Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book identifies design problems and imbalances between technological system demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book’s recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives.
Consumer Health Information Technology in the Home introduces designers and developers to the practical realities and complexities of managing health at home. It provides guidance and human factors design considerations that will help designers and developers create consumer health IT applications that are useful resources to achieve better health.
You may have heard that an employee who managed “social media” for Chrysler accidentally posted on Chrysler’s twitter account about *ahem* poor driving in Chrysler’s home city of Detroit. Click here for the original story.
The guy who sent the tweet blames the program he used for multiple twitter accounts. The article calls it a “glitch,” which would not necessarily be usability, but it seems more likely to be a problem with understanding what account a tweet will come from when multiple accounts are accessible.
Scott is convinced a software glitch on a program called Tweetdeck led to the tweet being sent out on the wrong account. He says he deleted the Chrysler account from the program, but somehow it still went out.
His attorney, Michael Dezsi, says Scott has a case.
“A simple web search shows a number of other users have encountered the same issues,” Dezsi said.
Action News made contact with a Tweetdeck spokesman via email about the claim.
“We are not familiar with the error you describe–tweets sent from a deleted account–but we normally would try to replicate it to make sure there is no problem on our end (although it sounds very unlikely that this is a TweetDeck issue). If you know the type of hardware, platform and TweetDeck version we could check further,” said Sam Mandel, Tweetdeck executive vice president of business operations.
One evening, well into the night, we asked some of our friends on the Apple design team about their view of user-centric design. Their answer? “It’s all bullshit and hot air created to sell consulting projects and to give insecure managers a false sense of security. At Apple, we don’t waste our time asking users, we build our brand through creating great products we believe people will love.”
I’d argue that someone at Apple noticed how Microsoft had been building tablets since 2002 and hadn’t quite gained traction. Apple tends to step in and refine the work of others, often picking the perfect moment in time when the capabilities of a technology and users’ willingness to accept a technology intersect. The question of how they choose those moments is hotly debated – if it was more apparent to the world, their competition wouldn’t always be following them into the market, often AFTER pioneering the first generation of the market Apple dominates (see Microsoft with tablets, Creative Labs with the iPod, Xerox with GUIs).
I believe there is a common misunderstanding that User Centered Design(UCD) is asking users what they need and building it. If that were UCD, then we’d just let marketing and sales departments design products with the feature lists provided by customers and, in many cases, that would be a sufficient source of information to drive an evolutionary product design process. However, I would argue that proper full-spectrum user centered design *leads* to revolutionary product designs. The problem lies in the assumption that user centered design is building what the user thinks he/she wants.
Jonathan Ive is fond of a quote from Henry Ford that I use in explaining the differences between customer feedback and user experience research – “If I had asked people what they needed, they would have said faster horses.” I think this sums up the Apple philosophy that they are creating things so new and cool that the future users wouldn’t even know what technologies were available, let alone be able to assemble them into new category of device. The mistake here is believing that the only tool available to the UCD practitioner is asking users “what should we build for you?”
What Ive ignores is that, although Henry Ford didn’t rely on potential customers to define his product, he did learn about their needs and try to accommodate them. The original Model Ts were designed to run on ethanol for the benefit of farmers who could make their own fuel from the land (as they did for their horses), and they were designed for the simple servicing by owners in the field (as they did their other farm equipment), in contrast to some more expensive competitors. He didn’t ask his users to design his product but he informed his designs by learning about their environment, goals, and needs.
On a smaller scale, I’ve seen failures of this sort during user testing, when some participants will offer direct design advice, proposing that you place this button here, add this feature there. A lot of researchers get frustrated and dismiss this sort of input, correctly asserting that the participant is not here to redesign the UI. I do, however, find follow-up questions on these design suggestions often produce interesting data points concerning user expectations, needs and even mental models of the system. I wonder sometimes if some designers and researchers overreact because they feel their value is undermined when they acknowledge any value in the ideas of potential users.
One last thought I have is that the new crop of development-centric, massively networked products presents new challenges to the value of UCD. Startups have always moved quickly, and they’ve always run the risk of losing a race to release a product if they spend too much time “polishing” their product before an initial release. As a result, user experiences and feature depth were usually poor to start with and improved over time as the user base increased. The major changes in user experience were made while the number of users forced to adjust was still small, and by the time wide scale adoption was realized, changes generally settled into enhancements and logical upgrades (largely speaking software here, but Consumer Electronics also fits).
