VCA - Digital Practice Management

Brought in to rescue a UX contract at risk, I led product design on a first-of-its-kind enterprise veterinary healthcare platform for two years, growing the design team from one to four and driving measurable gains across patient care, grooming, and boarding operations.

Photo of a dog forlornly looking for its owner while standing on railroad tracks.
Visual Experience of Operations Dashboard

Program Summary

VCA is building a practice management application to support their North American veterinary practice and replace file and paper based processes. I was one of two designers on the project hired by an organization that had VCA as a client. My design colleague was the visual designer, my role was interaction design and design strategy.

  • Type: Enterprise SaaS
  • Market: North America
  • Team: 2 Product Managers • 1 Technical Product Manager • 2 Designers • 11 Software Developers
  • Role On Feature: Senior Interaction Designer • User Research
  • Timeframe: 1.5-year Agile rollout • 2012

Challenge

My challenge was immersing myself in veterinary health and hospital operations quickly enough to design complex software spanning several distinct areas of care. The central design problem was a fundamental one: in human healthcare the client and patient are the same person, but in veterinary care they are separate. The pet can't speak for itself, which adds an entirely different emotional layer to an already charged healthcare experience, one the design had to account for at every touchpoint.

I was also brought in to solve a trust problem. VCA had lost confidence in the team's UX capabilities and was close to cutting it from the contract. Rebuilding that relationship was as critical as the design.

The first feature I worked on was a pet boarding and hoteling flow. This was a common operational touchpoint of the three major services VCA offers: Healthcare, Grooming, Boarding

Key Metrics

  • Demonstrate we were the right fit for the UX portion of the project
  • Reduce staff training and onboarding time
  • Increase boarding price quote accuracy
  • Improve check-in and check-out efficiency
  • Increase boarding price quote accuracy
  • Improve medical record accuracy across paper and digital systems
  • Improve cage availability visibility and assignment
  • Support species, weight, and breed-specific care requirements

Results

The boarding proof of concept worked. VCA restored confidence in the UX process, kept the engagement intact, and what started as a contract rescue became an ongoing >12 year partnership. By the end of the first 2 years I had grown the design team from just myself to four designers.

  • -75%
    reduction in staff training and onboarding time
  • -37%
    reduction in average check-in time
  • +40%
    improvement in boarding price quote accuracy
  • +52%
    improvement in medical record accuracy over the previous paper system

How'd I get there?

Understanding the bigger picture with what's at stake

The VCA product VP was a student of Apple's design philosophy. Knowing that, I proposed two actions designed to speak directly to that values system: a field research strategy to demonstrate rigor, and a design proof of concept to show execution quality.

  1. Conduct a user research study with hospital staff
  2. Develop a design solution on one feature

I visited five hospitals to immerse myself in day-to-day staff operations: four cats and dogs facilities spanning oncology, surgery, and emergency trauma, and one all-critters hospital treating mammals, amphibians, and reptiles that I included deliberately as a contrast case for boarding and procedure variety. I already had pet owner experience, now I needed to get into the mental state of a pet care professional. As the project evolved, I returned to each hospital as each new feature deserved fresh eyes in the field.

Approach

Foundational Research and Discovery

How Does a Veterinary Hospital Operate?

Observing and interviewing hospital staff on location to understand their duties and pain points across several different sized veterinarian hospital brands.

Deep Dive on the research methodology

Pet Boarding

Documenting pet owner and pet touchpoints about how a patient (pet) is boarded and other discovery moments.

Two Types of Pet Owners

An icon showing a person running out the door
The Runaway:

This pet owner is trying to beat traffic or possibly flee the country. They come in and want to hand off their pet as soon as possible. They may cut the line, may be aggressive or agitated, and may just possibly abandon their pet without properly checking in.

An icon showing a person running out the door
The Melancholic:

This pet owner has a hard time letting their pet go. They may ask a lot of questions, may give a long list of care instructions, and may require reassurance, extra attention, and might need a nudge out the door to get on.

Pet Journey Map

Unlike cats, dogs do not travel light. They arrive with leashes, toys, their favorite treats, and behavioral instructions. Cats though are by no means fully exempt, they can arrive with collars, toys, and plenty of instructions or nothing at all. In either case the new digital system needed a way to document belongings, diet restrictions, and behavior.

Once the pet is greeted and checked in, usually with a clipboard and signed form handed back from the owner, they are escorted to where they will be boarded. The cage location and care instructions for the pet is critical throughout the stay. Different hospitals have their own criteria for daily play time, meal time, and what personal belongings they will accept based on the reason and length of the pet's stay.

