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Usability- A Primer
Why UsabilityUsability is been identified as one of the top ten barriers in Healthcare IT adoption and is even more applicable for emerging markets due to factors like IT skills, Cost Factors, Maintenance, varied cultures etc.,Usability is been often cited as major reason of frustration and resistance among healthcare professionals.Health Care IT is more susceptible to lack of usability due to gestation period this sector is undergoing.A usable Health Care system can substantially improvise Clinical Efficiencies in terms of adoption, support costs, training, learning curves, cognitive loads etc.,Lack of Usability impacts user fatigue, error rates, user satisfaction ratings.Features and technological brilliance is ignored by users due to lack of usability and resulting frustration.Proven Usability “Silver Bullet” a.ka. guidelines and substantial usability implementation evidence yet to emerge for healthcare IT sector. As such, no proven usability “Silver Bullet” exists in Healthcare IT and will have to be researched from case to case.Research in emerged markets have been pointing out at the need of structured usability methodology for Health Care IT
What is Usability“Usability is effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment”The important thing is to remember that usability is about people. It is about designing THINGS so that people can use them easily. It is NOT about training people to cope with badly designed things.Usability is a scientific and structured methodology based upon Human Factors and Ergonomics, Cognitive Psychology, etc., collectively known as User Centered Design or UCDUsability is the end result of following the User Centered Design methodology through out the design process
What is not UsabilityUsability is not UI Design/Development. UI Design/Development is more a discipline focusing on the technical aspects of front End developmentAesthetics and Visual Design does not ensure Usability, Usability is a result of research , domain expertise, technology and aesthetics.Asking users what they want and laundry lists do not ensure usability. A usability process that is solely dependant on asking what users want is prone to failures as users cannot precisely articulate what the core issues are. Observe users than ask.Marketing research can provide direction and base for Usability Analysis but is not entirety in itself for lack of ingrained end user focus.Common sense is not usability, Common sense based approach towards Usability tends to fail miserably as common sense differs from person to person and is often biased.
Measurable UsabilityClaiming that we did Usability Analysis and Testing may not be sufficient in ensuring measurability factor of Usability. Usability has to be backed up, validated and weighted with triangulation of Quantitative and Qualitative measures and metrics. Usability success factors are solely dependant on quantifying the amount and percentages of Usability implementations and realization.Triangulation is a proven method of claiming valid usability and indeed only way of ensuring successful Usability.
Types of Usability TestingFormative TestingConducted during the product or site developmentUsed to determine if a specific design objective is metUsed at a feature levelSummative TestingConducted at the end of developmentUsed to validate that a product has accomplished intended goalsUsed in evaluating complete product
Identifying Usability IssuesImprovements needed in User PerformanceBusiness ObjectivesCritical or frequent tasksQuestionable and new areas of designEvaluation resultsUser Comments
Example criteria for UsabilityMeasurable behaviorsTask  Groups XYZ will be completed in less than a minuteUser will be able to identify fast paths for the navigation XUser will be able to complete task x with zero errors90% of users will be able to complete task x in first attemptPerformance based criteriaTime to complete critical tasksSuccessful task completionImprovisation in critical pathsReduced failuresSUS rating of 8 on a scale of 1090% of users would want to use the application90% of users appreciate the concept90% of users acknowledges the application as a critical and valuable tool for their performance
Tasks and ScenariosSet of critical tasks tied into a narrative formatSet in users terminology and designed from actual usage perspectivesAsks user to step through the scenarioCan be clubbed with target personas to pre-validate design decisionsEnables development teams to step into end user’s shoesEnables users or representative users to evaluate application in their natural setting
Types of TestingLow Fidelity prototype testingHigh Fidelity prototype testingEnd User Testing-Live SiteTesting ModesLaboratory testingRemote testingLive Site testing
Low Fidelity TestingConducted during the initial stages of information architecture and presentation design phases. Usually conducted using wireframes or skeletons and Visual Composite samples. Helpful in A/B testingExpectancy Test- Evaluate initial mental modelsPerformance Test-Navigation DesignVisual Affordance Test- Affordance, Aesthetics and Ergonomics
