Digital Maternity Records: Motivation, Acceptance, Requirements, Usability and Prototype Evaluation of an Interface for Physicians and Midwives

Abstract

Maternity records ("Mutterpass") are a central tool in Germany’s antenatal care. Its digitalisation offers advantages such as improved readability, data standardisation, analysability, digital assistance and the avoidance of media breaks. Despite the examined necessity and technical possibility, no system has been implemented yet. In this work, we address this gap by assessing physicians’ and midwives’ perception, motivation, acceptance and requirements of a digital maternity record and its user interface in particular. Nine medical professionals participated in semi-structured interviews. Based on the results, an interface prototype was subsequently developed. The prototype laid a particular focus on two different gravidogram implementations. Thirteen medical professionals participated in the interactive user interface study, which aimed to assess general acceptance, completion time, error rate and implemented assistance functions compared to the analogue counterpart. Results show that the implementation of the digital maternity logbook is of value and that its advantages are both accepted and demanded by medical professionals. Eight key requirements were identified. A tabular gravidogram prototype, inspired by the analogue maternity record, was favoured over a more novel list prototype. Users presented a clear learning curve of the digital system. Nevertheless, the digital average completion time is 30% higher than its analogue counterpart. The digital prototype lead to a lower average number of errors per entry (0.45±0.3 vs. 0.58±0.4). With respect to digital maternity records, this work underlines user acceptance, summarizes key user requirements and presents a first step on the path to a digital maternity record interface for medical professionals. On a broader scale, it delivers insights based on several metrics with respect to digitalisation in an area that is still highly dominated by long established paper-based tools.