Your patients are telling you something. The billing experience confused them. The portal couldn't answer their question. The care communication arrived too late. You know exactly where it breaks.
The harder problem is building the case to fix it. Patient pain lives in experience language — but budgets move on HCAHPS scores, reimbursement rates, and retention numbers. Significant Machine helps patient experience leaders close that gap. We map the journey, find where the pain has a financial address, design the fix, and leave the team with tools they own.
The gap between
pain and proof.
A disconnected billing experience isn't just a complaint. It's a drag on your HCAHPS score, your reimbursement rate, and your team's ability to fund the next fix. CX leaders who can connect patient pain to financial and regulatory consequence get the budget. The ones who can't are still writing the same journey map they wrote three years ago.
Three steps.
No ambiguity.
Map where the journey breaks — and what it costs
Research, stakeholder interviews, journey mapping across acute, ambulatory, and billing touchpoints. We find the pain points and connect them to HCAHPS metrics, reimbursement risk, and retention impact.
Design the fix — strategy, design, infrastructure
Portal UX, billing redesign, plain-language communications, design system components. Solutions grounded in research and built to work across the EHR, app, and front-desk surfaces that make up the real experience.
Leave you with tools — not just a report
Design systems, journey map artifacts, and AI-powered tools your team owns and operates. The improvements become durable. The business case stays built. The next initiative is easier to fund.
Five principles
that shape the work.
Patients are not users
Users opt in. Patients are routed in. They are anxious, time-pressured, often non-native English speakers, and frequently using the product on the worst day of their year. Designing for "users" produces software that fails patients on the days that matter most.
The portal is not the experience
The patient experience is the journey across portal, billing, communications, scheduling, and the front desk. Improving one surface without improving the others moves friction around. The win is in the seams.
Comprehension is the metric
In healthcare, an interface that looks beautiful but cannot be understood by a 72-year-old reading on a five-year-old Android is a failed interface. We design for readability, plain language, and task completion — in that order.
Design systems are the strategy
A patient experience improvement that does not get codified in a design system decays as soon as the project ends. The system is how good design becomes durable across teams, vendors, and reorgs.
Compliance is a design input, not a constraint
HIPAA, WCAG, plain-language statutes, billing transparency rules — these are not obstacles to good patient experience design. They are part of the brief. Teams that treat compliance as a designer-vs-legal fight lose both the audit and the patient.
What we do
for health systems.
Patient Journey Mapping
Acute, ambulatory, and billing journeys mapped end-to-end. Phases, touchpoints, emotional curve, breakdowns. The artifact that puts every team on the same map.
→Patient Portal & App Design
Patient-facing app and portal UX. Designed for the three tasks portals actually get used for, not the twenty-three that clinicians wish they would.
→Billing & EOB Redesign
Plain-language billing statements and EOBs grounded in readability research and tested with real patients before they ship.
→Healthcare Design Systems
Tokens, components, and patterns built for patient-facing product teams. The multiplier that makes every other improvement durable.
→CX Strategy & Advisory
Fractional CX leadership for healthcare product orgs. Embedded perspective, principal-delivered, retained monthly.
→Tools we built
for this work.
We built our own tools because the work demanded them. When you engage SM, you don't just get strategy — you get the infrastructure the strategy runs on.
The Ledger
Connects patient journey research to financial and regulatory data. Maps pain points to HCAHPS metrics, reimbursement risk, and retention impact. Runs in production at a regional health system today.
Learn more →The Compass
Journey intelligence that surfaces patterns across touchpoints. Where patients drop off, where comprehension fails, where the system loses them — made visible and actionable.
Learn more →Healthcare
design, answered.
What is patient experience design?
Patient experience design is the practice of designing the patient-facing surfaces of a health system — portal, billing, scheduling, communications, in-clinic screens — as a single connected experience rather than a set of disconnected products. It draws on customer experience strategy, service design, and UX, but it is calibrated to the realities of healthcare: anxious users, regulatory constraints, accessibility-first patient populations, and design decisions that carry clinical risk.
How is healthcare CX different from B2B SaaS CX?
B2B SaaS optimizes for engagement, retention, and expansion. Healthcare CX optimizes for comprehension, task completion, and trust. Patients do not "engage" with their billing portal — they get in, finish what they came for, and leave. Designing for engagement metrics in healthcare produces overbuilt products that frustrate patients on the days that matter most.
Do you work with Epic / MyChart / Cerner?
Yes. Most US health systems run on Epic, Cerner, or similar electronic medical records platforms, and most patient portals are built on top of MyChart or equivalents. Our work usually sits in the design layer — patterns, components, plain-language standards, journey maps — and is implementation-agnostic. We have worked alongside Epic, MyChart, and custom portal teams.
Are you HIPAA-aware?
Yes. Engagements are scoped so we never need patient health information to do the work. Journey mapping, portal UX, EOB redesign, and design systems can all be done with de-identified examples and synthetic data. Where stricter access is required, we work under the client's BAA and follow their access protocols.
What size health systems do you work with?
Our experience is concentrated with mid-to-large integrated health systems — multi-hospital networks serving hundreds of thousands to millions of patients. The patterns transfer well to smaller systems and to payors and healthcare SaaS companies that build patient-facing products.
How long is a typical engagement?
Patient experience work is not a one-sprint project. A first engagement is usually 8–12 weeks (a journey map, a redesigned surface, or a design system foundation). Most evolve into multi-year retained relationships, because the design system and the journey map become living artifacts that the client needs ongoing partnership to maintain and extend.
Connect the pain
to the proof.
If your patient experience work isn't moving scores or getting funded, the gap is usually the same. Let's close it.