Many companies encourage their employees to think about special projects – working on side projects or exploring a problem – outside the normal day-to-day of their responsibilities. In early spring of 2016, our CTO at RadNet came to our design team and asked us to do just that – to consider how we might dedicate some time thinking about the problem of medical billing, and submit an entry to the “A Bill You Can Understand” Design & Innovation Challenge, sponsored by the AARP and in collaboration with the US Department of Health and Human Services and Mad*Pow.

Prompted by the Obama administration, the challenge asked designers and thinkers to improve the state of our medical billing process – to help Americans better understand the “financial aspect of health.”

“Americans feel confused and disconnected to their care. This challenge is part of HHS’ larger effort to put patients at the center of their own healthcare. We are creating progress toward a medical bill that people can actually understand and a billing process that makes sense.”

— Sylvia Burwell
U.S. Secretary of Health and Human Services

Within our team, the prevailing opinion about the challenge was, that while squarely within the healthcare space we occupied, the timeline was ambitious to the point of making us nervous. “If nothing else,” we thought, “we’ll learn something about a problem near and dear to us.” After all, as the nation’s largest radiology provider, RadNet generates a massive number of patient bills. We have plenty to gain from looking at this problem, and I was excited to help lead the design effort which was eventually selected as the winning entry.

Along with my team leader Randy Ziegler, we dug in – parsing the research reports and other source information provided by the competition sponsors, doing our own audit of sample bills, EOB statements and documenting our own experiences.

As a criteria of the competition – spelled out in the guidelines – all concepts needed to take a human centered design approach in order to be considered. Before doing any design work, we started by first putting ourselves in the shoes of those we were designing for.

By developing “personas” we were able to align all of our work with real people, helping make sure we designed with empathy.

As design progressed, a series of user testing sessions were held with the people our personas were based on, which provided valuable feedback and helped our team make refinements – we gathered real data from real participants.

To help focus our work, some key principles guided the way:

  1. Use plain language
  2. Focus on clarity and simplicity
  3. Hide (and manage) complexity
  4. Use color as a critical indicator
  5. Provide context

The finished work included a regular paper bill that most recipients are used to getting, but some some critical changes are proposed in the design. QR codes are included to link the (much) simplified paper bills to a more detailed online statement. This allowed the paper bill – being the first interaction a patient has with their medical expenses – to be an experience that’s clear and simple, using jargon-free plain language and breaking down the expenses into the most essential parts, displaying them using “cards.”

Each of the charge cards included contextual cues – health provider photos, icons, “charges included” summary – to help bill recipients make personal connections to the healthcare events.

The design also establishes a visual language, using both clear, large-enough typography and color to display specific elements in deliberate ways. This helps bill recipients make distinctions between the types of displayed information with ease, rather than doing lots of extra work sifting through elements to pull out the information they want.

“I particularly like the relationship between a simple paper bill and a more detailed explanation online as it allows patient to get as much or as little information as s/he sees fit.”

— Design Challenge Advisory Panel

“This bill is easy to understand. A great presentation of app and paper bill that is not over- simplified. A patient-first approach for the episode of care. A clear depiction of how insurance is factored into patient’s cost of care.”

— Federal Panel