperwork and faxing, enabling nurses to spend more time on direct patient care.

Operational Efficiency: Preauthorization requests are now processed faster and with fewer errors, reducing back-and-forth communication between clinics and insurance providers.

Positive adoption: Within the first 3 months, over 80% of nurses migrated from paper-based requests to the digital portal.

Final Designs

BEFORE

AFTER

Intake form

This is where we collect the patient, procedure, diagnosis, physician, and facility details. All of these details will then be passed into what we call the "rules engine" which essentially will automate/generate the status of 40% of all procedure requests without the need for any manual human intervention.

Intake form

Inquire form

Nurses or doctors can look up the status of the precertification request. Made it easier if they have the request number they can simply add it and you can skip filling out the form.

Final Designs

Patient profile

This is simply what the user will see when they inquire about a patient in the system that has more than one procedure request. Here the user may click into one of these requests to see the details about the status.

Admin tool

This is the admin side of the UM Portal. Users can invite non-registered physicians to utilize the portal. This also allows users to resend the invitation to physicians.