Tech for Skeptics in the Holistic Health Community

Seamless Client Management for Midwives and Doulas

Overview

The scope of this project was a three week sprint, in collaboration with two other UX designers. Through this project we analyzed a start up’s existing application and utilized user research and design methodologies to improve their client management dashboard. We each played an active role in each phase of the project. We completed this project remotely over video conferencing.

Methods

• User Interviews

• Affinity Mapping

• User Persona

• Design Studio/Divergent Design

• “How Might We”

• Competitive Analysis

• Comparative Analysis

• Heuristic Analysis

• Card Sort

• Wireframing/Prototyping

• Usability Testing

Background

Currently, the United States has the highest maternal mortality rate amongst developed nations, and the numbers are still rising. In part this is due to the healthcare system which takes measures, such as unnecessary C-sections, as a means to decrease costs throughout labor, even when it may be disadvantageous to expecting mothers.

One overlooked factor in our healthcare system is independent health-care professionals such as midwives and doulas. However as independent professionals they face a wide variety of challenges in their day to day lives.

Our client is a small Bay Area based startup whose mission is to ease the challenges of holistic health care workers, primarily midwives and doulas, through providing a simpler digital client management tool.

User Interviews- Understanding the Day to Day Life of a Midwife

“There is no such thing as a ‘normal day’ as a midwife”

The everyday life of a holistic care professional is always subject to change. As much as they may try to create a structure in the chaos, by sticking to a schedule, setting boundaries for client communication, etc. pregnancy is not always so consistent.

For example due dates, are more like a horoscope than anything resembling a guarantee, and are only correct about 4% of the time. Pregnancy complications can happen at any time. Although certain complications might be more likely to happen in a particular trimester/phase of pregnancy, new conditions/complications are never to be ruled out as a possibility. Whether it’s something like blood pressure which may just need to be monitored more closely, or preeclampsia, midwives must always be ready to step up at a moments’ notice.

“My primary role is to support the mother- emotionally, mentally, and physically”

As truly empathetic holistic care takers, midwives’ responsibilities and roles throughout their care extend far beyond delivery. Holistic maternal healthcare providers feel that their primary role is more on the mental and emotional spectrum, rather than the purely physical check-ins that are common in most traditional hospital experiences.

They feel that their value lies in being an empathetic support system, and an educational resource- helping mothers to deal with the pain they are experiencing, helping new parents know what to expect about their mental state, helping mothers assess whether their pregnancies are “normal” or something to be looked at more closely etc.

User Interviews- Understanding Challenges

“Sometimes It feels like I spend more time with my clients’ information, than my client”

Through all the chaos and unpredictability of their day to day work, midwives are managing a huge amount of information about each of their clients. They can spend up to a few hours a day with a single client’s health history, especially through the first few meetings with new clients.

This is especially hard for midwives and doulas, who feel that the time they have to spend with client information detracts from their real role, which is to support the family and mother, emotionally, mentally and physically.

To give some context of the types of information they are managing for each client

• Health info

  • General Health

    • Age

    • Height

    • Weight

    • ...

  • Necessary for each visit

    • Blood type

    • Allergies

    • Clotting Issues (if any)

    • STIs

    • The list goes on…

  • Pregnancy History

    • Complications

    • Familial Complications

• Mental Health

  • Mental Health History

  • Familial History

• Scheduling

• Billing

• Emergency Info

“Less Information is better than ugly information”

Currently, there is only one competitor that aims to solve this problem for this specific group of people- Mobile Midwife and Mobile Doula.

We used heuristic analysis- a method that looks at digital experiences through metrics called heuristics. They are scored on a scale of 1-5 to denotes how bad an aspect of an experience is (1 being fine/no issue, and 5 being unusable) Through our competitive heuristic analysis we found that most maternal care providers faced issues with being too visually busy, having poor navigation (poor learnability and memorability), and poor efficiency.

These particular heuristics are particularly important to your target users, as we know they are already very busy, and dealing with a lot of important info.

“The more it feels like a diary the more likely I am to use it”

In addition to the negative experience with the technologies themselves. Midwives and doulas as a community tend to be very skeptical of the tech companies that are providing their tools. 

Often times, when technology is specific to their work, midwives and doulas feel more like a monetary resource for techies that are “jumping into this niche”, rather than a community that is being helped by companies that truly value their work and understand their struggles, goals, and obstacles in this field of work. 

Independent maternal care providers also feel very distrustful about how tech companies may use their clients’ information. Taking care of expecting families in such a private, exciting, and intimate time means that midwives and doulas must be extra sensitive and careful about how they are keeping and protecting their client’s information. Another role in their work is to protect the families they care for. One of the most important aspects is making sure that their pregnancy journey is kept private.

