Usability in the Era of HealthCare.Gov

It is hard not to be frustrated at all of the glitches that have surfaced during the recent deployment of the US government's HealthCare.gov website.   Since the website was planned to play an integral role in making "Obamacare" a reality for a large segment of U.S. citizens, I assumed that strict attention to details would have been followed, from the initial conceptualization of the site until it was "ready" for the world.  

I was wrong. 

Maybe there was a miscommunication between the folks at CGI Federal, the company contracted to work on the HealthCare.gov website, and the HealthCare.gov project team, I don't know...

My guess is that there weren't enough people knowledgable about usability and user-centered design on the planning teams from the start.  Whatever the case, it seems like someone forgot to check the US government's very own Usability.Gov "Improving the User Experience" website!   

Usability.Gov

The wealth of information on the Usability.Gov  website been available for years - online, in books, and taught in a number of IT-related courses.  Usability is not limited to ease-of-navigation principles for websites and software user interfaces - a common mis-perception. It is an important component of user-centered software engineering and design, and more.  

In the following video, featured in the User-Centered Design (UCD) section of the Usability.Gov website,  it is noted that "at least 50% of a programmers' time during a project is spent doing rework that is avoidable."   Citing a 2005 study by IEEE, the narrator explains that the three top reasons for tech projects to fail are poorly defined requirements, poor communications, and stakeholder politics.   

So true for the Healthcare.gov website!


Was the Healthcare.Gov website doomed to fail, given all of the confusion and controversy surrounding the Affordable HealthCare Act from the start? 

Perhaps.   

So how can things be prevented?

If this is a topic that interests you - even if you aren't a developer, take the time to soak in some of the information from the Usability.Gov website to learn more about user-centered design, usability, and ways to prevent costly mistakes.  

If you are a computer science, software engineering, or preparing for a career that intersects with technology development or implementation in some way, plan to take a course or two that covers topics such as Human-Computer Interaction (HCI),  Human Factors, and User-Centered Design (UCD). 

Consider joining professional organizations, interest groups, or meet-ups if you are already working in the tech world, but lacking in up-to-date knowledge and skills in this area. 

Places to start:

ACM SIGCHI  - Association for Computing Machinery, Special Interest Group on Computer-Human Interaction
Usability Professional's Association
IXDA - Interaction Design Association
HFES: Human Factors and Ergonomics Society
IEDO's Human-Centered Design Toolkit

RELATED
Why Obama's Healthcare.gov launch was doomed to fail
Adrianne Jeffried, The Verge, 10/8/13
How we're working to improve HealthCare.gov  (Health Insurance Blog)
HealthCare.gov contractors testify they warned of glitch risk before launch
Hari Sreenivasen, PBS Newshour Transcript
Health Care Site Rushing to Make Fixes by Sunday
Sharon LaFraniere, Eric Lipton and Ian Austen, NYT, 11/29/13
Software, Design Defects Cripple Health-Care Website
Christopher Weaver, Shira Ovide and Louise Radnofsky, WSJ, 10/6/13
Meet CGI Federal, the company behind the botched launch of HealthCare.gov
Lydia DePillis, 10/16/13
CGI Federal
Why Software Fails: We waste billions of dollars each year on entirely preventable mistakes
Robert N. Charette, IEEE Spectrum, 9/2/2005
The ROI of User Experience with Dr. Susan Weinschenk (Video 1/27/11)
Usability.Gov
Aquilent Proudly Supports Usability.gov "Re-Boot" to Further User Experience Best Practices"  Business Wire, 7/18/13Aquilent
Digital Government (Whitehouse.gov)

Part II: Websites and Apps for Teens and Education

If you plan to design/develop websites or applications that provide an element of "edutainment" or informal educational activities for teens, it might be good to think about how your site/application can fit into the requirements of an educational system. Much has changed over the past three years. 

For example, many schools have adopted a 1:1 laptop/netbook/tablet initiative. In some cases, the students no longer carry textbooks, because digital versions are installed on their devices. They access on-line digital content, such as videos and interactive learning games, and self-correcting quizzes provided by the textbook publisher. These activities are accessed by the students during and after school hours. 

