CVS Notifications: Email, SMS, Push
Overview
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CVS was managing 221 separately coded notifications for their health services (MinuteClinic visits and Pharmacy visits)
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My team and I created a design system to unify email, SMS, & push designs which resulted in 23 user-tested design templates
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This case study is focused on how we created the design system and applied to confirmation emails — work in 2024 & 2025 follows
Skills
Design Team Management, Systems Thinking, Product Strategy, Negotiation Skills, Visual Design, User Experience Design, User Research, Usability Testing & Analysis
Time Frame
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This case study: January-June 2023 (Design System, Templates, & Confirmation Emails)
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Jump down to present day: July 2023-Present (Reminders, Check-ins, Cancelations, Reschedules, Post-Visit, SMS, & Push)
Role
Experience Design Manager
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I collaborated with our Product Director (Lauren Sheerr Beshears) and our Senior Design Lead (Jordan Williams) to strategize how to consolidate the emails
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I reviewed and gave feedback on all designs and all content along the way for Stephanie Nguyen, James Quirk, Daree Allen-Nieves, and KC Skeldon
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I gave Stephanie and James guidance and direction on the design system
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I analyzed the usability testing results which validated our designs and content (and helped plan the testing plan prior with others)
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I designed and wrote content for additional notification use cases with the team as they came in throughout 2024-2025
Outcome
We set a strategy for consolidating the emails by identifying common sections, writing new content, and creating components to build the notifications:
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Consolidated 221 notifications into 23 reusable templates in Figma (Design) and SalesForce Marketing Cloud (Engineering)
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Created a new consistent messaging experience for customers in terms of branding, voice, and design (regardless of health service or business area)
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Decreased average time to make design/content adjustments to minutes rather than days for designers, content strategists, and engineers
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Our CTA engagement rate increased ~65% in terms of getting people to fill out pre-visit checklist items or letting us know they couldn't make it
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Impacts ~8 million patients per year (and in total, we send ~27.6 million notifications for health visits each year)
Problem
Inconsistent branding, voice, and design across all notifications
CVS had 221 notifications that were individually coded with varying designs and content, being managed in different BCC (Business Controlled Content) slots. Our engineers had to manually update each email which was becoming too much to manage.
This makes for an inconsistent experience for patients when receiving notifications from CVS, and makes it difficult for CVS teams to manage the content and designs.
This case study will focus on the problem of Confirmation emails, which had their own variations:
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MinuteClinic general care (digitally-scheduled, kiosk-scheduled, provider-scheduled)
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MinuteClinic mental healthcare (digitally-scheduled, kiosk-scheduled)
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Virtual Care (digitally-scheduled, provider-scheduled)
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Virtual Primary Care (digitally-scheduled, provider-scheduled, on-demand related visit emails, scheduled visit emails)
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CVS Pharmacy immunizations
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Health Service-specific emails with special instructions (ie. "Drink water before getting your covid vaccine")
Pictured above are examples of health service emails, all inconsistent in their design, content, and branding when compared to each other.
Strategy
How to consolidate confirmation emails
I worked closely with our Senior Design Lead, Jordan Williams, to break down the steps of how we could work towards consolidating the design and content of the emails, and then delegate it out to our team.
We understood that in order to get to our goal, we needed to first gather all existing confirmation emails, identify common sections, create a new template, and then design new emails based on that template:
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Identify and create common email sections
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Niveda (Product partner) gathers emails for all services
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Stephanie (Experience Designer) reviews existing emails to identify common email sections (reviewed by me and Jordan)
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Create email template
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James (Visual Design Lead) creates common email sections as individual components with variants in Figma (reviewed by me)
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Unify content for all emails based on the template and get approval
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Stephanie gathers current state dynamic content across each email section, and suggests unified content
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Daree (Content Strategist) reviews and edits Stephanie's suggestions of unified content (reviewed by me, Jordan, and Jennifer [Content Manager])
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Stephanie creates new consolidated emails using James's components and Daree's updated unified content
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Jordan and I facilitate stakeholder reviews of the new emails
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KC (Content Strategist) makes updates based on stakeholder reviews of the emails
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Stephanie and I conduct usability testing for the emails to verify the designs and content
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We reviewed the plan with our Product and Engineering leadership to make sure it would fit with their timeline and we weren't missing anything.
