My Health Record is a Commonwealth Australian service, managed by the Australian Digital Health Agency (ADHA). It is a safe and secure place to keep key health information, available to people in Australia and their healthcare providers any time, including in an emergency. THis resulted in the my health gov app, designed for both smartphone and tablet, and both iOS and Android platforms. The app was entered and won a 2023 Good Design Award.
In early 2022 ADHA received funding to build an app to offer My Health Record information to consumers securely and conveniently. The Experience and Service Design team was tasked to design and support the delivery of an MVP as the foundation for future updates and improvements. The main technical constraint was that the app could only use current APIs and not require significant new infrastructure for delivery. My main goal was to make it as useful and valuable as possible within that constraint.
Summary
The following diagram describes the design process for this project.
The Process
I worked with a Senior Service Designer to define the design principles, value proposition and user scenarios of a mobile health documents experience. I used previous research to surface all the wants and pain-points of the existing browser-based service to prioritise features and needs. It was also an opportunity to re-frame the tone of voice and character of the My Health Record service for the mobile channel. As one of the main problems was findability and the formal terminology of the browser channel, I started with the information architecture and navigation. I set some card sorting tasks at interviews with practitioners and consumer representatives to understand what re-framing the view away from clinical documents and towards a more pedestrian terminology and timeline view would be like for them. The first wireframes after this were tested to explore navigation, Information architecture and early interaction hypotheses and view concepts.
I worked with the product team to agree the functionality and business rules for the app within the constraints of time, budget, development feasibility and clinical safety. I collaborated with the Agency architecture and system leads to ensure design concepts were clinically feasible. I led showcases and discovery workshops internally and externally.
I led the UX Design crew and set the design direction for the UI Designer through the feedback and testing. I managed relationships across stakeholders within the agency and external vendors and consultants. I led all design decisions during the delivery process. With each feature release I coordinated a test plan using which ever asset made sense, from wireframes or prototype through to pre-release builds, using detailed, realistic test data.
Testing process
The app was tested many times across several stages in the process. Early wireframes were tested for navigation, findability, information density, flow, and comprehensibility. Early UI designs were tested for accessibility and sentiment. As features were being built, it was tested by consumers recruited across several demographics. Once a Beta version was ready and stable and could connect to a person’s real My Health Record data, we ran a month long limited pre-release test.
I designed the testing process, including test scripts and recording/notation and COVID safety protocols (through Aug 2021 to Aug 2022) . They are described in more detail elsewhere.
I coordinated with the external accessibility vendor who conducted both SME tests and facilitated tests by participants with disabilities. I supported the vendors to understand the test results and re-tested the updated builds based on my own accessibility knowledge and vendor reports.
Delivery to release
I coordinated design tasks, taking some on myself and sharing the rest across the design team addressing all minor and major issues and features not yet developed. I led negotiations with the product team, the development vendor and the UX Crew to bring feasible and practical solutions to the build release. After the limited release in Feb 2023 I worked with the app development vendor, the My Health Record system vendors and internal Agency teams to resolve teething issues.
Following the release I led the workshop among senior stakeholders, including CEO, CTO Director of Product, and Senior Managers to select the next collection of features to work on after the release and to roll out over the next 18 months. I led the Workshop team to pull together 25 or so concepts based on Agency priorities, Health industry knowledge and research from several studies into patient expectations of a health information system.
Challenges
The biggest challenges were technical, as the Agency could see that all the design decisions were based on solid research, or direct and validated input from test participants, Beta users and consumers These technical challenges included a reduced set of the features available in the browser-based My Health Record, and not launching with the most desired features, still to be made available in MHR, like e-Prescriptions and booking an appointment with a health practitioner. These have since been prioritised and some are now available at time of writing (Feb 2024). I prioritised the user-desired additions ahead of the Agency promoted ones, and all technical constraints to them are being addressed.
Delivery was very fast and significant UX decisions had to be made on a near-daily basis, but then the app was on hold for 4 months due to budget and logistics. As the app was a major focus of the Agency, navigating the needs of all levels was challenging.
The non-technical challenges have been the My Health Record itself and not the app’s fault. The MHR program has challenges getting some health practitioners to upload patient information to MHR, which is an identified patient pain-point. I recommended the app release be coordinated alongside other campaigns to improve and increase health information from practitioners for better patient outcomes. Some of this campaign is to leverage user feedback the app, with users asking for increased health information.
Outcomes
As the app has not yet been “officially” launched, and all the attention has been organic and not advertised, it has received positive feedback. At time of writing (Feb 2024) there have been over 150,000 registered users (not just downloads) of a potential total of 3.5 million MHR accounts. The only negative feedback is outside of the app’s features, based on the scope of information provided by practitioners.
The app drove the development of an extensive usability testing lab that is now more widely used across more products and has received interest from other agencies in the space. The app is part of a coordinated campaign to raise the quality of information recorded by encouraging practitioners through patient requests. It is expected that increased use of the app will increase health information quality.
The my health gov app won a 2023 Good Design Award.