Case study

IMG

Pin-sharp digital overhaul for vital NHS tool
  • Tech: React, Django
  • Time: 12 months
  • Team: 2 devs, 1 UX, 1 QA
  • Host: AWS
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The challenge

If you’re given an injection, in hospital, anywhere in the NHS, there’s a strong likelihood that the person injecting you will use the IMG – the Injectable Medicines Guide.

It’s how they know all the vital information about the drug they’re administering; from the best injection site, to how much to give you, medicine interactions, and more. And it’s used millions of times a week.

With guidelines changing regularly – and with vital patient safety at stake – the IMG has to be easy to use, exceptionally clear, and simple yet secure to update. But how best to do this digitally?

The existing website was starting to show its age. So, it was time for the IMG to have a radical digital overhaul. Although it had been built and long-maintained by an in-house team, the decision was made to put it out to tender, via the government’s Digital Outcomes and Specialists framework.

Three images taken during user research for the Medusa Injectable Medicines Guide project in Leeds. From left, an image of a cabinet with a poster saying 'Scan for access to Medusa' with a QR code for users to scan. Middle image shows a poster detailing some guidance on how to administer injectable medicines. The furthest right image shows a binder which contains different monographs that have been printed off as a hard copy, with a cover that says 'Intravenous Drug Monographs', with a QR code for quick access to the old Medusa Injectable Medicines Guide.

The project journey

Having won the tender, our first job was to get ourselves to hospital and watch the IMG in action.

The question of usability is one we take very seriously. Many of our projects deal with secure data for time-poor users, often in fairly stressful environments and as part of specialist roles.

We knew that although some IMG users would be administering the same drug multiple times a day, and know it inside out, the system has to be robust enough for much less comfortable environments.

The Injectable Medicines Guide open in two separate windows on a Dell laptop. On the left, the search and navigation interface to select route and patient group, and on the right, the monograph for Eculizumab
The Injectable Medicines Guide open on an iPad, showing the Hydrocortisone powder monograph, with the risk management section open, and an iPhone showing the Ketamine monograph with the Example calculations section open.

It could be used by a nurse who’s never worked on that ward before, by a nurse who might be less technically adept than other colleagues, or by a tired nurse, working as part of a crash team, under pressure at 5am.

And when you take into account that, if the NHS trust has subscribed to the IMG, every ward from A&E to urology, and from obstetrics and gynaecology to geriatric will need access to it, it has to be clear and easy enough to use in the most varied and tricky of situations.

So we took to St James’ Hospital in Leeds for deep user research, watching and talking to the nurses who were actually using it. It was an eye-opener, showing us first-hand the difficulties they face, from department to department. Challenges that will be replicated and multiplied in NHS trusts all over the country.

That process meant we were not only able to pinpoint numerous additional improvements, but also take our direct findings back to NHS leaders and prove the validity of our recommendations, as witnessed on the frontline.

Once we’d refined and agreed our approach, we spent around a year building the system. Then it was time to migrate the information from the old website to our new, more modern and usable format. And add thoughtful, user-friendly touches, such as printable posters with QR codes, for medics to attach to the medicine cupboard, providing easy mobile access to the IMG exactly when and where it’s needed.

The Injectable Medicines Guide administration interface used by trust admins and the Medusa team, open on a Dell laptop in two windows. On the left, an interface to manage all the monographs within the system, and on the right, a dashboard to surface useful statistics and information.
The Injectable Medicines Guide open on a Thinkpad, as it would appear to those looking up information, such as nurses. It shows the Omeprazole monograph.

The impact

User acceptance testing is running like clockwork, with nurses responding very positively to the new, clear interface and easier access.

The IMG team is delighted with the improved editing process, with robust audit trails built in, to make sure the system is super secure.

With rollout happening imminently, everyone involved is confident that the new IMG is set to save the NHS vast amounts of time, while making nurses’ lives that little bit easier.

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