Streamlined Patient Onboarding & Waiting Room

Eliminating patient anxiety through streamlined onboarding and a creative waiting room solution

Project Overview

As the design lead for a telehealth platform, I redesigned the patient experience in two phases to eliminate confusion and reduce technical anxiety. This project addressed fundamental challenges in how patients navigate a telehealth app when we have no visibility into their appointment schedules.

The Challenge: Designing in the Dark

Unlike typical telehealth platforms, our system faces a unique constraint: we don't know when patients have appointments. Providers schedule visits in external software, which means:

  • We can't send appointment reminders
  • We can't provide direct links to specific visits
  • We can't tell patients "your appointment is in 15 minutes"
  • We have no way to verify if an appointment is running late

This lack of data created significant patient anxiety: "Am I in the right place? Is this working? Did my provider forget about me?"

Phase 1: Streamlined Onboarding

The Problem

The existing onboarding flow created unnecessary friction right at the start:

  • Four screens including redundant "almost ready" and "setup complete" messages
  • No clear explanation of how the app actually worked
  • Help resources buried in settings where patients couldn't find them
  • Messages interface showing search bars and compose buttons patients couldn't use
  • No "home base" for patients to orient themselves

The Solution

I eliminated the noise and created clarity.

Simplified Flow:

  • Reduced from 4 screens to 2: permissions → home (50% reduction)
  • Removed confusing "almost ready" and "setup complete" screens
  • Direct path to understanding and using the app

Redesigned Home Screen:

I designed an informative landing page with a pattern background and three white content sections:

  1. "How it works" - Sets expectations that providers initiate contact
    "Your healthcare provider will contact you directly through this app. You don't need to do anything else right now!"
  2. "What to expect" - Details the notification flow and backup links for both appointments and messaging
  3. "Need help?" - Direct access to Contact Practice, FAQs, and pMD Technical Support

Intelligent Navigation:

  • Bottom nav with Home (always visible) and Messages (conditional)
  • Messages tab only appears when patient has at least one conversation
  • Search functionality hidden until messages exist
  • Compose button removed entirely (providers initiate all contact)
  • FAQs moved from settings to accessible home screen

Implementation: 1 week iOS | 1.5 weeks Android (design, development, QA)

Why This Mattered

By creating a clear home base, patients immediately understood:

  • They were in the right place
  • What would happen next
  • How to get help if needed

This foundation was critical for Phase 2.

Phase 2: The Waiting Room

The Problem Evolved

Even with better onboarding, patients still experienced significant anxiety before appointments:

  • No way to test their camera and microphone beforehand
  • Uncertainty about whether they were "ready" for their video visit
  • Technical difficulties during critical appointment time
  • Camera/mic controls that only worked after both parties joined
  • The fundamental question: "Am I in the right place?"

Without appointment data, we couldn't reassure patients with typical solutions like "Your appointment is scheduled for 2:00 PM" or "Dr. Smith will see you shortly."

The Solution: A Creative Approach to Presence

I designed a waiting room that solves a psychological problem, not just a technical one.

The Core Insight: Even though we don't know when appointments are scheduled, we can create a place where patients feel confident they're where they need to be.

Key Features:

  • "Join Waiting Room" button prominently placed on the home screen
  • Self-view video so patients can see themselves exactly as their provider will
  • Fully functional controls (mute/unmute, camera on/off, camera switching) available immediately—not just after joining
  • Universal auto-connect: If ANYONE calls that patient while they're in the waiting room, the call is automatically accepted
  • Clean, focused interface with no navigation distractions

Platform-Specific Design:

  • Mobile: Full-screen immersive experience
  • iPad: Split-view with waiting room on the right, allowing patients to view appointment details or messages on the left while waiting

Implementation: 3 weeks iOS | 2 weeks Android (design, development, QA)

Design Decisions

Why Universal Auto-Connect?

Without appointment data, we can't match patients to specific providers or time slots. The solution: if a patient is in the waiting room and any provider calls them, they're connected automatically. This elegantly solves:

  • The "did I miss it?" anxiety
  • The "do I click the right button?" confusion
  • The manual joining delay

It's a blunt instrument, but it works because we trust that if a patient is actively waiting, they're expecting a call.

Why Call It a "Waiting Room"?

The metaphor matters. A waiting room is:

  • Where you go before your appointment
  • A place that signals "you're here, you're ready"
  • Familiar to anyone who's been to a doctor's office
  • Inherently temporary—you're not meant to stay forever

Why Show Self-View?

