The ROI in your new IA UX

Digital users want to do things, but website IA came from newspapers.

There are a lot of distinct digitized products and services across a $4 billion enterprise-scale healthcare network of 15 hospitals, 800 physicians, 15 labs, 15 urgent cares, which in total have 3 different financial portals, 5 different CRMs, 3 different chatbot vendors, 6 different digital booking vendors, and 9 different logins. Even when the information architecture isn't complicated, it's still deep, multi-tiered, and full of jargon. That's before enterprise-wide politics get involved :).

As Sr UX Architect for all digitally connected products, my role was to find the impact moments and impact service enhancements to generate more ROI across all products and services, that have any digital element, by increasing access or increasing engagement.

My first assignment, Day 1, was to create and enterprise-wide information architecture and responsive web design (across breakpoints) so we could "reskin" the entire 10,000 page website with "just" the current team (of rockstars) in graphic design and content management while it was under upgrade from the more hard-coded SitCore7.5 to the SiteCore9.x component-based responsive web & mobile.

I had 16 weeks and I said yes.

Information Architecture (IA) in 2018

Digital Experience IA was still more website based than action t based in 2018, though, and the organization was very proudly unifying all the services and products of the healthcare ecosystem, after the organization and acquisition of different hospitals, practitioners, urgentcares, and labs. But they all had to be found quickly and easily on the website. and so through competitor analysis, card-sorting, and cognitive walk throughs, I created an healthcare ecosystem IA that was roughly equal to 98% of the other excellent healthcare ecosystem IA sites. "Find Doctors" "Get Care Now" "Locations." The Account for Patient Portal went in the upper right (though we had five other accounts people used).

UX Research on the BayCare Information Architecture

The Finance Team wanted their user flow to be called "Finance" but "Pay My Bill" won out 4/5 and 5/5 in two rounds of user tests. Even when customers imagined they needed financial assistance (the finance team's concern), customers found and chose "Pay My Bill" 4/4 and 5/5 times faster than "Finance."* Little variance was found between "Services" and "Our Services." "Hospitals" got their own tab because the 15 hospital presidents had the collective power to say so, in this early combination of all the hospitals and practices being brought together for the first time on one website (instead of 33 different websites).

THE FUNNIEST RESULT

*When asked which tab the participants would use if they got a statement from insurance that additional money was needed, 2/5 of the first participants picked "Locations" over "Pay My Bill." When shown the "Pay My Bill" link in post-test debriefing, they again chose to pick "Locations." When asked why they would pick Locations over Pay My Bill to close out an insurance statement, it's because both are over 65 and have never used digital websites to pay anything. They chose Locations to know 1) where to send the check to, and 2) where to drive to to finish paying in cash.

And it was good. Top-Nav traffic popped over 100%. Organic SEO popped 20%. And internal reviews throughout the organization suggested employees could navigate the site well.

But it still bothered me. Responsive web/mobile was still new and the combination of mobile app IA and website IA hadn't fully resolved itself. Websites were still based on newspaper & brochure organization styles, and not the account-based navigation inherent to mobile apps. As a 10 year leader in mobile and web user experience, I favored an account style.

Users come to interactions to do things. now And they know what the action they want to do, more than the sub-category underwhich those interactions may be filed.

Information Architecture in 2024

Every website has an account now (and if you don't, call me, you even need a loyalty program). And once you have an account, everything should be redesigned around the account. The logged in account lets the user take quick conversion actions and make the organization easy money.

The problem at BayCare was that we had nine consumer accounts across the organization. And if a customer only knew their product or program came from BayCare, they should log in to the the BayCare website for that personalized interaction. So many complaints fielded by CX and Contact Center were related to logins for the different accounts across hospital stays, eMedical records, finance statements, medicare advantage insurance statements, the loyalty program, the blood pressure machines in pharmacies, etc (not to mention all the employees who tried Login there).

In 2020 I began experimenting with a new approach to IA started by A List Apart, a UX firm. The goal - especially for data heavy digital platforms like mine - was to organized the actions a customer needed to take instead of the subject categories of the things they may wish to do it with. Modelling their process, I ultimately arrived at what I can easily say is the worst received work ever put in front of stakeholders in all my 16 years of UX.

But user tests loved it.

Schedule Anything, Pay Anything, Login Anywhere

Schedule Anything

Pay Any Bill

Login Anywhere

Or as I lovingly call it now, "the schema nobody liked."

For the record, I didn't even like it. It felt right, but I couldn't hard sell it at first. I sold it in pieces to the differently affected departments using the prototypes above. All I was using was the fastest web-tree steps for the interaction, and putting those choices in an open container with secondary-importance buttons from the component based BayCare Design System for SiteCore I'd previously designed.

The "Pay Any Bill" workflow simplified so many web steps the stakeholders greenlit the "Pay Any Bill" category for our account-based patient portal immediately without testing.

But Schedule Anything?? People hated Schedule Anything.

The reason nobody liked it is because it's too broad and too simple. It's almost dismissive to the product - especially doctors and hospitals - as if to say "Schedule Any Ol' One of Them."  Every stakeholder of a the main business unit hated it. Even when it was "Schedule Any Service" they hated it. Using words like "Anything" just doesn't seem brand appropriate for anything much less a healthcare system made of important doctors and surgeons, the bulk of which have brand voices that are formal and professional. Not only did the stakeholders reject it, the UX team, the content teams, the dev, the digital leaders, and all of the individual marketing managers, rejected it.

USER TESTS

Unfortunately, this couldn't be a simple A/B test. The way our Content Management System was set up, the IA was hard coded. The dev team and content management team said testing IA live would be too hard. The staff and the stakeholders really didn't want to make a change without compelling evidence.

All we had was qualitative originally with these IA tests sprinkled in with conversion funnel user research I was running monthly for the site. So it was only tests of 3-5 people but it was almost always "3/3 prefer Schedule Anything," and "5/5 prefer schedule anything." And even in those small tests the speed at which customers achieved objectives halved. Some of my last direct work on this was setting up the larger scale unmoderated user research at larger scale to get this IA tested. I left just after these user tests secured funding for the larger tests. That was Oct 22.

RESULTS

After conclusive larger scale tests using UserZoom, BayCare released "Schedule Anything" as the first link of the IA on the mobile site only in June 2023. The data below is normalized change YOY for June to October 2023:

"Schedule Anything"

• 87% Top Nav Utilization increase

• 48% Lab Test traffic increase

• 87% Imaging Exam traffic increase

• 25% Urgent Care traffic increase

• 25% PCP traffic increase

• 155% Content Library traffic (Wellness) increase

• 20% SEO score (vs Desktop) increase

While the business will focus on the increased traffic metrics to our core transactional offerings, I[m particularly proud of the last one, the overall SEO for the entire mobile site increase. Many people don't know that sophisticated UX impacts enterprise-scale sites' and apps' SEO tremendously. Google organically rewards websites with high IA throughput metrics because Google trusts that high throughput signal means many different Google users find the answers they'd Google-searched for.