I planned out the tasks needing to be done for our 2-week sprints by working with James, Stephanie, and Daree to write stories, estimate the work, and time everything so it could be finished within 5 sprints.
This took an entire quarter to execute, but our initial plan worked as everyone had a defined role that worked towards the goal.
Identify and create common email sections
Patterns of sections across all emails
After Niveda gathered all confirmation emails for every service, Stephanie identified common sections of the components and reviewed them with me and Jordan:
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Email header
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Email body
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Confirmation code
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Visit details section
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Who the visit is for
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When
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Where
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Confirmation Code
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What to bring
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Next steps / How to check in
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COVID-19 precautions
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Additional information
She then identified within each section what common information and styles there were. Examples include:
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Heading
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Paragraph text
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CTAs/Links
With this set, Stephanie had a pattern for each part of a confirmation email, no matter the line of business or service type.
Creating the sections
Once Stephanie, Jordan, and I agreed on the email sections, Stephanie mocked up draft sections which included:
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Elements of each section
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Style of each element (size, weight, color)
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CTAs within sections
Pictured is the "Visit details" email section, which every confirmation email would need, regardless of the line of business or service type.
With this, Stephanie had established the pattern for each email section we could use to create a template for our confirmation emails.
Create email templates
Componentizing the common sections
Our Visual Design Lead, James Quirk, took Stephanie's common sections and created components for them in Figma.
The difficult part that he and I worked through was creating components that contained all information that could possibly needed, but allow for less information if needed. Some visit types and health services required different information to be included in each section (for example, "Confirmation code" wasn't needed for Virtual Care visits, so that part of the component could be toggled off).
By building these components, James created a way for any designer to:
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Pull the components from a new email library
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Toggle the information needed for the section
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Drag-and-drop the components to build an email
Stephanie and James's work allowed them to create a "Max View" Confirmation template.
The template included all of the possible common sections that make up a confirmation email, using James's components.
This set us up to be able to insert the content we needed for each email type, along with being able to toggle on/off any section or part of a section that we needed to.
Unify content for all emails based on the template
Consolidating content for each email section
While James was working on creating the components, Stephanie gathered the content for each of the email sections.
As an example, for the Email header component, the current content for each line of business and scenario differed:
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"Your visit is scheduled"
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"Your visit has been scheduled"
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"Your new visit has been scheduled"
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"You're in line! Learn what to expect as you wait"
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"Here's what to expect."
While the content is slightly similar, it wasn't the same and didn't have the same tone across each email. Ensuring that each email header was consistent on the confirmation message made sure:
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It's clear that the patient's visit is scheduled and confirmed (for in-person visits)
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There are clear next steps (for virtual care visits)
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Consistent content means CVS teams have less content to manage for multiple scenarios (if we had to make a change, we could change it for multiple emails if the content was the same, rather than all of them separately if the content was different).
Daree took what Stephanie gathered and she consolidated what made most sense.
In this case, Daree narrowed these 5 headers down to 2 headers:
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"Your visit is scheduled" (in-person visits)
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"Here's what to expect" (virtual visits)
After Daree consolidated the content, I reviewed it with her manager, Jennifer, and Jordan to make sure we approved that the messaging met the goals. Daree did this consolidation for every email section that Stephanie identified.
Inserting content into the components
After I approved the content with Jennifer and Jordan, Stephanie plugged the content into James's components for each line of business.
For example, the Visit Details component had minor differences depending on the line of business.
MinuteClinic visits require a confirmation code, while virtual care and Pharmacy visits do not.
Get approval from stakeholders
Stephanie would tag me to review the components, and then I would loop in our Product Director, Lauren, to review the work from a business perspective to make sure we didn't miss anything.
Based on Lauren's comments, I would make adjustments to the content myself, until everything was resolved. Jordan also helped during this process by making content adjustments as well.
Once Lauren approved of all of the components, Stephanie created the emails for each line of business. Pictured is the original emails next to the updated ones. The updated emails finally had consistent design and content.
