In our last blog post, we talked about our inclusive approach to user research, seeking out people who are at a higher risk of health inequality and/or digital exclusion. Over an 8-week period, CDPS spoke to over 50 participants as part of their research. What did we discover? Anne Watkins and Sian Thomas from the Digital Maternity Cymru team explain...
Importance of maternity notes
Maternity records are largely paper-based, and each woman or birthing person holds a clinical maternity record which is physically carried by them to each appointment.
A common theme from our user research was that women and birthing people understood the importance of their notes, and they kept them safe. They were interested in the information they contained, reviewing it after the appointment, although they found the medical terminology challenging to understand and confusing to find specific information.
"They give you a book that reminds me of the Argos books – it's quite thick."
"I tried to find a contact number and couldn't remember where it was in the book – ended up Googling, just so much info, and not understandable."
Most were positive about the idea of having a digital record and saw the clear benefits. They liked the idea of accessing their record on a smartphone and not having to carry around a large folder of paper notes. They often found it difficult to find important information within the notes. They thought it would be easier to read a digital record compared to handwritten notes, and not having to repeat their story at each appointment would have clear benefits.
There were some concerns about what would happen when they were on holiday or in an emergency and one user expressed the additional stress that it caused her to return home for her paper notes after forgetting them when attending an urgent appointment.
"I had a time when I couldn't feel the baby – I was on the way to the hospital and I called and they said they needed me to bring my notes – so I had to drive 15 minutes home and back. That extra half hour was scary…"
We also wanted to explore how women currently access information. The research identified that women and birthing people with specific health-related concerns sought information for reassurance. Google was their first point of call for medical-related information, and no one browsed directly to the NHS website. Whereas women and birthing people with limited or no English, sought information from webpages in their own languages or used Google translate. This raises concerns that women are making decisions based on non-evidence information.
This research has shown that we have an opportunity to support vulnerable women with health issues by providing the information they seek for reassurance. We can also prioritise and organise information based on specific needs, for example, if a woman has diabetes. We can support women's information-seeking behaviour by linking them directly from the digital record through a woman's portal, providing them with links to appropriate evidence-based information to make informed choices and relieve anxieties.
Using insight to inform design
Now that we have a deeper understanding of the experience of people who use the service at the moment, we have turned our focus to the design of the new digital maternity system.
In our next blog post, we will share how we used this insight to design and test ideas to provide people with the information they need before and after an appointment.