re-imagining prenatal care as a wellness experience through service design - marnie meylor, mayo...

Marnie Meylor | Mayo Clinic Center for Innovation@marniejo

Re-imagining prenatal care as a wellness experience through service design

October 2nd, New York City

Service Design Global Conference | October 2015

Transforming low-risk prenatal care by leveraging technology and redesigning services

OBJECTIVE

How might we provide additional ways for people to connect with the OB practice in ways that de-medicalize care and empower expectant parents to feel both supported and confident in their own intuition?

OB Nest Project


Center for Innovation Methodology

14 Experiments

Online Communities

Text-a-Nurse

Video-Appointments

Video-in-a-Friend

Confirmation Calling

Tummy Photos

Tracking “Just Come In” Advice

Video Nurse Visits

Your Care Options

Proactive calling

At-Home Measurement

Drop-in Care Stations

Technology Access

Patient-Centered Team Care


Examples of the range of issues and questions that come up between visits:

CURIOSITY CONCERN

wait until next appointment call inon my own

How much swelling is too much swelling?

Where do I go to find a maternity swim suit? The baby hasn’t

been kicking...

I’m not feeling the baby move consistently yet...

What brand of vitamin should I take?

I’m going on vacation next week...

I’m bleeding...

OB / CNM

NURSE CALL ROOMAPPOINTMENTCOORDINATORS

THE CARE NAVIGATION VISIBLE TO THE PATIENT VIA THE PHONE LINE

VISIT VISIT

The range of issues women have during pregnancy



CURIOSITY CONCERN




been kicking...




I’m bleeding...

OB / CNM



VISIT VISIT


CURIOSITY CONCERN

wait until next appointmenton my own call in

4 WEEKS UNTIL NEXT APPOINTMENT

CONCERNCURIOSITY


LESS THAN 1 WEEK UNTIL NEXT APPOINTMENT

I haven’t felt my baby move. Should I be concerned?

Example issue

Patient’s willingess to wait until her next appointment

VISIT VISIT


VISIT VISIT VISIT VISIT

BETWEEN VISITS

DURING VISITSOne-dimensional, Provider-centric perception of Continuity of Care

No perception of continuity, lack of connection to OB


DRUMBEAT

Impact on patient experience


CONCEPTION DELIVERY 6w12 18 – 20w6-8w 36w

mom

’s an

xiet

y

THE “EMOTIONAL HUMP”

I’m pregnant!

AN

XIE

TY

A typical pregnancy experience


mom

’s an

xiet

y


I’m pregnant!



mom

’s an

xiet

y


I’m pregnant!

AN

XIE

TY

A typical pregnancy experience


mom

’s an

xiet

y


I’m pregnant!

The level of interest womenperceive coming from their

OB Care Team


VISIT

SIGNALS

... is sickness care

... is a dangerous process

... requires specialist care

Low-risk pregnancy...

Pregnancy is a MEDICAL EXPERIENCE

REDUCESAutonomyConfidenceSelf-AwarenessEmpowerment

The clinic’s “Gravitational Pull”


DECENTRALIZE MAYO-OB

RE-CENTRALIZE MOM

I come to Mayo OB to get prenatal care for myself and my baby

Mayo OB helps me feel confident about the care I give

myself and my baby, and I know OB is there for me if I need them.

Shifting a clinic’s culture from “sick care” to wellness care



RE-CENTRALIZE MOM

ACTIVATE

SIGNAL Wellness & NormalcyJoy & Celebration

AutonomyConfidenceSelf-AwarenessEmpowerment

PartnersFamiliesRelatives & FriendsCommunities

STRENGTHEN


RE-CENTRALIZE MOM

ACTIVATE




STRENGTHEN

INCREASINGCONNECTEDNESS

REDEFINING CONTINUITY OF CARE

Shifting a clinic’s culture from “sick care” to wellness care




RE-CENTRALIZE MOM

FROM A SICKNESS CLINICAL MODEL

CURIOSITY CONCERN




been kicking...




I’m bleeding...

DR. SMITH, M.D.

