BROOK Phase 1 Evaluation Report

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PHASE 1 EVALUATION REPORT

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CONTENTS REPORT INTRODUCTION Context Brief DISCOVERY RECAP User needs in discovery Suggested phase 1 features Phase 1 outcomes PHASE 1 EVALUATION Methodology Key insights by topic PHASE 2 RECOMMENDATIONS Backlogged discovery opportunities Immediate phase 2 potential from phase 1 evaluation

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REPORT INTRODUCTION

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CONTEXT Following successful delivery of a ‘digital front door’ platform for Brook, Mindwave carried out 3 feedback sessions during March over 3 days. These workshops were aimed at addressing details about the digital front door and giving an opportunity for participants to provide feedback on the Phase 2 roadmap. The workshops were conducted with staff to provide an update on the ‘Digital Front Door’, learn from their professional experiences with sexual healthcare provision pre and post Covid, and get feedback on features that were backlogged from discovery in phase 1 implementation. It was hoped that the sessions would allow us to decipher what might be prioritised for phase 1 improvements and aligned with current user needs for phase 2.

BRIEF Mindwave were asked to co-design and lead facilitation of the 3 workshops, analyse the outcomes into high level themes and recommend actionable insights to take forward into phase 2.

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DISCOVERY RECAP

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USER NEEDS IN DISCOVERY The discovery phase allowed us to cast a wide net over the needs of all potential plaform users, to identify broad user requirements, these emerged as follows: Service users • Efficiency and customisation • Step by step explanations of what to expect • Community and collaborative solutions • Inclusive and judgement free processes • Signposting and choice • Access to regular information and follow up • Offline functionality • Stigma reduction • Empowering messages and a human approach Staff needs • Admin functionality for stock control • Data reporting and staff/centre management • Onboarding/triage tool • Data collection for marketing • Task planning and logistics • Flexible comms system • Central record keeping and system integration • Building on existing digital tools • Collaborative, inclusive platform, trusted by young people • Central digital resource facility accessible by educators, service users, and their family • End-to-end approach to education for prevention through to aftercare • Partner liaison facility

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SUGGESTED PHASE 1 FEATURES The image to the right is extracted from the discovery report outlining possible feature suggestions related to user needs identified in discovery. The prioritised selection of features recommended by Mindwave for alpha prototyping and testing towards a phse one solution were as follows:

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Online booking

Remote appointments

Resource hub

Digital triage

Digital referral forms

Online patient accounts

Online staff accounts

Patient-generated forms and records

Increased access to remote services (e.g. online test ordering)

Community tools

An agreed selection of enhanced features


Guaranteed answer facility; refer if cannot treat

Online test kit ordering

Partner notification tool

Choice of after-care

Prior appointment self-assessment

Expression of interest form

Appointment checklist

Live chat

Google Maps search for clinics

Pregnancy risk calculator

Multiple languages

Virtual clinic tours

‘Meet the staff’ videos

Testing kit guides

Client reminders

Linked staff dashboards for resource

Case studies

Onboarding needs quiz

Video consultation

Account functionality

‘Find our service’ tool

Social history for potential risks

Regular screening advice

Emergency contraception calculator

Appointment booking

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PHASE 1 OUTCOMES Following alpha prototyping, iterations and user refinement, two areas from the above receommended features were agreed by the team for development. Namely, “increased access to remote services” (for service users) and “online staff accounts”, this manifested into three specific tools for phase 1 with contained features:

Signposting tool • • • • • • • • • •

Interactive signposting through important topics on the Brook website Advice and support Mythbuster tool Urgent help “Other people ask” facility Interactive chatbot with concern flagging and signposting Find a service tool Emergency contraception journey Risk of pregnancy calculator Data monitoring for reporting and tool development

Online ordering of STI kits • • • • • • • • • •

Accessible from various start points Screen reader compatible Risk clarification Step by step process clarification Eligibility Alternative provision signposting Built in safeguarding flags with links to staff hub Customisation Data monitoring for reporting Link to staff hub for kit approval

Staff hub • • • • • • •

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Key component of digital front door for staff Management of online requests for STI kits See how service users interact with digital tools Lablink to manage STI results Manage safeguarding concerns Feedback facility Digital support facility


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PHASE 1 EVALUATION

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METHODOLOGY The co-created online workshop structure was delivered to Brook staff during their digital training week. Three workshops were held in succession using “Miro” digital whiteboard solution, sessions were well attended by clinical, education and central services staff. The workshops provided: • An update for all staff on the digital front door • An opportunity for staff feedback on Phase 1 • An opportunity to discuss the Phase 2 Roadmap features get staff input • An ideation session in groups to consider the current needs of users • A summary session to conclude key emerging themes for next steps Following a recap on the work done to date, we proceeded to ask the participants several topical questions to tease out opinions, experiences and suggestions related to: • Work done to date • The use of digital at Brook • The changing needs of users • The impact of change and the unknown • Phase 2 roadmap features • Persisting challenges/blockers • New opportunites/enablers • Immediate phase 2 potential Open discussion and debate led to valuable feedback from almost all of the participants on the calls. This was captured on digital sticky notes, from which high level emerging themes and subcategories were created for further consideration in phase 2 planning.