Jordan and I facilitated stakeholder reviews of the emails by either meeting directly with the business partners in charge of those lines of business or starting email threads. These stakeholders included Product partners, clinical partners, legal, security, and other business stakeholders.
KC, our content strategist, would attend those meetings and make adjustments to the emails as needed.
Usability testing to get feedback and improve the emails
Prototype
Stephanie, KC, and I created a research study for the emails:
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Goal: Validate email designs, content, and CTAs based on customer comprehension and expectations
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Tasks:
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Have patients view each email subject/preview and state their expectations of what the email will contain
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When patients see the email, ask if their expectations were met and why
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Ask what they see in the email and what they think they can do
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Ask what they expect the CTAs do ("Start PreCheck-in," "Add to calendar," "Get directions," etc)
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Ask what the purpose of the email is to test comprehension
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Prototype of mailboxes, confirmation emails, and reminder emails was created by James and Stephanie.
We submitted the test to usertesting.com and Stephanie took notes on all of the videos.
I did the analysis of the testing by reviewing notes for each question, drawing conclusions, and then matching the insights to our research goals and objectives.
After testing and analyzing, we learned:
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All participants understood the main purpose of each email
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All participants said the emails have the right information, it matched their expectations, and nothing was missing
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A majority of participants would use "Add to calendar," but had no expectation as to what it would do, which app it would open, or what information would be included in the invite
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A few participants could not find the "reschedule/cancel" link, so we needed to make it more visible
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Some participants confused "PreCheck-in" and "Check-in" which are two different processes
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A few participants misunderstood the check-in process, thinking they could check-in before arriving to MinuteClinic, which is not how the process works
Stephanie and I put a presentation together and presented the findings to our design team, design leadership, Product leadership, architecture, and engineering.
Next steps were to make adjustments based on learnings:
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For MVP, remove "Add to calendar" and replace with the specific app, "Add to Google calendar" and "Add to Apple calendar"
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Visually emphasize the "reschedule/cancel" link so participants can find it
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Conduct a study on "PreCheck-in" and "Check-in" terminology to ensure participants understand what they're expected to do and know they have to be at the MinuteClinic to check in
Result
My team successfully executed on the strategy of consolidating confirmation emails:
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Consistent design, branding, and content for 6 lines of business
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Less content to manage for our team if changes come up
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Better expectations for customers around confirmation of their visits and next steps
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Validated through usability testing and approved by stakeholders
Pictured are some examples of consolidated emails (each line of business has the former design and the new design next to it).
Present day: Continuing the work in 2024 and 2025
Reminders, Check-ins, Cancelations, Reschedules, Post-Visit Notifications, SMS, Push
The design system we established has been wildly successful:
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After consolidating confirmation emails, we quickly consolidated reminders, check-ins, cancelations, reschedules
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We added SMS & Push notification components to the system
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Over the past 2 years, our team has rapidly delivered updated or new notifications each sprint:
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Some requests can be completed in less than an hour if it's a small copy improvement based on patient feedback
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Larger business requests can be quickly mocked up for discussion and iterated upon for quick delivery
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AI used for content
I used Writer AI which is integrated with CVS's content style guide to:
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Check for grade level
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Align content with CVS content style guide and tone
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Reduce text for notifications
Visuals in emails
Cora Books and I collaborated on adding illustrations within the emails to grab attention based on analytics of patients not always finishing PreCheck-in or viewing the full visit details. All illustration credit to Cora Books!
Push notifications
Our team added push notifications sparingly for specific use cases (like when the patient is in the store, we'll send a check-in push).
Reducing the amount of push notifications was the right call, as later testing showed that patients prefer SMS and email over push.
Testing channel and frequency preferences
While patients can manage communication preferences, we wanted to make sure that we weren't sending too many notifications.
I worked with Beth Koloski to run a test to 100 people and found that SMS was the most preferred for reminders, with email second for post-visit notifications.
This surprised us, we thought email would be on top and push would be next because it's convenient, but the data showed it was overwhelming.
We adjusted our messaging frequency based on this.
Conclusion
Overall, we send our notifications to an average of 8 million patients per year — and continue to see that our tweaks and updates increase engagement. The templates we created proved to consolidate designs and content in a way that was easier for patients to understand, and easier for us to manage at CVS.