CARE NAVIGATION WITHIN THE CLINIC, DURING VISITS

CARE NAVIGATION OUTSIDE OF THE CLINIC, BETWEEN VISITS

OB / CNM

NURSE CALL ROOMPACs

VISIT VISIT

VISIT VISIT

VISIT VISIT

RANGE OF ISSUES OR QUESTIONS THAT COME UP BETWEEN VISITS


VISIT VISIT VISIT VISIT VISIT

This is my only alotted time where I am visible to OB

The other ways I meet my pregnancy needs

are less important

If something goes wrong, it’s OB’s fault

Pregnancy is a dangerous process

My needs and concerns revolve around my visits

The provider is the only person qualified to tell me that I’m okay

OB knows everything about pregnancy

OB knows my body best

This is the most important way my pregnancy needs

are met

This is the only time I can really get reassurance that

my baby is okay

The clinic needs to monitor me constantly to make sure my baby

and I are okay

confirmationvalidation

celebrationco

nnection

mile

ston

e

rela

tions

hip

measurements

record keeping

questions

communication

planning chec

k-in

hear

tbea

t

expr

ess

conc

erns

reas

sura

nce

education

VISIT

CENTER OF GRAVITY

Signalsto m

om

Objectives

appointments

fulfill

Moms often are concerned with being considered “bad patients”, or contacting OB too often between scheduled visits

Many moms are sensitive to the capacity and workload of their care team and perceive that any attention outside of the appoint-ment is “extra” and is burdensome to their providers; therefore many will wait to have concerns addressed until their next appointment

Moms are aware that OB as a practice faces many lawsuits, and feel that this affects the way they are treated – moms appreciate the uncensored advice of those not directly connected to her OB care

Many moms who feel confident, informed, and in control of their choices regarding their prenatal care and delivery see themselves as counter to the culture of OB

OUT OF SIGHT, OUT OF MINDLanguage like “we’ll see you again in 4-6 weeks” enforces moms’ feeling that she is cared for only when physically in the clinic.

ONE-DIMENSIONAL PERCEPTION OF CONTINUITY Because moms perceive their prenatal care to come only from their provider, continuity with this person is of highest value to them and everyone else is anonymous.

LACK OF CONTINUITY OUTSIDE OF CLINIC WALLSThe only member of the team that matters to patients is their provider and it is very difficult to connect with them outside of appointments (unless they have a personal relationship or workaround.)

Outside of appointments, moms feel that the rest of the staff is an obstacle to connecting to their provider.

Patients are not confident in the information sharing between departments, staff or providers.

Because of the complex navigation that is required to get a question answered outside of appointments, moms find it time-consuming and frustrating to access OB between visits.

I’ll see you again in 4-6 weeks

MOMS ARE DOING WHAT THEY’RE TOLD TO DOMoms trust that they are following a rhythm of care that their providers have intentionally designed – they assume that there is medical rationale behind their pattern of visits.

Moms rely on the appointments as confirmation that their pregnancies are on track; Only their providers can reassure that they and their babies are healthy.

Many moms are unclear of what specific risks their providers are monitoring for, and do not understand the purpose of the routine measurements taken during visits.

“If they spaced them out (appointments) greater than what they are, I don’t think I would have known any different […] I just come in because this is when they tell me to come in.”

“I’ve never done this before, so I mean if they say to do something, I’m coming in and doing that.”

“This is my second time around and I’m only coming in because they tell me… I’m feeling my baby kick all the time”

WHEN MOM CALLS OB, SHE HAS NO IDEA WHOM SHE IS CALLING

BYPRODUCT OF EXCESS SYSTEM NAVIGATION

IMPACT ON THE RHYTHM OF CARE

IMPACT ON PATIENT EXPERIENCE


ANTICIPATION FOR NEXT APPOINTMENT

CONCERN

CURIOSITY CONCERN


4-5 WEEKS UNTIL NEXT APPOINTMENT

CURIOSITY



VISIT VISIT

BECAUSE OF THE BURDEN OF ACCESSING OB BETWEEN APPOINTMENTS the closer moms get to their appointments, the greater the concern needs to be to contact OB

LACK OF TRANSPARENCY BEHIND CURRENT RHYTHM OF CARE

VISIT

MEANS THE CLINIC IS AT THE CENTER OF CARE, NOT MOM

HOW DO WE CREATE A CLINICAL PROCESS THAT BETTER LEVERAGES THE 99% OF CARE THAT OCCURS OUTSIDE OF THE CLINIC


RE-CENTRALIZE MOM

SIGNALS








CURRENT STATEMOM’S CURRENT RELATIONSHIP WITH OB

BETWEEN VISITS





TO A WELLNESS CLINICAL MODEL TRANSFORM A PRACTICE

ACTIVATE




STRENGTHEN

WE KNOW WHAT WE NEED TO DO...

