Case study · Healthcare · Service design
End-to-end service design for peritoneal dialysis ordering at Fresenius Medical Care: four connected tools replacing paper, fax and phone across six countries.
Out of 3.7 million patients worldwide with chronic kidney failure, 440,000 perform home dialysis. Their supplies were ordered through paper forms, faxes and phone calls.
Home dialysis patients encounter real friction when ordering their treatment products while managing their condition. Nurses navigate manual processes and piles of paperwork alongside providing patient care. And every other stakeholder in the ordering chain deals with inefficiencies caused by the lack of fast, responsive tools.
We designed a comprehensive digital ecosystem for collaborative ordering of dialysis supplies, with dedicated tools for every user involved. Manual actions dropped by 70%, paper-based interactions by 85%.
Mobile and web application that lets clinicians work paperless with the flexibility they need: tasks, enrollment, prescriptions, orders.
A mobile app that empowers patients to self-manage orders and deliveries, whenever it best fits their day.
A web portal that simplifies daily requests and enrollment operations for Sales and Support agents.
A CRM handling orders and operations for Customer Service (developed outside the design team on Microsoft Dynamics).
“The strength of the Order Management Ecosystem is that every stakeholder and user in the ecosystem was considered, and their specific needs designed for: from patients who need a simple and easily readable app, to nurses and doctors who are constantly on the go, to customer service and sales agents. The rigor the team described in their design process, from ethnographic research to piloting the product, is apparent in the result.”
Tracy Rolling · UX Design Awards juryThe project launched its first MVP in 2020 and kept expanding: from clinician touchpoints to tools for patients, Customer Service and Sales and Support agents; from Peritoneal Dialysis to Home Hemodialysis; from the German market to Italy, Spain, Sweden, the UK and now the US.
The challenges were multiple: familiarize with the world of dialysis and its terminology, handle complexity across a multidisciplinary team, translate multifaceted business requirements into services, bring a design perspective into a historically tech-driven company, account for country-specific localization, and build a modern multichannel design system.
Research explored the comprehensive service proposal and validated each touchpoint, activated in a sprint-based manner every time a new aspect needed exploration. Sessions involved users on both the company side (PMs, sales, support, master data, customer service, marketing, legal, data privacy, IT security, medical office) and the clinical side.
In validation sessions we presented high-level user journeys with assumptions across multiple scenarios, asked stakeholders to validate them against current practice, and collected the country-specific requirements needed to adapt the service. One How Might We framed each user:
How might we facilitate order management for nurses to minimize administrative burden?
How might we enable patients to self-manage their orders with minimal involvement of the nurse?
How might we standardize data flow and avoid paper to minimize manual work?
Clinicians spend their days on repetitive, time-consuming administrative tasks performed with obsolete processes and analog tools. They want a single place for fast, streamlined activities so they can focus on delivering care.
Streamline tasks and enhance efficiency, so nurses focus more on patient care and less on administrative complexity.
Enable direct connections with customer service, support and managerial processes: faster responses, shorter waiting times, remote actions.
Relevant actions one click away, content presented progressively. The software becomes genuine digital support.
Features: task management with due dates and approvals, patient enrollment for both existing and new patients, prescription creation with remote nephrologist review and digital signature via DocuSign, and order creation triggered by each patient’s ordering frequency.
The most pressing feeling for dialysis patients is the fear of running out of life-saving products, yet stock management is complex: supplies fill a room quickly, and delivery routes and insurance impose their own limits. Patients want control and independence: choosing when and where to order instead of being called by Customer Service, possibly in public, about their condition. And with a population mainly 65+, the app had to be friendly and accessible on every level.
Ideation started with a team-wide crazy 8 session involving non-designers too, followed by low-fidelity prototypes tested with patients as early as possible, across countries.
A discreet assistant: order reminders and status updates without overwhelming communications.
Ordering support without patronizing, while respecting supply and warehouse constraints. Safe-order warnings flag over and under stocking.
Inclusive patterns make the product friendlier for elderly users and more pleasant and reassuring for everyone.
The portal for Sales and Support agents was approached as an internal technical platform: requirements collected from the business, core processes drafted via wireframes, early testing with agents, then delivery to the development team, which built it applying components from the nurse web app’s design system. It covers enrollment of agents, nurses and nephrologists, demo users, and support request management.
Mob testing design-development. Designers prepare a test plan with steps and expected results for each feature; designers and developers walk through it together, marking pass or fail. Failures go to bug fixing and are retested with the same process.
Pilot launch. Meticulous preparation with each country: tailored training sessions, instruction manuals, FAQs and marketing materials, plus periodic checks after go-live.
Continuous improvement. A feedback system of in-app surveys and weekly reports, with feedback categorized (bugs, usability, to investigate) to monitor satisfaction during the pilot and beyond.
Takeaways. The project became a blueprint at Fresenius Medical Care for the Dual Track Agile approach: internal stakeholders began to appreciate agile and dual-track methods through its tangible success, and it promoted a design-driven, research-first way of working. Templates and use cases developed here now serve as starting points for other product teams, and the ordering experience itself is being integrated into other company products.
Challenges. Managing complexity across numerous internal and external stakeholders, and addressing customization needs country by country.