1. Usability- A Primer

2. Why Usability Usability 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 UCD Usability is the end result of following the User Centered Design methodology through out the design process

4. What is not Usability Usability is not UI Design/Development. UI Design/Development is more a discipline focusing on the technical aspects of front End development Aesthetics 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 Usability Claiming 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 Testing Formative Testing Conducted during the product or site development Used to determine if a specific design objective is met Used at a feature level Summative Testing Conducted at the end of development Used to validate that a product has accomplished intended goals Used in evaluating complete product

7. Identifying Usability Issues Improvements needed in User Performance Business Objectives Critical or frequent tasks Questionable and new areas of design Evaluation results User Comments

8. Example criteria for Usability Measurable 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 attempt Performance 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 Scenarios Set of critical tasks tied into a narrative format Set in users terminology and designed from actual usage perspectives Asks user to step through the scenario Can be clubbed with target personas to pre-validate design decisions Enables development teams to step into end user’s shoes Enables users or representative users to evaluate application in their natural setting

10. Types of Testing Low Fidelity prototype testing High Fidelity prototype testing End User Testing-Live Site Testing Modes Laboratory testing Remote testing Live Site testing

11. Low Fidelity Testing Conducted 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 testing Expectancy Test- Evaluate initial mental models Performance Test-Navigation Design Visual Affordance Test- Affordance, Aesthetics and Ergonomics

12. High Fidelity Testing Simulates actual application to the possible levels within the identified scenarios Not a replacement for Live Site testing but can identify potential usability issues Free Exploration test-Identifies associated learning curves for first time users, may provide valuable data for navigation design and support systems Eye Tracking-Identifies key focal points and scanning patterns on the presentation layers. Can be a valuable tool while designing mission critical, and information dense applications Performance Test-Organization of content, Navigation Design, Layout, Task Flow, Controls and Content

13. Ethnography/Field Studies Field 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 researches Provides basis and validity for UCD methodologies Data derived can help in identifying appropriate conceptual models as per the criteria Suitable for research groups and long term and continuous Human Factors data collection

14. Laboratory Testing Moderated testing and Un Moderated testing Closed door or one way see through window Allows facilitator to interact with participant and clarify test related details Helpful while testing new and highly confidential concepts, will enable to control what data flows out of the floor May not be appropriate for small scale testing and is not an effective replacement for field testing To be chosen carefully considering un-natural environment for the participants and cost.

15. Remote Testing Moderated and Un Moderated Testing Helpful when users are spread across the globe Helps in observing users in their natural environments Data collections, analysis, logs become easier Facilitates remote observers to join from various locations Multiple teams can participate and collect logs and observations Scenarios and Tasks can pushed remotely Tools like Morae can automatically collect various parameters like task completion rates, task failures, success ratios etc.,