User Persona

In order to synthesize the data we used affinity mapping to consolidate the motivations, challenges, and experience into a user persona- the “multitasking midwife.”

Problem Statement 

The Multitasking Midwife’s workday is hectic and highly variable because they manage many clients at different phases of their pregnancy and health journey. [Persona] also has to juggle multiple platforms to manage different types of information such as calendars, billing, digital health information, as well as paper documents, such as diary logs, paperwork, and notes.

Because this large amount of information is spread across a number of different platforms, it is difficult for the Multitasking Midwife to know exactly where a specific piece of information may be. This is especially difficult when trying to organize the most pertinent information related to their client visits. 

This also impacts her ability to update her client’s information. Information can change quickly during pregnancy, and because they are often working with many paper tools- such as notebooks and large amounts of paperwork, reviewing and updating notes crossed out and rewritten in pen can be a daunting task.

Hypothesis

By creating a seamless, easy to navigate client dashboard, with the clients pertinent information readily at hand, intuitive information architecture, and convenient editing ability that does not compromise the simplicity of the interface, we believe that midwives and doulas will feel more satisfied with their daily work.

Solution: Intuitive information management for the tech resistant

What makes tech more intuitive to the tech averse?

For one, we decided to prioritize a desktop based experience. Throughout our user interviews, we learned that the Multitasking Midwife wasn’t likely to use technology in front of her clients. Instead, she would wait until she got home and then use her computer so that data entry and updating was easier with a keyboard and larger screen.

Unlike our competitors, whose product was only available for iPad, we wanted to ensure that the digital experience was maximized for the most common use case- which is on a desktop or laptop at home.

Boiling Information down into the necessary: Client Summary

Because the Multitasking Midwife is managing so much information, for multiple different parties, we created a “Client Summary” which is the default view of her client’s information when looking at a client profile. This allows the Multitasking Midwife to quickly review all of the most important information that she needs to review before each meeting, rather than having to assess multiple platforms and tabs.

Intuitive Navigation for those used to outdated hospital forms: IA and Tabs

As mentioned above, the amount of information that midwives and doulas manage can easily be overwhelming. In order to ease finding that specific information, we incorporated tabs that sorts information into pages that are relevantly labeled. In order to create this specific organization we used an open and mixed card sort to ensure that the information on each page was organized and labeled in the ways that users would expect to find it

Editable Info

Unlike their pen and paper, with endless crossing out and rewriting we wanted to give our users a way to easily update any information at any time so that they could be sure any information in their records was the most recent. This feature is particularly important for keeping track of any recent complications or measurements as pregnancy progresses.

To make this the most efficient process, users can click the pencil icon to edit any “card” or subset of information at a time, rather than a whole page, as was the case for our competitors.

 Future Steps

Different input types

 As of right now, almost all of the inputs are text lines. We’d like to play around with how different types of inputs (buttons, selectors, drop downs, etc.) would look. This is also important for error prevention and helps maintain information consistency across different clients

Edit Function

While the edit function worked fine during our usability test, we had other ideas about how to make it more visually clear to users, by changing the check mark to a save and cancel button. We did make a high fidelity mockup of this feature, but it isn't in the flow because it did not get usability tested with.

Results and Reflections

There is still a lot of work to be done in meeting the needs of this wonderful and underserved community

Empathetic Language

One of my biggest takeaways from this experience is the importance of empathetic language in design. Throughout the process, we had to learn how to communicate a warmth and openness to learn in order to fully engage and understand our user. Their skepticism of technology in general pushed us to really examine our tone in communication throughout our user research interviews, as well as the language in our final product on screen. 

If I could go back in time, I would change the language and messaging on the app even further to communicate a more conversational and open tone, which is something I will continue to improve upon moving forward

Color, Branding, and Tone

If not language, how can we create a sense of warmth and safety in a product, for a community who is already predisposed to have negative feelings about it? One of the ways to communicate visually is through color. Coming into this project, the branding was all very centered around vibrant shades of pink and purple, and color was used generously across the entire application.

Because independent maternal care providers are comprised of over 99% women, it is easy to understand why the company felt justified in using typically female gendered colors (aka pink and purple.) However, we wanted to rethink the idea that products for women should be pink and purple.

But, in order to maintain the branding, as designers we simplified the color scheme across the screen in order to preserve it for just the elements we wanted to draw specific attention to.

Knowing your audience

Ultimately, the biggest lesson from this experience, through language, color, and information architecture, is knowing your audience.

Even though we were designing a product with all of the same general medical information, we had to incorporate and organize it in the most relevant and useful way for maternal medical professionals. Through language and color, we had to be certain that we were communicating the right message the correct tone. As far as UX projects go, we really had to understand the midwives and doulas to make sure that the end product was just right for them.

Thank you so much for reading, I hope that you enjoyed!