Unpacking DNFB for small hospital clients

Using a variety of research and design thinking methods, I worked with our teams to frame key design problems. I also facilitated planning discussions and created a series of artifacts that helped shape the zone's understanding of our users.


Over the course of 6-7 months, I engaged in a comprehensive discovery process to uncover the core problems our clients faced in reducing time in DNFB (Discharged, Not Final Billed). Through research, discussions, and workshops, we were able to align the teams on 5 discrete "Hills" that corresponded to the most significant problem areas. The discussions and artifacts resulting from this process helped inform our strategy and planning discussions throughout our releases.


The Claim Readiness zone in athenaCollector focuses on helping revenue cycle clients do the work required—Coding, Charge Entry and Chart Processing/Review—to get claims out the door efficiently. In the Hospital space, part of our charter was to reduce the length of time between patient discharge and a claim being created—also known as DNFB. The factors that go into DNFB are complex and span multiple systems, both human and software. Our product teams needed to understand which of those factors we could make the most impact on.


After talking with stakeholders and designers within the zone about the basic components that make up DNFB tasks, I worked with the team to start some primary research on how people within these workflows find and move through their tasks. In addition to reviewing existing research, I conducted site visits with hospital clients, and sat in on interviews with practice managers and Customer Success Managers. The resulting report included a series of key pain points, and recommendations for how we could address them.

Using a Rainbow Spreadsheet made it easy to see patterns in the research analysis.

Working with designers and product managers, we started mapping pain points to different sections of the workflow, and started to group the problems into a core set of themes.

Whiteboard session to map pain points

One of the biggest challenges the zone leadership team faced was giving our Agile teams important problems to fix, while giving them agency over how they solved them. By moving away from specific features and framing our goals in terms of Hills (an approach used by IBM Design), we were able to give the teams an intended outcome that was more specific than "reduce DNFB." We were also able to communicate priority without teams feeling like we were dictating a specific approach.

I put together a presentation for our planning ceremonies to align teams on our new prioritization approach.

The new approach to problem framing made the release planning conversations more productive, by giving the teams something to rally around. The research I did to inform the Hills gave me the ability to create a custom Airtable database to organize user insights, and accelerate future research projects.

Example of our user research database.

Key Contributions

  • Conducted foundational research to guide our understanding of the problem space.
  • Helped break down our complex design problem into a set of 5 user-centric Hills to help focus prioritization discussions.
  • Created a set of persona character alignments to focus the teams on mindset and context instead of relying too heavily on user roles.
  • Organized a database of user feedback to accelerate finding previous user insights.