In a world where consumer technology has mastered the art of holding our attention, the healthcare industry often struggles to get patients to even show up for an appointment. Faisal Zain, a veteran expert in medical technology and innovation, argues this isn’t a failure of patient motivation, but a fundamental failure of design. He believes that by applying the same principles that make apps like TikTok so compelling, we can transform healthcare from a confusing, bureaucratic chore into an experience that is intuitive, supportive, and even delightful. We sat down with him to explore this concept of “experience reform,” discussing how to overhaul frustrating processes, build genuine trust with technology, measure what truly matters, and break through the bureaucratic inertia that holds the system back.
You contrast TikTok’s high engagement with healthcare’s, calling it a “design problem” and citing the 56% higher no-show rate for Medicaid members. Can you describe, step-by-step, how you would apply tech’s UX principles like simplicity and delight to overhaul a frustrating process like scheduling a first appointment?
Absolutely, it’s a perfect example of a high-friction process begging for a redesign. First, you have to map the current, painful journey. A member gets a list of providers, starts making calls, hits endless phone trees, gets told they need a referral they thought they had, and eventually gives up. It’s a maze of dead ends. The first step in applying UX is to radically simplify this. We’d scrap the phone-tag model and start with a simple, proactive text message: “Hi Maria, it’s time for your check-up. We have an opening with Dr. Smith next Tuesday at 10 AM. Reply ‘YES’ to confirm or ‘OPTIONS’ to see other times.” That one text eliminates a dozen frustrating steps.
If Maria replies “OPTIONS,” we don’t send her to a clunky portal. We follow up with two more curated choices, right in the text thread. Once she confirms, the next step is about creating a feedback loop and a moment of delight. Instead of silence, she immediately gets a confirmation: “You’re all set! We’ve added it to your calendar and will send a reminder from your care coordinator, Sarah, a day before. Great job taking this step for your health!” This isn’t just about scheduling; it’s about making the member feel seen, successful, and supported from the very first interaction. We’ve taken a process that felt like a bureaucratic burden and turned it into a two-tap, reassuring experience.
You emphasize that the “interface” is human and trust is foundational, suggesting a text reminder works best from a known person. Could you share a specific anecdote from your work where this high-tech, high-touch approach successfully turned a disengaged member into an active participant in their care?
I remember a gentleman, let’s call him David, a dual-eligible member with multiple chronic conditions who hadn’t seen his primary care physician in over two years. The plan’s automated system had been sending him generic portal notifications and robocalls, all of which he ignored. He was labeled as “non-compliant” and “disengaged.” We knew the automated outreach was just noise to him. So, we assigned him a community health worker, Anna, whose first job was just to build a relationship. She didn’t start by nagging him about appointments. Her first call was just to introduce herself and ask how he was doing.
After a few real, human conversations, Anna became a trusted name for David. That’s when we brought in the technology. Anna sent him a text: “Hi David, it’s Anna. I was talking with Dr. Evans, and he had an idea about your medication. There’s an opening next week. Would you be open to a quick visit?” Because that text came from Anna—a person he knew and trusted—he responded for the first time. He went to that appointment. The technology was just a simple text message, but it worked because it was used to support a human relationship, not replace it. It turned David from a line on a “non-compliant” report into an active, engaged person who finally felt the system was there to help him, not just process him.
You distinguish healthcare’s task-based definition of engagement from the consumer world’s focus on connection and loyalty. What specific, non-traditional metrics should a health plan track to measure this deeper sense of trust and satisfaction, and what’s the first step to start gathering that data effectively?
We are obsessed with measuring the wrong things. We count portal logins and scheduled visits, which are just tasks. That’s like a restaurant measuring its success by the number of times the front door opens. To measure real engagement—connection and trust—we need to track metrics that reflect the member’s experience. For instance, we could track “Time to First Resolution.” When a member calls with a problem, how long does it take, and how many people do they have to talk to before it’s solved? A shorter time and fewer handoffs indicate a more seamless, trusting experience.
