Designing a digital concierge that gets patients from a phone call to surgery in weeks
A UK-based private healthcare company was looking to build a new venture for a very specific, very 2021 problem: During the pandemic, the NHS had to push back procedures that were important but not immediately life-threatening — hernias, endoscopies, the kind of thing that won't kill you but slowly takes over your life. Waits stretched into months, sometimes a year.
The Challenge
Weak entry points There was one rule we couldn't design around: before anything else, a patient had to speak to a PCO on the phone. A phone-first service is hard to make feel modern on the web. If your website's main offer is a phone number, you've put all the effort on the patient, and made it very easy to close the tab and never call.
Breadth of Work The more we mapped it out, the clearer it became that this was a service with at least three sets of users who all had to move in sync: the patient, the PCO, and the surgeon. The patient's experience looked simple on the surface, but — underneath it — the PCO was running the entire operation.
How We Worked
In 30 days, we moved from an early service idea to a validated MVP concept spanning patients, patient care operators, and surgeons.
1
Understand the service
Stakeholder interviews, competitive research, and direct conversations with surgeons, PCOs, and prospective patients.
2
End-to-end mapping
A service blueprint connected the three experiences and exposed the dependencies we needed to solve for in the MVP.
3
Design & research in parallel
We moved into concepts early, using real product ideas to make research more concrete and keep the work moving quickly.
4
Rapid iteration
We tested those concepts with all three audiences, iterating the connected experience into something the founders could confidently take to investors.
Service blueprint
With three sets of users, we needed to see every touchpoint each one hit, and where their paths crossed, before we could design anything. Laying it out side by side allowed us to clearly frame pain points and the opportunities around them.
Most importantly, it revealed truly how much revolved around PCOs, guiding our decision to start with the PCO product, then build the patient and surgeon products in relation to it.
The PCO platform
The app is the friendly face of Onward, but the PCO platform is everything behind it. It is what enables PCOs to provide the speed, hand-holding, and and attention to detail that makes the service valuable.
A dashboard built around a day
Each PCO opens to their own working view: the patients on their calendar, new patient requests waiting to be booked, and a running preview of messages — because a huge part of the job is simply staying in conversation with people.
The decision that came from watching people work
Our first version led with a big Add New Patient button, and it started the sensible way: a new caller, so open a new record — first name, last name, date of birth, address.
When we watched PCOs actually take calls, that order was backwards. Their instinct is to listen first: hear the problem, reassure the person, and show them there's already an appointment on the calendar for what's wrong with them — before turning the call into a form. Leading with "date of birth, home address" made the tool fight the exact thing PCOs use to earn someone's trust.
So we renamed the primary action New Appointment and flipped the sequence: search by issue and location, surface real availability, and only then capture the patient's details. It's a small rename with a big idea behind it — the software should follow the conversation, not interrupt it.
One place to carry a patient
Every patient gets a profile that works like a service hub: appointments, documents, test results, health record, payments, messages, and a task list the PCO owns.
A private surgical journey is a moving to-do list. To keep everything moving, patients must make payments, upload referrals, get blood work done, book follow-ups, so the PCO-controlled to-do list feature drives much of the concierge experience.
The patient app
On the patient side, the whole thing had to feel like the concierge service it was — human, calm, handled.
Getting into the app without losing anyone
We were nervous about the app-store handoff, so after the call, patients get a text link that lets them create their account first, then download the app. Small thing, big effect: nobody stalls at "download an app before you can do anything." When we simulated this with participants, all eight said they'd happily download it and that the path felt easy — which is exactly the assumption we were most worried about.
Organized around the next appointment
Our first home screen put tasks in a carousel across the top. In testing, people read it as abrupt and a little demanding — the opposite of concierge, like a chore list greeting you at the door. What they wanted first was context: what's my next appointment? Then, and only then: what do I need to do for it?
So we reorganized the home screen around the single next appointment and attached the relevant task right to it — "pay to confirm" as part of the appointment, not a pile stacked on top of it.
Keeping documents moving
Onward's whole promise is speed, consultation to surgery in about a month, so document exchange couldn't be the thing that slowed everyone down. Patients can find their documents, lab results, and billing in one place, and upload straight from their files or a photo. We tested this specifically with an older, less tech-savvy group, and being able to just take a picture mattered most to them.
Keeping the human visible
The app never tries to automate the PCO away. It just gives that relationship somewhere to live between phone calls. Patients can message her directly, which cuts down on calls without losing the direct line, kept in the same place as everything else.
The surgeon product
Surgeons matter to the service, but they weren't the operational users of the MVP, and they already work across plenty of systems. So we built them a deliberately light experience for the moments where direct access actually helps: see the day's schedule, review a patient, get to the records, notes, and documents that matter. Everything else stays PCO-led, on purpose.
