Maternity Care Companion leverages digital health technology to achieve health equity for Black birthing parents.

Client

NYU Langone Health

Timeframe

15 weeks

Role

Product Design, UX Research

Team

April Chien, Suri Namkoung

Introduction

As part of the NYU Langone’s

Healthcare Innovation Bridging Research, Inxformatics, and Design (HiBRID) Lab

partnership with my team of three created a solution for promoting
equity service for Black birthing parents.

DESIGN CHALLENGE
How might we leverage digital health technology to achieve more equitable health outcomes and experiences for Black birthing parents at NYU Langone Health?

WHY SHOULD WE CARE

Black birthing parents in the U.S. are

2-3 times more likely to die from pregnancy or childbirth

than women in any other racial group due to lack of care from medical personnel at the hospital.

PROBLEM

Users are often restrained or hesitant to speak up to the healthcare system, resulting in miscommunications with their healthcare providers and being mistreated.

SOLUTION OVERVIEW

Maternity Care Companion empowers Black birthing parents to take control of their maternity process by better preparing and educating themselves and communicating their preferences and needs to the hospital efficiently.

Communicate your maternity preferences with healthcare providers

Users can set preferences for various aspects of their hospital visits including doctor's cultural background to avoid miscommunications and potential discrimination.

Personalized pregnancy reading materials

Because users often feel reluctant to turn to healthcare providers, providing users with specific resources tailored to them empowers users to speak up or pull through with more knowledge on hand.

Care companion chatbot to get quick answers

Not having that much face-time with their doctors, users can talk to the chatbot to either get quick answers or to be directed to resources on topics they’re curious about.

Prepare for Each Visit

With it sometimes being difficult to verbally express what they need, users can record any symptoms and questions, and expectations for their doctors that can be reviewed at their next visit.
‍

SECONDARY RESEARCH

We look into the statistics to understand the quantitative context of the possible scope and researched a variety of different areas of potential causes to find out the leading causes we should start improving on.

Out of the

3.74M birthing parents

/year,

17%

of them are Black birthing parents.

Out of the

1.3K maternal deaths

/year,

32%

of them are Black birthing parents.

According to CDC,

60%

of these cases are

preventable.

KEY FINDINGS

The main cause of the high mortality rate of Black birthing parents was

racism in doctor attitubes

towards patients.

Less accurate diagnosis

Approaching patients with a condescending tone that decreases the likelihood that patients will feel heard, failing to provide interpreters when needed.

Curtailed treatment options

Black people facing more barriers to accessing care, which includes preventive services, acute treatment, and chronic disease management.

Worse clinical outcomes

Systematic racism such as granting special privileges to others can be internalized and affect the disproportionate rates of heart disease complications, which takes up 40% of the SMM (Severe maternal morbidity) rate of Black birthing parents.

The New York Health Foundation

REFINED CHANLLENGE
How might we serve Black birthing parents
 with the same high-quality care
 experienced by all birthing parents?

8 IN-DEPTH USER INTERVIEWS

Semi-structured interviews with users from different medical institutions (Birthing center, private hospital, public hospital) helped us understand what works and what doesn't work for them, and where the opportunity lies.

Stories are often not unique to one person and we saw a lot of common pain points in

miscommunications

with the hospital personnel,

lack of professionalism/respect

from the healthcare providers.

I can't imagine getting pregnant again because of the discrimination,

They make you feel like you should leave and not come back at all

My labor ended up being 24 hrs because my daughter hadn't turned around yet.

There weren’t notes in the system

or they

didn't even take the time to look at the ultrasound pictures

to see if she had turned around yet.

I asked for a retest to verify but they wouldn’t back down. If I believed that

wrong diagnosis and went to surgery

, I would have

lost my kid

They insulted me but I

couldn't tell anyone after all because all of them who attended to me were all white

We mapped out a user priority chart prioritizing users' most essential need attributes and showing today's medical institutions offerings in those areas.

We mapped out each user's empathy map to highlight the key insights.

PERSONA

Based on our interviewees, we created our persona to highlight the type of users we are mainly designing for.

CORE INSIGHTS

Users don't feel seen by healthcare workers and are often restrained or hesitant to speak up due to fear of discrimination when meeting white healthcare workers.

There is a certain degree of miscommunications between users and healthcare workers due to the lack of user generated data and handover within the hospital workers.

Users think the feedback system in the hospital is not reliable because they never got a call back and non of their compliant went to the management.

Design

OPPORTUNITIES

We tied what we learned from our users to certain facts we know to identify design opportunities.

What we heard...

🙅🏾‍♀️

Users don’t feel educated enough about conditions to speak up.

⏱

Doctors have tight schedules and don’t have much availability.