Teachers do not limit their assignments to the resources provided by text-book publishers. In some classes at the high school level, students are required to work on group projects that extend over several weeks. Students use protected websites, i.e. Moodle, provided by the school district, to store digital content and collaborate on group projects. 

During the course of a group project, teachers provide students with links to approved websites. Some of these websites provide tools to assist in the creation of content related to their project. Students might work together to create an animation or video, or work individually on one component of the project to contribute to the final project. For example, one student might work on an animation to demonstrate a biological process, and another might be responsible for organizing a story board for a video that the group presents to the class.

After completion, the products generated from the students' work may be available for viewing by others on-line, and in some cases, featured on the school's website.

If you are interested in developing applications or content for use in education, it is important to know that most states have adopted the Common Core Standards. Educational applications must align with these content standards in order to support the learning and teaching goals for a particular subject. 

It is also important to have a grasp of learning and teaching theories, an understanding of child and adolescent development, and a working knowledge of applications and technologies that have been successfully used with this age group to support learning.  Consider working with a knowledgeable interdisciplinary team!

RELATED/SOMEWHAT RELATED

Nielson-Norman Group Research Reports

Children 3-12 on the Web

Teenagers (Ages 13-17) on the Web

College Students (Ages 18-24) on the Web

Pew Research Center Resources

Featured Research: Teens

Pew Research Center Trend Data (Teens)

In-store Mobile Commerce During the 2012 Holiday Shopping Season

Teens and Education Resources 

The following websites also provide resources for other age groups and related topics.

Edudemic

Edudemic Ed-Tech Tools 

Edutopia

Edutopia: 6-8 Grade Level Resources

Edutopia: 9-12 Grade Level Resources

Mind/Shift

Other Resources

National Center on Universal Design for Learning

National Education Technology Plan 2010
National Educational Technology Standards

Common Core Standards Initiative

For readers interested in learning more about educational technology and related "nuts and bolts", the following links will provide food for thought:

Virginia DOE Educational Technology Plan Executive Summary (pdf)

Tips for Apps and the Web: Designing for Teens, Part I

Jakob Nielsen, of the Nielsen Norman Group, recently wrote an interesting post about designing website for teens. He provides good information for anyone considering this age group.  The study includes tips for designing for smaller screens such as laptops with track pads, touch-screen tablets, and smart phones.

Teenage Usability:  Designing Teen-Targeted Websites

Jakob Nielsen, Alertbox, 2/4/13

The research shared in Nielsen's post is important. The results of research conducted 8 years ago are compared with current findings.  Nielsen discusses some of the myths about teens and technology. As Nielsen points out, teens might appear to be tech-savvy in some ways, but they possess brains that are in the midst of cognitive development,  just one factor to consider when designing web experiences for this age group.

Nielsen Norman Group's related product, "Teenagers (Ages 13-17) on the Web" provides additional information on this topic. It includes 110 design guidelines informed by research conducted with teens.  Busy web developers might find the fee of $149.00 for this report appropriate.   

The information in this report would also be useful to design/development teams who aim to provide web-based educational content for this age group.

Pew Internet & American Life

Another good resource for designers/developers targeting applications or websites for teens is the Pew Research Center website.  The Pew Internet & American Life Project continues to investigate a wide range of topics related to the use of technology among people of all walks of life.  What I like about the Pew Research Center is that their reports are free, and include summaries as well as samples of interview questions.

Researchers from the Pew Internet and American Life Project share their knowledge in a variety of forms.  Data is available for download in SPSS and comma-delimited format, crosstab files and questionnaires.

