User Research

My Favorite Three Product Experiences in 2016

Let's face it, 2016 has not been the easiest year. I'm writing this day after we lost Princess Leia, and everyone seems ready for the ball to drop in Times Square in a couple days. At least my beloved Cubs ended their long championship drought.

To balance out the negativity, I felt like sharing some positive during the year in the form of some amazing products. These are examples of products that stood out to me as a User Experience specialist. And no, I was not involved with these products in any way (although I wish I was).  

Hala Stand Up Paddle Boards:

Over the summer, I was invited out to do a little Stand Up Paddleboarding (SUP) and quickly realized how much I missed being on the water with a paddle in my hand. I decided I was going to invest in an SUP and get myself on the water as much as possible. I knew I wanted an inflatable board for storage purposes, but I didn't know much else. The local retailer showed me the Hala SUPs, and I immediately fell in love. 

What immediately struck me was the backpack that comes with the board. Most of the other boards come in duffle bags that look like they are difficult to carry around. The Hala SUPs come with a backpack that also has wheels. This allows the paddler to carry it just about anywhere at 20 some pounds, or to drag it through the airport for the epic trip they are about to embark on. The idea of taking the board up to a lake 2 or 3 miles from civilization just triggered my outdoorsy sense of adventure. And what a bonus if I wanted to bring it along on a trip that was a bit too far to drive. 

I can tell you that this SUP got the job done when I went a few miles up a dirt road to a lake in the middle of the San Juan mountains. In just minutes, I was on the water enjoying the solitude. And when it looked like the weather was going to turn, I was packed up within minutes and driving away.

Every time I was on the board this summer, I felt like someone was reading my mind when they designed the board and the backpack. It is easy to tell the product is targeted for that adventurous, loves to travel paddler. The designers at Hala did their homework in understanding their users, and developed a product that I know I will enjoy for many summers. 

Progressive's Mobile App:

One of the low points of 2016 for me was getting rear ended in a car accident in stop and go traffic. Luckily there were no injuries, but it is still a scary experience to be in that situation. As we waited for the patrolman, I started thinking about insurance, getting my car fixed, and what a pain the whole thing was going to be. 

I opened up my Progressive phone application so I could exchange my insurance information with the other driver, when I noticed there was a menu selection to start a claim. Interesting...I could get my accident claim started right there on the side of the road. All I had to do was answer a few easy questions about the accident. Then it allowed me to take pictures of the damage as part of the claim report. I clicked the pics with my phone, and within 5 minutes of opening up the app my claim was submitted. 

Did Progressive have all the information they needed for the claim? No. But they called me the next day to gather what they needed from me. What impressed me was that they kept the questions simple, and it kicked off the whole process with very little thinking on my part. Wondering if my back was okay and if the passengers in the other car were fine was a much larger priority for me than filling out a detailed set of questions about the crash on my phone. 

The application asked for just what was needed in a stressful situation. It did not add any stress to my situation. The fact I was so impressed with the design in that moment should say a lot to group that built and designed just enough and not anything more. 

Barracuda Luggage:

A friend of mine showed me their new Barracuda luggage while in Chicago recently. I was immediately blown away, and was lucky enough that someone checked it off my Christmas wish list. 

This luggage is a travelers dream. Are you tired of searching for a place to plug in your phone at the airport? It comes with a battery pack in the suitcase. Having trouble finding a place to store your luggage? It is collapsable and comes with a bag that you can hang up in your closet. Airline lose your luggage? GPS tracker! And I haven't mentioned the nice, ergonomic handle that makes it a little easier to navigate those tight crowds. 

I can tell someone who has had a lot of headaches while traveling really thought through these problems. It is another example of a product where I feel like someone was in my head and knew exactly what I needed before I realized it. Suddenly, I'm looking forward to traveling more...even if that means more TSA in my life. 

Bottom Line:

The common thing that brought my attention to these three products was how much they grabbed my attention with a great User Experience. It is easy to notice a bad design and complain about a bad product. It is also easy to overlook a good user experience, because it is almost invisible and just fits what someone needs. To feel like someone interviewed me as part of the user research process for their product is a testament to the hard work that had to go into it. 

I'm all about doing my homework when it comes to User Research within UX. I feel like a lot of places are forgetting this or shortcutting this process. So a tip of my hat to these three products that made my 2016 a little better. 

My Favorite UX Tool

I have enjoyed watching the maturity of the UX field over the years. When I went from curious observer to Usability Engineer, the only tools I had were PowerPoint for design and a Usability Study template to test those designs. Over ten years later there are a wealth of applications and research techniques available in the UX Designer’s toolbox. As exciting as it is to see this growth, it can be be overwhelming as well. Like a plumber or carpenter, it takes years of practice to know what to grab out of the toolbox for the task at hand. Through my years of experience I have found my favorite to pull out of the UX toolbox are Personas. 

