Telstra Health / NHS

Healthcare / B2B / SaaS

How Iterative Design is helping the NHS fight COVID-19 faster with Telstra's VaxApp

7x

Planned User Adoption

250,000+

Vaccinations recorded to date

30%

Reduction in task time through iterative design

Overview

When I joined Telstra Health as UX Manager, I made a clear promise to the NHS that we wouldn't just build products for them, but build with them.

In an environment where trust in technology vendors was waning due to solutions being deployed without consultation, my commitment was to forge a new path – one of true collaboration and user-centred design. This promise was put to the test immediately with VaxApp, a critical project to rapidly develop a national vaccination management system.

Through a deeply iterative process, guided by strategic design bets and principles, and fuelled by an exceptional cross-functional team, we not only delivered VaxApp but exceeded expectations - 7x planned user adoption, a 30% reduction in task time over 4 campaigns and recording over 250,000 vaccinations, demonstrating the tangible impact of user-centricity and collaborative design on a national scale.

This case study explores how this approach transformed a critical need into a resounding success, and how the lessons learned continue to shape our design philosophy.

Screenshot of VaxApp patient record interface showing a patient named Irene Mona Grogan with encounter history that includes an immunization consent not given for a COVID-19 vaccine. The interface has a green color scheme and displays patient details including NHS number and date of birth.

The Challenge

To design and deploy an end-to-end vaccination management system, VaxApp, within the MedicalDirector Helix ecosystem, seamlessly connecting General Practitioners to the NHS SPINE.

This system needed to be robust and clinically precise, meeting stringent medical requirements, while simultaneously being intuitive and user-friendly for busy healthcare professionals. The core design challenge was balancing these often-competing needs within a high-pressure, time-sensitive environment.

Constraints:

• Tight Deadlines: Rapid deployment of iterations was essential to support urgent NHS vaccination campaigns against COVID-19 and Flu

• Technical Complexity: Integration with the NHS SPINE and the existing Helix platform demanded intricate technical considerations

• Critical User Needs: The system had to cater to the diverse needs of GPs and practice staff under immense pressure, where efficiency and accuracy were paramount

• Accessibility Imperative: Ensuring accessibility was not just a 'nice-to-have' but a fundamental requirement for equitable healthcare delivery within the NHS, especially given existing shortcomings in the base design system

VaxApp ecosystem diagram showing the interconnection between Users, Business (Telstra Health), and Regulatory (NHS) components. The diagram includes Telstra Health's values and mission, healthcare professional requirements, NHS requirements, and API integration specifications against a green background.

Process & Iteration

Our approach was rooted in a strategic design framework and a commitment to iterative development, fostering deep collaboration across Product, Design, Development, and QA.

Design Strategy: Bets and Principles as a North Star

To ensure our design efforts were strategically aligned, I established a system of Macro and Micro Bets. These 'bets' acted as North Stars, connecting Telstra Health's business goals with the Helix value proposition for the NHS and its users.

Macro Bets

Business and Value Drivers

Time Saving: Streamlining workflows to reduce administrative burden.

Interoperability: Seamless integration with NHS systems and the Helix ecosystem.

User-Centred Evolution: Building a platform that adapts and improves based on user needs

Micro Bets

Design Decision Pillars

Reduce Interaction Cost: Minimising user effort and clicks.

Align to User Task: Designing workflows that directly mirror user tasks and mental models.

'One System, One Tab' Appearance: Creating a cohesive and integrated user experience within the Helix environment.

These bets were further translated into actionable Design Principles, closely aligned with the NHS' own design values. We mapped each principle to Telstra Health values and, crucially, to measurable metrics. This allowed us to move beyond subjective design discussions and ground our decisions in data and tangible outcomes.

This entire system of Bets and Principles formed the basis of the 'Experience Ideal' strategy, inspired by MedicalDirector's mission to 'Enable Ideal’.

Telstra Health's VaxApp design principles document displaying eight key principles including Design for All, Design with Users, Design for Intuition, and Design to Simplify, with brief descriptions of each principle arranged in a numbered grid format.

Iterative Cycles: Campaigns as Roadmap

We leveraged the cyclical nature of NHS vaccination campaigns (Spring/Summer, Autumn/Winter) as natural iterative opportunities. Each campaign served as a roadmap, providing a live environment for testing, feedback, and refinement.

User Feedback Loops during Live Campaigns:

We established multiple channels for continuous feedback:

Direct access to Customer Support for immediate issue reporting
Open communication lines with practices and stakeholders for broader insights.
On-site observation sessions at test sites to directly witness user interactions and pain points.
Rapid response capability to swiftly address and deploy fixes for critical issues identified in real-time.

Prioritisation and Planning Between Campaigns:

Between campaigns, all collected feedback was rigorously analysed and fed into a value-effort matrix. This allowed us to prioritise improvements based on user impact and development effort, translating them into detailed user stories for development and release in the subsequent campaign cycle.

Deliberate Design: Applying Miller's Law

In designing the core Vaccination Encounter workflow, we intentionally structured it as a seven-step process, grounded in Miller's Law - a psychological principle suggesting people can hold around 7 items in working memory.

Benefits of Applying Miller's Law

How the 7-steps of the encounter and Miller's Law connect to the core tenets in the strategic bets and principles:

Manage Cognitive Load: Prevent users from being overwhelmed by breaking down the encounter into manageable steps.

Improve Focus: Enable users to concentrate on one chunk of information at a time, reducing errors.