However, recently, to be successful a product needs to become ubiquitous almost upon release. Between social networks and newly established cycles of technology obsolescence,* there is little time to build up a base of users to try the early versions of your product before widespread acceptance. One might assume this would motivate companies to work harder to use UCD to create good designs before that initial release, but this has not been the strategy applied by the biggest winners. Instead, I believe successful companies are setting out to provide one or a handful of killer features, often wrapped in a barely serviceable user experience, to as many people as quickly as possible. Rather than risk missing out on a key moment, they skip the needs gathering and early stage user research and take their best shot instead. If they are successful and widely adopted, the reasoning goes, they can go back and improve the experience later with direct user feedback.
Of course, this approach runs into a lot of practical issues. For instance, there is an installed user base who may rebel when confronted with change (although if you provide an irreplaceable device/service, people will complain but still be your customer). Additionally, once the company is successful, it has the dual role of providing an improved future experience and maintaining the current experience, splitting resources and attention. For this reason, companies often find it hard to actually follow through on step 2 of the plan where step one is “get customers” and step two is “make product better for customers.” In this phase, iterative refinements of the product design get bogged down in new features, and there is no time for conducting full-spectrum user research.
Based on these factors, I do wonder, outside of giant corporations or products with decade-spanning development (such as aircraft, medical technologies or anything the government watches over), are we likely to see a rapid decline in user research in innovative product designs, and in early product development for most products? My intuition is that we will see an increase in demand for practitioners capable of research, design and implementation, but with less specialized training in user research and user centered design. The only “concrete” evidence I can back it up with is my anecdotal observation that the majority of interesting opportunities for user research I’ve found have been specifically requesting a developer/engineer with the ability to conduct research or complete designs in addition to implementing them.
* Products such as netbooks, iPads, iPods and smartphones are as expensive as appliances we used to expect 10+ years of service from. The average washing machine is less than an iPad, but you can expect the iPad to be out of date in ~ 2 years. People would be up in arms if their washing machines (or even microwaves, at 1/4 the price) stopped performing after 2 years.
Travis Bowles, M.S., is a usability consultant in San Francisco specializing in enterprise software, novel consumer electronics, and web interfaces.
We’ve discussed Mark Coleran before with his fantastical work with those fake user interfaces you see in movies (see movie below). According to this Fast Company blog post he will have a hand in designing real interfaces.
But Coleran doesn’t just throw out the rule books on user experience and “human interface guidelines.” In fact, because many of his clients know his movie work, he spends a lot of time talking them out of doing something like Children of Men or The Bourne Ultimatum. “One of my biggest frustations is when people will say, ‘We have these specifications and requirements, now execute it just like we saw in the movie,'” he says. “What they don’t realize is that the requirements for those movie FUIs were completely unlike the ones that they’re dealing with. In a movie, you see an interface for at most a couple of seconds. In real life, every design decision has a consequence, and it doesn’t go away. It’s there day in and day out. Those human interface guidelines are there for very good reasons.”
“A couple of days ago, a friend was asking me for a restaurant recommendation. Easy task, I thought. I had some restaurants in mind and just needed to check and see if they were open and send her the websites. What should have been a 5-minute email turned into a half-hour nightmare as I slogged through websites that are more intent on impressing me with movies, music, and other annoyances than on giving me direct information.”
“Who thinks it’s good idea to blast annoying music at people going to your site? Why do they so often rely on Flash, which doesn’t really add anything to the experience, when half the time people are looking up the site on mobile devices to get basic information? Why this bizarre preference for menus in PDF format?”
“… has a notoriously ludicrous website which – granted – may well appeal to the sort of ‘zany’ people who eat there. As for everyone else, it will probably just make you want to smash your fist through your monitor.”
Perhaps I’m still unhappy about spending an hour looking for a place to eat in Little Rock last weekend. Flash websites and PDF menus on a 2007 Sprint Treo is not for the faint of heart.
Below is the preface and excerpt of Chapter 1 from our forthcoming book. The book is available where finebooks are sold or directly from our publisher CRC Press. Until January 31, 2011, you can get 20% off the cover price when you purchase directly from CRC Press using this link and this code: 810DE.