High Fidelity TestingSimulates actual application to the possible levels within the identified scenariosNot a replacement for Live Site testing but can identify potential usability issuesFree Exploration test-Identifies associated learning curves for first time users, may provide valuable data for navigation design and support systemsEye Tracking-Identifies key focal points and scanning patterns on the presentation layers. Can be a valuable tool while designing mission critical, and information dense applicationsPerformance Test-Organization of content, Navigation Design, Layout, Task Flow, Controls and Content
Ethnography/Field StudiesField Research and is a continuous research activity. Helps in identifying social, cultural, geographical and market impacts.Not to be confused with Usability Analysis and or Testing. Ethnography is a Human Factors discipline and is derived from Anthropology and Social Sciences. Forms the basis for wide array of social and cognitive researchesProvides basis and validity for UCD methodologiesData derived can help in identifying appropriate conceptual models as per the criteriaSuitable for research groups and long term and continuous Human Factors data collection
Laboratory TestingModerated testing and Un Moderated testingClosed door or one way see through windowAllows facilitator to interact with participant and clarify test related detailsHelpful while testing new and highly confidential concepts, will enable to control what data flows out of the floorMay not be appropriate for small scale testing and is not an effective replacement for field testingTo be chosen carefully considering un-natural environment for the participants and cost.
Remote TestingModerated and Un Moderated TestingHelpful when users are spread across the globeHelps in observing users in their natural environmentsData collections, analysis, logs become easierFacilitates remote observers to join from various locationsMultiple teams can participate and collect logs and observationsScenarios and Tasks can pushed remotelyTools like Morae can automatically collect various parameters like task completion rates, task failures, success ratios etc.,

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Usability Primer

  • 2. Why UsabilityUsability is been identified as one of the top ten barriers in Healthcare IT adoption and is even more applicable for emerging markets due to factors like IT skills, Cost Factors, Maintenance, varied cultures etc.,Usability is been often cited as major reason of frustration and resistance among healthcare professionals.Health Care IT is more susceptible to lack of usability due to gestation period this sector is undergoing.A usable Health Care system can substantially improvise Clinical Efficiencies in terms of adoption, support costs, training, learning curves, cognitive loads etc.,Lack of Usability impacts user fatigue, error rates, user satisfaction ratings.Features and technological brilliance is ignored by users due to lack of usability and resulting frustration.Proven Usability “Silver Bullet” a.ka. guidelines and substantial usability implementation evidence yet to emerge for healthcare IT sector. As such, no proven usability “Silver Bullet” exists in Healthcare IT and will have to be researched from case to case.Research in emerged markets have been pointing out at the need of structured usability methodology for Health Care IT
  • 3. What is Usability“Usability is effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment”The important thing is to remember that usability is about people. It is about designing THINGS so that people can use them easily. It is NOT about training people to cope with badly designed things.Usability is a scientific and structured methodology based upon Human Factors and Ergonomics, Cognitive Psychology, etc., collectively known as User Centered Design or UCDUsability is the end result of following the User Centered Design methodology through out the design process
  • 4. What is not UsabilityUsability is not UI Design/Development. UI Design/Development is more a discipline focusing on the technical aspects of front End developmentAesthetics and Visual Design does not ensure Usability, Usability is a result of research , domain expertise, technology and aesthetics.Asking users what they want and laundry lists do not ensure usability. A usability process that is solely dependant on asking what users want is prone to failures as users cannot precisely articulate what the core issues are. Observe users than ask.Marketing research can provide direction and base for Usability Analysis but is not entirety in itself for lack of ingrained end user focus.Common sense is not usability, Common sense based approach towards Usability tends to fail miserably as common sense differs from person to person and is often biased.