Dog Boarding Journey Map

Outlining the Boarding Problem Statement

Hospital staff finds the current system tedious and limiting in functionality based on their current job responsibilities in providing accurate boarding quotes, determining boarding capacity, and efficiently identifying and checking in boarders and tracking their personal belongings and care schedule.

Execution

Quick Iterations To Build Confidence in the Process

Addressing the challenge of stakeholder confidence in the UX process, I borrowed from Lean UX principles and ran rapid design sessions on a whiteboard, with the entire team in the room. The result was immediate: stakeholders watched the process unfold in real time, asked questions, and weighed in as subject matter experts, getting a direct look at how I approached problems, not just the polished output.

Figure A1: Smart Sense Cage Suggestion Feature
Figure B1: Additional Upsells and Services Exploration
Figure C1: Boarding Booking Combined Wireframe Early Concept

Final Artifact of the Whiteboard Sessions

Figures A1 through D1 show the evolution of a base boarding screen with the stakeholders and applying the data I collected from visiting the hospitals. It was more UI than UX at this stage. As it was focused on getting the core booking elements right: cage size, animal type, date and time, and cost estimate. D1 was the final version of this base screen, built around dog cages.

Two issues with the whiteboard sketch that I needed to address. The calender was limited to only one week, and the second was the booking UI was limited to only one type of species cage and one cage.

Figure D1: Wireframe of visual schedule of cage availability by week

Designing the Boarding Solution

This project predates my current toolset. These wireframes represent the fidelity appropriate to the engagement as the goal was validated workflows and stakeholder alignment, not visual polish.

Fixing the Whiteboarding Missed Opportunity

To solve the one cage and one species type problem, I introduced a tabbing element like browser tabs that is controlled by the left panel as the user indicates how many pets will be bordered. The tab name defaults to the species and since dogs are boarded more frequently the UI defaulted to the dog cages.

To solve the view more than one week problem, left side of the tab container was a scrollable calendar so the user could see all available cage types on a particular day. The scrolling was in sync across all tabs.

My solution also addressed the multiple pets sharing a cage problem. As the smaller cage sizes in the tab would become disabled from the UI if >1 pet was selected to share a boarding cage or kennel.

One Tab
Boarding Experience Showing One Tab
Two Tabs
Boarding Experience Showing Two Tabs

One Full Use Case

Booking any type of appointment for hospital staff always begins with two scenarios.

  • Existing Client

    has pets on account or is adding a new one. Considerations: account standing, loyalty discounts, documented pet behavior.
  • New Client

    no pets on account, no relationship history. Considerations: often comparison shopping, no loyalty incentive yet, frequently in a hurry.

Early Boarding Iterations

Want to see how this played out? Here's a closer look at the use cases and problems I was working through.

Paul and his partner Karina want to get away for the weekend, so they call VCA to price shop on boarding 2 of their 3 pets. Brianna queries Woofware to determine the availability and the price for the two pets and inquires if they are existing clients. Paul and Karina agree to book the boarding.

First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience
First Iteration of the Boarding Experience

Video of Prototype

Tasked Based Storytelling Through Prototyping

To test the design solution with users and for stakeholder review; I used Balsamiq as the de facto prototyping tool. The video incorporates further iteration and demonstrates one way Brianna would use Woofware to accomplish the task outlined in the following scenario.

Download a Transcript of the Screen Names and Steps

Impact

What I Accomplished

The boarding proof of concept worked. VCA restored confidence in the UX process, kept the engagement intact, and what started as a contract rescue became an ongoing >12 year partnership. By the end of the first 2 years I had grown the design team from just myself to four designers.

  • -75%
    reduction in staff training and onboarding time
  • -37%
    reduction in average check-in time
  • +40%
    improvement in boarding price quote accuracy
  • +52%
    improvement in medical record accuracy over the previous paper system

Woofware Phase 1 was released into five hospitals on schedule as a three-month Beta test to measure how well we accomplished our goals in the complexity of real life situations. It was then rolled out into the 400 hospitals. In the middle of the Beta, I earned a second promotion to become the UX Practice Manager for iLink Digital Inc. and ceased having direct day to day individual contributor responsibilities with VCA and Woofware.