This book is focused on the design of displays for the older user. Why does this topic deserve a book? Aging leads to a complex set of changes both mentally and physically that can affect technology acceptance, adoption, interaction, safety, and satisfaction. Design with an understanding of these changes will result in better products and systems for users in all stages of the lifespan. Conventional wisdom (possibly informed by personal experience) is that getting older leads to a decline across a broad set of skills and abilities; however, the reality is that as some capabilities decline with age others remain stable or increase. For example, although a sixty year old man may not be able to beat his granddaughter in the computer puzzle game Tetris, the elder will invariably beat the youth in games of knowledge such as the board game Trivial Pursuit or the television quiz show Jeopardy. Design of displays and technology can capitalize on these capabilities to ameliorate the limitations that can come with age.
As human factors professionals, we have often been frustrated at how little research makes it to practice. This is why the target audience for this book is a usability engineer, or user interface/user experience designer who is tasked with creating an interface that might be used by older adults. Literally hundreds of papers have been written about interface issues experienced by older adults, but how many actually influence the designs older adults use? We believe the challenge comes in part from the sheer number of articles available. Design and usability evaluation are fast-paced activities with little time allowed for literature review. Many professionals do not have the time to sift through thousands of papers to determine: a) which are related to the question at hand and b) whether the design or study has merit. Another reason may be that academic papers typically target other academics and may not stress the application or design implications of their findings. Finally, another barrier to knowledge transfer may be that academic publishing moves slower than the design and usability industry. The time it takes for journal articles to reach the audience, from submission time, can be months to years. As such authors may be loathe to nail down concrete design guidelines opting for the conceptual and general (but often vague and hard to implement) because their research may be published a year in the future. This book distills decades of published aging research most relevant to the design of displays.
We believe this book offers a benefit beyond individual research studies. The first half of the book is a primer of age-related changes in cognition, perception, and behavior. Theory can be used to organize examples from the literature into meaningful principles that improve understanding. Using theory backed up by evidence provides an understanding of why we see certain problems with many displays and often predicts solutions. This understanding surpasses an individual interface and provides the practitioner with ways to plan for older users on multiple display types. We then apply these theories in real design exercises. In all chapters we provide specific guidelines for display examples to bridge theory and practice.
Age is simply an indicator of how long one has lived, but is not a complete indicator of a specific individual’s capabilities and limitations. One can easily imagine how a physically fit 55 year old tri-athlete could out-perform a 34 year old in a marathon, personified by Cliff Young, the sixty-one year old winner of the 1983 Sydney ultra-marathon (544 miles). Similarly, with respect to cognitive capacity, there is wide variety in capabilities and limitations that are linked with age. Thus the definition of “old” and “older” can be a tricky issue. The issue is further complicated by the sheer variability in any given ability as we get older. Generally, for younger and middle age groups, capabilities vary but this variability widens as people get older: the older adult age group (defined as those aged 65 and over) are more different from each other than people in other age groups differ from persons in their own age group.
One way to think about the older user is via their familiarity with current technologies and interface conventions. Jakob Nielsen reported that “Between the ages of 25 and 60, the time users need to complete website tasks increases by 0.8% per year.” But does this time increase come from a rapidly changing technology or declines in the human body? Both culture and the physical aging process play a role. Such dual causes for the same symptom exemplify why designs should be carefully analyzed as to the difficulties they produce. It is important to know how much of a role the display plays in increased time to complete tasks versus slowed completion times due to the user’s inexperience with that type of task or any number of other variables.
Another way to think about the older user is by the appearance of perceptual and cognitive changes that we usually associate with aging. This may include far-sightedness, the need for bifocals or reading glasses, hearing aids, and an increased reliance on notes rather than memory for everyday tasks. An understanding of these changes and the effects they can have on display use is critical, because these changes often interact with each other. Thus, understanding a single age-related change, such as vision, can lead to designs that adversely affect other senses and cognitions such as the high working memory requirements of audio displays or creating the need to scroll larger text, which can require precise movement.
1.1 What Do Older Adults Want from Technology? What Do They do with Technology?
Across a wide range of everyday activities users encounter electronic technology. Technology, for the purposes of this book, is broadly defined as any tool or artifact that helps the user accomplish a task, limited to electronic displays for the purposes of this book. Even with this limitation, consider how ubiquitous technology is for most people. Table 1.1 shows everyday technologies located in typical environments.
