Health Innovation Manchester (HInM)
Health Innovation Manchester (HInM) is an academic health science centre that leverages digital capabilities to improve the health and wellbeing of Greater Manchester’s nearly 3 million citizens. HInM was formed in 2017 by merging the former Greater Manchester academic health science network (GM AHSN) and the Manchester academic health science centre (MAHSC). https://www. healthinnovationmanchester.com/
Since early 2018, Greater Manchester Health and Social Care (GMHSC) Partnership has had a smokefree pregnancy programme in place, whose aim is to support pregnant individuals in their effort to quit smoking tobacco products. The specially trained midwives work with pregnant smokers as part of the programme — they meet with the patients throughout their pregnancy to support their attempt to quit. If they have been successful at quitting smoking, the programme participants are given a reward in the form of a voucher. If not, they are given repeated chances to engage and make further quit attempts with the aim to reduce their tobacco consumption and let their baby reach its full potential. The specialist teams provide ongoing support for up to a year after they enrol.
This type of long-term patient engagement and monitoring generates the need to store and process large volumes of data. As such, the GMHSC Partnership was looking for a way to transform their manual, paper-based process. They wanted to make a standardised platform for record keeping and data collection, and to make the management of the programme more consistent by creating a single space from which they’d also be able to report to the national NHS Digital stop smoking statistics.
As the smokefree pregnancy programme is an incentive-driven initiative, which requires the GMHSC Partnership to invest a certain amount of capital, the organisation was hoping that a digital solution would also help them assess the ROI and efficacy of the programme.
Health Innovation Manchester (HInM) has worked with GMHSC Partnership to develop the digital platform to support specialist midwives working on the programme.
Project work on the GM Smokefree Pregnancy platform began with remote workshops during which mock-ups were created for the application’s entire system. The mock-ups served as the basis for what needed to become part of the final solution and helped the Objectivity team to precisely define the backlog.
The mock-ups also allowed the GMHSC Partnership to experience the look and feel of the final product before its realisation. Whereas the User Acceptance Testing, which took place after each phase of the project, accelerated the customer feedback cycle.
The GM Smokefree Pregnancy platform created to assist midwives has many user-centric features.
Calendar — enables midwives to create and manage patient meetings; it has a special functionality that sends an alert around the time that the next patient visit should be scheduled. The calendar can also be accessed by all advisors across the region as many women will require stop smoking support outside of the hospital they choose to give birth in, allowing for timely access to appointments when referrals are made and reducing duplication.
Patient Profiles — Midwives create patient profiles where they can record information regarding patients’ demographics. They can also create referrals based on which geographical area they reside, they can add multiple pregnancies, the expected delivery date, and other details relevant to providing safe and effective care. The profile is connected to the calendar and includes a list of planned and past appointments. Once the patient is no longer pregnant, midwives can add this information to their record and close the profile.
Health Status Indicators — the application monitors various key health indicators, such as CO readings. It also allows individuals who support the programme participants on their stop smoking journeys to be added to the profile and monitored.
Real-Time Data Reporting Dashboards — this feature enables the lead midwives to organise their teams and track their progress, gain learning and intelligence that will support future programme innovation.
Email & SMS Notifications — the application sends email and text message notifications about upcoming scheduled visits, enabling midwives to effectively manage their workflow. The platform also sends motivational messages encouraging them to maintain their quit attempt.
Offline Capability — certain system features were custom developed to work offline, making the application more convenient and easier to use when there is a lack of Wi-Fi connections, which can happen in more rural areas.
Much like certain other applications developed as part of The Greater Manchester Combined Authority’s Digital Strategy and Early Years initiative, the GMHSC Partnership solution was also developed using the Mendix low-code platform. This allowed the Objectivity team to apply the same UI, thereby ensuring consistency across products and accelerating time-to-market.
During the COVID-19 pandemic, pregnant women have been identified as being at a higher risk from COVID-19 and smokers are often more susceptible to respiratory illnesses, so it has been essential to continue to provide this specialist support. “By working with the system to identify the needs and co-design a digital solution, we are enabling this important service to continue to help people quit smoking while also reducing the administrative burden maternity teams have faced in the past.
What we achieved
Thanks to the GM Smokefree Pregnancy platform, the GMHSC Partnership is able to manage their work processes and patients’ needs more effectively. The application has synchronised and automated various programme activities as well as ensured data and reporting consistency.
All this helped to optimise the midwives’ work processes and enabled a greater number of pregnant individuals, who are seeking to cease smoking, to be enrolled in the programme.
The calendar functionality allows the midwives to easily organise, manage, and cancel meetings with patients from within a single system. The lead midwives also gained insight into their teams’ calendars. This made holiday management simpler and more convenient, by enabling them to often see at a glance what’s happening with their service delivery at any given moment, thanks to having access to real-time data insights.
The GM Smokefree Pregnancy platform has supported the centralising of data availability to improve monitoring of programme performance against agreed local and national Key Performance Indicators. The system ensures that there is no duplication of individual records and that no two midwives end up unwittingly helping the same patient. All pregnancy information is kept in the same location, with access to important historical data. As a result, the midwives don’t need to create a new profile for a patient who, for instance, becomes pregnant again and wants to join the programme for the second time.
Through the use of the application, lead midwives can monitor various indicators and have an overview of their teams’ task progress, allowing for better capacity and time management.
The application sends email and SMS messages with reminders about upcoming meetings, allowing midwives to prepare for or cancel them ahead of time, if necessary. This helps to optimise their key work processes.
Not all areas of Greater Manchester have access to the internet, making the GM Smokefree Pregnancy platform’s offline capability one of its key features. Without this capability, if a midwife were to undertake a home visit where there is poor Wi-Fi connectivity, they would usually have to take notes by hand, leading to extra work and increased potential for human error.
To create the GM Smokefree Pregnancy application, Objectivity leveraged the Mendix low-code platform, which was also used to deliver another Greater Manchester public sector solution. Doing so significantly accelerated the application’s time-to-market as the team was able to reuse some of the UI components they prepared as part of the other project.
Greater Manchester is seeing significant benefits to its maternity-led stop smoking teams thanks to the implementation of a new digital platform. The digitisation of the stop smoking pathway is releasing more time for them to care for individuals and increase capacity. The platform is allowing us to engage with more pregnant individuals and their partners, advise them about the dangers of smoking during pregnancy and give them personalised support to quit.