IT’S THE HOW THAT’S TRANSFORMATIVE



PRACTICE-LED SHIFTS IN...

ROLERHYTHM&

EXPERIMENTSMETHODOLOGY 14 (115 MOMS)

CFI

INTERVIEWSCO-CREATION

OBSERVATION>>


OBSERVATION>>

VISIT VISIT VISIT

OB NEST ONLINE CARE COMMUNITY

OB PHONE LINE

AT HOME MEASUREMENT

ASYNCHRONOUS COMMUNICATIONOB helps mom

Mom helps herself

VISIT VISIT

{

{

Current state

Future state

PACs

Mary

NURSETEAM

OB / CNM

VISIBLE PROCESS TO PATIENT INVISIBLE PROCESS TO PATIENT

SHIFT IN RHYTHM OF CARE

“Unobstructed access” to care

Access to reassurance on mom’s schedule

System flexibility and transparency

SHIFT IN ROLE OF OB

As a guide and connection to resources

Shared staff accountability, continuity, and relationships

Staff operating at highest level of licensure

DIVERSIFY CONNECTED

CARE RESOURCES

OB\GYN and the Center for Innovation (CFI) are partnering to explore new ways to meet the evolving needs of patients

• In particular, we are exploring ways to serve patients without them needing to leave home and come to Mayo Clinic.

• Transforming prenatal care for low-risk population leveraging technology and redesigning services

• Offered to Mayo Clinic patients throughout Rochester practice.

wait until next appointment call in

CALL IN

on my own

ONLINE COMMUNITY TEXT VIA ASYNCHRONOUS APP

ACCESS TO MEASUREMENT EQUIPMENT

CURIOSITY CONCERN

VISIT VISIT

14EXPERIMENTS

AT HOME MEASUREMENT

ASYNCHRONOUSCOMMUNICATION

ONLINE CARECOMMUNITIES

VIDEO IN A FRIEND

PROACTIVE CALLS

DROP-IN CARE STATIONS

SHIFT IN RHYTHM

SHIFT IN RHYTHM

PROVIDE UNOBSTRUCTED ACCESS TO CAREACCESS TO REASSURANCE ON MOM’S SCHEDULE

SHIFT IN RHYTHM

SHIFT IN RHYTHM



SYSTEM FLEXIBILITY & TRANSPARENCY

SHIFT IN ROLE OB AS A GUIDE AND CONNECTION TO RESOURCES

SHIFT IN ROLE SHARED CONTINUITY & RELATIONSHIPS


SHIFT IN ROLE STAFF OPERATING AT HIGHEST LEVEL OF LICENSURE

NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS

FLEXIBLE SCHEDULING(express care model)

Conversation in beginning to set expectations around rhythm of

care throughout pregnancy

NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

Online Care Communities

Video-in-A-Friend

Proactive Calls

Hi, I’m Mary, your nurse.

Hi Jane, how are you feeling?

SEPARATE NURSE PANELS

PUSH & PULL

RN BACK-UPNURSE

OB/CNM BACK-UPOB/CNM

Mom and Nurse are continuously connected using the Asynchronous Communication Tool, so both feel comfortable with the time between visits

RN

PRENATALCARE GUIDE

OB/CNM

EXPERT GUIDANCE& OVERSIGHT

PAC

CARE EXPERIENCEPLANNER

CA

CONNECTED CARESPECIALIST

EMPOWEREDCARE MANAGER

MOM

AND HERE IS WHY!!!!

NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS


NURSES ONLY HAVE THE ABILITY TO BE REACTIVE... NOT PROACTIVE

.5 FTESHARED PANELS

BE TRANSPARENT ABOUT NURSE

THE NURSES WERE THE “BETWEEN VISIT CARE” BEFORE, THEY JUST DIDN’T HAVE THE TOOLS OR THE PERMISSION. OPPORTUNITIES

UNLEVERAGED STAFF SKILLS

ALREADY PROVIDING CONNECTED HEALTH

99% OF CARE @ HOME

MAYO IS IN A POSITION TO GO BACK TO BASICS ON PRENATAL CARE

OPPORTUNITY TO USE THE MAYO BRAND

LEADERSHIP OPPORTUNITY – PREVENTIVE CHRONIC CARE MODELS

OTHER...