Another powerful metric would be a “Relationship Score,” derived from analyzing the sentiment of communications. Are the member’s responses positive? Do they initiate contact? Are their interactions becoming more frequent and less problem-focused over time? The first step to gathering this data is simple: start asking better questions. After a significant interaction, like resolving a coverage issue, send a one-question text survey: “On a scale of 1-5, how easy was that for you?” or “Did you feel heard today?” This isn’t a 30-question survey; it’s a simple pulse check. It gives you immediate, actionable data on the feeling of the experience, which is the foundation of loyalty and trust.
You state the barrier is a “lack of imagination” and call for in-volving UX designers and consumer-brand strategists. What are the first three practical steps a large, bureaucratic health system could take to effectively integrate these creative roles and foster a genuine culture of “experience reform”?
This is the key challenge—breaking through the institutional inertia. The first step is to create a protected space for innovation. Don’t try to change the entire organization overnight. Form a small, cross-functional “Experience Team” with a UX designer, a member, a care manager, and an IT lead. Give them a clear, specific, and high-impact problem to solve, like “reduce no-show rates for first-time behavioral health appointments by 30%.” This small-scale, focused approach prevents them from getting bogged down in enterprise-wide bureaucracy.
Second, you have to empower this team to work differently. They need to talk directly to members, build prototypes, and test ideas quickly without needing ten levels of approval. This means leadership must provide air cover, allowing them to fail and iterate. Their mandate isn’t to just implement a known solution, but to discover the right solution through experimentation. Third, and most critically, you must change how success is measured for their pilot project. The primary success metric shouldn’t be ROI in the first six months. It should be member satisfaction scores, usability ratings, and qualitative feedback. By celebrating wins in user experience, you start to shift the entire organization’s mindset, showing that a better experience isn’t just a “nice-to-have”—it’s a direct path to better outcomes.
You describe an ideal two-tap Medicaid redetermination process. Given the high stakes of members losing coverage, what are the primary organizational and technological barriers preventing this “standard UX practice” from being implemented, and how could a plan realistically start dismantling one of those barriers tomorrow?
The barriers are a tangled mix of old technology and old thinking. On the technology side, you have siloed data systems. The information needed to pre-fill a redetermination form might live in three or four different legacy platforms that don’t talk to each other. This makes pulling it all into a simple text-based workflow a massive technical challenge. Organizationally, the biggest barrier is a deeply ingrained, risk-averse culture. Complicated, multi-step processes are often seen as necessary for compliance. The idea of a two-tap confirmation feels legally risky to a compliance officer who is used to long forms and wet signatures, even if the result is that people lose coverage.
So, how do you start dismantling this tomorrow? You don’t start by trying to overhaul the entire IT infrastructure. You start by making the problem visible. A health plan could literally map out the current redetermination journey from the member’s perspective. Create a visual journey map showing every single step, every confusing piece of mail, every phone call, and every dead end. Present this visual—this story of frustration—to leadership. When they see that their “compliant” process is actually a 40-step nightmare that pushes people out of care, it creates the emotional and political will to tackle one piece of it. That might mean starting with a simple pilot to just pre-fill the member’s name and address. It’s a small technical step, but a giant leap in changing the mindset from “how do we protect the system?” to “how do we help the person?”
What is your forecast for experience reform in healthcare?
My forecast is one of cautious but determined optimism. For years, the conversation has been stuck on policy and payment, but the needle is finally moving toward experience. The rise of consumer-driven health and the stark reality of post-pandemic health disparities have made it impossible to ignore that a bad user experience is a clinical risk. We’re going to see a slow, but steady, infusion of talent from the consumer tech and design worlds into healthcare. Initially, progress will be in pockets—innovative health plans or startups will build incredibly simple, human-centered solutions for specific problems like appointment scheduling or care coordination. The biggest challenge will be for large, established systems to adopt this mindset. But as members begin to see what’s possible, their expectations will change. They will demand a system that is as easy to use as it is effective. Experience reform won’t be a single, grand project; it will be a thousand small, thoughtful redesigns that, over the next decade, will fundamentally change our relationship with healthcare for the better.