Many of these technologies are either specifically for or related to communication with others. Mobile communication occurs commonly with all age groups, though use of mobile communication technologies can vary by age (Table 1.2). Those over age sixty-five are less active users of the full range of advanced mobile services, but they are enthusiastic users of mobile voice communications, especially in emergency situations (Table 1.3). The need to communicate is enabled through cell phone use and thus the product has been adopted by older adults. Indeed, this adoption occurred in spite of the fact that many cell phones are not well designed for older users. These design problems can partly explain the lower use in older age groups compared to younger. When a user group is excluded from these everyday technologies by designs that do not accommodate them, both the quality of life of those users and the market share of the product companies can suffer.
Similar to cell phones, use of the internet as a tool beyond information seeking is becoming more common among older adults. According to a 2006 Pew survey, 41% of internet users are over age sixty-five. Online banking is a popular activity and 43% of internet users engage in some form of online banking. However, only 27% of users aged sixty-five or older regularly banked online. This is a fairly typical finding when relating age and technology use, but there are many potential reasons as to why. These reasons range from usability issues with the interface to unease in accessing financial information over the web (mistrust). These are two different reasons for avoiding online banking and one would take different paths to overcome them. The lesson from investigating reasons for non-adoption of a technology is that it is important not to conclude that older adults avoid technology for any stereotypical reason, as avoidance is often affected by context, needs, and experience levels. Understanding the barriers to the adoption of potentially useful services and products is crucial to overcoming the problems and increasing adoption. Stereotypes of older users should be avoided in favor of evidence-based analyses.
1.2 Stereotypes of Older Users
A common stereotype of older adults is that they do not and will not use technology. If this were true, there would be no need for this book: all displays and interfaces would be translated to disinterested older adults by their children and grandchildren. However, this stereotype could not be farther from the truth. Adults over sixty-five want to keep up with technology and take advantage of what a technological world has to offer. About half of persons aged sixty-five to seventy-four are cell phone subscribers, and a third over seventy-five pay for service. The Center for the Digital Future found that in 2009, 40% of persons over sixty-five in the United States were internet users. Participants in our research studies frequently mention that understanding new technologies makes them feel connected to others and the world in general.
Use of the internet is one microcosm of older adults’ perception of technology. Though the statistic of 40% using the internet seems impressive, it is paltry when compared to the nearly 100% of younger users who take advantage of the web on a daily basis. A common stereotype of older users is that they are unable to learn to use complicated technological systems. However, when older adults reject technology it tends to be due to not perceiving a benefit of the technology, not necessarily because it is too difficult or time consuming to learn. The end result may be the same, fewer older adults use new technologies, but the reason is important. When older adults perceive a benefit, they are willing to invest the time to learn. However an unusable interface is more likely to tilt the scale in favor of “not worth it.”
Email provides another useful example to illustrate these points. Email is form of communication, both business and personal. Imagine someone having only this knowledge about email. Would one understand that email allows instant communication? Would one know that they could send and receive pictures of the people they care about the very day the pictures were taken? Would they know that email is free? Would they understand the asynchronous nature of email; that the person they are communicating with did not have to be available at the instant the email was sent, but that the message would be there waiting for the recipient(s), or even that the same message could be sent to more than one person at the same time? If potential users do not know these things there is no reason to prefer email over a letter or a phone call. It should not be assumed that “everyone” understands these benefits of email and if a person does not know of these benefits there is little reason to adopt the technology.
This book is part of the Human Factors & Aging Series. The first volume in the series is Designing for Older Adults: Principles and Creative Human Factors Approaches by Fisk, Rogers, Charness, Czaja, and Sharit and is available now. Forthcoming titles are: Aging and Skill Acquisition: Designing Training Programs for Older Adults (Czaja & Sharit) and Designing Telehealth for an Aging Population (Charness, Demiris, & Krupinski).
After a long process and over a year of work, Anne’s and my book on user interface design for older adults is almost available! The cover of our book has been finalized (shown below). The book will be released September 21st, 2010 and will be available where finebooks are sold or directly from our publisher CRC Press.
We’ll give away a few copies of our book and in a future post provide an excerpt when we get permission. Unfortunately, the book is not scheduled to be available in electronic format but we hope that will change. An ebook will also be available (thanks Peg!).
