Updox • Growth • 2021 – 2022
Reducing churn by removing friction from care team workflows
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MY ROLE
Led end-to-end design, reframing initial requirements through research to define a broader set of user problems and improve retention.
Collaborators
Product Owner, Business Analyst, Engineering, Customer Success Team
Timeline
~6 months
Shipped Q2 2022
Overview
Video Chat is Updox's telehealth platform for scheduling, managing, and hosting virtual appointments
As telehealth adoption increased, care teams relied on Video Chat for high-volume appointment management, but it struggled to support clinical workflows at scale. I led product improvements to improve reliability and reduce churn.
Impact
"The updates to Video Chat are so valuable, simplifying and unifying the Telehealth experience for patients and providers…" – Updox Co-Founder

+32,000
Daily appointments

+15
Components adopted system-wide
tHE HYPOTHESIS
Care teams were churning because Video Chat didn't support the realities of day-to-day clinical operations
We believed that friction across scheduling and session participation made Video Chat harder to rely on at scale. By better supporting high-volume and multi-participant workflows, Video Chat would feel more reliable, reducing missed appointments and churn to competitors.
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Previous waiting room experience – Limited to single patient management
pain points
Identifying where daily friction impacted reliability and scale
To better understand where issues for care teams occured, I analyzed 30 reviews, 2,000 survey responses, and conducted 2 contextual inquiries with care teams. Research revealed that friction appeared when teams needed to manage large volumes of patients or adapt mid-appointment:

Participant access limitations: Appointments were restricted to a 1:1 participant model and required camera access, creating barriers for care team coordination and participants without video.

Unpredictable wait times: Care teams had limited visibility into patient readiness, leading to idle time between appointments.

Unknown connectivity status: Care teams and patients lacked clarity on whether their devices were connected or experiencing technical issues, increasing uncertainty, missed appointments, and support tickets.

Time-consuming scheduling: Invites and waiting room management were manual and sequential, making it difficult for teams to scale appointment volume.
These findings helped us focus on the workflow improvements most critical to trust and churn, alongside a visual refresh to improve consistency across the product.
exploration & key decisions
Expanding session flexibility
To support group and audio-only participants within appointments, I initially explored three layout options: pinned participants, a grid view, and a dominant speaker view with collapsible participants.
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Option 1: Pinned to right; Option 2: Grid view; Option 3: Dominant speaker w/collapsible participants
While the pinned participants layout minimized dev effort, it restricted visibility in larger sessions. After reviewing trade-offs with the Product Owner and engineering, I recommended a hybrid solution that allowed care teams to change their layout during sessions, balancing usability with future scalability.
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Refined solution – Gallery and speaker layout controls
Managing participants during appointments
After expanding Video Chat beyond its 1:1 participant model to support group and audio-only participants, care teams still needed a way to manage participation during appointments as needs changed.
Because real-word care often required adding caretakers, family members, or interpreters as needed, I introduced participant management by leveraging the existing side panel to enable invite/search behaviors.
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Updated workflow – Adding a participant during mid-appointment
Upgrading from 1:1 to group calls relied on third-party software, which introduced unpredictable delays. I designed clear loading and failure states to communicate progress and recovery paths, reducing confusion and support escalations.
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Left: Loading state while upgrading to a group call; Right: Failed state
Separating device previews from the waiting room
In the original experience, in-call controls and live self-previews were always visible within the waiting room. This experience increased visual noise and made it harder to focus on patient management.
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Previous experience – Preview & audio controls visible in waiting room
I refocused the existing waiting room on patient management by moving video previews and audio controls into a 'My Device' dropdown, allowing care teams to access device checks when needed.
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My Device' dropdown for pre-appointment video preview and audio controls
Supporting high-volume scheduling and patient management actions
Care teams routinely scheduled multiple appointments, but the experience only supported sending patient invites one at a time. I added batch invites and expanded table level actions, allowing clinicians to edit, remove, and track patient status more efficiently.
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Top: New invite dropdown; Bottom: Notification to provide visibility of patient status and 'More Actions' menu added
System contributions
I introduced system-level components and design token enhancements adopted across Updox’s product suite, shipping 15+ new components and standardizing 150+ tokens to improve accessibility and enable faster implementation.
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outcomes & learnings
Within six months of launch, the redesigned workflows increased Video Chat's daily usage from 15,000 to 47,000 appointments, reduced no-shows, and improved user retention.
Post-launch usage revealed that layout preferences varied by appointment type. Teams primarily running 1:1 appointments preferred the grid view, while multi-participant sessions used the dominant speaker layout more.
This insight reinforced the importance of flexibility for retention across diverse care workflows, leading me to design a system-level enhancement that allows teams to set their default video layout within Video Chat settings.