BLUF
I took over the Prenatal Visits project in its early phases when the workflow lacked clarity, consistency, and a feasible direction. I redesigned the core experience by restructuring the Card View, rebuilding the flowsheet, and introducing interaction patterns that matched clinical decision-making.
I strengthened trend visibility and created scalable components that aligned with engineering constraints and future product needs. Usability testing reflected strong performance with a 74 percent SUS score and measurable improvements in task efficiency. The redesign was completed and prepared for implementation as a stable and scalable clinical workflow.
Situation
The Historical Partogram was developed in response to needs expressed by patients and clinicians. Patients wanted a document they could revisit after delivery to understand how their pregnancy and labor unfolded. Many shared that labor can feel overwhelming, and important details are often forgotten afterward. A structured summary could help them revisit the events at their own pace. Some patients also wanted it as a formal record that they could refer to for personal or medical use later.
Clinicians had a parallel need. When patients returned for follow up visits or during later pregnancies, clinicians often had to navigate multiple screens to piece together the previous labor history. A consolidated document would save time, reduce the risk of missing information, and provide a more standardized reference for continuity of care.
The product team gathered these insights and created a detailed requirement set. The document needed to:
Present a clear timeline of labor events
Include screenshots from the actual live partogram
Maintain a clinically appropriate structure
Capture both graphical and textual data
Remain simple enough for patients to understand
Fit into existing backend and documentation frameworks
The timing created additional constraints. Engineering had limited availability during the release cycle, with about ~6 weeks of capacity to support this feature. They clarified that they could not add new data feeds, alter existing pipelines, or implement interactive components. The final output needed to be fully static.
Documentation standards created one more boundary. Cerner’s design rules define typography, spacing, terminology, and layout patterns for clinical documents. Any deviation would require additional approvals that would delay the release. This meant the document had to fit within strict visual and structural boundaries.
This combination of user needs, technical limits, design rules, and a compressed timeline defined the situation in which I began the project.
Task
My responsibility was to transform a dense and detailed set of requirements into a clean, readable, and technically feasible document that served both patients and clinicians. To deliver this, my tasks included:
Organizing the information into a logical and clinically accurate structure
Selecting a layout orientation that supported a clear timeline
Ensuring that the design remained simple enough for patients while still detailed enough for clinicians
Integrating screenshots in a way that preserved familiarity and trust
Reducing design complexity to align with engineering constraints
Ensuring compliance with Cerner’s documentation standards
Preparing a development ready layout that required minimal custom engineering effort
Creating a long term concept exploring more interactive possibilities
The design needed to be thorough but also realistic within the engineering limits. My goal was to meet the immediate needs without compromising clarity, while also envisioning what the experience could eventually become.
Action
I began by mapping the requirements into clear categories: labor progression, fetal monitoring, contraction activity, maternal observations, interventions, and outcomes. This breakdown helped define a natural document flow.
Choosing the Layout Orientation
I explored several early layout variations in both portrait and landscape. Landscape orientation emerged as the strongest option because it supported time based visuals more naturally. It provided enough horizontal space for graphs, timelines, and screenshot alignment without feeling compressed. After reviewing these options with the product team, we agreed to proceed with landscape.
Early Iteration and Simplification
I created multiple layout drafts and iterated based on feedback. These iterations focused on improving:
visual hierarchy
spacing between major sections
alignment of screenshots with corresponding data
readability for both technical and non technical users
Over the course of ~8 structured iterations, the design became increasingly clear and aligned with what engineering could support.
Exploring Interactivity and Removing It
During the early phase, I explored the idea of a semi interactive timeline that allowed users to navigate through labor events easily. However, engineering confirmed that this would exceed the available bandwidth by a large margin. Based on their assessment, interactive elements would require significantly more time and additional backend preparation.
With that constraint confirmed, I shifted the entire design toward a static, print ready document. This required reorganizing the timeline into clearly separated sections so that users could follow the flow without relying on interaction.
Integrating Screenshots
Screenshots from the live partogram were essential for preserving continuity. I refined their scale to keep them readable without overwhelming the layout. Placing screenshots next to their related data helped users connect the visuals with the numeric information instantly. This made the document feel more trustworthy and aligned with the system they were familiar with.
Clinical and Documentation Compliance
I validated terminology, color use, and sequencing with clinical subject matter experts to ensure the document maintained accuracy. I also aligned the entire document to Cerner’s documentation standards, ensuring that spacing, headings, and typography matched what clinicians expected from official outputs.
Future Concept
Alongside the immediate design, I developed a long term exploration that envisioned a guided, interactive timeline. This future concept outlined how zoomable graphs, collapsible sections, and dynamic summaries could be implemented when engineering capacity allowed. This helped the team see how the Historical Partogram could evolve over time.
Result
94%
on System Usability Scale (SUS)
5 of 6 participants
had no concerns about having these different layouts for the same patient
The Historical Partogram delivered strong outcomes across usability, clinical value, and technical feasibility.
User Testing
Usability testing produced positive results:
5 out of 6 participants experienced no issues navigating the document
65 percent appreciated how quickly they could scan the historical information
The only concerns raised were related to the clarity of one screenshot
I addressed the screenshot issue by updating the visual asset, ensuring that the final document had consistent clarity throughout.
Engineering Success
The final design fit comfortably within the engineering window of ~6 weeks.
By keeping the design simple and consistent, the engineering team could implement it using existing data without additional pipelines or interactive elements.
Clinical Impact
The structured timeline format improved clarity and gave clinicians a consistent reference for follow up care. The document reduced the time spent reconstructing labor history from scattered screens and improved the flow of discussions in postnatal visits.
Future Value
The long term exploration concept provided direction for how the Historical Partogram can evolve. Engineering and product teams noted that parts of the concept can be integrated when more development time is available.
The Partogram is an MPages view within PowerChart Maternity (PCM) that allows clinicians to identify early deviations from the normal progress of active labor, as well as maternal physiological deterioration, to facilitate timely decisions about direct intervention or referral of care.
Clinicians need the ability to go back and review a snapshot of what the Partogram looked like during a patient’s labor.
Clinicians may need to review this historical partogram within a couple days or weeks of delivery or it could be several years later they would like to review when the patient comes back pregnant again.
The historical partogram may also be used in legal cases to represent and tell the story of the patient’s labor and interventions, so it is key that the historical partogram looks as it did for the patient on the day they delivered.
Uses
A patient comes back for Post-Partum visit.
A patient is pregnant 2nd or 3rd time
A patient has some need for Legal, the document is required in such cases.
Partogram needs to be printed just after the partogram stop is reached so as a patient could take home what happened during their pregnancy and the delivery story.
Product Team proposed a snapshot of the Partogram be taken at a specific point in time (Partogram Stop) and saved off as a document type. This document type should show the graphical and flowsheet information as it displayed to the clinician when the patient was in labor, and should not be interactive. For any relevant clinical information that is displayed in a side panel through user interaction on the live partogram, this information should be available supplementary to the graphs or flowsheets as needed. This can display next to or below each relevant graph.
Workflow and Final Design
After discussion with the team, I had created three concepts on how the data could be displayed.
Workflow Design
Historical Partogram is accessed from a side panel in Pregnancy History component.
It opens up as a modal window and loads up as a document which could be printed from the button located in the modal header.