The website also provides access to number of presentations, such as the one below:

Teens 2012: Truth, Trends, and Myths About Teen Online Behavior from Pew Research Center's Internet & American Life Project

RELATED/SOMEWHAT RELATED

Nielson-Norman Group Research Reports

Children 3-12 on the Web

Teenagers (Ages 13-17) on the Web

College Students (Ages 18-24) on the Web

Pew Research Center Resources
Featured Research: Teens
Pew Research Center Trend Data (Teens)
In-store Mobile Commerce During the 2012 Holiday Shopping Season

Teens and Education Resources 
The following websites also provide resources for other age groups and related topics.
Edudemic
Edudemic Ed-Tech Tools 
Edutopia
Edutopia: 6-8 Grade Level Resources
Edutopia: 9-12 Grade Level Resources
Mind/Shift

Part II will focus on teens and considerations for educational technology.

Designing for Touch & Gesture: Tips for Apps and the Web (Updated)

In the past, our fingers did the walking, sifting through files, papers, pamphlets, and phonebooks, and then by point-click-clicking with a mouse to interact with images and text, in essence, electronic imitations of the paper-based world. Traditional forms, brochures, ad inserts, and posters informed much of the design. 

How much have things change?   It is 2013, but you'd think it was 1997 from the PowerPoint look and feel of many apps and web sites!   Touch is everywhere, but from what I can tell, not enough designers and developers have stepped up to the plate to think more deeply about ways their applications can support human endeavors though touch and gesture interactions.  

For an overview of this topic, take a look at my 2011 post, written after a number of ugly encounters with user-unfriendly applications:  Why bother switching from GUI to NUI?  

For an in-depth look into the history of multi-touch, the wisdom of Bill Buxton is well-worth absorbing.  He's worked with all sorts of interfaces, and has been curating the history of multi-touch and gesture systems since 2007:


Multi-Touch Systems that I have Known and Loved
Bill Buxton, Microsoft Research, Updated 8/30/12



Even if you are not a designer or developer, I encourage you to explore some of the links below:

Touch Gestures for Application Design
Luke Wroblewski, 10/9/12

Common Misconceptions About Touch
Steven Hoober, 3/18/13

Designing With Tablets in Mind:  Six Tips to Remember
Connor Turnbull, Webdesign tuts+, 9/27/11

Finger-Friendly Design: IDeal Mobile Touchscreen Target Sizes
Anthony T, Smashing Magazine, 2/21/12

Best Practices: Designing Touch Tablet Experiences for Preschoolers (pdf)
Sesame Street Workshop


Are Touch Screens Accessible?
AcessIT, National center on Accessible Information Technology in Education

iOS Human Interface Guidelines
Apple

Android User Interface Guidelines
Using Touch Gestures
Handling Multi-Touch Gestures
Android

Designing for Tablets?  We're Here to Help!
Roman Nurik, Android Developers Blog 11/26/12

Touch interaction design (Windows Store apps)
Microsoft - MSDN

Multi-Touch Systems that I have Known and Loved
Bill Buxton, Microsoft Research, Updated 8/30/12

First-Person User Interface; Mobile to the Future; Mobile Experience Design Strategy: Presentations by Luke Wroblewski

Luke Wroblewski is a digital product/interaction/interface designer who has written about mobile computing and web design. His presentations provide a good summary of how smartphones are functioning in today's world, how they might be used in the very near future, and what designers/developers need to consider.

"The tools are in our hands to really design experiences in a different way."

Presentation: First Person User Interfaces (pdf)
"The design challenges and opportunities of interfaces that allow people to interact with the real world as they are currently experiencing "

Luke Wroblewski | Mobile to the future from IxDA Oslo on Vimeo.
Presentation: Mobile to the Future (pdf)

Mobile Experience Design Strategy with Luke Wroblewski 
(Presented at Cascade SF Meetup)

(At about 45:30, Luke discusses the problem of "checkout" on a mobile phone, giving an example from Dell.)

Usability of Windows 8: Food for thought from Jakob Nielsen's Alertbox

I haven't had the chance to play around with a tablet or PC running Windows 8, but from the screenshots and thoughtful comments posted on Jakob Nielson's Alertbox ,  I might be in store for some user confusion.  