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KEY INSIGHTS BY TOPIC The following pages describe the insights and subcategories captured in relation to questions asked, supported by participant quotes.

TOPIC A - WORK DONE TO DATE Theme 1 - Staff hub • • •

The platform should be made accessible to all staff in all roles More work needs to be done for EPR integration More could be done for safeguarding with automatic flags built in

Theme 2 - Resources • • •

Make resources and services accessible and appealing to all ages Format of the mythbusting tool should be capitalised upon

Theme 3 - Accessibility and engagement • • • •

The platform is visually strong and has good accessibility overall Resources and tools should be made accessible to non-clinic users The chatbot feature should be further expanded upon The platform should link to other all age services

Theme 4 - Usability • • •

Navigation is good and the platform has a clear information heirarchy The find a service tool is excellent and so easy to use The platform needs communication on how it can be accessed using a range of browsers and devices

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“THE FIND A SERVICE TOOL IS SO EASY TO USE” TOPIC B - THE USE OF DIGITAL AT BROOK Theme 1 - Linking with alternative services • • •

Our service provision should link up with other sexual health services Referrals and two way transparency is important for phase 2 We should be able to tap into whatapp for comms

Theme 2 - Delivery of resources • • •

Health advisors should be contactable by phone Online and offline resources should match Digital resources should be available in a central bank for sharing

TOPIC C - THE CHANGING NEEDS OF USERS Theme 1 - Stock management •

Integrating a stock and stores tool

Theme 2 - Increased mental health challenges •

Increase need for support reguarding mental health issues

Theme 3 - Safeguarding issues • • •

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Increase in relationship abuse, self-harm etc. leading to therapeutic need An increased need for safeguarding Suicidal ideation, sexual harrsament and abuse makes it important to have contact with relevant adults.


Theme 4 - Digital vs in person appointments • • • • • •

Many problems were faced with shifting to digital during the pandemic Walk in appointments should still be made available for testing Telephone and in person appointments still have their own place A hybrid model of virtual and walk in appointment is needed Digital work in Brook needs to exceed other providers Digital provides financial gains and allows more users to access the platform

Theme 5 - Reduction in school provision • • •

The pandemic hindered direct teaching provision in schools Most schools focus on training a specialist to deliver RSE Support provision post ‘My life’ requires consideration

Theme 6 - Increased access to digital information • •

Users have learnt quicker about sex related topics through increased use of digital information during the pandemic There is an increased reliance/expectation on digital

Theme 7 - Confidentiality and trust in digital • •

Service users have concerns over confidentiality of their personal info in relation to digital sexual health A push in funding for digital currently

“TRENDS COMING OUT OF APPS LIKE TIKTOK ARE HARMFUL AND YEILD AN INCREASE IN SEXUAL ABUSE AMONGST YOUNG PEOPLE” 17


TOPIC D - IMPACT OF CHANGE & THE UNKNOWN Theme 1 - Links to existing platforms • • •

Parents feel comfortable using apps which help them have easier conversations We should have the ability to integrate systems so there is better internal communication Existing platforms should link in and out of the Brook website

Theme 2 - Practicalities of use •

There exists a need for an ‘offline mode’

Theme 3 - Education and training • • •

Teachers could use a ‘support tool’ to be better informed Schools need more funding for training Provide support and education specifically for parents.

TOPIC E - PHASE 2 ROADMAP FEATURES Theme 1 - All age service •

Could include more age specific resources for all age groups

Theme 2 - Links to partner platforms • •

A 2-way link to the Brook website and signposting to resources Need an integration with Lilie and SH24

Theme 3 - Patient history • •

Require an ‘emergency exit’ button to clear history and maintain confidentiality We need a record of prior treatments and comms

Theme 4 - Triage •

An effective triage system to help people get what they need quickly is much needed

Theme 5 - Communications • • • •

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There should be provision to order condoms online A digital template for positive results would be helpful Staff hub could link with patient comms Ability to communicate through text, email, call or whatsapp would be desirable