STAFF DOESN’T HAVE CAPACITY OR FLEXIBILITY TO BE PROACTIVE

VISIT VISIT

Our current focus

Our current blind spot

All other members of patients’ care teams are anonymous.

Patients feel bounced around – Tools to connect do not allow for continuity

Current method of connection only allows for reactive communication – where patients are connecting wtih OB as a reaction to their own needs??

FIRST CFI PROJECT TO GO THROUGH ALL OF THESE PHASES...

PROCESS OF EXPERIMENTATIONMORE CERTAINTY – SOLUTIONS FEEL INEVITABLE...

DRUMBEAT

MOM’S ENTIRE PREGNANCY JOURNEY IN CONTEXT

HYPOTHESES ABOUT FUTURE RELATIONSHIP WITH CARE

PREGNANCYST1

DELIVERYST1

PREGNANCYND2

DELIVERYND2

PREGNANCYRD3

DELIVERYRD3

PREGNANCYTH4

MISCARRIAGE


NOBN NOBR

ROB

I’m pregnant!


ROB ROB ROB

Post-partum

Ultrasound


THE EMOTIONAL HUMP

NOBN NOBR

ROB

I’m pregnant!

ROB ROB ROB

Post-partum

Ultrasound

Asych

ronous C

omm

unicatio

n Tool

OB Phone L

ine

Online C

are C

omm

unities

At-Hom

e Mea

sure

men

t

NOBN

NOBR

ROB

ROBROB

ROB ROBROB

ROB

ROBROB

ROB

US

mom

’s an

xiet

y



I’m pregnant!

SCANNING & FRAMING RESEARCHING & EXPERIMENTING PROTOTYPING IMPLEMENTINGSYNTHESIZING>> >> >> >>


THE NURSES WERE THE “BETWEEN VISIT CARE” BEFORE, THEY JUST DIDN’T HAVE THE TOOLS OR THE PERMISSION.

THE “ANXIETY” HUMP

OB CONNECTED CARE MODELBLUEPRINT

Leverage 1.5 – 2-hour time investment

Patient’s nurse uses the Asynchronous Communication App to schedule time to follow-up with mom after delivery

Patient’s personal nurse

INVESTMENT PHASE CONNECTED PHASE PREP PHASE DELIVERY/POST-PARTUM

Visit Pre-OB 5-8 12 18-20 FLEX 28 36 38+ DELIVERY 1w Post-Partum 6w

Prescheduled Prescheduled Express Care Scheduling Model Prescheduled Video / Phone Call

Interaction/Duration Call to schedule OB care

NOBN Visit2 hrs

NOBR Visit45-60 min

Ultrasound Visit45 min

Check-in20 min

Glucose testing

ROB VisitGroup B Strep Test15-20 min

ROB Visit15-20 min

Post-Partum Phone Call / Video Chat15 min

Post Partum Visit15-20 min

Care Team Member PAC Patient’s Nurse OB/CNM Patient’s Nurse Nurse or OB/CNM OB/CNM OB/CNM Patient’s Nurse OB/CNM

Tasks • Schedule NOBN visit

• Direct mom to online OB space (online communities)

• NOBN Standard Education• Explain Rhythm of Care,

What to expect (infographic)• Establish relationship

and how to connect

• NOBR Standard Care• Fetal Doppler

Training

• Review ultrasound• Standard 18-20w education• Fundal Height Training

Ongoing Activities: • Data Collection/Interpretation• Proactive Communication

via Text

Option for Virtual Check-in

Standard Care based on Gestation

Standard Care based on Gestation

• Congratulate mom, discuss delivery, lactation, healing, depression issues, etc.

• Opt out of 6w Post-partum (if applicable

Standard Care

Behind the Scenes Staff MFM Physician

Tasks View Ultrasound

Supporting Staff PAC/CA CA CA CA CA CA CA

Tasks Setting up tools – technical assistancePrescheduling future OB Visits

Rooming Technical assistance, if needed

Rooming Rooming Rooming Rooming

Patient-facing Tools Online Communities

Mayo Clinic Guide to a Healthy Pregnancy / OB Connect – Mobile App

Asynchronous Communication Proactive Communication

At-Home Measurement Kit (Doppler, scale, BP cuff, Photo App)

Mayo-Campus Drop-in Care Stations

Alternative Connection Methods Video ROB Capability

Infastructure Modifications Express Care Scheduling System

Patient Panels Visualizations

Establish expectations on how to connect between 18 and 36 weeks

If mom miscarries, her nurse calls her to follow-up


RE-CENTRALIZE MOM

FROM A SICKNESS CLINICAL MODEL

CURIOSITY CONCERN




been kicking...




