Cadence

Cadence Health books most of its appointments online across 60 clinics. They came to us with a simple question: why does booking a doctor’s appointment feel harder than booking a flight? Patients were abandoning the flow at the calendar step, and the clinics were filling the gaps by phone.

The brief

Research told us patients cared about one thing above all: when can I actually be seen. The old interface buried that answer four screens deep, behind a clinician directory, a service picker and an insurance check. People were asked to commit to a doctor before knowing whether that doctor had anything free this month.

The brief we agreed was narrow on purpose. Rebuild the path from landing page to confirmed appointment, leave clinical records and billing alone, and ship inside one release window. Anything that did not shorten the route to a date and a time was out of scope.

Availability first

The central decision was to invert the flow. Instead of picking a clinician and then discovering their availability, patients see real appointment slots first and filter down from there. Written out it sounds obvious, but it shifted the weight onto a booking API built to answer questions about people rather than questions about time. We spent three weeks with Cadence engineers on a slot index before drawing a single final screen.

Two ideas were tried and dropped. A conversational booking assistant tested well in the room and badly on the floor: patients typed one sentence, waited, then went hunting for a calendar anyway. A month grid looked calm and lied, because a month of open Tuesdays says nothing about whether the 9am you want exists. Both gave way to a seven day rail that loads real openings and never shows a date it cannot fill. The flow also had to survive a five year old Android phone in a clinic car park, so we budgeted every screen under 120KB and handled a dropped connection mid-booking.

What shipped

A rebuilt scheduling flow for web and mobile web, a design system covering 40 screens, and a motion specification for the moments where waiting is unavoidable: slot loading, hold timers and confirmation. We prototyped the hold timer at length, because a slot that expires silently is worse than no slot at all.

Cadence also got a reschedule and cancel path built from the same components, accessible states tested at 200% zoom, and a short handover document their team uses to add new appointment types without calling us.

After launch

Completed bookings rose 31% in the first quarter after launch, and the median time from landing page to confirmation fell from just over four minutes to 71 seconds. Front desk call volume dropped enough that two clinics moved a receptionist to patient follow-up. The lesson is smaller than the numbers: when people are anxious, they want a date, not a directory.