“SOME SCHOOLS ONLY HAVE THE RESOURCE TO COVER THE BASICS” TOPIC F - PERSISTING CHALLENGES AND BLOKERS Theme 1- Service shift to digital • • • • •

Challenges in staffing Lacking availabillity of sufficient digital alternatives to cover the in person provision Safeguarding issues are prevalent currently Hybrid system not preferable for some users People think the testing window isnt important in reltation to digital

Theme 2 - Funding and geographical boundaries •

Geographical boundaries or restrictions means we are turning away high numbers

Theme 3 - School provision •

Schools are only capable of delivering the basics due to lack of resource advice and training

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TOPIC G - NEW OPPORTUNITIES/ENABLERS Theme 1 - Mental health safeguarding •

Safeguarding with mental health issues are more apparent currently

Theme 2 - Development of trusted resources •

Could develop a trusted resource hub to counteract pornography

Theme 3 - Continuing short user journeys •

We need to continue to produce short user journeys

Theme 4 - Digital access to contraception •

Should be able to access any information digitally about contraception

Theme 5 - Communications • • •

Could help provide education to both parents and teachers through an education tool Would be helpful to have an effective triage system which helps save time by identifying people who need to go straight to level 3 A hybrid of virtual and in person appointments provides more reassurance for service users

TOPIC H - IMMEDIATE PHASE 2 POTENTIAL When participants were asked to summarise the topics discussed in the workshops, they suggested the following as holding the greatest potential for phase 2 of the platform’s development, with the highest priority item at the top of the list • Efficient routes to user goal • Training • Links to other platforms • Hybrid provision • Comms and resources

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PHASE 2 RECOMMENDATIONS

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BACKLOGGED DISCOVERY OPPORTUNITIES The follow items were suggested post discovery but are yet to be fully explored, these should be considered alongside outcomes from the phase 1 evaluation, and also the immediate potential for phase 2 (as suggested by Brook employees) when creating user stories and prioritising features for phase 2 • • • • • • •

Remote appointments and online booking Resource hub (inclusive of both clinical and education resources) Digital triage Digital referral forms (viewable by all users including 3rd party) Online patient accounts (with access to EPR and health history) Patient-generated forms and records Community tools (such as a forum)

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PHASE 2 POTENTIAL FROM PHASE 1 EVALUATION The follow suggested features have been drawn from the topics and themes uncovered in the phase 1 evaluation workshops as new areas of focus for staff who participated in evaluating the platform progress to date:

For staff • • • • • • • • • • • • • •

The platform should be made more relevant to education and central services staff Provide onboarding (triage) to identify service users that are level 3 and to help people get the help they need quickly The platform needs communication on how it can be accessed using a range of browsers and devices Referrals and two way transparency is important for phase 2 We should be able to tap into whatapp for comms Digital resources should be available in a central bank for sharing A stock and stores tool should be implemented Create a bank of resources for training education staff on delivering RSE through the portal with provision for support “post my life” Create a tool where educators can “ask a question at any time” Include offline mode Provide digtial alternatives to cover all in person provision Integrate with lilie and SH24 for patient history drawing out all prior treatment and comms Create digital communication avenues between staff and patients inclusive of text, email, phone and whatsapp Provide a digital template for when results are positive

When asked the direct question related to phase 2 potentials and priorities, the staff participants cited the following list of items as key to phase 2 success, with the most important at the top of the list: • • • • •

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Efficient routes to user goal Training Links to other platforms Hybrid provision Comms and resources


For service users • • • • • • • • • • • • •

More work needs to be done for EPR integration More could be done for safeguarding with automatic flags built in Make resources and services accessible and appealing to all ages with links to other all age services Health advisors should be contactable by phone Online and offline resources should match Increase availability of mental health and sexual abuse resources A hybrid model of virtual and walk in appointment is needed where both can be booked through the platform Create ‘emergency exit’ button that clears history Enhance explicit communication on the platform related to confidentiality of data to encourage wider usage Develop a trusted resource hub to counteract pornography use Provide all information easily about contraception digitally inclusive of online ordering (especially condoms) Make the platform accessible to all young people regardless of geographical location or use of physical services Provide clear explanation about the importance of ‘testing window’ in relation to digital

For parents • • • •

Resources and tools should be made accessible to non-clinic users Use portal to increase contact with relevant adults in relation to suicidal ideation, sexual harrsament and abuse Create resources related to sexual health specifically for parents Implement apps that help parents have easier conversations with their young people

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ILSA PARRY UX RESEARCH LEAD e: ilsa@mindwaveventures.com t: 07974186677 SWETHA RAVINDRA JUNIOR UX/UI DESIGNER e: swetha@mindwaveventures.com t: 07307257645

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