Accelerating access to care through secure messaging

This article was co-written and designed by Gabrielle Williams

At Oscar, we believe that getting guidance on your health care should be as easy as making plans with a friend. When first envisioning how to do so, we asked ourselves, “What if you could send a message and get reliable answers to all of your health needs on your own time?”.

As an insurer, we sit at a powerful intersection in the health care system between patients, physicians, and pharmacists, where we can connect the dots that are otherwise difficult and inconvenient for a consumer to navigate on their own. We aim to be the entry point into the healthcare system for all of our members, so that we can direct them to the best and most affordable care.

That’s why we built a messaging support channel: an interface through which our members can get answers to their health care questions by typing a quick message on their phone or web browser.

Members are able to message their Concierge teams directly and securely from the Oscar app.

Behind the message

Behind every message is a dedicated Concierge team for every member. Each Concierge team is comprised of a group of care guides and a nurse clinician. Their goal is to provide personalized, quality care and support by finding high-value doctors, coordinating care during emergencies, chronic conditions or surgeries, and helping our members navigate their health plans.

Messaging at Oscar is backed by our awesome Concierge teams.

From the moment a member sends a message, to when their Concierge team reads the message and gets ready to respond, a slew of internal tools and systems come into play. Our Concierge teams’ first priority is to research and respond to these messages in a timely manner. To operationalize this support channel, our messaging microservice — which was built as a standalone Thrift service — is in constant communication with the ticketing system that our Concierge teams use to track and resolve issues.

The message first needs be routed to the member’s assigned Concierge team. To do this, a support ticket is created for every inbound message, which automatically gets directed to the queue for the member’s Concierge team to act on. If the member submits an attachment with the message — like a photo of their health issue — the attachment needs to be virus scanned before it is uploaded into our document storage system, tagged to that member, and made viewable in the message and ticket.

If the issue can’t be resolved immediately, our Concierge teams get alerted any time there’s a new message or action on the support ticket. The messaging service toggles the status of the ticket when members reply to a thread, which means that our teams never miss a new message.

Fully-integrated messaging

Aside from operationally handling messaging as a support channel, our Concierge teams need to be able to provide the most informed and up-to-date response to the member. To do this, we built a user interface that surfaces the important contextual information for our teams to provide reliable answers. This way, any information that Oscar knows about a patient is collected and displayed for their Concierge teams. They’re made aware of past issues and potential conditions that might affect how Oscar recommends they seek care.

This internal messaging tool is designed based on the workflows of our Concierge teams. The interface displays important context on the member’s demographics, plan, and data driven health tags to reduce the need to navigate to other pages to get all of the background on the member.

The internal messaging interface surfaces helpful member info for Concierge teams to reference.

Additionally, the ticket information that is used to manage the support status and case information is displayed in the right side panel of the screen to reduce the need for our teams to navigate back to our ticket management tool to gather information on the case. Displaying this data alongside each message empowers our Concierge teams to stay up to date on the member’s health and reduces back and forth.

Collaboration through messaging

If a member needs help finding a rare specialist, the request becomes a collaboration between a care guide and a nurse. The messaging user interface facilitates this hand off by allowing multiple internal users to be tagged internally to the message thread and participate in the conversation.

The messaging service also integrates with various applications across Oscar. This allows messaging to be used by a range of internal users including Virtual Primary Care Physicians (vPCPs) and physicians at the Oscar Health Center, and sets the stage for us to be able to scalably introduce other internal teams to messaging as a form of support.

Oscar’s messaging service was built to be highly integrated with existing tools.

Keeping our members’ protected health information (PHI) safe is our highest priority. We’ve built messaging to be as secure as possible with its own permissioning system. We operate under the Minimum Necessary Rule when handling our members’ information, and limit access to the messaging threads to internal users whose job responsibility requires the access.

Strict permissions determine which message threads a user is allowed to access.

At Oscar, we’re focused on improving our secure messaging platform so that our digital experience is a member’s go-to for managing their health care. In the future, we look forward to bringing provider partners into the conversation, so that our members can communicate with us and their doctor in a single location. We’re also researching what a real-time messaging experience entails for both our members and our Concierge teams, and continually evaluate what we can do in our messaging support channel to make it a great experience for our members. The more members enjoy using our product, the easier it is for us to route them to the highest quality care.