Pregnancy Pathway – Digital, Practical, Safe (Region South Denmark Ecosystem)

6 February 2019

From Handheld Paper Journal to Digital “Pregnancy Folder”

More than 100 participants across municipalities, hospitals and General Practice showed up on 5th February in Odense, South Denmark, for a thematic event about the development of a digital solution for pregnancy pathways, which will replace the handheld paper journal (“the yellow envelope”) once and for all. 80 % of the participants were clinicians; midwives, GPs, obstetricians and Childrens’ Health Visitors, which pleased Nanna Skovgaard, Head of Division at the Danish Ministry of Health, as the event was held on behalf of the digital solution development project owned by the Ministry of Health and managed by the Health Innovation Centre of Southern Denmark.

The event followed a pre-project that analysed the needs for the digital solution across all stakeholders. National digitalisation of the journal has been attempted before, unsuccessfully, however according to Nanna Skovgaard this project has the strength of momentum, political will across sectors, technological maturity, a general focus on patient pathways and a by now highly digitalised public sector in Denmark.

Debate about Challenges and Opportunities

After a presentation of the needs analysis results, which stated that the overall purpose of a digital solution is to achieve better pregnancy pathways for all stakeholders; the pregnant woman and the healthcare professionals she meets across her pathway, the event focused on a debate about the challenges and opportunities of this digital solution. To inspire this debate, at team of actors depicted the challenges connected with the current handheld journal in the Plug &Play lab, which is a physical demonstration lab that can show interactions and pathways across sectors; the citizen’s own home, the GP’s office, the midwife’s office and the hospital. The purpose of putting on a play was to provide the participants with a common ground for their debate, and the comical approach that the actors used in the depiction contributed to and to some degree provoked the participants to have important discussions that they may not otherwise have entered into in the presence of strangers. Three humorous “true story” interviews with women who have experienced challenges with the handheld journal supported the setting of the scene.

An implementation researcher, Annemette Digmann, described the significant challenges of implementing new public solutions across sectors and fields of expertise. She went so far as to say that it is easier to enter into warfare than to collaborate across sectors. She offered some good advice on how to approach successful implementation; include implementation from the beginning, state a common vision (e.g. “we are doing it for the pregnant woman”), and agree on rules of play.

The final panel debate across relevant stakeholder representatives concluded that the time is ripe for successfully digitalising the journal, as long as the solution supports clinical practice and can adapt along the way. The panel’s obstetrician therefore strongly urged his colleagues to contribute to the development process and support the IT specialists in understanding the clinical daily operations.

FUN FACT: the event programme was provided for each participant in actual “yellow envelopes” (the current handheld paper journal) with intentional coffee stains and all to represent the way that this envelope usually looks at the end of a pregnancy pathway, in which it has been brought around everywhere for 30+ weeks.

Development Project

The next steps in the development project is a specification of the solution to enable presentation of the first prototype. The development is a collaboration between clinicians, the Midwife Assocation, the Obstetricians’ Association and the Danish Organisation of General Practitioners as well as MedCom, the Health Data Board etc., and the Health Innovation Centre of Southern Denmark fulfills the role as Project Manager for the Analysis and Specifications Phases.

More information about Region South Denmark Ecosystem here.

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