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)

Usability, utility, user-centered design, data security, Section 508 Accessibility, interoperability: Issues related to Electronic Health Records (and student information systems?) Link to info and resources

Although this topic is not directly related to the focus of this blog, I think some of my readers would be interested in my recent TechPsych post about the topic of electronic health and education records:


Electronic Health Records, Electronic Special Education Records: What are the issues?  (Usability, utility, user-centered design, data security, interoperability, Section 508 accessibility....)


In the post, I've included direct links to in-depth resources that apply to health and education information systems, including information from the U.S. government regarding information systems and data ethics.

Kids and and Tangible Tabletop Interaction: The NIKVision Project

NIKVision is an interactive tangible tabletop designed for young children, but suitable for "kids" of all ages. Javier Marco Rubio shared his team's work on the NIKVision system on the TechSpark website, and I thought I'd share some of the videos on this post. What I like about NIKVision is that the team encouraged the participation of children as design partners, which is a very special approach.

The NIKVision team is part of the GIGA Group, at the Computing Department of the Zaragoza University (Spain). The team collaborates with the ChiCI Group in the University of Central Lancashire, Preston (UK)



NIKVision Tangible Tabletop Demo

NIKVision Tangible Tabletop Demo from Javier Marco on Vimeo.


"NIKVision is a Tangible tabletop in which toys control the games. NIKVision has been created by Javier MMarco, from GIG Group in University of Zaragoza, Spain." http://webdiis.unizar.es/~jmarco
Researchers for this project included Javier Marco, Eva Cerezo, and Sandra Baldassarri.

NIKVision Toys & Games

NIKVision Toys & Games from Javier Marco on Vimeo.

NIKVision, highlighted in the news in Spain (in Spanish)

For a smile: Gain Detergent Container Looks Like Don Norman's User Unfriendly Teapot

The designers who created the Gain detergent container below obviously didn't read "The Design of Everyday Things."

No matter which way you try to pour the darn thing, it still makes a BIG mess. The "spout" is really air vent, I've been told.  More info on The World Is My Interface blog.

The Internet of Surfaces? Microsoft's Pete Thompson discusses screens and surfaces of all sizes.

I came across this video of Microsoft Surface's general manager, Pete Thompson, on the GottaBeMobile website. According to Thompson, the people who worked with TouchWall discussed in the video, were also involved with Microsoft Surface.

Apparently, the Surface and Wall folks at Microsoft aren't sure of what they are doing with screens of all sizes.

(If you are interested in surface form factors, see my previous blog post, Emerging Interactive Technologies, Emerging Interactions, and Emerging Integrated Form Factors.)

There are many unanswered questions from my perspective.

Bill Gates portends that every surface will be a computer, a concept that is echoed in the video. If so, what are people doing to ensure that surface-supporting environments are universally designed?

Before Microsoft and other companies unleash "surface" technology to the masses, they must get a few things right.

Will they?

Will the researchers at Microsoft find out how various screens play out in classrooms, in the community settings, on-the job, and in-between?

For example, large interactive displays in urban and retail settings have the potential to provde people with a rich amount of information about what is around them. These displays serve little purpose if they are user-unfriendly, and no purpose at all if they are not accessible.

If developers and designers are not following basic user-centered design guidelines and usability standards now, how can we expect the nextgen systems of display surfaces to support universal usability? As our population ages, this will be more of a problem.

From what I can tell, there will be more opportunities for people to use their mobile devices to interact with larger screens and surfaces when they are out and about. For example, when I was at the airport recently, I noticed that there was a large display that offered cell-phone ringtone downloads. Microsoft was behind this display.

Interconnectivity and interoperability between devices and screens of all sizes is important to think about. If universal usability guidelines are not followed, our mobile devices will be difficult to use in the world of surfaces.

It isn't much of a leap to see the big picture. Just think about the problems we have with our remote controls and entertainment centers in our homes! We might have to carry all sorts of devices just to get from point A to point B. I'm not kidding. It will not be a pretty sight, especially if the privacy and security issues are not resolved as we move to a world that supports the internet of things.

Or shall I say, the internet of surfaces?

How NOT to create an interactive touch-screen map!

I came across this interactive map that was situated in a kiosk along a skyway at a large, highly respected hospital.

If you are interested in designing usable and useful interactive wayfinding applications, avoid much of what you see in this videoclip!



This isn't an example of good user-centered design.