How better content reduced patient no-shows by 15%
Livi works with the NHS to help make healthcare more accessible for everyone.
Owned by Kry, its Swedish parent company, Livi has cared for over 3 million patients across Europe.
⭐ ⭐ ⭐ ⭐ ⭐ 4.9 out of 5 · 34.7k reviews
Problem: why are so many patients missing their appointment?
Working in partnership with the NHS, Livi had recently built a web-only version of their product for video GP appointments.
But something wasn't working as it should...
The number of patients missing their appointments was unusually high. This was wasting GPs’ time and meant patients were not getting medical help.
30% of patients were missing their digital GP appointment
Team
🔬
Researcher
🎨
Product Designer
✍️
UX Writer
Goal 🎯
Our product team, the Patient Experience Team, needed to investigate why so many patients were missing their appointment.
Our goal was to reduce the number of no-shows by a statistically significant amount, ideally more than 5%.
What I did
It was my responsibility to:
-
Steer and contribute to the research from a content perspective, including asking questions for the data analyst to investigate, writing usability testing questions and tasks, writing survey questions
-
Analyse the results and findings of the research
-
Review and map the existing content and user journey
-
Ideate solutions to improve the experience, with specific attention to the content
-
Plan, run and analyse content tests for the new designs
My process
Whenever I can, I like to follow the double-diamond design process. (I love thinking about content like a designer, not an editor.)
The process can be scaled up and down – but the central ideas are to:
-
create a shared understanding of the problem
-
involve stakeholders at the beginning, middle and end
-
iterate, iterate, iterate
-
design and content are equal partners
Discovery 🕵️
Data investigation
To help us understand why patients weren’t showing up, we delved into the product data to see if there were any clues about what was going wrong. Were patients confirming their appointment? Were they clicking the links in the reminder text messages? At what stage in the journey were they dropping off?
Moderated usability testing
The data threw up some interesting ideas, but the real eye-opener was seeing patients use the product. We observed users going through the whole journey – from booking through to attending the appointment. We asked questions at each stage to gauge their understanding, finding little frustrations and confusions we never anticipated.
Survey and content testing
To back up the usability testing with more quantitative data, we asked 100 patients about their experience of digital healthcare appointments. I also used the survey as opportunity do some simple content testing, showing users different versions of the instructions.
Key research insights 💡
-
Overloaded with too much information, patients were missing crucial instructions.
-
Deliberate cancellations by the user were much lower for the web product. It seems patients who didn't need the appointment thought it would be cancelled automatically.
-
Patients' expectations were shaped by previous experience of phone call GP appointments – this led to confusion when our product was a little different.
Design and content review
After our research, and with a deeper understanding of what was going wrong, I mapped out the user journey to identify content that could be improved.
Before
⚠️
Important info below the fold and hidden in drop down boxes. This led to confusion and users missing crucial instructions.
After
✅ Breaks info down in to steps and chunks. Reveals the detail when it becomes relevant. Keeps key instructions at the top of the page.
UX principle:
Progressive disclosure
"Users are less overwhelmed if they're exposed to complex features later. An interface is easier to use when complex features are gradually revealed later."
Interaction Design, "Progressive disclosure"
Before
⚠️
Push notifications suggest the appointment will be cancelled automatically if the patient doesn't need it anymore.
This led to far fewer cancellations than expected, and wasted GPs time.
After
✅
Clarifies how to cancel and appeals to empathy and emotions
UX principle: Appeal to emotion
"When our emotions are awakened, we can be tremendously caring. Once we attach an individual to a problem, we're much more willing to help."
Dan Ariely, "The Irrational Bundle"
Before
⚠️
Content hierarchy prioritises the wrong information.
Previous experience of telephone GP appointments, and unspecific language about how it works meant users expected a phone call.
After
✅
Cut down to a single, clear instruction about what happens next.
More specific so users realise it's not a regular telephone GP appointment.
UX principle: Mental models
"Users have preconceived notions about how things work. What users believe they know about a system strongly impacts how they use it. Mismatched mental models are common, especially with designs that try something new."
Norman Nielsen Group, 'Mental Models'
Business outcome
-
Reduced the number of no-shows for web appointments by 15%
-
Improved clinical efficiency by 10% (that’s the average number of patients GPs see every hour)
-
NHS continued with the trial, rolling the product out to a further 50 GP practices around the UK