Windows 8 -- Disappointing Usability for both Novice and Power Users 

"Hidden features, reduced discoverability, cognitive overhead fro dual environments, and reduced power from a single-window UI and low information density. Too bad." -Jakob Nielsen

I wonder how this will play out in the future, especially for people who often rely on two large monitors with several windows up at the same time to complete tasks efficiently, alone, or with a colleague.

RELATED
Take the time to read the following article, and if you have the time, skim through the over 200 comments:
Why Jakob Nielsen's Windows 8 critique is old-school thinking.
Jay Green, c|net, 11/21/12

Your Palm as Remote Controller (Video and Links)

Traditional remote controls for televisions and home media centers are particularly frustrating to use, in my opinion.  There are too many buttons, the buttons are too small, and it is easy to mess it all up.  (I've touched on this topic in a number of blog posts, such as UX of ITV: The User Experience and Interactive TV (or Let's Stamp Out Bad Remote Controls) and others, linked at the end of this post.)


There is hope for the future!  I'm happy to share a video about a method of remote control that might make interacting with my TV less annoying...and possibly pleasant! 


Researchers at the Technical University of Darmstadt have been working on a way for people to control their TV without a remote or hand-held device.  I think they are on the right path. The video shows how UI elements, mapped to the hand, can be touched, with accuracy, to interact eyes-free with a large-screen TV.  This work won the Best Paper award at EuroITV'12.


For more details, see Leveraging the Hand Surface as and Eyes-free TV Remote Control and the references below:
Niloofar Dezfuli, Mohammadreza Khalilbeigi, Jochen Huber, Florian Müller, and Max Mühlhäuser. 2012. PalmRC: Imaginary Palm-based Remote Control for Eyes-free Television Interaction. In Proceedings of the 10th International Conference on Interactive Television (EuroITV '12). ACM, New York, NY, USA, to appear. 


Niloofar Dezfuli, Mohammadreza Khalilbeigi, Jochen Huber, Florian Müller, and Max Mühlhäuser. 2012. Leveraging the palm surface as an eyes-free tv remote control. In Proceedings of the 2012 ACM annual conference extended abstracts on Human Factors in Computing Systems Extended Abstracts (CHI EA '12). ACM, New York, NY, USA, 2483-2488. http://doi.acm.org/10.1145/2223656.2223823

SOMEWHAT RELATED
Oh! No! Sony's "Mother of Remote Controls" for Google TV
Interactive Multimedia Across Platforms and Screens: Adobe's Open Screen Project; MEX Mobile User Experience Manifesto... (Please don't annoy the user!)
Usability of a Remote Control
Quick Link:  The Remote - Death by Voice Control?

Quick Link: The Remote- Death by Voice Control?

Voice Control, the End of the TV Remote? Samsung, LG, and others are racing to bring voice control to the TV Set 
Peter Burrows and Cliff Edwards, Bloomberg Businessweek, 12/7/11


"Most consumers’ first opportunity to talk to their TVs—and have them listen—will be through voice-enabled apps for their smartphone or tablet."

I look forward to seeing if/how Apple TV uses Siri as a remote control!

Picture from Amazon.com

RELATED

Remote Control Anarchy

Jakob Nielsen, Alertbox, 6/7/04  

(A great read, still holds true in 2011!)

Oh! No! Sony's "Mother of Remote Controls" for Google TV

Lynn Marentette, Interactive Multimedia Technology, 10/12/10

Sony, Sony, what have you done?

Harry Brignull, 90 percent of everything, 10/6/10

Bad hospital TV remote control:

Instructions for my last remote control:

Usability of Touchable-Moveable Multimedia Content. Part I (carousels and more)

I've been revisiting the topic of interaction design/usability for "touchable/moveable" multimedia content for the past couple of weeks.    I recently got an iPad2, so I'm in the "app" exploration phase -  a new world, since I never had an iPhone, iPod touch, or iPad "1".  


I plan to share  experiences, thoughts, opinions, and suggestions related to this topic during the upcoming months.   I welcome input from IMT readers!


Getting back to my iPad2....In addition to using the device to run apps, like most people, I also use it to visit websites.  Many sites now appear to be optimized for mobile devices, which is great for my Android-based smartphone, but for my iPad, not so much.   I thought by now we'd have more touchy-feely content to play with.


