Signature Medical Group

User research with patients first, then a rebuilt website for an independent group of 110 doctors

Rebuilt by another team in 2021

The Signature Medical Group site as it stood in January 2016, one month before the rebuild launched
The rebuilt Signature Medical Group homepage: the masthead and Find a Doctor navigation above a photographic hero of a patient with a clinician
Before

signaturemedicalgroup.com before rebuild, January 2016

View archived site →
After

signaturemedicalgroup.com after rebuild, 2016

Visit current site →

My role

Creative director

Employer
Timmermann Group
Client
Signature Medical Group
Years
2014 to 2015
Team
Seven people
  1. Led a team of seven: an account strategist, two content strategists, two art directors and two WordPress developers.
  2. Led the user research: a survey on the live site, six patient interviews and five interviews with the group's leaders.
  3. Designed the information architecture and wrote the WordPress theme and plugin code that it ran on.
  • 25.3% of visitors came to find a doctor, one of the top two reasons for a visit
  • 76% of phone and tablet visits that started on a doctor's page left from it, in the 2014 analytics audit
  • 10 years Find a Doctor has led the menu, through another team's 2021 rebuild
  • 5 of 10 of my decisions outlived the team, the software and the system staff use to edit the site

Summary

Signature Medical Group is an independent group owned by its doctors: more than 110 of them, across some 30 locations in St. Louis and Kansas City. Patients came to the website to find a doctor, and on phones and tablets most visitors who landed on a doctor's page left from it.

I started with research: a snapshot of how people used the old site, a survey on it, and interviews with patients and with the group's leaders. The new site put Find a Doctor first and gave every doctor and every practice a page of its own. It launched in February 2016, after I had left, and that menu is still in place today.

Who was involved

  • Patients Six sat for hour-long interviews, three who knew the group and three who didn't, and more than eighty answered the survey.
  • SMG's leaders The stakeholders. Five gave interviews and ranked their wish list Must, Should, Could and Won't.
  • The Timmermann Group team An account strategist, two content strategists, two art directors and two WordPress developers. The team I led.
The rebuilt homepage: Find a Doctor leading a four-item primary navigation, above a masthead whose photograph of a clinician and patient sits under a teal scrim, then the Find a Doctor and Find a Practice search panel beside a Doctor Spotlight. Checked against a saved copy of the live site.
Find a Doctor, front and center. Find a Doctor leads the menu and comes first again in the page.

Context

The old site ran on dated Microsoft technology, and nothing on it led you naturally to what you came for. We began in October 2014 with an analytics baseline, a snapshot of how people used the old site before we changed anything, and a comparison with competitors' sites.

But the real problem only showed once the numbers were in.

The Signature Medical Group site as it stood in January 2016, one month before the rebuild launched.
The old site. The site in January 2016, one month before the rebuild launched.

Research

Research ran from October 2014 to January 2015. A one-question survey on the live site found the top reasons for a visit were finding a physician, at 25.3%, and reaching health records, at 24.1%: about even. On phones and tablets, 76% of visits that landed on a doctor's profile left from it.

Most people arrived from a search engine like Google and looked at about three pages before leaving, so SEO (making sure the right page comes up in a search) was part of the job from the start. Six patient interviews became a journey map in five stages, from Research to Post-Visit. The people we asked were the site's own visitors and six patients, not a sample of everyone.

Research

Research started in October 2014, and nothing went live for sixteen months. I was building prototypes in Sketch from day one, and once the research report was done we tried versions on a private test copy of the site. Only the launch waited. We used three methods. A survey went to visitors on the live site. Six hour-long patient interviews became a journey map. And in five stakeholder interviews with SMG's leaders, I scored how much they agreed with each other.

