“Linnéa not only took the challenge, she just made it her own. She brought in ideas and concepts that were new to us.
"Linnéa not only met with our board, she met with our presidents of the hospitals, she met with our CTOs of the clinics,... She did it like a seasoned professional.
“Through every milestone of the project, every time we would see a color palette, Linnéa would describe what book she was using, where she was sourcing this out on the web,... If we were looking at logos, she would show us competitive logos...
“Having that knowledge, and having Linnéa walk through that with me, benefitted me in ways that I could never have done on my own.”
"Linnéa not only met with our board, she met with our presidents of the hospitals, she met with our CTOs of the clinics,... She did it like a seasoned professional.
“Through every milestone of the project, every time we would see a color palette, Linnéa would describe what book she was using, where she was sourcing this out on the web,... If we were looking at logos, she would show us competitive logos...
“Having that knowledge, and having Linnéa walk through that with me, benefitted me in ways that I could never have done on my own.”
— Stephanie Dozier, Connxus Executive Director
CLIENT
METHODS + TOOLS
• IN-DEPTH interviews
• STAKEHOLDER INTERVIEWS
• SURVEYS
• Competitive analyses
• Background research
• STAKEHOLDER INTERVIEWS
• SURVEYS
• Competitive analyses
• Background research
• Figma
• SURVEYMONKEY
• Microsoft Office
• Google Suite
• Zoom
• Microsoft TEAMS
• SURVEYMONKEY
• Microsoft Office
• Google Suite
• Zoom
• Microsoft TEAMS
Timeline
• 3 months, part-time
Initial Scoping
I was initially hired to design a new website.
At our kickoff meeting, though, my stakeholders made it clear that they wanted to take the organization in a new direction, both to diversify and to combat an image problem. Together, we agreed that rebranding to support their new direction and refresh their image took precedence: any website work would have to be redone post-rebrand, anyway.
Given free rein to determine my course of action, I decided on these overarching objectives:
(1) uncover the true issues underlying ICC's difficulty gaining and retaining new partner organizations,
(2) consider whether rebranding and overhauling the business model would actually address those issues, and
(3) find, consolidate, and compellingly present evidence to support suggestions as to how best to address them.
(2) consider whether rebranding and overhauling the business model would actually address those issues, and
(3) find, consolidate, and compellingly present evidence to support suggestions as to how best to address them.
THE PROBLEM
Organization stagnation. Healthcare organizations had stopped joining Integrated Care Collaboration (ICC), and stakeholders were uneasy.
PRIMARY Questions:
— Why have organizations stopped joining?
— How might ICC address their concerns?
— How might ICC rebrand for growth? (see Part 2)
— How might ICC address their concerns?
— How might ICC rebrand for growth? (see Part 2)
MY ROLE
UX Researcher • UX Designer
This was a multi-stage project facilitated by the CONNECT Fellowship program at the University of Texas at Austin.
I planned, implemented, and communicated everything from end to end, working closely with a trio of ICC employee stakeholders to ensure their input, understanding, and buy-in throughout the process.
Project roadmap
First, a quick definition —
What is an HIE?
A Health Information Exchange is a system that allows doctors, nurses, pharmacists, other healthcare providers and patients to securely access and share a patient’s vital medical information electronically—improving the speed, quality, safety, and cost of patient care.
HIEs can take different structures, but we'll be focused on ICC's: a centralized exchange. This takes the form of a single repository that stores all patient data, managed by the HIE.
HIEs serve diverse users with divergent needs. At the time of this project, many were struggling, failing, or getting absorbed by larger interoperability organizations.
Now for Part 1—
REBRAND RESEARCH: Setting the Stage
REBRAND RESEARCH: Setting the Stage
Quick Caveat: This pair of case studies reads linearly for ease of comprehension, but the project, itself, was anything but: steps overlapped, looped back, and influenced each other regularly.
For a quick snapshot of the full rebrand research phase, check out this research wrap-up presentation deck —
Overall Objectives
Understand the state of things:
• How do current and potential members view ICC?
