Using AI to advance cervical cancer screening for all

OVERVIEW

UCLA Health partnered with Slalom Build to reimagine and rebuild their patient digital experience platform, retiring more than 250 legacy subsites and modernizing their tech stack in the process. Prognosis? A vibrant and healthy future.

SCOPE

Software Engineering, Modern Web Development, Experience Design, Quality Engineering, DevOps,
Agile Coaching

TECHNOLOGY

Cloudflare Workers, Drupal, PHP, JavaScript, Storybook, Bitbucket, Acquia

There’s no cure without access to care

Cervical cancer is the fourth most common cancer found in women globally. Medical science has fortunately developed reliable screening methods so that, diagnosed and treated early enough, many patients can be cured. So why are so many people still dying from it?

For many patients, human papillomavirus (HPV) vaccines and the requisite Pap or HPV test for cervical cancer screening are widely available and routine. For others, preventative care visits may be few and far between. So cervical cancer may not be identified until long after symptoms develop—when it’s often too late. And because of that basic inequity of care, hundreds of thousands of mothers, daughters, and loved ones die from a preventable disease.

In fact, of the estimated 342,000 deaths from cervical cancer in 2020, about 90 percent of cases occurred in developing countries. Can a cure really be called a cure when it’s only available to the more fortunate?

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Re-examining the partnership procedure


As with any procedure, a pre-op check-in was required. Determining patient needs and how they wanted to engage with the website was paramount. Fortunately, our Product Engineering Methodology (PEM), is designed to answer these important questions.

First, some subsites had the same look and structure as the main site, however they led patients off the domain or to dead-ends that lacked clear navigation and integration with the main site, generating a user experience that could be confusing and frustrating.

Second, there were redundancies among the subsites. We needed to examine subsite content to eliminate duplicate information and pages.

And third, some subsites were owned by doctors or organizations that were no longer active or whose sites lacked current information. We needed to eliminate the inactive sites, and for the others, identify new owners and train them on the new platform to ensure consistency and relevancy.

UCLA Health was intent on creating a more cohesive, navigable experience for their patients.

The diagnostic process

To understand what it would take to build the platform technically and architecturally, we started by building a minimum viable product (MVP), dividing workloads into engineering and content development, to further clarify ownership and responsibilities.

Working as a connected team, daily standups helped us define and prioritize the features and functionality patients wanted. These check-ins sped up time to delivery and were critical to the team’s success.

As we built the MVP, we also developed a phased approach to transition 250+ subsites that had been independently built and managed by various UCLA Health organizations and physicians throughout the health system. Our first step was scrubbing the top twenty-five prioritized subsites to prepare them for the transition. In doing so, three main concerns emerged.


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A clean bill of health


Once the main site moved from the legacy platform, UCLA Health was able to address the hundreds of subsites that needed to remain active on the legacy platform until they were able to go live on the new one.

By putting a content delivery network in front of the legacy platform, we were able to route all active subsite traffic intelligently between the legacy and new platform, without any interruption to patient services.

Through prioritization and collaboration on our carefully planned roadmap, the new uclahealth.org main web site — approximately twenty-five subsites — launched in July of 2021. Despite the challenges, the site was delivered smoothly, and today, regionally dispersed patients can easily access the most relevant and time-critical information they need in just a few clicks.

With patients at the heart of the rebuild, this work led to a 12% increase in self-scheduled appointments and a 482% increase in online appointment requests. Plus, the new site shows significant performance gains over the legacy platform, including a 26% increase in visitors, 30% improvement in Time to Interactive, 50% increase in online search results brand visibility, and 71% improvement in Time to First Byte.

The strong partnership between UCLA Health and Slalom Build continues to this day—we’re transitioning legacy subsites on a regular basis and invigorating the new site with more features and functionality, such as faceted search.

Because of our commitment to help clients transition successfully, Slalom Build engineering will continue to partner with the UCLA Health marketing team through 2022, until they are fully prepared to take ownership and maintain the health of their powerful and flexible, easy-to-use, patient-loving platform!

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With patients at the heart of the rebuild, this work led to a 12% increase in self-scheduled appointments and a 482% increase in online appointment requests. Plus, the new site shows significant performance gains over the legacy platform, including a 26% increase in visitors, 30% improvement in Time to Interactive, 50% increase in online search results brand visibility, and 71% improvement in Time to First Byte.

The strong partnership between UCLA Health and Slalom Build continues to this day—we’re transitioning legacy subsites on a regular basis and invigorating the new site with more features and functionality, such as faceted search.

Because of our commitment to help clients transition successfully, Slalom Build engineering will continue to partner with the UCLA Health marketing team through 2022, until they are fully prepared to take ownership and maintain the health of their powerful and flexible, easy-to-use, patient-loving platform!

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The beginning of digital cytology’s future

In initial tests, the algorithm achieved a level of accuracy that far exceeded expectations. The AI autonomously detected abnormal cells within whole slide pap test images with roughly 70 percent sensitive recall.

We proved that our AI algorithm can learn to replicate what human cytologists see—both accurately and at impressive speeds. And as the algorithm improves over time, the results can only get better.


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AI makes cervical cancer screening so much faster while not losing any accuracy,” affirms Ashley Jarosz, Hologic lab supervisor. “I'm absolutely inspired that this work could further improve patient outcomes.”

Potentially the first automated algorithm of its kind used for cancer screening, this technology is already being deployed in Europe with plans to continue expanding globally.

Michael Quick is excited about what this means for the future of patient care, “The technology that we've developed at Hologic with Genius Digital Diagnostics and Genius AI could propel the World Health Organization's goal of eradicating cervical cancer in our generation.”

And in the meantime, life-saving cancer prevention can become more readily available to people everywhere.

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