I've noticed that  basic features that work OK with touch interaction, such as the carousel, 
seem to miss the target, as discussed in the following article:



5 Big Usability Designers Make on Carousels
Anthony, UX Movement, 8/2/11


Although the above article was written from a "click" rather than "touch" perspective, many of the comments Anthony brings up ring true for websites and apps that are accessed through tablets and other touch enable screens.



I'm disappointed.  Here are a few of my grumbles:

• Many designers/developers have been slow to look at the increasing number of people who are accessing websites and applications via touch-enabled screens - of any size.   
• Many designers/developers have been slow to catch on that a website or app might be viewed/used by more than one person at a time.  Websites for house-hunting, home furnishings, vacation/travel, and education are a few examples that come to mind.
• Too many "multimedia" apps/websites are flat. Many still have a power-pointy feel.
• Websites optimized for mobile devices often leave important features out.
• Designers/developers sometimes don't seem to think about the various scenarios in which their applications/websites might be used - while balancing a baby on one hip, preparing a meal,  working out,  walking the dog, trotting around the mall with a friends/kids/spouse,  eating, waiting at a stop light, etc.

Too many iPad apps are flat and power-pointy. Too many apps don't take full advantage multi-touch features.  Very few apps allow for efficient interaction between two people on the screen.  




SOMEWHAT RELATED
Carousel Design Patterns   I will add more related links in the future - not limited to carousels : )
Carousel Interaction #21 (Mike Highfield's Rapid eLearning Blog
Carousel (Interaction Patterns Wiki)
Carousel (Welie)
Mobile Implementation of a Web 3D Carousel with Touch Input
Bjorkskog, C., Jacucci, G., Lorentin, B., Gamberinit, L.



Photo Credit:  Ohad

Quicklinks: Cute video about need for Google+, Spielburg on 3D, Tactile Pixels, Touch Screen Steering Wheel, and More

Here are a few interesting links  and a couple of videos.  Enjoy exploring!


Comic-Con 2011: Steven Spielberg Gives His Thoughts on 3D
Jason Barr, Collider, 7/22/11

Tactile Pixels Will Make It Easy To Read Braille on Touchscreens

Kwame Opam, Gizmodo, 7/9/11

Gestural Input on a Touch Screen Steering Wheel in the Media

Albrecht Schmidt, User Interface Engineering Blog, 7/17/11

Potential to improve some user experiences, using HTML 5
HCI 596 Course Blog, Iowa State University, 7/11/11


PBS Launches LearningMedia, a New Digital Repository for Educational Content
Audrey Watters, Hack Education, 6/27/11


Link to Microsoft Surface 2.0 SDK and Resources
Luis Cabrera, Surface Blog, 7/12/11


AI (Artificial Intelligence) Demonstrates Natural Learning, Applies New Skills To Civilization
Devin Coldewey, Tech Crunch, 7/13/11


21 Google+ Privacy Tips: the Ultimate Guide
Craid Kanalley, Huffington Post, 7/21/11


iPad K-12 Sales Outpace Mac Products
Ian Quillen, Education Week, 7/20/11


Wearable lab coat TV packs thousands of LEDs, heads for Burning Man
Zach Honig, Engaget, 7/13/11

(I'd like a job where I can do tech experiments, silly ones, too!)

Best Practices For Designing Websites for Kids - Quick Link

Best Practices For Designing Websites for Kids
David Morrison, Smashing Magazine, 7/6/11


Here is a short quote from the article:


"According to Jacob Nielsen’s research on teenagers, interactive website features (such as forums, mini-games, polls, ranking systems, competitions and 3-D interfaces) are valued by kids if they build a sense of community and foster participation. Bolting such features on will not likely prove effective, because kids will soon see the gaps and re-evaluate the website, despite any initial interest."

Quick link: "14 burdens placed on the user" by Jeff Sauro, Measuring Usability Blog

It is 2011 and usability issues continue to plague us.