• How do current and potential members view HIEs?
• What needs, pain points, and gaps exist that ICC might fill through services, products, initiatives, or communication?
• What table stakes, pain points, gaps, and opportunities exist in competitors' branding, tools, and services?
METHOD 1
In-Depth Interviews
Research Questions
> How do current and potential members perceive ICC?
> How do current and potential members perceive HIEs as a whole?
What needs, pain points, and gaps exist that ICC might fill through services, products, initiatives, or communication?
Method
Why interviews?
We wanted a deep look into peoples' perceptions of ICC and other HIEs to set a baseline for our work. Moderated, semi-structured IDIs (in-depth interviews) are a time-tested method for gathering that sort of rich qualitative data.
Caveat: This study targeted those with a say in their organizations' partnerships, rather than those who might interact with the HIE's offerings day-to-day. Only one interviewee (the stethoscope-bearing prospective member) held a position that would also make them a direct user of the HIE's services.
——Why? The ultimate goal was to effect a change that would draw in new member organizations, requires decision-maker buy-in, rather than that of users.
——Why? The ultimate goal was to effect a change that would draw in new member organizations, requires decision-maker buy-in, rather than that of users.
Participants
Opportunity sample of 15 individuals who:
— worked for a healthcare or adjacent organization that either:
• maintained membership with ICC (members, board members, affiliate) or
• could benefit from ICC membership if they were to join (prospective members)
• maintained membership with ICC (members, board members, affiliate) or
• could benefit from ICC membership if they were to join (prospective members)
— were decision-makers in their respective organizations—typically C-suite- or director-level
— volunteered to participate without compensation (hence, the opportunity sample: no recruitment budget)
Interviews lasted 30 minutes. Longer would have been preferable to allow for deeper digging, but these were busy folks offering their time for free!
KEY FINDINGS
[TL;DR] Awareness of HIEs is low and misunderstandings are widespread amongst those who are aware.
It's generally believed that HIEs are costly to join (in time, money, and effort), and provide little to no ROI.
It's generally believed that HIEs are costly to join (in time, money, and effort), and provide little to no ROI.
—Awareness
#1 reason why HIEs are failing: non-members don't know what they are!
Interviewees estimated the ratio of healthcare professionals in Texas who had positive vs negative perceptions of HIEs —
40%
POSITIVE
According to interviewees, these individuals:
— were members of well-connected HIEs
— held a holistic view of healthcare
— emphasized on population health
— were members of well-connected HIEs
— held a holistic view of healthcare
— emphasized on population health
60%
NEGATIVE
According to interviewees, these individuals:
— were NOT members of well-connected HIEs
— believed HIEs provide little value
— were skeptical of HIEs' ability to deliver on promised benefits
— held a narrower view of healthcare
— tended to focus on individual care over population health
— were NOT members of well-connected HIEs
— believed HIEs provide little value
— were skeptical of HIEs' ability to deliver on promised benefits
— held a narrower view of healthcare
— tended to focus on individual care over population health
More than anything, though, interviewees emphasized awareness as the critical factor: the 40:60 ratio applies only to the small minority of professionals with knowledge of HIEs.
—Costs
Top Concerns (anticipated costs)
Sustainability.
HIEs are on their way out – why board a sinking ship?
HIEs are on their way out – why board a sinking ship?
Expense.
It can't be cheap to join with all that complex infrastructure.
It can't be cheap to join with all that complex infrastructure.
"Culture of Mistrust."
It's every provider out for themselves here.
It's every provider out for themselves here.
Patient poaching.
What if another provider sees my patient's info through the HIE and reaches out to transfer care?
What if another provider sees my patient's info through the HIE and reaches out to transfer care?
Lack of oversight to prevent PHI breach.
What if someone hacks into the database and steals my/my patients' data?
What if someone hacks into the database and steals my/my patients' data?
Advantage-taking.
What's to say that others won't take advantage of any data I share?
