UX Lead: Cleveland Clinic Diabesity Program

In 2011 Cleveland Clinic was running a wildly successful program to help patients manage what they call "Diabesity." See, diabetes and obesity are inextricably linked in the United States, and it also turns out that a person newly diagnosed with diabetes does almost nothing to treat their condition when you just send them a bunch of mail.

Now that you've heard about this, you'll start seeing this word everywhere. Trust me. 

Now that you've heard about this, you'll start seeing this word everywhere. Trust me. 

People don't like being told they are sick, or that to get well, they need to change their behavior. And it turns out we are very bad at just changing our behavior on our own with little prompting or being held accountable over the long term. Also, people lie to their doctors! I still have no idea why people do that.

So the Clinic decided to get real people involved and by the time I arrived on the scene, they had a call center full of nurses who follow up with patients and their doctors to make sure they are "adhering" to their program. If a patient does what their assigned nurse and doctors say for a whole year and keep their A1C numbers level or lower, all treatment for their diabetes is FREE. 

FREE HEALTHCARE ... if you take care of yourself.

Because as it turns out, the cost of treating someone whose diabetes and obesity have gone unmanaged is astronomically higher than helping them stick to a plan with actual, real people involved. So the Clinic naturally wanted to expand the program to help more people and lower the eventual cost of treating diabesity.

The Business Problem
Remember the mandate for electronic medical records? People kind of... made a mess there. And these nurses paid the price -- to get a holistic picture of what was happening with a patient they had to access somewhere between TEN TO SIXTEEN discrete data sources, and then make their phone call. Assuming the patient answered at all, the nurse then had to then add any new information to multiple systems in different ways. The call center setup gave the Clinic a startling picture of how long all of that took, so they wanted a system that a nurse, doctor, nutritionist and even a patient could access to see what was going on.

The Approach
This pitch arrived on my doorstep  in mid-2011 because a technical sales guy at Avanade was told about the pitch by an Accenture sales guy. The Avanade guy had heard who I was, that I was good with clients and understood software development, so he just pinged me one day. I knew I didn't have the visual design skills or people on my team to pull off a whole design effort, so I reached out to a small agency I knew of in Chicago, c|change

The lead at c|change and I went to Cleveland and interviewed the people who would use the system, the internal teams running the disparate systems that were the nurses' data sources, and the business owners of the program. We returned to Chicago and spent two weeks collaborating with his designer on a set of screen views stitched together in a clickable PDF. The audience would need to see the flow and basic screens, but the tools just weren't quite there yet.

(Just three short years later, that process would be very different, result in a much more interactive prototype, and probably take a day or two with a designer.)

The Money Problem
In the end, the Clinic decided not to pursue the project because the Accenture price tag for it was in the millions. The cost wasn't going to be in design -- the cost was going to be figuring out how to get some very locked down, proprietary products to work together on the data side. I wish I knew what they decided to do after that, but just as the opportunity had appeared randomly, the Accenture guy disappeared.

What I learned
This might have been the first time I felt like the design skills I brought to the situation  could really, actually, materially make someone's life better. With the major medical experiences I underwent a few years ago, I can now see a trail between this project, my own experience, and my desire to use what I do best to really help people live better, happier lives. I haven't found the spot to do that from just yet, but I'm looking.

The Bermuda Triangle of Deliverables
They say never put something in your portfolio without a visual of your work. But I say this is a  project showing my approach to complex problems and working across multiple teams in multiple companies to pull off what really was a nice little proof of concept -- that I just don't happen to have pictures of right now.  

The interfaces were personable, friendly, and prioritized the most important information for the audience right there on the first screen. We used shades of the Clinic's green in their brand, photos of people, greetings and natural language to reinforce the human-ness in what could be a very dehumanizing situation for everyone involved. We made several screens for the nurses, a vision of how a doctor might interact with the tool (did you know a lot of doctors simply won't use email at all because they "don't type"?), and even a view for a patient to track their own progress.

It is a hard-won lesson: hold onto your stuff, you might need it for your portfolio one day. Especially for someone like me, who is looking forward, not back, most of the time. Whether through other team members doing work I led, multiple hard drive losses before the days of the cloud, NDAs that restrict me from showing my work, or just plain "I forgot to grab that stuff before I left," I just flat out don't have the screens. I'm working on it!


Service Design: Concepts for a Gogo partnership with American Express

The Business Problem
In the last two years, airlines have started taking away the American Express Platinum Cardmember privilege of free airport lounge access. From the outside this appears to be a huge blow to the Card -- all you have to do is look at the comments on AmericanExpress.com's Platinum Card page to see how people feel, and how many people openly say they will be downgrading or outright canceling (1,068 comments when I was looking in Dec '13).

As a result, Am Ex was looking to offer services to its Cardmembers that would have the same level of value, and approached Gogo as a potential partner.

The People Problem
When people are afraid, they can only function in the "what can we do right this minute" place, instead of seeing a possible (and completely doable even within constraints) future.  

The Approach
I was told by executives to "think way outside the box" and not consider any constraints; to come up with something great and we'd do what we needed to do to make it happen. I asked if they were sure an annoying number of times. Because when you put me on a pitch like this, I'm going to do my homework, but I'm also going to go further than people generally expect.  (<--That was foreshadowing.)

I lasso the moon, then I'm happy when I finish with a few stars.

I started here: figure out why Am Ex would approach Gogo by doing some research on who else they were working with and how they were talking about their services in the media. I found interviews, press releases, articles on innovation and then some. When I looked into the app, I noticed they were using Passbook in iPhones, but not because it provided a receipt or ticketing functionality. They were using Passbook for access to the geolocation of a device and to allow for push notifications to be sent because of a device/person's current location. And then I looked at their Concierge services and thought about how they might be used during a flight. 

Then I started thinking about how I, as a Cardmember, might want to have my travel experience as a Cardmember extend into the cabin of the aircraft I was in -- planning extravagant evenings of entertainment from the comfort of your first class or private jet seat, and how that might look in a commercial of theirs.

It was as clear as day: Am Ex is trying to build a connected, seamless travel experience that only Cardmembers have access to -- something so clearly valuable that people want the card for the services they get, not just because it's a "Card." That's why they need to replace the lounge access with services that have just as much perceived value.

Because, after all, we know that being a Cardmember has its privileges, and that turns out to still be extremely important to the brand.

Also -- this was a portable design for other partners that didn't put a ton of technical work on Gogo's plate. We just had to decide to do it.

The Deliverable
I created conversation starters. Ways to think outside the box with a partner. To see a world of possibility for their Cardmembers.

Concretely, it was a deck with some possible futures for the sales team to lift and drop into their meeting materials. From my point of view, with a potential partner like Am Ex, we needed to blow them away -- suggest a number of possibilities and talk about partnering in ways they might not even have considered when they reached out to us.

The Effect
Sadly, the team at Gogo was made extremely nervous by the ideas I put forward, even though I did my homework on their feasibility and desirability. In the end, a more modest, short-sighted proposal was pitched. From there the deal became something that interrupts the purchasing flow for all passengers trying to purchase Gogo. <sad trombone>

Some slides from that deck are below.