What we did
Digital Maternity Cymru aims to digitally transform maternity services for women, birthing people and clinicians in Wales.
It will allow professionals across every health board in Wales to share vital information more quickly, supporting safe, effective and consistent maternity services.
We took some of the requirements from the programme and focused on developing our prototypes around these.
How we did it
1. Clarifying target outcomes for the service
As a first step, we worked with the team to discuss, understand and refine the target outcomes the service wants to achieve as part of the digital transformation programme.
When defining target outcomes for a public service, we do so from the perspective of 3 groups:
- the service users (pregnant women and birthing people)
- the service providers (health boards and their staff)
- those setting the policy which the service delivers (Welsh Government)
This is because a good service balances the needs of each of these groups.
2. Creating hypotheses to be tested
We then created hypotheses – things we believed that were going to make the service better.
We based these on:
- our service evaluation with seldom heard groups and midwives
- good practice and our experience designing similar services
- secondary research into what works
- the anticipated capabilities of the third-party software
3. Designing a service wrapper for appointments
We focused on designing a service wrapper for all antenatal and postnatal appointments. In other words, the interactions a user has with the service before and after the clinical appointment.
By designing interactions that support the activity in the clinical appointment, we increase the opportunities for the service to contribute to meeting the target outcomes of the service.
4. Designing a reusable service pattern
Maternity is made up of repeated appointments that include similar activities, this provided an opportunity to design and test a service pattern for appointments that could be repeated throughout a user’s journey through the maternity service, and that could be reused for similar appointments in other health settings.
Service patterns offer an opportunity to create efficiencies for the service provider because it can be designed once and reused. It also creates a consistent experience to service users because all interactions happen in the same way.
5. Testing our hypotheses
We created:
- a series of scenarios and simple mocked-up screens to simulate the proposed service pattern – we call these ‘provocations’ because they provoke a reaction from participants
- a set of questions based on the hypotheses that were suitable for being tested by this sort of methodology
- a discussion guide designed to gather evidence for the evaluation questions, making use of the provocations, during face-to-face sessions with users
We ran tests with 12 pregnant women in one-to-one, face-to-face 90-minute sessions. 4 women in south Wales and 8 women in north Wales.
Each session consisted of an interview asking about the participant’s relevant experiences of pregnancy, followed by a walk-through of the service pattern provocations.
The main emerging themes were consistent across participants, giving us confidence there would be limited value in continuing to test with increasing numbers of participants.
Lessons learned
From this evaluation we have proposed 23 recommendations for the programme to consider when configuring the digital maternity portal. These recommendations are designed to contribute to the target outcomes of the service. For example, ensuring users can make informed decisions about their care. They are centred around 5 main themes:
- help users keep track of their appointments
- send information about activity and decisions in upcoming appointment with users
- help users to recall and ask for information
- ensure all information and messaging are accessible
- be consistent with the delivery and style of information and messages
Next steps
We have done some further work focusing specifically on the entry and exit points into a digital maternity portal and have done some testing with pregnant women and birthing people which we will discuss in a future blog post.