What's to say that others won't take advantage of any data I share?
Competitive atmosphere.
Sharing my patients' data might give my competition a leg up.
Sharing my patients' data might give my competition a leg up.
"Fairness" of access.
What's the incentive to share more than the bare minimum, when everyone reaps the full benefits, regardless?
What's the incentive to share more than the bare minimum, when everyone reaps the full benefits, regardless?
FOOD FOR THOUGHT
Raise awareness.
• Marketing
• Outreach
• Education: workshops, seminars, flyers, newsletters
Consider the underlying worries.
How might ICC forge more collaborative bonds in the community?
How might ICC better solidify trust in the HIE's data security?
Top ISSUES (experienced costs)
Initial setup.
Getting set up for real-time data exchange is confusing, time-consuming, and just a huge hassle.
Getting set up for real-time data exchange is confusing, time-consuming, and just a huge hassle.
Maintenance.
Whenever something goes wrong with the data exchange, it interrupts our workflow to pull the HIE tech people in to fix it.
Whenever something goes wrong with the data exchange, it interrupts our workflow to pull the HIE tech people in to fix it.
Data requests.
Direct data requests for population health research can be pricey, and it can take ages to receive approval.
Direct data requests for population health research can be pricey, and it can take ages to receive approval.
Data mistrust.
I just don't trust the data from my HIE. So many times I've seen duplicates, missing data, or even outright incorrect information. Accuracy depends on providers to enter it correctly!
I just don't trust the data from my HIE. So many times I've seen duplicates, missing data, or even outright incorrect information. Accuracy depends on providers to enter it correctly!
Board membership.
Board membership is the only way to have any say in an HIE's direction, but some HIEs require huge donations for that privilege.
Board membership is the only way to have any say in an HIE's direction, but some HIEs require huge donations for that privilege.
Portal access & use.
My HIE's portal is clunky, confusing, and a hassle to use — every time I want to pull up a patient's recent history, I need to log out of my company environment, into the HIE portal, then back again.
My HIE's portal is clunky, confusing, and a hassle to use — every time I want to pull up a patient's recent history, I need to log out of my company environment, into the HIE portal, then back again.
Determining usage.
It's just not clear what I'm supposed to do with this data! Figuring that out takes time and energy I just don't have.
It's just not clear what I'm supposed to do with this data! Figuring that out takes time and energy I just don't have.
FOOD FOR THOUGHT
Policy & infrastructure.
How might ICC...
— better support new members during setup?
— decrease wait time for maintenance solutions?
— decrease member wait time for data requests?
— reframe the issue to reduce negative reactions?
— boost member trust in ICC data?
— communicate that ICC board membership is free?
— improve the portal experience?
Use case & ROI clarity.
How might ICC...
— define & communicate explicit use cases?
— communicate ROI benefits?
—Value
Problematic Perceptions
• Little return for extensive investment
• Less effective than...
— national exchanges
— EHRs
— hospital systems
— HIEs with federated models
— Other TX HIEs
— national exchanges
— EHRs
— hospital systems
— HIEs with federated models
— Other TX HIEs
• No value beyond national exchanges
• HIE data is...
— incomplete
— missing
— not useful
— inaccurate
— incomplete
— missing
— not useful
— inaccurate
• Joining is low-priority
These problematic perceptions regarding HIEs appeared to stem from a variety of root causes, each with their own potential remedies —
Misconceptions
No value beyond national exchanges
Less effective than...
— national exchanges
— Electronic Health Records (EHRs)
— hospital systems
— HIEs with federated models
— national exchanges
— Electronic Health Records (EHRs)
— hospital systems
— HIEs with federated models
Potential Remedies
Communication & education:
— Workshops, seminars, newsletters, etc.
— Online presence development
— Community outreach
— Workshops, seminars, newsletters, etc.
