KICKOFF
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We had our Claims kick-off on April 10th 2019!
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The kick-off is an important step in the discovery and framing process. It's all about ensuring that stakeholders and the team are aligned. Through a series of workshops, we learn more about the stakeholders, business, and product goals for the claims process.
Balanced Team Members brainstorming
Agenda for Day 1
Stakeholder Mapping
The image below shows the stakeholder map that came from writing out our names, roles, and key project interests on a sticky note, and then grouping teams of people together, and using arrows to show connections between groups.
The key stakeholder groups identified include: LTC Cluster, ITS, SDC Project Team, SDC Team
MOL execs, Employment Standards, MOL IT, People Change Management (PCM) MOL, Legal, Privacy, Data Management Group.
Risks and Mitigation
In this exercise, we each listed the top 5 risks we thought could impact the project and validated these in groups. Then we ranked them :
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Y-Axis: high risk vs. low risk,
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X-Axis: easy to mitigate vs. hard to mitigate
The image below shows a list of the risks identified and the mitigation strategy for each of them.
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Personas
Claimant Clancy and ERO* Melissa came from our personas workshop. As a team, we did this exercise to create a real person the team could relate to. We wanted everyone on the team to have a clear vision of the person who will use our software, and thus gain empathy for them.
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*ERO stands for Early Resolution officer
White Board Capture of the Persona developed for an Early Resolution Officer (ERO) 'Melissa'
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White Board Capture of the Persona developed for a Claimant 'Clancy'
Value Proposition
This started as a sketching activity for the team to generate moments of delight or need to build empathy. Then it turned into a writing activity where we talked about the highest value this product might deliver for a user.
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For the Claimant
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When submitting a claim as a claimant, I want a more streamlined and efficient way of submitting docs with the claim so that I can complete the process and receive my money quickly!
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When I've submitted my claim as the claimant, I want regular status updates so that I can see the progress being made in my case
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As an ERO
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When a claim is filed as the ERO, I want the system to provide me with automated tasks so that I can resolve more claims efficiently.
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When the claim is received as the ERO, I want complete information on the claim, so that I can have all the information needed to investigate the claim.
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Value Proposition Statement for the Claimant
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Value Proposition Statement for the Claimant
Our End Users- Claims
We focused on 2 major end-users in the Claims Process, they were the:
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Claimant (person who files the claim) and the
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ERO - Early Resolution Officer
We chose these 2 from the list of users because they were the two groups of end-users most involved in the claims process who we knew the least about. So we sought to learn more about them and their needs.
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List of all users identified in the Claims process
Whiteboard capture of the key pieces of information we uncovered about our 2 selected end-users the Claimant and ERO. The text below describes the image in further details
Claims
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A claim is a complaint by an individual alleging a violation of the Employment Standards Act (ESA).
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Claims can be filed digitally or by Paper (mail or fax).
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An Average of 17,000 claims are filed per year (consistent since about 2010)
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Only about 7,500 of the 22,000 claims filed in 2018 were found to be violations.
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The majority of the others were closed, withdrawn (paid and resolved), denied (no violations found), settled (Employer and employee come to an agreement).
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5,100 were closed by an Early Resolution Officers (ERO), rest closed by ESO's
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Top 10 Claims Violations
Notes
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These numbers are from the ~ 7,500 that were found to be violations not the 17,000 claims submitted per year
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A single claim can have multiple violations
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These top 10 covers around 70% of violations
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Top 10 Claims Violations
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Payment of Wages (3,840)
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Vacation Pay / Time (2,859)
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Termination Pay (2,635)
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Public Holiday Pay (1,258)
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Overtime Pay (951)
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Poster not provided (918)
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Wage Statements (859)
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The poster was not Posted (706) isn't one anymore
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Limits on hours of work( 537)
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Deductions from Wages (485)
The Top 3 typically occur when an Employee is fired
The Top 5 Industries that cover 75% of claims
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Professional Services (e.g Lawyers, telemarketers (likely due to high turnover), advertising)
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Food Services & Drinking Places (e.g Restaurants, Bars, Fast Food)
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Cleaning Services (e.g Janitors, Home/ Business Cleaning Providers)
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Retail
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Health Services (e.g Doctor's offices, Dentists)
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Construction
Other Notes
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Hard to tell what the demographic details of the "typical" claimant are, as this information isn't tracked due to Privacy considerations. We might be able to later get details about their locations.
