There’s one reliable way to get on-demand health care in the United States: have (or wait for) something medically serious to happen to you, and then haul yourself up the triage desk at your local ER. Sure, you’ll be competing for resources with other patients suffering from gunshot wounds and heart attacks, but you can’t be turned away. But in the 21st century, why can’t quality, non-life-threatening medical care be "on demand" in the same way that taxis and takeout are? I know, I know: because, like, regulations and infrastructure and path dependence and stuff. Right?
In 2006, Dave Sanders, a Portland Oregon-based M.D., co-founded a network of walk-in clinics called Zoomcare to offer exactly that. Zoomcare wasn’t exactly Uber-esque, but it was like Starbucks or Chipotle: convenient, consistent, and affordable without coming off as "cheap." After successfully expanding into Vancouver and Seattle, Zoomcare’s creators decided to take a shot at expanding this "user experience" to more than just basic preventive care. Earlier this year, the company rebranded as Zoom and began offering their own health insurance, as well as a suite of medical services ranging from specialty care (such as orthopedics and cardiology) to bona fide ER procedures, not to mention "video visits" over Skype, dental exams, outpatient surgery, and mental health services.
Zoom calls this network of capabilities, spread out over 28 clinics in the Portland metro area, its "health campus." The goal is to implement an alternative-universe version of urban health care—driven by mobile-first technology, integrated UX design, and on-demand "retail"-style service—alongside the existing legacy system of hospitals, clinics, and insurance companies.
But first Zoom has to get Portland residents to trust them with their overall health—no mean feat for a company that’s been associated with cheap urgent care for almost a decade. Sanders likes to use buzzy phrases like "Uber for health care," but Zoom’s approach bears more resemblance to Apple's design strategy for its retail stores. Here are five ideas that Zoom is using to redesign its version of modern health care—a version that, if successful in Portland, Sanders hopes to transplant into cities across the U.S.
In late 2014, ZoomCare hired former Ziba executive creative director Steve McCallion to lead its rebranding into Zoom. He and his team updated everything you’d expect, from the typeface of the wordmark to the precise shade of blue in the company’s branding. But they also rethought the physical user experience of primary care. What if, instead of a forbidding concrete complex full of beige walls and depressing pamphlets, a medical facility looked like someplace you’d want to visit, with inviting colors and natural light, spacious interiors and even amenities—like upscale food and enrichment activities for kids?
Steve McCallion, a former executive creative director at Ziba and now Zoom’s creative director, wants Zoom clinics to feel as different from other medical facilities as Apple Stores do from Best Buy, or Ikea does from Sears. "It’s all about making it accessible," he says. "Many of our advanced care studios are sort of modeled after co-working spaces, where the specialists work not just with each other but with you."
McCallion and Sanders talk a lot about "Sarah," a persona that Zoom created to represent its initial customer base. This approach isn’t uncommon in product design, but for health care it’s radical: by definition, "Sarah" denotes as much about whom Zoom is not designed for (Medicaid and Medicare members, for instance, or people without regular access to mobile devices or the Internet). "We’re not apologetic about this," McCallion says. "One of the weaknesses of health care is trying to be all things to all people."
Dave Sanders sees it as part of Zoom’s overall "retail" approach to health care delivery, versus the "wholesalers" of hospitals and HMOs. "Segmentation and purpose-built systems are good and healthy," he says. He hopes to expand the definition of "Sarah" to include Medicare and Medicaid users, but only when—and if—Zoom can offer an insanely great experience to its initial customer segment. (Yes, Sanders is a fan of Steven P. Jobs.)
"One of the things I really enjoy in the Jobs biography by [Walter] Isaacson right is a section there where he said, ‘Sometimes it’s best to be the hands of a control freak,’" says Sanders. "I think people know what it’s like to have a beautifully designed product. I think they’re going to like it a lot."
Of course, there’s another reason that Apple can create those insanely great experiences, and Sanders doesn’t mince words about applying it to Zoom patients’ benefit. "We have to own you," he says. "Which is good." From Sander’s point of view, the medical infrastructure in America is so fragmented and dysfunctional that the only way to ensure a satisfying "user experience" within it is to build his own, from soup to nuts.
This is why Zoom rolled out its own health insurance, and it’s also the reasoning behind its distributed "health campus," where almost any medical service offered by a city hospital will also be offered a la carte at one or more Zoom clinics. "It has to be complete care on a membership platform at the control of your phone," Sanders says. "Zoom has to offer organ transplant, so it does. It’s a complete system of care without any exceptions."
Did he just say organ transplants? In what universe is that available at a neighborhood clinic? Obviously, Zoom has had to arrange strategic partnerships or nobody would buy into Sanders’s so-called "complete system." And Zoom’s launch partnerships seem intentionally designed to shore up uneasiness on the part of potential customers. It teamed up with Oregon Health and Science University (OHSU) Hospital, Portland’s Level 1 trauma center and teaching hospital, to place OHSU doctors in its clinics and provide health insurance to OHSU employees.
And much like Apple aimed to pre-validate its Music platform by bringing Drake out onstage at WWDC, Zoom has announced other insurance clients that seem tailor-made to appeal to the lifestyle aspirations of young, digital-native urbanites. Instrument, a Portland-based interactive agency that counts Google, Nike, and Flipboard as clients, inked a deal to use Zoom as its employee insurance option. Same for Hannah the Pet Society, a veterinary provider that looks like it could be on Zooey Deschanel’s speed dial.
The message is clear: if Zoom’s insurance is good enough for the city’s top doctors, hip digital creatives, and rescue-dog lovers, isn’t it good enough for you, too?
If you accept that the "use case" of medical care and insurance is, by definition, a catastrophe at worst and a nuisance at best, it makes sense to design it to be as simplified and streamlined as possible. That way, it’s there when things go wrong, but otherwise stays out of sight and out of mind—except, of course, for those monthly premium bills.
Zoom’s overall design leans into precisely the opposite strategy. It calls its primary product "performance insurance" in order to position it as something desirable, rather than a necessary evil. "The world hasn’t experienced what Steve [McCallion] and our team is designing," Sanders says. "It’s truly gorgeous retail health care, where products are really jewels."
It sounds like hooey, but it wouldn’t be the first time that savvy product design has transformed a boring service into a object of desire. The Nest thermostat, Tesla Powerwall home battery, and Google OnHub Wi-Fi router are all placing similar bets. Oscar is already trying to give health insurance a design facelift; Zoom’s gambit is to roll up insurance, on-demand care, and community accessibility into the same integrated package.
Sanders figures that people are already forced to spend thousands of dollars a year on medical care and health insurance anyway—so why not reframe it as a lifestyle product? "Health care is one of the largest household spending categories other than a car or food," he says. "For that kind of investment, it needs to be a life-enhancing platform, not just a commodity or a utility. Oh, and by the way, when you’re really sick, it’s got your back too."
There’s one way that Zoom does want to be an "Uber for health care": Sanders wants to expand it to the entire U.S., not just the Pacific Northwest. The service and UX design principles that he and McCallion are beta-testing in Portland can, in principle, organically grow in other urban centers too. "By designing almost all Zoom services to be in these retail-size parcels, we have a greater ability to enter and scale in major urban areas," Sanders says, "versus having to go and find a 40,000-square-foot complex to contain what you’re doing."
Time will tell if Zoom’s new design template for delivering health care can thrive in the Pacific Northwest, much less anywhere else. But if there were ever a sector of our economy in desperate need of an Apple-style "think different" shakeup, health care is it.