— Online presence development
— Community outreach
Out-of-sight, out-of-mind mentality
No value beyond national exchanges
Less effective than other options
Joining is low-priority
Potential Remedies
Marketing & outreach:
— Combat the out-of-sight, out-of-mind mentality
— Help potential members visualize how ICC could increase effectiveness
— Combat the out-of-sight, out-of-mind mentality
— Help potential members visualize how ICC could increase effectiveness
Too Little (useful) Data
Little return for extensive investment
No value beyond national exchanges
Less effective than...
— national exchanges
— EHRs
— hospital systems
— HIEs with federated models
— Other TX HIEs
— national exchanges
— EHRs
— hospital systems
— HIEs with federated models
— Other TX HIEs
HIE data is...
— incomplete
— missing
— not useful
— incomplete
— missing
— not useful
Potential Remedies
Grow database:
— Partner with larger entities, like national exchanges
— Institute an opt-out model for individual providers
— Begin including social determinants of health (SDoH) data in the repository
— Partner with larger entities, like national exchanges
— Institute an opt-out model for individual providers
— Begin including social determinants of health (SDoH) data in the repository
Meet users where they're at:
— Consider a service-based model
— Offer real-time updates
— Offer public utilities
— Consider a service-based model
— Offer real-time updates
— Offer public utilities
Data Inaccuracies
HIE data is...
— inaccurate
— inaccurate
Potential Remedies
Functional and/or policy changes
METHOD 2
Follow-Up Survey
Interviewees received follow-up surveys with their thank-you emails. This survey supplemented our understanding of the offerings, values, and characteristics members and potential members prioritize in an HIE. Values and characteristics informed brand identity ideation (see ICC:Connxus Rebrand 2: Visual Design), and offering data was used to inform and support the organization's strategic direction decision-making.
Research Questions
How do current and potential members perceive ICC?
How do current and potential members perceive HIEs as a whole?
> What needs, pain points, and gaps exist that ICC might fill through services, products, initiatives, or communication?
>> [Offerings] What do members/prospective members want from an HIE?
>> [Identity Attributes] What characteristics do members/prospective members most prize in an HIE?
>> [Brand Values] What values do members/prospective members consider most important for an HIE to embody?
Method
Why surveys?
Surveys introduce quantitative data into the mix, which acts as a support for qualitative data, helps provide a more structured view of the landscape in question, and results in numbers—which business-minded folks (such as ICC's board members) often consider more persuasive than qualitative insights.
A subgroup of six of interview participants responded to the survey.
The 60% attrition rate speaks to the difficulty inherent in recruiting without a budget—particularly such high-level individuals. In truth, 6/15 isn't so disappointing when you consider the multiple hundreds of dollars such participants usually cost to recruit!
KEY FINDINGS
Offerings I: What do members/potential members want to accomplish with an HIE's help?
#1 Grants & reporting ✓ Most do
#2 Direct patient care 𐄂 Few do
#3 Fund allocation ✓ Most do
#4 Research ✓ Most do
...So, let's focus on solutions that support direct patient care use cases.
Offerings II: What do members/potential members want from an HIE?
#1 Real-time alerts
#2 Comprehensive patient histories
#3 EHR integration (e.g., SSO)
#4 High and rising risk patient identification & alerts
#5 Discharge medication reconciliation
...
#14 Mobile access
These priorities informed ICC's product & service post-rebrand roadmap.
Characteristics: What characteristics do members/potential members most prize in an HIE?
#1 Tie: Usefulness & Connectedness
#2 Quality
#3 Simplicity/Ease of use
#4 Inexpensive/Cost-saving
#5 Flexibility
#6 Tie: Efficiency & Constant improvement
Real-time, Comprehensive, Seamless integration, and Connectedness all roll up into Usefulness: HIE usefulness hinges on data completeness, inclusion of data from all organizations a patient frequents, and point-of-need applicability within a member's workflow.
Values: What values do members/prospective members consider most important for an HIE to embody?
#1 Security
#2 Privacy
#3 Trust(worthiness)
#4 Ingenuity
#5 Tie: Honesty/Transparency & Accountability
...
