Thread by @RohanIrvine

Next up is Aaron Cheang & Michelle Pickrell from eHealth NSW

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Saving lives and making a difference: How User Experience techniques helped NSW Health rapidly respond to COVID-19

#UXA2021 #uxaustralia

Working within healthcare in UX is like a Anablep — it swims at the surface of the water, as it swims it's 4 eyes look above and below the water.

The work within health you usually see above the surface, in UX you get to see what's happening below the surface.

They'll share some case studies showing how they're nudging a massive organisation towards human centred design during a global pandemic.

"Move fast and break things" after 10 years of operation FB changes it's motto to "Move fast with stable infrastructure" which is kind of like healthcare where you need to make sure you don't harm patients.

Background on NSW health.

Very complex, multiple levels of government, private and NGO's.

The Local Health District managed by the state.

They are all different autonomous networks, and state wide practices aren't rolled out the same. Each LHD has their own tech, including electronic medical records.

On top of LHD's there's also a diverse group of state organisations that look after specific parts of health services.

The disparity between the services available at hospitals is huge.

The diversity in people who access health services is.

There are over 68k diagnosable conditions on top of this.

We also have to design for end of life, and often people aren't able to choose which part of the service they end up at.

The HCD team at eHealth NSW has been around for just under 2 years and new to most of the people they partner with.

For health the focus is on Quality & Cost — but when a global pandemic hits suddenly speed becomes a priority.

Aaron will talk about the setting up of a COVID vaccination clinic.

It was set up to vaccinate frontline staff 1a categorisation.

eHealth had 3 weeks to align with all the clinical operations across the state😐

They had a scrum master, project owner, developer and designer.

The first thing they did was do some field research.

The image shows how a Pfizer vaccine is prepared.

The biggest concern for the health system was about managing the precious commodity of the vaccine.

There are 45 steps to draw up a Pfizer vaccine.

It's delivered in a deep freezer (-79c) it can only be opened twice a day otherwise it will spoil. Once to put the vaccine in, once to get the vaccine out.

It's defrosted in a fridge next door for 30 minutes and can be kept for a month before it spoils.

You can only open this fridge for a total of 3 minutes a day.

Once you've diluted the concentrate you can only keep it for 6 hours otherwise it spoils.

Through doing this research it helped show us how critical planning how many staff would be coming in for vaccines.

You can never really predict how many vaccines you'll need and you don't want them to spoil.

They used the service blueprint to map out the dependencies in the journey to deliver a vaccine clinic.

It was a critical tool for change management, training, and operationally setting up the clinics.

Each member of the team picked a use case and mapped out their workflow.

They went from concepts to design to implementations incredibly quick.

They did field research about how the designs were working in practice — spending multiple days at the Liverpool vaccination hub observing the entire process.

It's not vaccinating over 1000 people a day.

Clinical Management Case Studies

When patients are discharged from hospital they are given a kit to remote monitor their blood oxygen

When exploring different designs Aaron looked at how best to represent data at the right level of granularity for patients.

This was the process used — testing is currently on hold with the current outbreak in NSW

When designing for safety there is a three step approach for eHealth NSW

Safe design factors in usability and safety — sometimes a level of friction is introduced to alert clinicians, it is usually a very big hard to dismiss object, purposefully poorer usability to prioritise patient safety.

Infection Control Design Sprint

Three main ways of infection transmission:
Contact
Droplet
Airborne

They were looking in particular at the infection control in an isolation room.

Some are designed to keep germy patients away from people, some are designed to keep immunocompromised patients away from others.

The WOW (Workstation on Wheels) is moved around to patients rooms — for isolation rooms you can't easily bring equipment in and out of rooms because they're an infection risk.

Also cleaning these devices adequately is extremely difficult.

We also can't afford to have one computer per room.

They used the google venture design sprint, the first time it had been used in NSW health.

Images from the design sprint

It was about testing the solutions in a fast scrappy way to figure out what will work in a clinical environment.

Introducing these tools to a new context is pushing boundaries, so it's important to have good change management plans in place along with good guardrails in place.

Making sure there's buy in from the top stakeholders, having the right people on the projects, and choosing low risk non health critical projects to introduce safe places to learn the tools.

It's important to define your quality level for your solution to be a success.

Give them the third best to go on with.
The second best comes to late.
The best never comes.

The perfect is the enemy of the good.

What are your organisational values?

What are the implicit things? The things discussed at morning meetings?

They will often tell you what the organisation really cares about.

Thank you so much Aaron & Michelle!

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