Please select the reason for your visit
  • I need to find a physician 25.3% +10.3 / −8.1
  • I need access to my health records 24.1% +10.2 / −7.9
  • I need to find a specialty practice 12% +8.7 / −5.4
  • I need to know who sent an invoice 12% +8.7 / −5.4
  • I need info on SMG 10.8% +8.5 / −5
  • I need to verify my insurance coverage 9.6% +8.2 / −4.7
  • I need to research general health info 3.6% +6.5 / −2.4
  • Careers // Job 2.4% +6 / −1.7

Research

Observation only

“Finding doctors recommended to me who accept patients & my insurance”

  • Internet search
  • Physician referral
  • Friend or relative
  • Insurance directory
  • Third-party doctor listings
  • Print, radio, television, billboard
  • Community event
  • Find a Doctor

Scheduling

Active

“Scheduling an appointment with a healthcare professional”

  • Request Appointment form
  • Click to call
  • Practice front desk

Pre-Visit

Observation only

“Waiting for and completing intake paperwork”

  • Get Intake Form
  • Patient Portal
  • Practice by phone

Visit

Active

“Consulting with the doctor about my health treatment needs”

  • In person, with the clinician

Post-Visit

Observation only

“Scheduling follow-ups. Paying bills. Updating my loved-ones”

  • Pay My Bill
  • Health Records
  • Patient Portal
  • Follow-up by phone
  • Family and carers

MUST

  • Improve awareness & ranking providers in search engine results 100%
  • Improve integration of group brand strategy 100%
  • Improve awareness & evaluation of patient-related value propositions 75%
  • Improve cross-marketing opportunities 75%

SHOULD

  • Improve online appointment scheduling 75%
  • Improve site resources/content engagement 75%
  • Improve awareness & evaluation of provider recruitment value propositions 75%
  • Improve patient understanding of costs/payments for services & bill readability 67%

COULD

  • Improve provider recruitment and retention rates 100%
  • Improve awareness of community projects 75%

WON'T

  • Improve health information portals 100%
  • Improve online appointment scheduling 25%

I chose people by Lead User Sampling: picking people who use healthcare a lot and have strong views about it, the way von Hippel described it in the journal Management Science in 1986. Six patients sat for interviews, three already familiar with the group and three not. More than eighty people answered a blind survey, one answer each. Five leaders gave interviews, each with a hands-on design exercise inside it. I also walked through six other healthcare sites step by step, as a patient would: four direct competitors (Esse Health, BJC, Mercy and SSM) and two indirect (Anthem and ZocDoc).

Seen firsthand. Gathered on the live site and in scheduled interviews between October 2014 and January 2015. The numbers come from the research report dated 8 January 2015, which gives a margin of error for each.

Written in the report at the time: the people we asked don't represent the general population, and this is not a statistically valid study by the numbers. It is an exploration meant to bring up problems that lead users (people who use healthcare a lot) are especially good at putting into words.

1 Card sort

Sort these pages into groups that make sense to you

24 cards · 0 sorted

2 Tree test

“I need to find a physician.” Where would you find that?

The survey’s top reason for visiting, given by 25.3% of visitors

Card sort first, then a tree test, both in Optimal Workshop: the pages people grouped into sections, then the tree they searched for a physician.
Assumption map

Design

The information architecture, meaning how the site's pages and menus are organized and what a patient meets first, made Find a Doctor more prominent: first in the menu, and a search panel on the homepage. The idea is on paper in the site map I drew before the build. Doctors and practices got pages of their own, and each doctor's page sits under the banner of the practice they work for.

Signature was a group behind its practices, and practices that housed independent doctors. So the pages said who belongs to whom twice: once on the page for patients, and once in hidden labels in the code that tell Google what each page is. I built those labels into the page templates, so they stayed correct with ordinary editing.