It may seem interesting to some that I would pick a deliverable which causes debate on how much value it truly adds. I believe when created well and utilized appropriately, Personas are a key factor to building a successful User Centered Design process. In a way, it is logical: Personas are representations of actual users. And User Centered Design is…well, design that is centered around the users and their needs. 

I have had a lot of success using Personas as a way to train my teammates on our users. When I present a new one to my teammates, I make sure I explain who provided the inspiration behind them. Their goals, their frustrations, and why they are using our product are all highlighted. A well presented Persona can save everyone a lot of tedious usability study recordings, and yet still get a feel for what makes the users tick. 

Not only are Personas great for raising user awareness on the development team, but I have seen them used successfully in other departments. Service and Support managers utilize Personas I have written as part of their new employee training. One of the coolest and most bizarre moments of my career was watching a Product Manager put on a wig and act like one of our Personas as part of a Sales Training course (he nailed it). Admittedly, watching one of our salesmen sweat during this exercise while painfully losing "the deal" with one of our more sassy Personas was kind of fun. 

I am not going to spend a lot of time on the basics of writing Personas. There are plenty of templates out there that serve as a good starting point (just Google Persona templates). I will provide 4 tips on how to make your Personas great:

Make sure your Personas are based on people you have met:

This may seem obvious, but it can be obvious when a Persona is based on assumptions and second hand information. Using only secondary research and assumptions will lead to a generalized Persona that is hard to relate too. A big part of the reason to use Personas is to help the team identify and empathize with the users. There is no need to make the difficult climb to a User Centered Design environment that much harder. It is also difficult to identify and prioritize user needs around a Persona that is too general. Generalized Personas are usually a sign of a lack of focus on priorities. 

Get out there and talk to the people living and breathing your product on a day to day basis. I actually believe you can create a great Persona just talking to 1 or 2 people. Some will say you need to talk to 5-7 people, but I would suggest creating a second Persona so you can capture some of the differences in personalities of your user base. Face to face interviews are ideal, because it is easier to pick up on the personality quirks that make each and every one of us unique…and thus making your Personas unique. 

Capture the Emotions:

To quote Amy Cueva, “Emotions matter”. None of us are robots, and neither are any of your users. (Although, it might be cool if we re-check this statement in about 10-20 years.) Sticking to the facts about a job does not really capture the reality of the situation. People get frustrated when things do not work well, and get a great feeling of satisfaction when they accomplish a difficult task. Avoiding the negative emotions and finding ways to trigger the positive emotions are part of the goal of good Experience Design. 

Capture these emotions as part of the Persona write up. Tie them to their work goals. Write a narrative about their daily life. What makes this person get out of bed in the morning? What are their aspirations? How can the experience you are designing make their day better? A great story captures the attention of your audience and helps get better buy in for a design. The most powerful healthcare presentations I have attended usually involve a story of how a medical error damaged someone’s life. 

Now you have some Experience Goals to focus on along with your prioritized user needs.

Do not let your Personas get stale:

People change and so should Personas. As a product matures and changes, so will the use of the product. A mistake I have made is putting up Persona posters in my office, and then leaving them there. If it appears that I forgot that I put them there, why should I have expected my teammates to remember them as well?

Ideally, Personas are called out in requirements and user stories so they cannot be forgotten. Regular check-ins with teammates to make sure they understand which users and their needs they are addressing helps as well. I recently started writing, “what am I thinking today” thoughts for my Personas as a way to share recent feedback from User Research Interviews. If you have a Persona named Beth, then start a “WWBD” campaign to raise awareness. 

Personas are not a Primary Research replacement:

The interviews have been conducted, the Personas are written, and the development team is buying into them. No need to keep up the User Research, right? Wrong! User Research never stops, and nothing can replace the power of interacting directly with your users. The market is always changing, meaning the goals of your users are probably evolving as well. Getting complacent can cause a big miss in learning about new user needs and requirements. Get out of the office!

In Conclusion:

Following these steps can help create a very powerful tool to pull out of the UX toolbox. My favorite aspect of Personas: they are a great empathy builder. Telling a good story, capturing emotions, and even role playing have made this a very fun way to help my teammates realize there are real people out there relying on us. And ultimately for UX, it is about the people we’re designing for.

AMA Makes Usability Recommendations

It is no secret that the usability of many healthcare IT systems are subpar and causing a lot of users headaches and anxiety. This is especially true with EMR systems. For years, I have heard complaints first hand from nurses and pharmacists about how much extra work it takes to navigate these systems. It seems an even larger voice is speaking up about it: doctors. 

The American Medical Association (AMA) caught my attention recently when they released a framework for their top 8 usability priorities for EHR usability. This is coming not long after a RAND report showed increased physician dissatisfaction with EHRs, and a lot of talk about health organizations wanting to switch vendors

The 8 recommended ares of improvement listed are (view the full report here): 

  • Enhance physician's ability to provide high-quality patient care
  • Support team-based care
  •  Promote care coordination
  • Offer product modularity and configurability
  • Reduce cognitive workload
  • Promote data liquidity
  • Facilitate digital and mobile patient education
  • Expedite user input into product design and post-implementation feedback

Two things caught my attention when I read the report. The first was a strong call for better User Research from the vendors. In order to reduce cognitive workload and enhancethe ability to provide high-quality care, there needs to be a real understanding of the clinical workflows that need to be supported. The AMA specifically calls out bringing user input in the product design lifecycle - that is a recommendation for User Centered Design. UX Researchers everywhere rejoice! 

