Designing & Developing MiSalud’s Inclusive Digital Health Platform in Just 5 Months

MiSalud is a US-based telehealth startup looking to address a very broken healthcare system – one that is particularly difficult to navigate for Hispanic communities. MiSalud provides personalized, culturally sensitive health and wellness services that are accessible and affordable to the Spanish-speaking community in the Americas.

To build the most trusted, fully compliant, digital health mobile application and platform, MiSalud engaged Wizeline as its end-to-end design strategy, research, experience design, and engineering partner. Wizeline provided a fully cross-functional team operating in concert with the MiSalud product leadership team to bring the innovative platform to life. 

The engagement started with a multi-week, hackathon-style approach to build the alpha, which was validated with real customers and then transformed into an on-platform beta version with enhanced features and functionality. Today, Wizeline continues to implement the complete roadmap while iterating on feedback from users/customers as they utilize the MiSalud mobile application. Read on to learn the details of this end-to-end product design and development story.

Due to longstanding inequalities in the US healthcare system, Hispanics are 23% more likely to be obese, 24% more likely to have uncontrolled hypertension, and 50% more likely to die from diabetes (CDC). Furthermore, they are 3x more likely to be uninsured, and 60% less likely to have a primary care doctor. Despite these alarming statistics and the wealth of digital health services available in English, no solution had been developed to cater specifically to the underserved and overburdened US population of 60-million+ Hispanics — before MiSalud. Notably, this population is expected to grow to over 130 million by 2050.

To realize the product vision and serve this community, the design challenge was to create an authentic, trusted, personalized experience for the Spanish speaker across various channels. The experience needed to be simple and intuitive, so that an individual’s tech-savviness would not be a barrier. Adding to the challenge, the platform had to connect with health coaches in Mexico and LATAM, as well as Spanish-speaking physicians in the US, so that members could have a culturally appropriate experience in their native language.

From a technology standpoint, the main challenge was creating a health platform with three principal participants: health coaches, patients, and US doctors. Patients are to log in from their smartphones to use the app, so the big hurdle here was to optimize consultation options for patients with a variety of internet connections: from chat to audio-only calls to video consultations.

On the physician’s side, replicating the experience of an in-person interaction was one of the most challenging tasks in developing the platform. Validation with real doctors, through both generative and evaluative research, was required as the project evolved, to ensure the designed workflows and interactions were defined based on the physician’s mental models. Furthermore, unlike all patients, the doctors are assumed to use a desktop/laptop and have a stable internet connection. Still, we found that doctors weren’t always tech-savvy, so, in building the app, we needed to ensure the platform was intuitive and easy to use so doctors could focus on patient care, not the technology behind it.

Creating a hybrid and multi-platform application (web and mobile) with telehealth features required Wizeline to staff a cross-functional team with the following composition:

• 1 Project Manager
• 3 User Experience Designers
• 10 Software Engineers
• 2 Quality Assurance Engineers
• 1 DevOps/Site Reliability engineer
• 1 Security Engineer

This diverse, talented team provided strategic consulting and worked using agile methodologies throughout the project to get the product from idea to alpha to beta. The team operated as a completely integrated team with MiSalud, taking part in collaborative standups, joint planning, frequent demos, and even weekly happy hour sessions — Salud Con MiSalud! — to cultivate a culture of continuous improvement and flexibility. 

The Wizeline team started with a 10-week integrated approach to design an experience prototype using tools like Twilio and a progressive web app (PWA) to quickly bootstrap the project. In doing so, we evaluated build versus buy solutions to determine the optimal software stack through technical proof of concepts. 

On the design side, we partnered with MiSalud to quickly establish the flows, wireframes, and a scalable visual design system, keeping in mind that establishing MiSalud as an integral digital health solution would require users to feel safe sharing their personal data and have complete trust in the experience. We defined a service blueprint and utilized various design prototypes to quickly show micro and macro interactions and validate them through user testing. 

Wizeline defined a service blueprint to help align our vision for MiSalud’s product and craft accurate user flows, which were a powerful source of truth for both design and development

The final output of this phase was an experience alpha for user testing on a tech stack designed to support rapid prototyping. MiSalud loved the agility and functionality of the prototype, especially when the Wizeline team enabled the first successful patient consultation within the application.

Going from initial immersion and product definition to a real, usable prototype

Screenshots from the alpha prototype of MiSalud

Once the alpha was in the hands of patients and physicians, we rapidly iterated on the experience, refining and extending functionality to create the final on-platform beta for broader evaluation. 

To bring the beta product to further maturity, Wizeline provided security consulting and engineering services, taking into account the needs of privacy, confidentiality, and integrity of the information handled by MiSalud to comply with regulations such as HIPAA, SOC2, and HITRUST.

The week-by-week beta development roadmap

The app’s dramatic evolution from alpha to beta

Technology Stack

• React JavaScript Framework as the frontend codebase
• NodeJs + ExpressJS + GraphQL as the backend
• WebSockets (Socket.io) for the real-time communication
• Twilio as video-call/SMS/email provider (third-party)
• Firebase Hosting as our main hosting provider
• Google Cloud Platform for IaaS/serverless services
  • CI/CD
  • Containers
  • Development Notifications 
  • Load Balancers
• GCP Firestore: NoSQL Database
• Auth0: HIPAA Compliance Authentication method (third-party)
• Ionic + Capacitor to convert the web app to a native mobile app

The User Journey

In October 2021, MiSalud and Wizeline successfully launched the platform to the Google PlayStore. With the app now available to the second-largest population of Spanish speakers globally after Mexico, MiSalud expects the number of users to quickly increase from thousands to hundreds of thousands. 

When asked about the most important KPI of the engagement so far, Johansson responded, “Definitely time to market. After project kickoff, we had a prototype in just a few weeks, an alpha in just a few months, and a downloadable mobile app in only five months. We’re confident that working with Wizeline knocked several months off our time to market and put us in front of customers faster.”

“I was also impressed by the quality of customer focus and ownership from the cross-functional team,” Johansson continued. “Everyone contributed their own friends and family contacts for MiSalud user research because they all could see the pain points of US Hispanics. This has led to ideation and ownership of the product that you typically don’t see from a consultancy.”

Over time, MiSalud has plans to mature the platform, working with Wizeline as a trusted delivery and design partner to implement additional features and integrations like records management, pharmacy, labs, imaging, and more. In doing so, MiSalud hopes to once and for all bring health equity to the US Hispanic community. 

The application is now available with limited access for California residents. Download MiSalud now.