Technical confidence comes from seeing proof. Patients can:

  • Verify they're visible and well-framed
  • Check their background
  • See that their camera is actually working
  • Make adjustments on their own timeline

Implementation & Quality Assurance

My Process

As both designer and QA lead, I managed the full cycle from conception to production:

Design Phase:

  • Created detailed specifications for developers
  • Defined user flows for all scenarios (primary waiting room, iPad split-view, end call behavior)
  • Specified platform-specific requirements for mobile and tablet
  • Documented auto-connect logic and control functionality

Development Oversight:

  • Coordinated iOS and Android implementation timelines
  • Managed parallel workstreams while other projects were in progress
  • Ensured consistent behavior across platforms

QA Testing:

  • Verified auto-connect functionality worked seamlessly
  • Tested camera/mic controls were immediately functional (not just after both parties joined)
  • Validated iPad split-view maintained proper aspect ratios
  • Confirmed end-call experience properly returned patients to conversation screen
  • Tested conditional navigation logic for Messages tab
  • Verified helper text updates maintained clarity

The Copy Challenge

While the waiting room solved technical anxiety, we still face a messaging challenge. Patients occasionally call support saying: "My appointment started 10 minutes ago but my provider hasn't called."

Unfortunately, we have no way to:

  • Verify when appointments are actually scheduled
  • Check if providers are running late
  • Communicate with the scheduling system

Future Opportunities:

  • Add messaging like "36% of appointments run late" to set realistic expectations
  • Gamify the waiting experience (perhaps a calming interaction or helpful pre-visit questions)
  • Provide better language around what patients should do if they've been waiting a long time
  • Consider a gentle prompt: "Still waiting? Here's how to contact your practice"

This is an area where improved copy and expectation-setting could further reduce support burden.

Results & Impact

Quantitative Wins

  • Reduced support tickets for "verify my setup is correct" queries
  • Contributed to improved App Store ratings (part of a broader experience improvement)
  • Efficient delivery: 5.5 weeks total across both platforms for both phases (while managing parallel projects)

Qualitative Improvements

  • Eliminated patient confusion during onboarding
  • Reduced technical anxiety through proactive testing capability
  • Faster appointment starts via auto-connect (no manual joining delay)
  • Improved patient confidence with self-view and working controls

Design Outcomes

  • 50% reduction in onboarding screens (4 screens → 2)
  • Contextual navigation that adapts to patient needs
  • Accessible help resources moved from buried settings to home screen
  • Novel solution to "invisible appointments" constraint

Reflection & Learnings

What Worked Well

Designing for Constraints:
Rather than fighting against the lack of appointment data, I designed around it. The waiting room doesn't need to know when appointments are—it just needs to make patients feel prepared and positioned correctly.

Phased Approach:
Building the home screen foundation first (Phase 1) gave patients a clear mental model before introducing the waiting room concept (Phase 2). The sequence mattered.

Cross-Platform Consistency:
Managing both iOS and Android implementations ensured patients had a consistent experience regardless of device, while still respecting platform-specific patterns like iPad split-view.

Integrated Design-QA Role:
Wearing both hats allowed me to catch edge cases early and ensure the implementation matched the intended experience.

What I'd Improve

Copy Iteration:
There's still work to be done on messaging for patients who've been waiting longer than expected. Setting realistic expectations upfront could prevent frustration.

Provider Communication:
Future iterations should explore how providers are notified when patients join the waiting room, creating visibility in both directions.

Metrics & Validation:
I wish I'd established clearer success metrics before implementation—measuring average wait times, drop-off rates, and correlation with support ticket reduction would strengthen the case.

If I Had More Time

  • Waiting experience enhancements: Progress indicators, calming content, or pre-visit questionnaires
  • Smart messaging: Context-aware copy that adjusts based on wait time
  • A/B testing: Different messaging approaches for the "still waiting" scenario
  • Audio test feature: Recorded playback so patients can verify they're audible

Key Takeaway

This project taught me that good design doesn't always mean having perfect data—it means designing solutions that work within real-world constraints.

We couldn't tell patients when their appointments were, but we could give them:

  • A place that feels right
  • Tools that work when they need them
  • Confidence that they're prepared

By reframing the problem from "how do we manage scheduled appointments?" to "how do we reduce anxiety when we can't see the schedule?", we created a solution that worked with our limitations rather than against them.

The insight: Sometimes the best solution isn't more data—it's better psychology.

design@juliasakalus.com