#13 Tradition
Security, Privacy, Trust, Honesty, and Accountability all harkened back to the competitive "culture of mistrust" within the regional healthcare community interviewees illustrated. Above all, they seemed to require assurance that membership would not compromise any aspect of their livelihood.
Ingenuity stands out as the only top seven value not tied to that concern for trustworthiness. When ideating on the new brand's identity attributes (discussed in Part 2), we cemented ingenuity's importance to the brand through the pillar of "innovation."
Key Takeaways: Interviews + Survey
Growth Opportunities
Recommendations
Awareness
• Marketing
• Community outreach
• Communication & education
— Workshops, seminars, flyers, newsletters, etc.
— Online presence development
— Workshops, seminars, flyers, newsletters, etc.
— Online presence development
Use Issues
• Fix issues that can be fixed
• Adopt a brand identity and communication style that emphasizes community, togetherness, & support
Value Add
• Align services with member needs (usefulness)
• Develop a brand identity that emphasizes ICC's priority use cases
• Implement services & initiatives that support better patient care — without the hassle
Here's the first report presented to stakeholders, outlining the information discussed above —
METHOD 3
Competitive Analysis: Tools & Services
To provide a more focused and actionable foundation, I conducted two distinct competitive analyses: one examining the tools and services offered by similar organizations, and another analyzing their branding and visual identity. This dual-track approach enabled deeper insights in each area, allowed for staggered delivery of findings, and ensured consistent progress without sacrificing quality or bandwidth.
Note: The Tools & Services analysis will be discussed here along with the conceptual identity aspects of the Branding & Image analysis. For the visual aspects of the Branding & Image analysis, see Part 2 of this case study.
Objective
Identify baseline expectations (“table stakes”), pain points, and opportunities for differentiation by analyzing the tools and services offered by comparable organizations.
COMPETITORS
Example Data
Key Takeaways: Tools & Services
> Poor Communication Clarity
Terminology, acronyms, long naming conventions, and poorly-defined use cases all compounded to make many competitors' offerings difficult to understand.
Pain points
— Inconsistent terminology across organizations
— Overuse of acronyms and lengthy names
— Few clearly-defined use cases
• Especially problematic for those unfamiliar with HIEs
— Inconsistent terminology across organizations
— Overuse of acronyms and lengthy names
— Few clearly-defined use cases
• Especially problematic for those unfamiliar with HIEs
Opportunity
Emphasize & clearly articulate well-defined use cases to stand out.
Emphasize & clearly articulate well-defined use cases to stand out.
> Emphasis on Direct Care
Most competitors prioritized direct care use cases—typically through clinical data portals—for their data, though several leading HIEs also highlighted additional tools and services.
Table stakes:
Direct care support, clinical data portal, real-time alerts
Direct care support, clinical data portal, real-time alerts
Additional differentiators:
Public health reporting, in-site data visualization tools, consulting/data services
Public health reporting, in-site data visualization tools, consulting/data services
> Variable, Diverse Offerings
Competitors differed greatly in the number and type of tools and services they offered.
Insight: Success depends less on sheer breadth and more on the quality, clarity, and usefulness of offerings.
> System Integration as a Success Factor
Top-performing HIEs offered single sign-on (SSO) or deeply integrated systems that fit seamlessly into provider workflows.
Insight:
Seamless integration and ease of use are key for adoption and engagement. Aligns with interview & survey responses.
Seamless integration and ease of use are key for adoption and engagement. Aligns with interview & survey responses.
Differentiation potential:
While rare among small HIEs, offering workflow integration could be a valuable long-term advantage if achievable.
While rare among small HIEs, offering workflow integration could be a valuable long-term advantage if achievable.
METHOD 4
Competitive Analysis:
Identity & Communication
Identity & Communication
Objective
Identify table stakes, pain points, and opportunities for differentiation by analyzing
how comparable organizations present their identities verbally.
how comparable organizations present their identities verbally.