I’m bleeding...

DR. SMITH, M.D.

CARE NAVIGATION WITHIN THE CLINIC, DURING VISITS

CARE NAVIGATION OUTSIDE OF THE CLINIC, BETWEEN VISITS

OB / CNM

NURSE CALL ROOMPACs

VISIT VISIT

VISIT VISIT

VISIT VISIT

RANGE OF ISSUES OR QUESTIONS THAT COME UP BETWEEN VISITS




This is my only alotted time where I am visible to OB

The other ways I meet my pregnancy needs

are less important

If something goes wrong, it’s OB’s fault

Pregnancy is a dangerous process

My needs and concerns revolve around my visits

The provider is the only person qualified to tell me that I’m okay

OB knows everything about pregnancy

OB knows my body best

This is the most important way my pregnancy needs

are met

This is the only time I can really get reassurance that

my baby is okay

The clinic needs to monitor me constantly to make sure my baby

and I are okay

confirmationvalidation

celebrationco

nnection

mile

ston

e

rela

tions

hip

measurements

record keeping

questions

communication

planning chec

k-in

hear

tbea

t

expr

ess

conc

erns

reas

sura

nce

education

VISIT

CENTER OF GRAVITY

Signalsto m

om

Objectives

appointments

fulfill

Moms often are concerned with being considered “bad patients”, or contacting OB too often between scheduled visits

Many moms are sensitive to the capacity and workload of their care team and perceive that any attention outside of the appoint-ment is “extra” and is burdensome to their providers; therefore many will wait to have concerns addressed until their next appointment

Moms are aware that OB as a practice faces many lawsuits, and feel that this affects the way they are treated – moms appreciate the uncensored advice of those not directly connected to her OB care

Many moms who feel confident, informed, and in control of their choices regarding their prenatal care and delivery see themselves as counter to the culture of OB

OUT OF SIGHT, OUT OF MINDLanguage like “we’ll see you again in 4-6 weeks” enforces moms’ feeling that she is cared for only when physically in the clinic.

ONE-DIMENSIONAL PERCEPTION OF CONTINUITY Because moms perceive their prenatal care to come only from their provider, continuity with this person is of highest value to them and everyone else is anonymous.

LACK OF CONTINUITY OUTSIDE OF CLINIC WALLSThe only member of the team that matters to patients is their provider and it is very difficult to connect with them outside of appointments (unless they have a personal relationship or workaround.)

Outside of appointments, moms feel that the rest of the staff is an obstacle to connecting to their provider.

Patients are not confident in the information sharing between departments, staff or providers.

Because of the complex navigation that is required to get a question answered outside of appointments, moms find it time-consuming and frustrating to access OB between visits.

I’ll see you again in 4-6 weeks

MOMS ARE DOING WHAT THEY’RE TOLD TO DOMoms trust that they are following a rhythm of care that their providers have intentionally designed – they assume that there is medical rationale behind their pattern of visits.

Moms rely on the appointments as confirmation that their pregnancies are on track; Only their providers can reassure that they and their babies are healthy.

Many moms are unclear of what specific risks their providers are monitoring for, and do not understand the purpose of the routine measurements taken during visits.

“If they spaced them out (appointments) greater than what they are, I don’t think I would have known any different […] I just come in because this is when they tell me to come in.”

“I’ve never done this before, so I mean if they say to do something, I’m coming in and doing that.”