Reduce Interaction Cost: Streamline the process and minimise clicks within each step, contributing to overall time savings.

Simplify User Journey: Create a more predictable and easily understandable workflow.

Design whiteboard for VaxApp showing application planning with handwritten notes on user interface elements. A tablet device displays the vaccination record screen for patient Irene Mona Grogan with consent forms and vaccination details.

Accessibility: From Reactive Fix to Proactive Standard

A significant challenge early in the project was the discovery that the shared HXUI Design System lacked core accessibility features. An audit revealed nearly 200 WCAG failures. We tackled this not as a setback, but as a critical opportunity.

Strategic Intervention

Collaborating with a dedicated developer, we systematically addressed each accessibility issue, prioritising them against WCAG 2.1 AA standards. Colour palettes were recalibrated, input fields redesigned, focus states implemented, and ARIA labels integrated.

Patient search interface showing search results for NHS number 999 999 9999, displaying Irene Mona Grogan's details. Adjacent panels show accessibility improvements with proposed color changes for buttons and text fields, highlighting contrast ratio improvements from failing WCAG standards (2.43:1) to passing (4.56:1).

HXUI Design System Evolution

VaxApp was built upon the HXUI Design System, and while maintaining core fidelity, we were empowered to refine and enhance elements. This timing was crucial as HXUI was undergoing a review. VaxApp became a live test case, with our enhancements and feedback directly informing improvements and contributing valuable insights back to the central design system, demonstrating a reciprocal relationship between product development and design system evolution.

Design system documentation for HxUI and HxUI:NEXT showing text input field specifications. The document illustrates default, focused, disabled, and error states for text inputs, emphasizing consistent styling and validation features across the application.

Beyond Compliance

Developing an Accessibility Standard: This reactive fix evolved into a proactive measure. We collaborated across Product, Development, and QA to create a comprehensive Accessibility Standard, embedding accessibility considerations into our core workflows as a fundamental development criterion.

Open booklet displaying Telstra Health UK's Accessibility & Usability Standard document. The left page shows the document title and background information, while the right page shows a healthcare professional's hands using a tablet device. A separate booklet cover is visible on the right.

Solution & Impact

The iterative design process and collaborative approach delivered significant, measurable impact. User feedback directly translated into actionable improvements, demonstrably improving efficiency. We achieved a 30% reduction in average task completion time, decreasing from 80 to 60 seconds over the course of 4 campaigns.

Key Iterations across 4 Campaigns:

Streamlining the User Journey

User feedback suggested consolidating the "Patient Consent," "Clinician Approval," "Vaccination Roles," and "Vaccination Record" sections into a single step, reducing the encounter process from seven to six steps and saving valuable data capture time.

Healthcare application interface showing a patient record for Irene Mona Grogan. The screen displays consent and clinician approval forms on the left, with vaccination record fields on the right, including options for dose amounts and administration details.

Usability Enhancements

User and Site Management improvements. Start Flu and Covid encounter CTA. Information visibility improvements

Comparison of VaxApp interface before and after improvements showing simplified user flow for starting COVID-19 and Flu encounters. The 'Before' interface requires three steps with a dropdown menu, while the 'After' design uses one-click buttons, reducing the interaction process.

In-Application Reporting

User feedback prompted the expansion of in-application reporting to include site and vaccinator-specific views, enabling more effective management and governance of vaccination campaign teams.

From VaxApp to HelixHub

Beyond efficiency gains, VaxApp's success has paved the way for its evolution into HelixHub, a versatile platform for place-based healthcare services. Recognising the broader potential, future developments for HelixHub include:

Opportunities to develop HelixHub further

Recognising the broader potential, future developments for HelixHub include:

Customisable consultation workflows: Enabling tailored 6-7 step encounters with configurable data fields to adapt to diverse healthcare needs.

SNOMED CT integration: Connecting data fields to standardised medical terminology for improved data accuracy and interoperability.

Adaptability for place-based initiatives: Leveraging the platform’s flexibility for deployment in community centres and pop-up clinics, aligning with the evolving NHS landscape.

HelixHub now stands as a testament to the power of user-centric design and iterative development, demonstrating how a platform built on these principles can drive significant efficiencies and adapt to the ever-changing needs of the NHS.

“Mike's insights have driven key improvements in our processes, from implementing user-centred design principles to streamlining workflows that enhance productivity without compromising quality…The Helix VaxApp is a game-changer in the fight against Covid-19, and we believe it will be an invaluable tool for healthcare providers across the country.”

Jack Gibson

Head of Product, Telstra Health

Delivering on the Promise

From the beginning, my commitment to the NHS was to co-create solutions with them, not merely for them. The triumph of VaxApp, and its progression to HelixHub, serves as a solid indication of fulfilling that pledge.

By assigning the highest value to user-focused design, endorsing incremental development, and cultivating profound partnerships, we fashioned a solution that not only addressed the immediate needs of the NHS in a pivotal period, but also established the basis for a platform that continuously transforms and adjusts to the future of health care provision.

The 30% decrease in task duration and the broad acceptance of VaxApp are not mere performance indicators, but palpable evidence of the effect of putting users at the center of the design journey, and a tribute to the efficacy of cooperative alliances.

Skills Used

Design Leadership / Design & DesignOps Strategy / Design Direction / UX Research / UX Design / Design System Management / Prototyping / Usability Testing / Accessibility / Design Metrics / Cross-Functional Collaboration

Matlock, Derbyshire UK