Aligning senior leadership on gaps and opportunities for an early detection alerts service for patients and nurses

Service design case study

Problem: Lack of end-to-end thinking left gaps and issues when developing a new out-of-range health metrics alerting service for patients and nurses
My Role: Service design consultant
My approach: Service blueprinting, narrative-driven storyboarding, workshop facilitation
Deliverables: Low-level service blueprint, end-to-end storyboard, large leadership workshop
Users: C-level and director leadership, clinical operations, nurses and patients
Results: Leadership visibility of key problems and opportunities, assigning actions and owners

Storyboard showing how the new service will work, including front stage and backstage interactions


Babylon is a virtual healthcare service providing patients with doctor and nurse consultations over video calls using an iOS or Android app. Patients can also track their health metrics and learn how to manage their chronic health conditions.

An early detection alerts service was being developed which would alert nurses when a patient adds an out-of-range health metric to the app. This would then be triaged and high-risk patients will be contacted before their condition worsens.


As the service design consultant I helped the EDA team with the following objectives:

  • Automatically monitor self-reported patient metrics
  • Identify health metrics that fall out-of-range and alert a nurse to triage
  • Identify high-risk patients that need nurse outreach
  • Reduce patients being admitted to the emergency room
  • Reduce patient healthcare costs

My contribution

The Early Detection Alerts work stream was already quite far along when I was asked to review the service and support the teams developing it.

I started by doing a low-level, screen-by-screen review of the patient experience looking at marketing and service emails, app onboarding screens, health metric tracking screens, SMS messages and phone scripts used when a nurse makes contact.

I next learnt about the nurses’ clinical workflows and l reviewed the tools they were using for receiving alerts, reviewing patient metrics, making outreach calls and documenting outcomes.

I finished by understanding how all the data moved between the patient apps, clinical tools and backend databases.

Service blueprint showing how the member experience ties into nurse experience

These learnings were recorded in a service blueprint with swim lanes for the patient, nurse and clinical tools. This then became a framework I used to meet with the various teams and record pain points, gaps, questions, notes and ideas.

Five of the highest risk problems and opportunities were chosen to be brought to a large workshop with C-suite executives, directors and key team members:

  1. Patients might not fully understand the value proposition of the service when deciding to register
  2. Patients might not remember / have noticed that the metrics they add to the app may result in a phone call from a nurse
  3. Nurses don’t receive real time metrics in their alerts tool, it’s the initial reading and no subsequent readings added by a patient
  4. Patients can enter multiple, sequential deteriorations for the same metric resulting in multiple alerts to the nurse
  5. Patients can enter out-of-range readings for more than one health metric resulting in alerts going to two separate nurses and possible two separate outreach calls

The service blueprint was a good tool to learn and understand, but I chose to convert the findings into an end-to-end storyboard for the workshop with leadership because it was more concise and accessible to people not so in the detail.

The storyboard tells the story of a patient called Alex who signs up for the service and starts to track her blood pressure. One day she records high blood pressure which results in a phone call from a nurse who discusses how she can manage it better. She’s booked in for blood work and a follow up appointment, and she eventually improves her health.

Communicating gaps and hypotheses

For each of the five problem areas I displayed the pain points, some probing questions and a hypothesis statement, all of which became the stimulus for discussion during the workshop.

As part of the facilitation it was my job to invite subject-matter experts to share their views, explain blockers or offer ideas. This allowed us to make decisions and assign owners to actions

Final thoughts

The workshop was tricky to facilitate with so many senior leaders attending but the storyboard was an effective framework to use to guide discussions and make decisions.

The outcome was alignment across the group on what the service currently looks like, where the blind spots are and what actions we can take to improve the experience for patients and nurses.

The service went on to launch successfully, and has since been improved with AI chat outreach that escalates to a human nurse.

Interested in working with me? Check my availability.

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