Context

Histopathology is a specialty area of training for medical trainees and consultants. It covers the study of changes in tissues caused by disease. A significant part of training involves visually inspecting thin slices of tissue through a microscope and interpreting what they see to diagnose potential conditions.

Government Digital Service

The NHS requires all digital products to follow the Government Digital Service (GDS) framework and guidelines, through the phases
of discovery, alpha, beta and live, with an assessment for each.

Discovery: understand the problem to be solved.
Alpha: Experiment with different solutions to the most risky problems discovered during the discovery phase.
Beta: Build the best performing idea from the alpha phase.
Live: Continue to iterate and develop the MVP launched in Beta phase.

Discovery

We worked closely with doctors, trainees and consultants to understand all perspectives. We identified seven user types and explored their current ways of working in terms of tasks, pains, desires and responsibilities.

At the time of starting the project, training of the pathology workforce for public healthcare had been outpaced by demand. Put simply, there was a need to expand the pathology workforce faster and at scale beyond its current capability.

Critical to the success of this project was the ability for consultant pathologists to submit microscope slides and supporting information that also aligned to a complex curriculum open to interpretation, all while working overstretched schedules.

Offline annotated ‘stamp books’ of microscope slides used for training didn’t offer the staged competence-based learning necessary for trainees to ramp up to the complex diagnosis they would need to understand in order to pass the final exams.

Scope

The number of related problems was huge, so we found themes and created a visual way to nest them to show the relationships between them, and how they could contribute to the goals of the project.

We used this as a tool to prioritise the opportunities so we were comfortable with the volume of work and the scope of the problems to explore. Orange were desired and red not needed immediately, everything else was to remain in scope.

Problem prioritisation workshop

Ideation

I facilitated ideation sessions for many of the subjects prioritised at this point. These included patterns of learning, gamification, staged learning (including digitising traditional experienced based knowledge), Information architecture (including specialities, reporting areas, curriculums, sub-specialities, years and levels).

Online access was a key requirement as was the ability for consultants to upload materials and assessment questions within their busy schedules. To attract users back to the system we explored and experimented with gamification techniques linked to graded learning.

Alpha

During Alpha we focused on the areas of the system that were the least certain (in terms of what shape a solution could take), we prioritised a shortlist of areas to explore: How to show training progress through a complex non-linear curriculum, training formats and how to determine answers to questions that were deemed correct or not depending on the stage of the user’s experience and the context of the patient information that supports the slide images.

Assessments

Each phase of the project is required to be assessed for suitability to move to the next phase. We passed all stages with some recommendations which helped us improve our processes and quality of work as we moved forwards.

Along with product assets such as prototype designs, testing results, service blueprints and general documentation. We also produced a backlog for the Beta phase of the project and onboarded an NHS internal product owner to begin the transition of ownership early to maximise project longevity.

Learnings

We involved stakeholders as much as possible to make the most of their expertise. Many of the stakeholders were not particularly tech savvy, so more time was needed than we expected to learn and use tools such as Miro. We switched to simpler workshop formats and longer times which helped the group ramp up to the more involved workshops once they were used to the tools.