“This is my second time around and I’m only coming in because they tell me… I’m feeling my baby kick all the time”

WHEN MOM CALLS OB, SHE HAS NO IDEA WHOM SHE IS CALLING

BYPRODUCT OF EXCESS SYSTEM NAVIGATION

IMPACT ON THE RHYTHM OF CARE

IMPACT ON PATIENT EXPERIENCE


ANTICIPATION FOR NEXT APPOINTMENT

CONCERN

CURIOSITY CONCERN



CURIOSITY



VISIT VISIT

BECAUSE OF THE BURDEN OF ACCESSING OB BETWEEN APPOINTMENTS the closer moms get to their appointments, the greater the concern needs to be to contact OB

LACK OF TRANSPARENCY BEHIND CURRENT RHYTHM OF CARE

VISIT

MEANS THE CLINIC IS AT THE CENTER OF CARE, NOT MOM

HOW DO WE CREATE A CLINICAL PROCESS THAT BETTER LEVERAGES THE 99% OF CARE THAT OCCURS OUTSIDE OF THE CLINIC


RE-CENTRALIZE MOM

SIGNALS








CURRENT STATEMOM’S CURRENT RELATIONSHIP WITH OB

BETWEEN VISITS





TO A WELLNESS CLINICAL MODEL TRANSFORM A PRACTICE

ACTIVATE




STRENGTHEN

WE KNOW WHAT WE NEED TO DO...

IT’S THE HOW THAT’S TRANSFORMATIVE



PRACTICE-LED SHIFTS IN...

ROLERHYTHM&

SCANNING & FRAMING EXPERIMENTATION

EXPERIMENTS


OBSERVATION

METHODOLOGY 14

PROTOTYPING IMPLEMENTINGSYNTHESIZING

( 115 M O M S )

CFI

>>


OBSERVATION>>

VISIT VISIT VISIT

OB NEST ONLINE CARE COMMUNITY

OB PHONE LINE

AT HOME MEASUREMENT

ASYNCHRONOUS COMMUNICATIONOB helps mom

Mom helps herself

VISIT VISIT

{

{

Current state

Future state

PACs

Mary

NURSETEAM

OB / CNM

VISIBLE PROCESS TO PATIENT INVISIBLE PROCESS TO PATIENT

SHIFT IN RHYTHM OF CARE

“Unobstructed access” to care

Access to reassurance on mom’s schedule

System flexibility and transparency

SHIFT IN ROLE OF OB

As a guide and connection to resources

Shared accountability, continuity, and relationships

Staff operating at highest level of licensure

DIVERSIFY CONNECTED

CARE RESOURCES

OB\GYN and the Center for Innovation (CFI) are partnering to explore new ways to meet the evolving needs of patients

• In particular, we are exploring ways to serve patients without them needing to leave home and come to Mayo Clinic.

• Transforming prenatal care for low-risk population leveraging technology and redesigning services

• Offered to Mayo Clinic patients throughout Rochester practice.

wait until next appointment call in

CALL IN

on my own

ONLINE COMMUNITY TEXT VIA ASYNCHRONOUS APP

ACCESS TO MEASUREMENT EQUIPMENT

CURIOSITY CONCERN

VISIT VISIT

14EXPERIMENTS

AT HOME MEASUREMENT

ASYNCHRONOUSCOMMUNICATION

ONLINE CARECOMMUNITIES

VIDEO IN A FRIEND

PROACTIVE CALLS

DROP-IN CARE STATIONS

SHIFT IN RHYTHM

SHIFT IN RHYTHM


SHIFT IN RHYTHM

SHIFT IN RHYTHM



SYSTEM FLEXIBILITY & TRANSPARENCY

SHIFT IN ROLE OB AS A GUIDE AND CONNECTION TO RESOURCES



SHIFT IN ROLE STAFF OPERATING AT HIGHEST LEVEL OF LICENSURE

NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS




NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

Online Care Communities

Video-in-A-Friend

Proactive Calls

Hi, I’m Mary, your nurse.


I know that Mary and Dr. Smith know me

SEPARATE NURSE PANELS

PUSH & PULL

RN BACK-UPNURSE

OB/CNM BACK-UPOB/CNM

Mom and Nurse are continuously connected using the Asynchronous Communication Tool, so both feel comfortable with the time between visits

RN

PRENATALCARE GUIDE

OB/CNM

EXPERT GUIDANCE& OVERSIGHT

PAC

CARE EXPERIENCEPLANNER

CA

CONNECTED CARESPECIALIST

EMPOWEREDCARE MANAGER

MOM

AND HERE IS WHY!!!!

NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS



.5 FTESHARED PANELS

BE TRANSPARENT ABOUT NURSE

THE NURSES WERE THE “BETWEEN VISIT CARE” BEFORE, THEY JUST DIDN’T HAVE THE TOOLS OR THE PERMISSION.