Competitor HIE brand identities commonly emphasized connectedness and healthcare values like professionalism and care. While rarely stated as identity attributes outright, efficiency emerged as a recurring trait through continual emphasis in content and messaging.
Social Media and Online Presence
All competitors maintained social media accounts and news feeds, though these tended to be better-maintained in larger, more successful organizations. As a small nonprofit, ICC had no marketing team and no budget for outside support in building their online presence. After refreshing their brand, ICC would need to consider options for a maintainable online presence.
Most successful organizations prominently displayed brand identity information like mission, vision, and values. These statements overwhelmingly focused healthcare, often framed through the lens of data and information exchange.
While ICC sought to expand beyond a healthcare-only narrative, competitors' tertiary emphasis on technology and innovation aligned well with stakeholder aspirations.
Key Takeaways: Identity & Communication
> Overabundance of Healthcare Verbiage
Most competitors leaned heavily on language centered around healthcare. This created a clinical tone and reinforced narrow, provider-facing perceptions of HIEs.
Insight
These conventions ran counter to ICC’s rebranding goals of modernity, inclusion, and community relevance.
Recommendations
— Explore conceptual ties to broader themes: community, support, data, technology, and innovation
— Explore conceptual ties to broader themes: community, support, data, technology, and innovation
> Clarity and Consistency as a Marker of Maturity
Most successful competitors conveyed cohesive identities through clearly-defined, prominent mission, vision, values, and value propositions.
Insight
A well-articulated identity signaled professionalism, increased user trust, and positioned the organization as a stable partner.
A well-articulated identity signaled professionalism, increased user trust, and positioned the organization as a stable partner.
Recommendation
Center ICC’s brand messaging around values of innovation, collaboration, equity & empowerment, and a more holistic sense of wellness — consistently applied across all channels.
Center ICC’s brand messaging around values of innovation, collaboration, equity & empowerment, and a more holistic sense of wellness — consistently applied across all channels.
*These five concepts eventually solidified into the main pillars (identity attributes) of the brand.*
> Variable Social & Digital Presence
While nearly all competitors had some form of blog, newsletter, or social media presence, execution varied widely. Larger or more prominent HIEs maintained frequent updates, while smaller ones often had sparse or outdated content.
Pain Point
ICC had no internal marketing team and lacked budget for external support. Though it had set up social platforms and a news blog, none had been updated in years.
ICC had no internal marketing team and lacked budget for external support. Though it had set up social platforms and a news blog, none had been updated in years.
Insight
An inactive presence appeared less professional than none at all and risked undermining credibility.
Recommendation
Develop a streamlined, sustainable digital presence aligned with ICC’s capacity—focusing on high-value touchpoints like LinkedIn and periodic blog updates.
Emerging Differentiators & Opportunities
Across offerings and language, certain trends stood out among leading HIEs.
Common Competitor Themes:
— Conceptual focus on care, professionalism, and connectedness
— Emphasis on direct care and data-driven efficiency
— Regularly updated social and digital communications
— Emphasis on direct care and data-driven efficiency
— Regularly updated social and digital communications
Pain Points Identified:
— Overly-clinical or formal tone
— Inconsistent or poorly-articulated brand identity
— Lack of transparency around use cases and services
— Inconsistent or poorly-articulated brand identity
— Lack of transparency around use cases and services
Opportunities for ICC:
— Differentiate through human-centered, approachable branding that reflects community and innovation over conventional healthcare-centric cues
— Position ICC as a forward-thinking, values-driven organization that supports community well-being through data-informed collaboration
— Reinforce a modern identity through color, tone, and consistent visual systems
Outcome & Impact
At the end of the semester-long fellowship, I presented my consolidated findings to the Board of Directors with an emphasis on recommendations, and they adjusted several of their intended "new directions" accordingly.
Afterward, my stakeholder team rehired me to continue working with them on strategic directions, finalize branding, and get a jump start on their website's redesign the following semester.
Questions? Critique? Project proposals? Get in touch!
Thanks for reaching out! I'll get back to you as soon as I'm able.
