FIG CHECKProviding physicians with prior auth insights throughout a seamless ordering experience
In 2023, I co-founded Fig Medical, an AI software startup facilitating prior authorization for healthcare providers. As Chief Product Officer, I was responsible for the strategy and design of our MVP, as well as several product iterations, including the integrated version of FigCheck, resulting in the acquisition of our first revenue-generating customer.
Company: Fig Medical // Timeline: Feb - Mar 2024
Role: Co-founder, CPO // Collaborators: CEO, CTO
Tools: Figma // Skills: User Research, Visual Design, Interaction Design
Enabling physicians to identify a Prior Auth’s approval probability
Fig Medical's mission is to reduce patient wait times for needed medical services, such as surgery or imaging, by improving prior authorization approval rates and turnaround times. As our MVP, we built an AI-powered web application that provides physicians and their medical staff with greater visibility into insurer-specific prior authorization requirements. FigCheck allows physicians to enter a patient’s insurance and health information and receive a probability of approval as well as suggestions for improvement.
Standalone web app prototype of FigCheck for medical services
Engagement of medical staff test users was very low
Within a month of launching the first version of our product we onboarded several test users across four private medical practices. Even though they had all expressed a clear need for a tool like ours, engagement with our platform remained surprisingly low. We checked in with our test users once a week, and quickly learned: While the tool would provide them with useful insights, they forgot using it, or were reluctant to use it, because it was not fully integrated into their existing EHR (Elecronic Health Record) workflow.
Development of daily FigCheck requests by first test usersCurrent order process of an Echocardiogram through EPIC
Physicians don’t have time to switch platforms while ordering medical services
While shadowing one of our test users in person, I observed how quickly they moved through their current workflow of ordering a medical service without leaving their main system. With a physician's tight patient schedule and the patient's expectation of undivided attention, there is barely any time left for administrative tasks.
Challenge
How might enable physicians to check prior authorization requirements without having to switch platforms?
Integrating FigCheck into the EHR ordering flow
As a first step, I analyzed at the current flow physicians go through in their EHR when ordering a new service. Regardless of the vendor, this process consists of three steps:
01 Selecting the medical service or treatment
02 Providing additional information (Date of service, expiration date, reason for ordering,...)
03 Signing the order
Since the additional information provided is used by the administrative staff to file the prior authorization request, I envisioned FigCheck to be integrated right in between steps 02 and 03. This would allow checking the information, notifying the provider of the approval probability, and suggesting improvements before they sign the order.
Synthesis of interviews with 50+ potential
Maintaining physician decision-making autonomy with an optional & flexible review process
While developing FigCheck, I conducted dozens of interviews with potential users. My main takeaway was that physicians have two principles for adopting new software: to spend a minimum amount of time with administrative tasks and to maintain their clinical decision-making autonomy. Based on these insights, I established three rules for this prototype:
01 Add a minumum of additional steps
02 Keep FigCheck optional
03 Allow providers to disregard, skip, or exit FigCheck at any time
Balancing our value proposition with technical feasibility through a straightforward UI
Next, I considered different options for displaying FigCheck’s results within the current EHR flow. I created three options for the UI of each of the two steps (displaying the approval probabaility, suggesting improvements): side drawers, modals, and directly embedded.
Because our team had limited knowledge about the feasibility of such EHR integration, my goal with this prototype was to communicate our vision of a seamless user experience while providing a realistic approach for potential users. Therefore, I decided to use a B. Modal display for the approval probability and a C. Embedded display for the enhancements, as I felt this would best focus attention on the key value while presenting a realistic scenario.
Demonstrating different approval probability scenarios in a final vision prototype
For the full vision prototype, I considered three possible scenarios:
01 Approval probability is >60%, without any suggestions for improvement: Continue to sign
02 Approval probability is >60% with suggestions for improvement: Suggestions are displayed and can be used/dismissed before continuing to sign
03 Approval probability <60% > Missing prerequisite/alternative service is suggested and user is redirected to select service
To create a clear visual distinction between the EHR platform and our product, I used our company branding for windows and information related to our tool. This would also help us maintain consistency across different EHR vendors.
Result
Scenario 1: Approval probability >60% with suggestion for improvement
Scenario 2: Approval probability <60% with suggestion for alternate service/prerequisite
Outcomes & Reflection
During various sales demos with potential customers, our team received much better feedback from potential and current users than when we demoed the previous version. Our biggest challenge in implementing this project was the fact that there are hundreds of EHR platforms in the U.S., and while the top two have over 50% market share, they are also the most difficult to integrate with. We therefore had to develop a prioritization strategy and decided to focus on the EHRs that our current test users were using, including AthenaHealth and MDLand, and align our customer acquisition strategy by targeting other providers using these platforms before focusing on other EHRs to integrate with. Unfortunately, I left Fig Mecial a few weeks after this project was completed and was not involved in the subsequent implementation.
Leaving Fig Medical after 15 months
In April 2024, I left Fig Medical after 15 months of working on the idea and 11 months of founding the company. This decision was driven by the realization that my co-founder and I had fundamentally different expectations of how to move the company forward. While she was committed to continuing to build a prior authorization tool, I saw some of the developments in the industry as too big of a threat for us as a small, unestablished company and suggested to pivot. Many of the country's largest healthcare software vendors, especially the largest EHR player, Epic, had announced that they were starting to move into the prior authorization space. In my opinion, this left us with very little moat and an even greater challenge of selling a product to risk-averse and technology-critical customers. Fig Medical is still in business today, and while I do not believe in the company's path, I do hope they can find a way to improve access to quality healthcare.