I am sure most of encounter many of the usability annoyances outlined in the following article several times a week, if not several times a day!


14 burdens placed on the user
Jeff Sauro, Measuring Usability, 7/5/11


via Smashing Magazine

A few interesting tech links from Experienta/Putting People First and HCI 596 Blog

No time for reflective blogging today, so here are a few interesting links!


The future of the TV Experience 
(Article discusses Blink, a media industry magazine)


Designing Pleasurable Products and Interfaces Conference (DPPI 11)

Cambridge Consultants: Patients Want More User-Friendly Medical Devices
Levent Ozler, Dexinger, 6/3/11

Internet of things blurs the lines of bits and atoms
Katia Moskvitch, BBC News, 6/2/11


NESTA: Hot Topics: Digital You-Discussion about Telepresence

Hot Topics - Digital You from NESTA UK on Vimeo.


NESTA is the UK's National Endowment for Science, Technology, and the Arts


RELATED
The following links provide a wealth of resources related to emerging technologies and human-computer interaction:
Experientia - Putting People First blog
HCI  596 blog 
"This blog is for the HCI 596 course being taught at Iowa State University through it's Human-Computer Interaction program."
NESTA 

Keeping up with Facebook complexity

Need I say more?

Why bother switching from GUI to NUI? - Asked and Answered by Josh Blake; My 2-cents; Stevie B’s Microsoft Research Video; Marco Silva’s NUI-HCI Presentation (and links)

In Chapter 1 of Natural User Interfaces in .NET,  Josh Blake asks and answers a question posed by many people who have been under the spell of keyboard input and GUI/ WIMP interaction: 


Why bother switching from GUI to NUI?  The answer?  Read Chapter 1 (pdf) of the book - the chapter is free.


Here are a few of my personal reasons:  
1.  I want to buy the next version of the iPad or something like it.
2.  I want to buy a new large-screen Internet HD TV.

3.  I want to buy a Kinect.

4.  I do NOT want to interact with my new TV with a Sony remote.  Too many tiny buttons!

5. I do NOT want to interact with my new TV with a keyboard,  because it reminds me of...work.

6.  Most importantly: 

I want to design apps for the people I care about, and others with similar needs:

    My mom.  

    My grandson.

Moms and dads with kids in tow.
People with special needs and/or health concerns, and the people who care and guide them.
Knowledge sharers and (life-long) learners....

RELATED

"Smart" Interactive Display Research

How Natural User Interfaces are changing Human Computer Interaction

 

View more presentations from Marco Silva

My YouTube Playlist:

Post-WIMP Explorers' Club Videos

"Natural user interfaces, gesture interaction, multi-touch, natural interaction, post WIMP examples and more... "

Interactive Multimedia Technology Post:
Interactive Touch-Screen Technology, Participatory Design, and "Getting It": Revisited

RELATED - and somewhat related   

Moms with Apps

Design for Care

SparkOn

NUI Group

UX Matters      "Why don't usability problems get fixed"

Encyclopedia:  Human Computer Interaction, Interaction Design, User Experience, Information Architecture, Usability and More (Interaction-Design.org)

Josh Blake's Blog: Deconstructing the NUI    Book: Chapter 1 (pdf)  Free!
Blake.NUI

"Blake.NUI is a collection of helpful controls, utilities, and samples useful for multi-touch and NUI development with WPF, Surface, and Silverlight."

OpenKinect Wiki

OpenKinect Community Founder Joshua Blake Comes Up With His Own Version of Win 7 Multitouch on Kinect   (Madhav K, KinectHacks 1/14/11)

Kinect SDK Could Open New Worlds for Motion-Controlled Interfaces (Mike Martin, TechNews World, 2/22/11)

Seth Sandler

Seth Sandler's Blog

Seth Sandler's  Ultimate List of Interactive Tables

Dan Saffer

Bill Buxton

Johnny Chung Lee's Procrastineering Blog
Adam Greenfield's Speedbird Blog

 (This is not an inclusive list.)


GUI to NUI Post-WIMP Manifesto:  TBA