The federated entity graph: group, practice, sites and physician Signature Medical Group is typed as a MedicalOrganization. Mid County Orthopaedic Surgery and Sports Medicine is typed as a MedicalClinic and declares memberOf pointing up at the group, with brand nested inside that declaration. The clinic declares three location properties, each a PostalAddress, because the practice operates inside three host buildings: Mercy St. Louis Medical Building, Progress West Hospital and Bellevue Medical Plaza. All three share one telephone number. A physician is typed separately and declares a single address rather than multiple locations, because a doctor is somewhere while a practice operates in several places. Group Signature Medical Group MedicalOrganization memberOf brand Practice Mid County Orthopaedic Surgery & Sports Medicine MedicalClinic location location location Site Mercy St. Louis Medical Building 621 S. New Ballas Rd, Suite 63B St. Louis MO 63141 PostalAddress Site Progress West Hospital 20 Progress Point Pkwy, Suite 106 O'Fallon MO 63368 PostalAddress Site Bellevue Medical Plaza 1027 Bellevue Ave, Suite 25 St. Louis MO 63117 PostalAddress memberOf Practitioner Physician, one page each Physician address → PostalAddress
The clinic works out of three buildings it doesn't own, all sharing one phone number. So in the labels for Google, a clinic lists several locations and a doctor lists one address.
The sitemap: a six-level tree of wireframe page thumbnails under Home, with Find a Physician drawn as a search control attached to the homepage rather than as a section of its own, primary navigation and utility links set out to the right, eight numbered orange annotations explained beneath, and a title block naming the client, project, document, version, date and author. The site map as we handed it to the client, dated March 2015 in its own title block. I still have it.
The site map. Drawn before any code, its note 1 puts the doctor search right on the homepage.
The Mid County Orthopaedic practice page: the building photograph banded across the top under a teal scrim, then the practice name above A Division of Signature Medical Group, with office, patient services and hours in three columns, a nineteen-physician roster with headshots, staff, an about section, accepted insurances and three other locations. Checked in the saved page's code: the "A Division of Signature Medical Group" line, and the hidden label for Google that ties the practice to the group.
The whole clinic on one page. Contact, services, hours, every physician and every location the clinic works from.
Robert P. Bruce's physician page: a teal band carrying KANSAS CITY BONE & JOINT CLINIC above A Division of Signature Medical Group, then his portrait beside his name, specialty, specialized services and office address, with Request Appointment set opposite; below, an about section, education, five hospital affiliations, languages, certifications and accepted insurances. Checked in the saved page's code.
A doctor under their own roof. What the hidden labels tell Google about the doctor is also shown to patients: specialty, procedures, hospital, address.
The same homepage on a phone screen: the masthead photograph under its teal scrim, no background video, navigation collapsed to a menu button. Compared on a desktop screen and a phone screen.
What the phone drops. On a phone, the background video and the full desktop menu are both switched off.
The appointment request form opened from a physician page: requested date and time, name, email and phone, a required choice of new, current or former patient of Dennis A. Dusek, and a referral source select. I opened the form on a saved copy of the page and took this picture.
A request tied to one doctor. The leaders split on online booking, so each doctor's page took appointment requests instead.

Outcomes

The site launched in February 2016, after I had left Timmermann Group. Nobody set up analytics to measure what the new menu changed, so I can't tell you whether more patients found a doctor.

What I can show is that it lasted. Saved copies in the Internet Archive and the live site today show Find a Doctor still first in the menu after another team rebuilt the site in 2021, and doctors and practices still have pages of their own. The hidden labels for Google did not survive that rebuild.

  • Health records, the second reason for a visit at 24.1%, came out of the footer onto every page.

  • Leaders split on online scheduling, so the site took appointment requests per doctor instead.

Credit

  • Robert Duebelbeis

    Creative Director

    Research, design, and the theme and plugin code. Planned the move of the old content with the team.

  • Alex Thip

    Moved the content onto the new theme.

  • Sara Sparrow

    Moved the content onto the new theme.

  • Andrew Mullens

    Moved the content onto the new theme.

  • Melissa Gall

    Moved the content onto the new theme.

Questions about this project?