Here is our description of the book:
Contains state-of-the-art aging research written in an accessible format
Includes four chapters of worked examples that put design suggestions into practice
Focuses on designing for the aging population
Explores the “hows” and “whys” of designing for an aging population
A distillation of decades of published research, this book is a primer on age-related changes in cognition, perception, and behavior organized into meaningful principles that improve understanding. It explores the complex set of mental and physical changes that occur during aging and that can affect technology acceptance, adoption, interaction, safety, and satisfaction. The authors apply these theories in real design exercises and include specific guidelines for display examples to bridge theory and practice. It opens the way for designing with an understanding of these changes that results in better products and systems for users in all life stages.
There seems to be a huge amount of interest in the use of iPads in academia as evidenced by the popularity of my last post on the iPad. This is just a follow-up post with some more app recommendations and more thoughts on how well it substitutes for my laptop after over a month of use.
I recently went on vacation for a few weeks (to Yosemite National Park) and carried the iPad exclusively. I used the Camera Connection Kit to download and view pictures and movies from my digital camera.
When I could get wireless in the park, the built-in email client worked wonderfully with my campus Microsoft Exchange email/calendar system. Touch-typing emails is a real pleasure once you get used to the software keyboard.
To temper my enthusiasm for the iPad, Anne will present her, “things I hate about the iPad” post shortly. In the meantime, I just wanted to follow-up with some more app ideas for anyone in academia who is thinking of using an iPad.
First, I still use Evernote as my primary note-taking application when I need to jot down an idea, draft a blog post, draft a paper review, etc. But the major downside (which isn’t the fault of Evernote) is that the lack of true multi-tasking is really annoying. I’d love to be able to have a small note window on the bottom half of the screen to take notes while I do something else. This is not yet a major annoyance and should be partially fixed when the iPad gets updated to iOS4 this fall.
I also still use iAnnotate a great deal to read PDFs. During my vacation, I used iAnnotate to store, read, and search PDFs of various things to do around Yosemite. I also used it for light airport/airplane reading of some work material. The instant-on capability (and 10+ hr battery life really came in handy on the cross-country air and road trip). PDF tip: if you scan your own journal articles, make sure to OCR them so that they are searchable within any PDF app.
Recently, the iBooks app, from Apple, was updated to support PDF reading. It presents another option if all you want is a PDF reader. It displays your documents on a bookshelf:
I recently downloaded DocsToGo to create and edit Microsoft Office-compatible files and have since abandoned the iWork apps (including Keynote). I recently created a presentation in Keynote but then only later realized that Keynote does not export to Office/PowerPoint for later editing on the desktop. It does import PPT files. Apple’s reputation for a closed ecosystem rears its ugly head!
Another major limitation of Keynote is in its presentation capabilities. When you pair the iPad with the iPad VGA connector (to connect to projectors) you might think you have a great, portable solution for presentations. Almost. The connector does output to a projector but you can’t see your presentation on the iPad itself. All you get is slide up/down control and a laser pointer simulation. Hopefully this will be remedied in a Keynote update.
The iWork apps (Pages, Keynote, and Numbers) are designed well and incredibly easy and intuitive to use but the lack of a proper export option precludes me from using them full time.
A really cool feature of DocsToGo is that it will interface with your Google Docs account and let you edit (offline) any file you have in the Google cloud. This is especially useful if you or your campus uses Google Docs for collaborative activities. Changes made offline on the iPad will be uploaded back into your cloud. It also integrates with DropBox (another must-have tool that is available on the iPad).
Mac-using academicians may be familiar with the Papers application which allows users build a personal database of PDF articles. A stand-alone version is available for the iPad:
Although this application does not require the desktop copy of the Papers application, I think it might work best when it syncs with a library that exists on your desktop. The company does not make a PC version so I’ve found this app of limited use right now. It might be more useful next time I need to do a new literature review.
This blog runs on WordPress. I know many other academics who run blogs also use WordPress because of its simplicity and ease of use. The WordPress iPad app comes in handy to do light editing, content creation, and spam management on the go.
There are many things that the iPad cannot do. One of them is run PC software like SPSS (used for data analysis). When I need to access specialized applications for a short time, I use VNC viewer which lets me connect to and control my desktop computer (which is running RealVNC) from my iPad. Controlling a desktop computer with only a touchscreen is executed very elegantly with the VNC viewer.
Finally, if you’re like me and don’t necessarily want to broadcast to the world that you are carrying around an iPad, what better hiding place than in a book! I just received the DodoCase (after a 6 week wait). Highly recommended: