35. Danielle Smith of Express Scripts

This episode of Dollars to Donuts features my interview with Danielle Smith, the Senior Director of Experience Research & Accessibility at Express Scripts.

Something that I’ve really changed the way I thought about since I’ve been at Express Scripts — we are in the healthcare ecosystem. So the experiences we deliver, if they are not of quality, they do have serious repercussions on people’s lives and people’s time. We are ethically bound to measure the user experience from different perspectives. Before something launches. We have prototypes or concepts or ideas, we do our due diligence in terms of user experience research, to make sure that the thing that we’re putting out on the world doesn’t just happen to people. – Danielle Smith

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Steve Portigal: Welcome to Dollars to Donuts, the podcast where I talk with the people who lead user research in their organization.

Many years after we moved into our house, we finally hung up our art. Sure, we had hung up individual pieces, something that was already in a frame, say. But it was always piecemeal, a nail here, a hook there. And we continued to accumulate meaningful pieces from travels or family events. And we continued to occasionally pull out the box (a moving box, made for a mirror, I believe) and spread out all the various bits and pieces and just generally fantasize about having them up.

My goal, however, was to have a plan, an intentional way of placing the different posters, prints, photos throughout our home. Every time we would try that, I would get overwhelmed and give up. I tried taking small bites: after seeing homes with big frames and medium photographs, we chose a few photographs from our travels, blew them up, ordered specially cut mat boards, and frames. We mapped out where in our living room these would go; we essentially carved off part of the home and planned the photographs that would go there. I hoped that this would simplify the challenge of where to put the remaining posters, but we found ourselves stuck, still.

Eventually, we opened up that box and made some hard decisions about what to hang and what to set aside, and then – before too much time could go by – arranged to get everything framed. We were inching closer, but sitting with our posters and prints, all framed, we still couldn’t figure out what to hang where and so (this shouldn’t be surprising) I got overwhelmed and gave up.

But buried in that frustration and surrender was a recognition of what skills I’m missing – an ability to reorganize visual information spatially in a few different ways, a set of starting principles for grouping, placing, and so on. Surely someone must have this expertise and be offering it as a service?

It turns out that, yes, there are professional picture-hangers. We called one and booked an appointment. A few weeks later, on the scheduled day, at the expected time, the doorbell rang. We answered the door and before we could finish greeting them, two men were in our foyer, one of them having magically unfolded and gently placed a table (please assume it transformed from a flat briefcase shape to a table with a soft whoop noise).

The guy with the table handled production. The other one handled creative (and the clients). We showed him all of our framed pieces and talked a very little about what they meant, and we showed him around our house, pointing out areas we were interested in and the few pieces we had already hung. Meanwhile he was riffing constantly, throwing out ideas, getting energized, and delegating to the production guy, who began attaching extra mounting hooks and hanging wire to all of our store bought frames. After a short time, we backed off, and we watched them work.

The “creative” began moving frames into different rooms, laying them on the floor and trying different combinations. Like a problem-solving algorithm, the solution began to appear, bit by bit. The floors throughout our house began to fill with clusters and arrangements of different prints, both thematic and visual groupings. We were called in for frequent consultations as the plan emerged. Eventually there was a plan for where everything was going to go. This was the piece we could not have done ourselves and in a short time, they had done it.

Then came the rest of the production. They began hanging up everything. That meant figuring out where each item went – exactly, putting in nails in exactly the right spot, using a level, all the details. Especially because so many pictures were clustered, something being slightly off would really show, so perfect execution was key. This was also something we could have not pulled off ourselves.

The final results were astonishing. Rather than hanging things in a grid, with the top edges aligned and a consistent space between each, they put together a number of clusters where the posters emanated from a central point in an almost-spiral flow. And they chose how to place different prints within that cluster in order to create a kinetic sense, such as having a poster with a bird along the left hand side, with the bird facing to the right, so that the content of the images supported the physical placement on the wall. This was not something we could have even imagined, let alone executed.

It is immensely gratifying to be in the presence of a highly-skilled individual. When those skills are being deployed for your benefit, it adds another layer of delight. I believe that delight is further enhanced when we ourselves have tried and failed. This story is a reminder to me to seek out these magically-talented individuals and take advantage of what they have to offer, whenever I can.

And it’s my goal to be a magically talented individual for the people I work with, someone who brings in a level of skill that isn’t achievable without my help. I strive to conduct user research with that kind of finesse, I hope that when I coach and train teams in doing research, I’m helping them see what that magical level of skill looks like and move them forward on their own path towards achieving that.

I would love to hear from you about what you are working on and how my expertise can support you in moving your effort forward. Please keep me in mind.

Now let’s go to my interview with Danielle Smith. She’s the Senior Director of Experience Research & Accessibility at Express Scripts.

Steve: Well, Danielle, welcome to Dollars to Donuts. Thanks so much for being on the podcast.

Danielle Smith: Thanks for having me.

Steve: Why don’t we start with an introduction from you to say a little bit about what you do where you work.

Danielle: My name is Danielle Smith. I am Senior Director of experience research and accessibility at Express script. And Express Scripts is actually Cigna company. But we are a pharmacy benefit provider. So we help with getting your prescription drugs. If you have insurance coverage, we are the companies that help with that. And my team measures the quality of the user experience from a few different perspectives. One includes user experience research. The other is our NPS program for our digitally engaged customers, and our data science team and some digital metric reporting, oh resides with my team.

Steve: So I want to ask about your team. But I want to just back up slightly, who are the kinds of people that are having this digital experience with your company.

Danielle: So our digital experience is primarily geared towards people who have prescription drug coverage through their health insurance provider or directly if you’re on Medicare Part D, but you are interested in getting home delivery of your maintenance medications. Our website does have kind of general information. If you do have a health plan, you want to go in there and look up a medicine see how much it costs which pharmacy But most of the functionality on our digital tools for consumers really look at the home delivery of medicine,

Steve: and then use the phrase to kind of describe what your team does. It’s about measuring quality. Is that right?

Danielle: Yeah,

that’s sort of the way I think of it.

Steve: Can you pick apart that phrase a little bit? It’s an interesting one. And I’m curious how you think about

Danielle: something that I’ve really thought about or changed the way I thought about since I’ve been at Express Scripts, we are in the healthcare ecosystem. So the experiences we deliver if they are not, if they are poor, or if they are not of quality, they do have serious repercussions on people’s lives some people’s time. So when I think about my team, we are almost ethically bound to measure the user experience from different perspectives. Before something launches. We have prototypes or concepts or ideas, we do our due diligence in terms of user experience research, to make sure that the thing that we’re putting out on the world doesn’t just happen to people. We have some ideas It’s usability, its appropriateness. And we’ve really tried to test a test and air quotes, do research on everything before it hits the site. And some cases, of course, we can’t do that. And I’ll talk about that in a second. But we’ve tried to do, I would say far above 80%, of what hits the site goes through some level of user research related to that. And another aspect of what we do to ensure quality is to make sure it’s accessible. And most of our accessibility work has really geared towards visual impairments or different visual abilities, because we are the digital team. So my team serves as subject matter experts to help our developers aren’t marketers, and to deliver experiences that are usable by people that use screen readers or have low vision just right out of the gate. So we don’t have a separate experience for folks who may be having any sort of different visual abilities. And that was a big point of focus for the first few years of my role here was to just really get that going. But it’s part of our user experience, practice and it’s in our The research team because we do specifically do studies, blind and low vision users throughout the year, to make sure even though it’s something’s technically compliant, it is actually usable by folks that use a screen reader specifically. But following good design practice, and rolling in those things before you launch still does not guarantee good experiences. And so the other parts of my team work to measure how what we build interacts with reality, and to see if it does actually generate a good experience and has, you know, high quality like we want. So the NPS program I know NPS itself is a problematic metric and has its taters in the industry. And that’s fine. I’m not here to defend it. But what it does is gives it lets us speak in a voice that executives and understand and it gives us the leeway to have an open channel with our users. So we send out these monthly surveys for one part of the program. But another part of the program allows users to leave feedback directly in our mobile app on our website. Tell us what’s going on. So yeah, that gave us a score, report the score, executive lift score. But the words that they use when they tell us if we’re on the mark or off the mark have been priceless and making sure that things actually work as intended given reality. And then the other piece is behavioral analytics. So we run a B tests, we instrument the site and make sure that things are working the way we think they should work in terms of people flowing through different funnels or parts of the site and monitor the experience that way. So we work really closely with our product teams to help them understand their metrics, make sure they’re gathering metrics and help them use them and interpret them in the right ways. So when you use the word quality, what does that mean for you? So for me, I’m using quality to be synonymous with a good user experience and healthcare so complicated. I’m not going to be so arrogant as to say we’re going to delight people. I just want them to be able to get their task accomplished which is getting their drugs prescriptions delivered. or checking the status of their delivery. I want them to get their tasks accomplished with ease. And that’s what I mean by quality. Are we not getting in their way? Do we make them feel like they’re part of the process? And do they understand what’s going on? Because it’s complicated enough.

Steve: You also use the phrase, I hope I get this right. working as intended given reality.

Danielle: Oh, yeah. Reality when you’re talking about healthcare is something that we cannot ignore. And we can’t we can’t even formulate all of the scenarios a person might be in at least you can’t do that yet. And people’s realities may be like right now like, Okay, well, now my doctor’s office is closed, and I need a refill. How do I do that? It’s a pandemic, what’s going on. So we have to be making sure that we are listening to user feedback to make sure we update the website, and even communications and talk to our friends in the call center to make sure that we are ready to respond to our users. reality, smaller, like everyday situations happen. As you can imagine, if you’re sick, there are some conditions that give you kind of a transient low vision situation. So you use the website yesterday, I, my team wants to make sure you can use website tomorrow. Just because you’re on this medication or you have this condition should not take away your ability to use certain tools. We also have lots of families, family situations are fluid who has access to your account today, you might not want them to have access to your account tomorrow. And this is your health information. So we have to be always ready to listen and react when people’s contexts change, or their actual reality is way more complicated than we even thought of when we were designing the user interface.

Steve: Can you say a little more now about the word measure is kind of the key verb that you use to describe kind of overall what you all are doing.

Danielle: Sure, and I’m glad you picked up on that because I don’t want to give people the wrong impression that Don’t do discovery or you know the call, but I am of the belief that the work that we do is still measurement. We may not have a type metric, we might not have a number around it, but it is still the collecting of data to get at some underlying construct as best as we can. And I was recently reminded that I came from a grad program that was more quiet leaning. And it’s probably why I did grow my team, the way that it grows more, including analytics, as well as user research and having them live side by side. So it’s not just about things we can put a number one it is about understanding scenarios and understanding people and listening to how we can resonate with our users and more. So I don’t want to miss categorize what we do, but I think of measure in the broad sense of the word.

Steve: I mean, it’s a really powerful frame for what research does and there are lots of different frames for you know, if you have to say one word, what is it that we do and measure is One that I have heard all that often, but it’s very compelling, especially when you kind of explain, hey, there’s lots of different kinds of measurements. And even when you’re talking before about NPS, and part of its value as a way to open up a conversation with other people in the organization, when you say measure overall, I imagine that that is similar that by framing this around measurement, you are positioning yourself relative to your stakeholders and colleagues that this is the kind of guidance and information that you can bring.

Danielle: Yeah, and I talked about it that way I talked about what my team does is x data sounds very superhero like that. It’s like it’s data about the user experience. And just because I say data does not mean it’s all quantitative, and it’s taken a while for our partners and even some folks on my team to get on board with this idea. But we need to be able to have some sort of convergence on the user experience. And convergent validity is a goal of most research teams that I’ve been exposed to where you want to have some analytics show problems and user research give you the other side of it, maybe some survey data to give you some aspect of scale of some of those opinions. And by us all being on the same team, it gives us that ability to be fluid in our methods and speak to the business in a way that allows them to hear us. And sometimes that way is to use NPS or a web analytic metric to get our foot in the door and expand how they view the users by layering on the qualitative and sometimes it’s vice versa. We have different stakeholders that are more interested in in qualitative data and then we overlay some quants to help them understand scale and focus and or if it’s even able to get to that level of maturity given where we are in the process.

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