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Also hard to tell the average number of claims per employer.
Claims Processing
Summary of Claims Processing
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1-Document Processor (currently 2- 3 people)
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Converts Paper claims (mail and fax) into digital claims
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2-Claims Processor
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Verifies that valid claim forms were used
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Verifies that mandatory fields were filled; contacts claimant for info if necessary
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Merges duplicate claims
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Adds operating location to the claim
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3-ERO- Early Resolution Officer (currently 32 people)
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Identifies Issues
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Contacts Claimants + Employers to gather evidence
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Gather + Evaluate Evidence
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Prepare the claim ( assign NAICS code, Legal Entity, Company Size)
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Make a decision about claim if enough info gathered
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if unable to make a decision/ if claim is a type that is unable to be resolved at ERO level, claims goes to an ESO
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4-ESO (currently 271 people)
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ESO gathers further info about claims
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Makes decisions, Serves Documents, Does Inspections
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5-Registrar
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Registrar performs some post closure activities, once the claim is closed
Service Blue Print
We mapped out the current paper process that a claim goes through from when a claim is submitted until when it is closed. Highlighting all the key players in a claim's lifespan and the stages the claim goes through helped us see a full picture of the journey of the claim. This journey mapping also included the average time the claim sits in each key player's queue.
The end result is what we call "Service Blueprint"; it is a diagramming tool that communicates a complex flow. It is especially helpful for multiple interactions to spread over time.
We started out on color coded post-it notes on then digitized the entire blueprint.
ERO Exploratory Interviews
Interview Prep
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An ERO is an Early Resolution Officer. In the claims process, EROs are at the first level of resolution for claims.
The day before the interview, we went over the blueprint and highlighted pain points.
Then we had a workshop where each person on our Balanced Team wrote out potential questions to ask EROs. These were all questions that we felt would help us understand more about the claims process. We used Google sheets to collaborate; each person had a tab to write as many questions as they wanted. Next, we each picked our top 5 ones and highlighted them, but didn't delete the remaining questions. We went through the questions and consolidated the top 5s into one sheet. See the image below for a screenshot of the consolidated questions.).
Next, organized the questions into a Topic map. This topic map was used to show common themes in our questions and to cluster the related questions around the overall themes. The themes included questions to help us understand: A day in the Life of an ERO, the current information system used by officers (ESIS), the current Claim Form(s), Claims Process, and also questions around Employers, Claimants, & Documents in the claim process. The image below is the Topic map what was generated from our questions.
Interviews
We had reached out to 5 EROs ahead of our D&F to book an hour to learn even more about the claims process.
Interviews took a full day. Most of the team listened in; we learned that hearing from the end users helps to build empathy and gives further context to the team regarding what's to be built. We had 2 note takers for each interview. We rotated the note takers, so that a different team member got a chance to be hyper focused on interviewee, noting all the pains, gains, opportunities and details of how EROs did their work.
The interviews were semi-structured, we tried to ask questions from each of the question clusters in the topic map but weren't insistent on asking every question. This allowed EROs to share as much as they wanted on each question.
Interview Synthesis
Finally, this image is the end result of interview synthesis for all 5 interviews. Each interview was color coded and grouped under the key insights from all the interviews.
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Assumptions
We did this exercise because if we don't address our implicit assumptions, we may make uninformed decisions about the project's direction. The output of this exercise can be used to generate user research questions.