  • 5. Measurable UsabilityClaiming that we did Usability Analysis and Testing may not be sufficient in ensuring measurability factor of Usability. Usability has to be backed up, validated and weighted with triangulation of Quantitative and Qualitative measures and metrics. Usability success factors are solely dependant on quantifying the amount and percentages of Usability implementations and realization.Triangulation is a proven method of claiming valid usability and indeed only way of ensuring successful Usability.
  • 6. Types of Usability TestingFormative TestingConducted during the product or site developmentUsed to determine if a specific design objective is metUsed at a feature levelSummative TestingConducted at the end of developmentUsed to validate that a product has accomplished intended goalsUsed in evaluating complete product
  • 7. Identifying Usability IssuesImprovements needed in User PerformanceBusiness ObjectivesCritical or frequent tasksQuestionable and new areas of designEvaluation resultsUser Comments
  • 8. Example criteria for UsabilityMeasurable behaviorsTask Groups XYZ will be completed in less than a minuteUser will be able to identify fast paths for the navigation XUser will be able to complete task x with zero errors90% of users will be able to complete task x in first attemptPerformance based criteriaTime to complete critical tasksSuccessful task completionImprovisation in critical pathsReduced failuresSUS rating of 8 on a scale of 1090% of users would want to use the application90% of users appreciate the concept90% of users acknowledges the application as a critical and valuable tool for their performance
  • 9. Tasks and ScenariosSet of critical tasks tied into a narrative formatSet in users terminology and designed from actual usage perspectivesAsks user to step through the scenarioCan be clubbed with target personas to pre-validate design decisionsEnables development teams to step into end user’s shoesEnables users or representative users to evaluate application in their natural setting
  • 10. Types of TestingLow Fidelity prototype testingHigh Fidelity prototype testingEnd User Testing-Live SiteTesting ModesLaboratory testingRemote testingLive Site testing
  • 11. Low Fidelity TestingConducted during the initial stages of information architecture and presentation design phases. Usually conducted using wireframes or skeletons and Visual Composite samples. Helpful in A/B testingExpectancy Test- Evaluate initial mental modelsPerformance Test-Navigation DesignVisual Affordance Test- Affordance, Aesthetics and Ergonomics
  • 12. High Fidelity TestingSimulates actual application to the possible levels within the identified scenariosNot a replacement for Live Site testing but can identify potential usability issuesFree Exploration test-Identifies associated learning curves for first time users, may provide valuable data for navigation design and support systemsEye Tracking-Identifies key focal points and scanning patterns on the presentation layers. Can be a valuable tool while designing mission critical, and information dense applicationsPerformance Test-Organization of content, Navigation Design, Layout, Task Flow, Controls and Content
  • 13. Ethnography/Field StudiesField Research and is a continuous research activity. Helps in identifying social, cultural, geographical and market impacts.Not to be confused with Usability Analysis and or Testing. Ethnography is a Human Factors discipline and is derived from Anthropology and Social Sciences. Forms the basis for wide array of social and cognitive researchesProvides basis and validity for UCD methodologiesData derived can help in identifying appropriate conceptual models as per the criteriaSuitable for research groups and long term and continuous Human Factors data collection
  • 14. Laboratory TestingModerated testing and Un Moderated testingClosed door or one way see through windowAllows facilitator to interact with participant and clarify test related detailsHelpful while testing new and highly confidential concepts, will enable to control what data flows out of the floorMay not be appropriate for small scale testing and is not an effective replacement for field testingTo be chosen carefully considering un-natural environment for the participants and cost.
  • 15. Remote TestingModerated and Un Moderated TestingHelpful when users are spread across the globeHelps in observing users in their natural environmentsData collections, analysis, logs become easierFacilitates remote observers to join from various locationsMultiple teams can participate and collect logs and observationsScenarios and Tasks can pushed remotelyTools like Morae can automatically collect various parameters like task completion rates, task failures, success ratios etc.,