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Hospital Observations

Several Onsite Hospital Visits

  1. Neighborhood Hospital
  2. Full Scale Emergency and Trauma Hosptial
  3. Various Critter Hospital (Exotic Pets)
3 panel hand drawn comic strip: Panel 1: A cat is sleeping on a countertop. Panel 2: The cat wakes up and jumps on a keyboard surprising the receptionist. Panel 3: The computer shuts off, the receptionist is dismayed.
True Story: Cat jumping on a keyboard causing the computer to shut off without work saved

Observation Methodology

Deep diving into the hospital setting to observe the various interaction and emotional touchpoints between customers, pets, and hospital staff was one of the best ways to learn and begin the process of creating a user centric oriented feature set.

Sample Questions
  • What happens the moment the patient comes in the door?
  • How are the human and animal greeted?
  • What are the steps of the check-in process?
  • What happens during a rushed drop off and leave?
  • What does a boarding involve?
UX Thought: Environment Matters

A couple of the most memorable findings reinforcing how busy and unpredictable a veterinary hospital can be.

UX Observation: Few animal visits are routine
Finding 1

While one of my visits in the reception area there was this cat sleeping on the counter. Then it suddenly jumped down onto the receptionist's keyboard and wiped out the patient notes she was typing up and knocked the screen over and sent the keyboard to the floor.

Finding 2

In the chaotic waiting room, I observed a family without a pet waiting after checking in and they were visibly distraught for several minutes. The doctor appeared and took them into a side room and delivered the bad news that their pet had passed away. The receptionist suggested that the new application should have a way to identify patients and clients in this situation so that staff can react quickly and take the appropriate action such as move them quickly to the bereavement area.

Finding 3

Dogs enjoy a slight advantage over cats, and both account for most medical appointments as compared to other types of pets. Dog boarding and grooming appointments is significantly higher than cats and other pets.

Finding 4

An index card system is used to track cages with a notebook. When a customer calls about cages the staff often is not near the cards and needs to place the customer on hold and go to the back room and see what cages are empty or call out to another staff member to check.

User and Audience Interviews

Interview Methodology

I selected two diverse participants that varied in tenure (where possible) within each of the five main operational areas at the five hospitals for interviews. We also conferred with two former hospital staff (receptionist, and a retired veterinary doctor) that were professional trainers at the corporate offices.

Interview Process

  • Created baseline interview questions for the team
  • Observe their daily tasks and how they interact with clients, patients, and current technology, what does it take to board an animal, how pets are treated and managed
  • Each interviewer took notes from their interviews and we grouped answers into an affinity board
  • We asked technical, aspirational, and emotional questions like
  • What is the most important aspect of a boarding?
  • What is one part of your job you would change? What would you change about it?
  • How would you create the opportunity for a personal touch?
  • How do you handle clients who are dissatisfied with the boarding?
  • Have you had a bad experience with a patient/boarder? What did you do?
  • How do the doctors and medical technicians feel about data entry?

Empathy Mapping with Personas

Our personas were created from a team effort between members of the VCA product and subject matter expert team, Akanksha, and myself. We used a mixture of data from our interviews, the product teams knowledge of operations, and job roles within the hospital.

* It is worth noting that on this project we enjoyed institutional support for our personas.

Meet Brianna a Receptionist
Meet Rose a Medical Technician

Brianna

  • They are under 30, love animals, and look at the job as temporary, yet a mostly enjoyable position.
  • They sometimes have the ambition to become a vet and they love learning new things.
  • They are frustrated with constant phone calls and people coming in, loud pets, dissatisfied clients, and occasionally colleagues.
  • They find the current software system boring, due to a lack of visual UI, and want whatever the new system is to be easier to learn.

Rose

  • They are under 30, love animals, and look at the job as a career. They will leave to make more money and most want to become a veterinarian.
  • They perform a lot of the medical tasks and are responsible for the boarding area and care.
  • They are frustrated mostly with the work load and are emotionally invested into the patients they see frequently.
  • They want the system to be faster to learn and reduce work interruptions. If it can read their minds, that would be ideal.

Further Personas

We created additional personas for a veterinary doctor, groomer, office manager, a business client (shelter/pound), a feline patient, and a new all critter patient. The latter represented the more complex yet edge case patient profile and associated business requirements.

Example Use Cases
  • Ability to see accounting or medical matters to inform Paul
  • Ability to see an inventory of all available cages
  • Ability to book an existing pet or a new pet
  • Ability to look up a client to see if they exist and see associated patients
  • Ability to upsell and add additional services
Missed opportunities:
  • Lacked insight into situational awareness to visualize cage availability over a specified time frame without having to select a date range first
  • Lacked insight into what cages are overbooked and waitlisted
  • Lacked insight into what types of cages are best suited for a particular pet type