The AMA Says Improving the Usability of HealthIT Should Be a National Imperative

By Bennett Lauber, Chief Experience Officer, The Usability People
Twitter: @UsabilityPeople

In November, 2019 the AMA calls EHR fixes a ‘national imperative’ after doctors give ‘F’ for usability

The capacity of the human brain to process information has remained not changed—even as the number of types of users for software-based Internet connected devices has increased at an exponential rate. The field of psychology, especially cognitive psychology has, among other things, focused on understanding the processes by which we store information, make decisions, and communicate with others.

We can solve the EHR Usability problem with science! Understanding and applying the research and theories of cognitive psychology can help information architects working in Health IT to create better user experiences!

Here are 7 +/-2 things that designers and developers in HealthIT should all know before attempting to design a medical system that interacts with human users.

Understanding diversity: Everyone is different. People think differently. By understanding the background and the needs of real users, and creating and sharing descriptions of roles and types of users, development teams can gain the perspective of users other than themselves. Personas help.

Visual processing and depth perception: Knowing how the human mind visually processes information can be an important tool to be used by graphic designers when they are creating the “visual language” of a project.

Differences between novice and expert problem solvers: Most HealthIT interfaces focus on either novice or expert users. Sure interfaces need to provide assistance to a user that is just learning the system, but eventually a transition to a different protocol” takes place. When this happens these users should be allowed to turn off the extra assistance and instead be offered a series of shortcuts (keyboard shortcuts, macros, etc.) to help them get their job done. Most users actually end up as “intermediate users.”

Recognition vs. recall memory: Forcing a user to remember something, and enter it into a text field, is much harder than selecting an item from a radio button or drop down list. Presenting choices provide the users with some prompts that may “jar their memory” and help them to make better choices.

Fitt’s Law: This is one of the most widely cited/used theories in the user experience field. It basically proposes that people can quickly find items on the screen based upon their size and their proximity to the current focus of attention. Arrange your UI to match the common screen workflows.

The fundamental attribution error: This is a term that is often associated with the field of social psychology and is the basis for the expression, “You never get a second chance to make a first impression.” People tend to make judgments based upon what they first perceive in a situation, and not based upon any situation factors. Your application might provide a great feature or function, but if people get a bad taste in their mouth, it will influence their perception of everything.

Habituation and learned helplessness: People are creatures of habit and will tend to try to do things that they have learned in one application (or website) when they encounter another. Their “mental model” will eventually guide their default interaction with your site. Some novice users have unfortunately adopted an “I dunno” mental model. They feel helpless and many have learned to lean on their friends or co-workers for help. These users often follow a “cheat sheet” without ever branching off and exploring the interface.

Affordances as perceived action possibilities: When your interface has a control that people may believe performs a particular action, they will try to perform that action using that control. If something looks like a button, people will try to click on it. If it looks like a link, they will click on it. If the particular perceived action is not a performer, you will have an unhappy user.

Vigilance, focused attention, and divided attention: People can only effectively deal with a limited number of items for a limited amount of time. Interfaces need to be designed that understand and exploit these limits. A well-designed application can attempt to steer the user’s attention to those items of interest and hold that interest until the task is complete. Ask us about our “follow the yellow brick road” strategy.

Understanding and integrating these (plus, of course, the 7+/- 2 rule) and many others can help inform a strategic user experience plan that focuses on the cognitive skills of users to provide better experiences and positively impact business ROI.

There is typically a 10 to 100 times return on investment (ROI) on resources spent on Usability and Human-Centered Design. In HealthIT usability can be a patient safety issue, the ROI can be measured in lives!

This article was originally published on The Usability People and is republished here with permission.