NURSES AND CLINICAL STAFF ARE ALREADY PROVIDING CARE AT A DISTANCE –

JUST NOT GIVEN THE TOOLS/PROCESSES TO BE SUCCESSFUL???

OPPORTUNITIES

UNLEVERAGED STAFF SKILLS

ALREADY PROVIDING CONNECTED HEALTH

99% OF CARE @ HOME

MAYO IS IN A POSITION TO GO BACK TO BASICS ON PRENATAL CARE

OPPORTUNITY TO USE THE MAYO BRAND

LEADERSHIP OPPORTUNITY – PREVENTIVE CHRONIC CARE MODELS

OTHER...

STAFF DOESN’T HAVE CAPACITY OR FLEXIBILITY TO BE PROACTIVE

VISIT VISIT

Our current focus

Our current blind spot

As a result, any care happening outside of clinic can only be reactive, nurses and clinical staff are not given the tools to be proactive.

All other members of patients’ care teams are anonymous.

Patients feel bounced around – Tools to connect do not allow for continuity

Current method of connection only allows for reactive communication – where patients are connecting wtih OB as a reaction to their own needs??

FIRST CFI PROJECT TO GO THROUGH ALL OF THESE PHASES...

PROCESS OF EXPERIMENTATIONMORE CERTAINTY – SOLUTIONS FEEL INEVITABLE...

DRUMBEAT

MOM’S ENTIRE PREGNANCY JOURNEY IN CONTEXT

HYPOTHESES ABOUT FUTURE RELATIONSHIP WITH CARE

PREGNANCYST1

DELIVERYST1

PREGNANCYND2

DELIVERYND2

PREGNANCYRD3

DELIVERYRD3

PREGNANCYTH4

MISCARRIAGE


NOBN NOBR

ROB

I’m pregnant!


ROB ROB ROB

Post-partum

Ultrasound


THE EMOTIONAL HUMP

NOBN NOBR

ROB

I’m pregnant!

ROB ROB ROB

Post-partum

Ultrasound

Asych

ronous C

omm

unicatio

n Tool

OB Phone L

ine

Online C

are C

omm

unities

At-Hom

e Mea

sure

men

t

NOBN

NOBR

ROB

ROBROB

ROB ROBROB

ROB

ROBROB

ROB

US

mom

’s an

xiet

y



I’m pregnant!

Proactive, Open-dialogue between visits


NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS


NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS


Building transparency around the rhythm of care




PUSH & PULLHi Jane, how are

you feeling?

PUSH & PULL


NOBN

5-8 10-12

NOBR

18-20

ULTRASOUND

36

ROB

PRESCHEDULED VISITS




Creating diversified access to care

OB PHONE LINE

SELF-MONITORING

SECURE MESSAGINGOB helpspatient

Patient helpsherself

VISIT

{

{ONLINE CARE COMMUNITY

VISIT



been kicking...




I’m bleeding...

OB PHONE LINEONLINE COMMUNITY SECURE MESSAGING

[SELF-DIRECTED] [WITH OB GUIDANCE]

CURIOSITY CONCERN

The resources available for the range of issues that come up between visits:

SELF-MONITORING


OB PHONE LINE

SELF-MONITORING

SECURE MESSAGINGOB helps patient

Patient helps herself

VISIT

{


VISIT



been kicking...




I’m bleeding...



CURIOSITY CONCERN


SELF-MONITORING


CURIOSITY CONCERN




been kicking...




I’m bleeding...

OB / CNM



VISIT VISIT

...that meets women where they are


OB PHONE LINE

SELF-MONITORING

SECURE MESSAGINGOB helps patient

Patient helps herself

VISIT

{


VISIT



been kicking...




I’m bleeding...



CURIOSITY CONCERN


SELF-MONITORING

...that meets women where they are


Transforming the Status Quo...


mom

’s an

xiet

y


I’m pregnant!


Into an integrated, continuous model of care


mom

’s an

xiet

y


I’m pregnant!

NOBR

ROB ROB

Post-partum

UltrasoundNOBN


PREGNANCYST1

DELIVERYST1

PREGNANCYND2

DELIVERYND2

PREGNANCYRD3

DELIVERYRD3

PREGNANCYTH4

MISCARRIAGE

Into an integrated, continuous model of care


What’s Next?


Thank you!

Marnie [email protected]