Medicare Newborn Enrolment — Alpha assessment

The objective of the service is to automatically enrol newborns into Medicare at the time of birth ensuring less paperwork for new parents.

Department / Agency
Department of Human Services
Date of Assessment
22 March 2016
Assessment type
Digital Transformation Agency-led
Assessment stage
Alpha
Result of Assessment
Pass
Lead Assessor
Anne Judd
Service Manager
Cathy Sear

Assessment report summary

The Medicare enrolment for newborns service team is seeking to progress from Alpha stage of the service design and delivery process to Beta.

The team explained that the objective of the service is to reduce paperwork for parents at a busy time in their lives with the arrival of a newborn. The service will also provide a faster way for parents to be able to seek services with Medicare reimbursement if needed, using a digital image of the Medicare card until receipt of their card, which takes an average of two to three weeks.

The team were able to demonstrate that meeting user needs was the primary focus of the service and that the team had done the work required to understand the user context when they encountered the Medicare enrolment service. This included a good cross section of in depth face to face interviews at the point of service, as well as in depth contextual interviews with parents prior to, and after the birth of their child. The team ensured a good cross section of users were considered, actively seeking out Aboriginal and Torres Strait Islander research participants, and low English migrant groups.

Some research was done with hospital staff at the Gold Coast University Hospital and with DHS staff, including workshops, and one-on-one interviews.

The team has demonstrated that there is a user need to be met and the process of enrolling a newborn could be made simpler and less complex, by removing the manual paper driven burden from parents.

The team has come together in a co-located environment and has worked cohesively to identify a service to be designed and delivered. The solution the team defined does not have a digital interface and as such no digital prototype, however the service has and will continue to need to be prototyped, tested and iterated using service design methodologies such as service blueprinting and model office (pilot) approaches.

Outcome of service assessment - Pass

After consideration, the assessing team have concluded the Medicare newborn enrolments, to be trialled with the Gold Coast University Hospital has met the three key Alpha assessment criteria and have passed this Alpha assessment.

We look forward to seeing the outcome of the beta with the Gold Coast University Hospital and, if appropriate, the plans for further roll out of the service and the relevant improvements to the service as a result.

Reasons

User needs research (Criteria 1)

The team understood that a generic approach to considering Medicare enrolment would be unlikely to result in a good user experience and chose to focus on the specific context of enrolment of a newborn.

There are around 300,000 newborns enrolled for Medicare annually through a manual, paper-based process, completed at various times after birth, depending on the parent’s knowledge of the process, or on a need arising, such as a parent having to seek medical attention for a newborn. The team focussed on further understanding the enrolment process and designing a service that minimised effort for new parents, allowing them to concentrate on their newborn, rather than paperwork.

The team demonstrated a solid understanding of user needs gained through a thorough user research process, including site visits at DHS service centres, intercepting both before and after enrolment, and conducted contextual face to face interviews with expectant and new parents. The team met with Aboriginal and Torres Strait Islander, low English and migrant parents and expectant parents. The team gained good insight into where government services feature throughout pregnancy and in the first few weeks of parenthood, and concluded that the Medicare enrolment often had no relevance to parents until such time as they needed to seek medical attention for their newborn.

Multidisciplinary teams (Criteria 2)

The team is co-located within DTO, is predominantly drawn from DHS resources, and brings together a good mix of subject matter expertise. There have been some roles adapted to fit the needs of the team. The team recognise that the absence of a digital interface does not remove the need for ongoing user research and the service design capability. This new service may introduce new user needs that will need to be met through new touch points and the longer term removal of existing touchpoints and support of those new needs may require further extension or change of the team makeup.

Service Design and Delivery process (Criteria 3)

The team has worked effectively using an agile approach, including forward sprint planning, daily stand-ups and showcases. To further support and embed the agile approach in the organisation, the team has attended formal agile training within the department. The vision for the service has been developed around findings from the completed user research with one enrolment cohort and the Gold Coast University Hospital staff. The proposed service design uses the existing systems that handle Medicare enrolment, using people to pass data between systems.

Data, tools and systems (Criteria 4)

As the service progresses further documentation and procedures will need to be captured on how data will be securely extracted and transferred from Gold Coast University Hospital to DHS systems to eliminate potential risks.

The proposed service design could lead to challenges when considering how to scale the service, and may raise questions around the sustainability of the operational processes required to support it. The current implementation will be iterated further when expansion of the service is considered past the Gold Coast University Hospital trial.

Personal data and mandatory obligations (Criteria 5)

These are well understood by the team.

Accessibility and Assisted Digital (Criteria 10)

The proposed service significantly reduces the paperwork for the parent by introducing a consent form to allow for the use of information already captured by the hospital’s current processes. Further work will need to be done in the Beta stage to understand how best to meet the needs of users with particular access needs.

Alternative digital channels (Criteria 12 and 13)

The proposed service removes a manual process from parents so adoption is likely to be high.

Areas of good performance against the Standard

User needs and service design

The team have done a good job of understanding the service from the context of the users and not attempting to create a generic solution for users that disregards all the other events occurring in their life at the same time they need to enrol in Medicare. They have continued to push themselves to design a service that best meets the needs of the users and the resultant service is so successful that it has entirely removed a form from the user experience.

Agile Team

The team adapted well to a very new way of working for government services and adjusted the team as required to ensure the right degree of expertise was available through various stages of the process, such as having a member of the team able to provide immediate legal advice on privacy and electronic communications.

Recommendations

User needs research (Criteria 1)

The team should aim to further understand the other users to the service and ensure their needs are not overlooked. A greater understanding of the needs of hospital staff, including midwives, administrators and ICT support staff, will further help inform the design of this service, and its potential iterations to a live service.

Multidisciplinary teams (Criteria 2)

The team should consider what changes may be required to further iterate the service past the Gold Coast University Hospital Beta. They will need to consider the particular user research and service design capabilities needed for a true service change (not just a digital service implementation).

Design (Criteria 3)

The service will benefit from further user research. There should be some consideration given to consent form design, and agreement of what, if anything may require change on the current paperwork completed by staff.

Data, tools and systems (Criteria 4)

The focus of the next stage should consider the differences in the technical implementation and operational processes at additional hospitals both public and private as well as the other cohorts (for example, home births and others born out of hospital). The team will also need to consider how to best manage the complexity of multiple different business systems. The team should also look to future opportunities to further automate the manual processes performed by DHS staff.

Personal data and mandatory obligations (Criteria 5)

These are well understood by the team.

Accessibility and Assisted Digital (Criteria 10)

The proposed service significantly reduces the paperwork for the parent by introducing a consent form to allow for the use of the information already captured by the hospital’s current processes. Further work will need to be done in the Beta stage to understand how best to meet the needs of users with particular access needs.

Alternative digital channels (Criteria 12 and 13)

The team will need to do additional service mapping to understand how users might be accessing phone and shopfront in combination with this service and make sure that experience is seamless.

Assessment against the Digital Service Standard

Assessment result for each criteria
CriteriaResult
1Pass
2Pass
3Pass
4On track
5On track
6Started
7Started
8Not assessed
9Not assessed
10On track
11On track
12Not assessed
13On track
14Started