An Assumption is anything we have assumed which has not yet been proven/validated.
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This below document is the grid of assumptions we uncovered regarding the claims process. They are arranged on the Y-Axis with High-risk ones on top and Low Risk at the bottom, and on the X-Axis with Hard to validate assumptions on the Left and easy to validate ones on the Right.
Birds Eye View Map
MLTSD 360 Claims Investigation Assignment Algorithm.
Employment Standards Prioritization
This session was an education session where we worked with the MOL Subject Matter Experts to assign priorities to the standards. On a 2 by 2 grid, we ranked the standards on the Y-axis from the ones most contravened to the least contravened and in the X-axis from the most complex standard to the least complex.
On a separate grid, we ranked the industries on Y-axis by High-Low offending industries and on the X-axis from to High-Low Complexity claims.
The document below are the resulting grids.
Finding our Skateboard/ Golden Nugget
Our Skateboard analogy comes from the agile way of building software that places high emphasis on providing value to the customer by focusing on "the underlying need the customer wants fulfilled". The image below depicts this idea of increasing the value delivered with each iteration using the example of building a car but starting with delivering a skateboard which can be used to get from one point to another, rather than delivering just the wheels of the car which the client would not be able to use. So we prioritize starting with building the Minimum Viable Product (MVP).
In this post, we're referring our skateboard equivalent as our "golden nugget".
Henrik Kneberg's illustration of Agile Software development using the example of building a car but starting with delivering a skateboard and incrementally building upon that. Rather than delivering just the wheels of the car which the client would not be able to use .
The Golden Nugget
The portion of the image highlighted in yellow was our 'golden nugget'; it was the portion of the future service blueprint where we plan to start working on.
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How we found our Golden Nugget
We revisited our service blueprint and updated it with our prioritized insights (a summary of desired functionality for both the EROs and the Claimants ranked by the value they bring to our users and the complexity of building).
Armed with the knowledge gained from our weeks of framing the problem and productive discussions with our MOL subject matter experts, and the full balanced team, we determined the yellow highlighted nugget to be a suitable point for starting the solution. All the discussions, interviews, and document reviews we did till this point in the D&F indicated that collecting better data and guiding Claimants through the claims process would provide the most value to both Claimants and EROs (the 2 sets of users we're focused on) for the initial stages of this project.
Next, we validated this assumption with the solution for the nugget. It's important to note no code was written just yet. We were working on the minimal amount to learn the most from. This means the Designers were making mocks, which look real, and then we had real users validate whether we were on the right track.
Scenario Writing & Sketching
The MVP version of the Intake Form Process for the Claimants broadly covered these areas:
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Is this the right place to file my complaints?
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What is my complaint about?
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Does my complaint have any merit, am I possibly owed anything?
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What Information do I need to file a claim with MOL?
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How will I know that my claim has been submitted and received?
Flow Chart showing MVP Intake Form Process for the Claimant
Scenario Writing
To begin sketching what the form would look like, we did the following:
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broke down the intake form process into smaller chunks (scenarios)
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wrote goals for what the claimant needed to achieve in each portion
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wrote a real life scenario that our persona (Claimant Clancy) would be dealing with
Screenshot of Scenario 1 showing the first steps for filing a formal complaint. Clancy will determine if this is the right place to file the type of complaint, see helpful links of where to go if this isn't the right place, and if it is the right place, she'll be able to provide preliminary information about the alleged contravention.
Screenshot of the Goal, Context, and Real-life scenario that Claimant Clancy would be faced with when she initiates a claim intake process, as well as the information she would see, and have to provide to proceed.
Detailed Requirements of the fields to include in the sketch for Scenario 1 above.
Sketching
Here's an example of a sketch. The colored bubbles are the comments by the rest of the team from our digital sketch critique, which followed each sketching session (we used Zeplin.io for the digital sketch critique).
Some High Fidelity Mocks & Final Design