🤝

Users don't just want to be a number, they want their doctor to know who they are even if they are assigned a different doctor at each visit.

🙁

Users have choices pushed onto them, like taking pain killers when they are against taking them or having a c-section when they want a natural birth.

🧑🏼‍⚕️

There’s a general fear of discrimination around the white healthcare workers they interact with.

versus what we know

📚

Hospital has a library of comprehensive informational resources to provide.

👩🏽‍💻

Patients are willing to learn and seek out answers on their own time.

🗃

Hospital file transfers don’t have any user’s information or input other than diagnosis from their previous doctor.
‍

👩‍💼

Doulas exist to help explain options so they are prepared to make informed decisions during their pregnancy.
‍
‍

👨🏽‍⚕️

Hospital also offers visits available for booking with doctors from different racial group.

AREAS OF DESIGN

After identifying the opportunities, we articulated a few design goals that acted as guiding principles for this project.

Improve information transfer between patients and doctors

Empower patients to take control of their own pregnancy process

Provide patients with tailored resources and education

Extend healthcare beyond hospital visits
‍

IDEATION

A pretty intense brainstorming session + sketching out prioritized ideas + laying out concept details provided more context and established common ground for the team

INFORMATION ARCHITECTURE

LOFI-WIREFRAME & USER TESTING

After ideating features and building IA, we created low-fidelity wireframes and tested them with 3 users and 2 hospital clinicians.

TESTING INSIGHTS

Having certain information like patients' preferences being communicated outside of hospital visits is the highlight of the app.

User are guided by the information provided to support their decisions

I especially like my plan, birth plan, and readings because they not only let me set preferences but also guide me about certain choices a birthing parent I might need to make.

User 1

Users feel more secured around the healthcare system

I like this(My Plan section) because this is putting mom and baby’s healthcare and their wishes a priority, it shows that they are listening and I can expect them to follow my wishes. I also like that I can choose a doctor's cultural background, for example, I feel more safe around Indian doctors.

User 2

Clinicians could focus on more important questions or diagnoses each visit

You know doctors have limited time. Still, there isn't any digital birth plan right now, so seeing those maternity preferences they set let us know their expectations quickly and that each visit could focus on more important parts.

OBGYN Clinician of NYU Langone Health Hospital

FINAL USER FLOW

We designed key user flows to construct the core experience. This helped us focus more on the experience and needs of the user and less so on the details that we would solidify later on.

Concentrate more on communicating preferences with healthcare providers (My Plan) and providing educational materials to empower their decisions.

We also found that journaling is not a necessary feature, so we make it a less dominant feature and more about writing down the critical information for users to pull out during visit.

Information Transfer & Empowerment

Communicate preferences with healthcare providers

Serving as a digital doula, users can set different preferences for various aspects, including choose a doctor with cultural background or ethnicity similar to theirs.

Extend Beyond Visits

Get real-time answers from Care Companion chatbot

Users can talk to either get quick answers to more basic questions or to be directed to resources on topics they’re curious about, allowing certain information to be communicated outside of hospital visits.

Tailored Resources

Access personalized materials to empower your voice

Drawing on the demographic data that users input when signing up , Black birthing parents are provided with specific resources tailored to their background and related health conditions.

Information Transfer

Pre-visit notes to optimize each session with doctors

Patients have an opportunity to record any symptoms and questions for their doctors that can be reviewed at their next visit, getting an additional space for them to communicate their needs and expectations to doctors.

OUTCOME

Winner of Strategic Innovation in Product and Service Design pitch competition, shared at NYU Langone Health Center for Digital Health Equity and NYU Langone Health FuturePractice lab's Innovation Room.

They did such a strong work! Really cool to collaborate with them. It's like it's ready to pitch to the stakeholder and ship.

Kerilyn Tacconi, Innovation Manager of NYU Langone HiBRID Lab

"The data and insights are very confronting. It very important that solution is based off of that."

Roger Madar, Managing Partner of AMPERSAND.vc

I am incredibly impressed by how clear they lay the story out.

Criswell Lappin, SVP of Design at Bigtincan

WHAT I LEARNT & REVISION

Delve into the universe where the users are.

Being an Asian woman, I was especially aware that I had to fully immerse myself in the complexity of race-based health disparities in the United States. Understanding it on a systematic level as well as hearing people's stories help us find out their needs.

It's ok to start small.

An app is small, but it can make great impacts. After talking to our NYU Langone Health sponsor, I realized that although there may be a better solution out there that tackles the root of racism in healthcare, we designed an experience that works well for most of their users in the short run.

Keep your users close, your teammates closer.

Aside from attentively listening to the users, it's equally important to have great communications with your teammates. It will not only improve your quality of work, sharing your takes on the progress can result in vital shifts in project direction. A team works best when their hearts are together.

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