The other item that caught my attention was the item on product modularity and configurability. In other words, we need better interoperability between systems. This is a hot topic of discussion in the Health IT world right now. The reality is, not one piece of technology can do it all well. AMA President-elect Steven J. Stack, M.D states this nicely: 

 “Now is the time to recognize that requiring electronic health records to be all things to all people - regulators, payers, auditors and lawyers - diminishes the ability of the technology to perform the most critical function - helping physicians care for their patients,”

For a while it seemed usability was just checking a box or a competitive differentiator in healthcare. But there has been a push to improve health IT usability coming from the ONC and NIST standards. The AMA has a lot of influence, and now they have evidence to show this needs to be addressed. In my opinion, the AMA report is a signal that we have reached the point where good health IT usability is an expectation.

I’m glad to see this tipping point has been reached. What concerns me is how the industry is going to overcome years of technical debt to really provide usable, streamlined clinical solutions to all caregivers. It appears to be time for third party Health IT vendors to shine.

The Best Career Advice I Recieved

I was recently asked by a friend what was the best advice I have received in my healthcare career. My first thought was “wow, that’s a tough question!” As I was racking my brain, I could have come up with something cliche like “be passionate about what you do” or “be comfortable saying you don’t have the answer”. As I was cycling through my brain, I suddenly flashed back to an early point in my career:

“If you don’t spend time in their environment, how will you know how users really use your product?”

To give some context, I was very new to the world of User Interface design and was the lead Usability Engineer for a critical care ventilator. I was working with designs coming from the anesthesia device product line to promote consistency between the products and to ease the cost of development. The Product Manager shared his Respiratory Therapy experience by sharing the common ventilator settings that needed to be programed. Here is what the RTs do, here is what the other development team is doing, figure out where it goes on the display - no problem! 

But there was a problem: I had never set foot in an ICU. I heard a lot of stories, seen a few pictures, but I was designing off a lot of assumptions and from my knowledge of observing a few surgeries in the OR. Enter Terri, a former ICU nurse and great colleague and friend of mine that felt the need to not so gently guide me on the right path. I honestly can’t remember if those were her exact words, but the message rang clear. I was never going to make the best design decisions if I didn’t get a chance to observe the messy, real world environment of the ICU. It was an easier said than done solution, since most hospitals prefer that some random guy does not just walk into an ICU.  

My opportunity finally came through the unfortunate admission of my grandmother into the ICU. 50 plus years of smoking, high cholesterol, and COPD will usually require the need to be placed on a ventilator. It was an emotionally difficult time, filled with potential end of life care discussions. Since she was expectedly anxious, I decided to help the family out by spending a couple nights in the room with my grandmother. 

It ended up being a learning experience as I was immersed into the day to day life in the critical care environment. I was able to observe clinician interactions with my grandmother and the equipment in her room. Some things I noticed included:

  • Her ventilator was tucked into a corner, behind a lot of other equipment. I think I saw it touched once in 2 days. 
  • The nurses usually came in the room, checked my grandmother, checked her vitals, and looked at the IV pumps before leaving the room. They usually didn’t glance at the ventilator.  
  • If my grandmother coughed and trigged the high pressure alarm, no one came running in a panic…in fact usually no one came in. Alert fatigue is a real thing. 
  • A Respiratory Therapist would come in every few hours for a nebulizer treatment. They would check the ventilator, but hardly needed to adjust anything. 

Before this, I was designing under the assumption that the ventilator was under constant supervision, like an anesthesia machine. This was hardly the case. The ventilator was a life support tool that rarely needed to be adjusted compared to the IV pumps, catheters, and other equipment keeping my grandmother alive. You set it up, might make an occasional adjustment, and you just expected it to work. 

After that experience, I remember coming back to work and saying “I get it now, I really get it” to Terri. I understood the environment and each clinicians interactions within that environment. I saw how busy and overwhelmed the clinical staff was. I finally realized that what I was designing was a piece of a much bigger clinical puzzle to care for a patient. 

In the product development world, it is easy to have such a strong focus on the product that it is designed as if it is the most important part of someone’s day. The reality is, most of us are designing products that are just a tool…and may not be looked at for more than a few minutes over the course of the day. In healthcare, the patients really are the most important piece of that puzzle, not the technology. This is just one reason why User Research is so important in the development lifestyle. Good User Research shows the reality of the problems in a work environment allowing for smarter, more informed design solutions. 

I have had a few of these reality checks in my career (here’s another great exmaple). I would like to think these experiences have made me a much better UX designer as a result.

Just remember: “If you don’t spend time in their environment, how will you know how users really use your product?”