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Can doctors and computers get along?

Practice Fusion, the leading provider of health records software for medical professionals, has published a nice recap of their user conference, Connect11, where Alan Cooper spoke about the role of interaction design in health care. Among the questions answered - "what do you get when you cross a computer with a doctor's office?"

At the 13 minute mark, Stefan Klocek presents a prototype of Practice Fusion's new iPad app.

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Cooper shows Practice Fusion's iPad app at Connect 2011

There's nothing we like more than seeing our design work come to life. Last week, Cooper Principal Designer, Stefan Klocek went on stage at Practice Fusion Connect 11 to present a prototype of the company's new iPad app to a room of 1200 physicians. Cooper designed and developed the EMR prototype in close collaboration with Practice Fusion over the last few months.

The iPad app represents a first look at a tool that extends Practice Fusion's free electronic health record platform to a format that is portable and easy for the doctor to use while seeing a patient. The goal of the design is to make it easy to document an encounter, while keeping the focus on the patient, rather than the computer. By leveraging smart defaults, templates, voice recognition, and streamlined workflows, doctors will be able to quickly capture salient facts, make diagnoses, and rapidly order medications, labs and specialist referrals. For the large percentage of patients with common ailments, the iPad will allow charting with little or no typing, and provide a structured guide for the exam which ensures nothing falls through the cracks.

With 25 million health records, Practice Fusion is by far the largest electronic health record system in the country. Adding an iPad app to their offering will help more doctors make the transition from traditional paper-based record-keeping to a digital, cloud-based system that's available from anywhere. An increasing number of doctors are opting for a fully digital office, giving them the efficiency benefits of information technology along with the promise of more accurate diagnosis and personalized treatments.

Stefan presents Practice Fusion iPad app
Stefan presents the iPad prototype on stage, accompanied by Edwin Miller, VP of product management, and Alan Cooper.

Practice Fusion iPad schedule view
The app makes it easy for doctors to familiarize themselves with each patient's condition. Patients are organized by appointment time and a summary view presents the most relevant items from the patient's medical history. A simple swipe reveals more detailed information or tools for quickly updating each record.

Practice Fusion iPad dictation view When meeting patients, doctors would like to focus on their needs, not keyboard typing. The app includes tools to make text entry fast and accurate, such as dictation and template features.

Credits: Stefan Klocek, Andreas Braendhaugen, Jayson McCauliff, Jenea Hayes, Raphael Guilleminot, Nick Myers, Doug LeMoine

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You can't save your way to innovation

What's wrong, you might argue, with keeping costs down? Quite a bit, it turns out. If your objective is to design a product people want to use, or to invent something brand new, you must embark on a journey of creativity and innovation. That might seem like normal, every day business, but don't make the mistake of trying to run your creative organization like a conventional one.

Business sage Peter Drucker asserted creative employees "are not labor, they are capital." This has profound implications on the way you should manage and account for your business. As Drucker also asserted, "What is decisive in the performance of capital is not its costs, but its productivity."

In other words, if there is something you can do to enhance the creative abilities of your people, it doesn’t really matter how much it costs, or how long it takes. If it results in a successful invention, or a compelling design, that’s what really counts.

Business people trained in industrial age thinking cut costs from force of habit. After all, expense reduction was an excellent strategy when manufacturing costs were dominant; they are easy to measure and provide instant benefits. In the post industrial age, manufacturing costs are neither dominant nor elastic, so reducing them reduces your quality without improving your desirability. Today, trying to make your product cheaper just makes it frustrating to use and unlovable without making it any cheaper to buy. It’s no longer a valid competitive strategy.

Cooper helps TaskRabbit design new iPhone app for help with chores

TaskRabbit’s service connects people who want help with simple tasks—anything from walking the dog, standing in line at the DMV, or moving furniture—with “Rabbits,” a network of background-checked and pre-approved individuals who have the skills and time available to complete tasks.

TaskRabbit
With a design ideal for mobile task posting, the app provides a simple, seamless process for securing extra help.

Cooper designers collaborated closely with developers at Pivotal and the TaskRabbit team to design a user experience specifically optimized for busy, on-the-go people, offering timely help for folks with unfinished errands or other tasks. With just a spin of the wheel and a few taps, the app enables a task to be posted on the TaskRabbit service network in a matter of seconds with minimal, if any, typing.

TaskRabbit
Credits: Faith Bolliger, Jim Dibble, Glen Davis, Tim McCoy and Nick Myers.

TaskRabbit, has more than 1,500 runners in San Francisco, Boston, Los Angeles, and Orange County fulfilling up to 3,000 tasks per month and they just opened the service in New York City.

Congratulations to the TaskRabbit team, as the new app release has been featured on Mashable, TechCrunch, and Forbes and has received great reviews.

Download TaskRabbit at the App Store and start getting stuff done!

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Will Ford learn that software isn't manufactured?

Ford Motor Company has just convincingly demonstrated that being an excellent industrial manufacturer doesn’t automatically mean that you are an excellent maker of digital technology. Despite Ford’s improvements in manufacturing quality, their overall ratings fell precipitously this year due solely to the poor software interaction on their dashboards. A recent article in the New York Times discusses Ford’s plummeting fall in user rankings this year, focusing the blame on their new touch screen interface.

Ford Display
MyFord Touch on new Ford Edge—heavily criticized in J.D. Power's research and "frustrating" according to Consumer Reports.

According to the article, J.D.Power, the auto industry arbiter, dropped Ford’s ranking from 5th to 23rd, and subsidiary Lincoln’s ranking from 8th to 17th place. J.D.Power acknowledges that both Ford and Lincoln’s fit and finish are excellent. It was the “annoying” behavior of their driver-facing interactive systems that caused their ratings to plummet. Other reviewers concur, as Consumer Reports yanked their “Recommended” rating from Ford’s new 2011 Edge model.

The Drawing Board: Smart Checks

Here at Cooper, we find that looking at the world from the perspective of people and their goals causes us to notice a lot of bad interactions in our daily lives. We can’t help but pick up a whiteboard marker to scribble out a better idea. We put together "The Drawing Board", a series of narrated sideshows, to showcase some of this thinking.

Almost everyone enjoys a great meal out with friends, but splitting the bill can be unnecessarily complicated. In this Drawing Board, Cooper designers turn their attentions to the way groups of people pay the check while dining out.


Credits: Greg Schuler, Peter Duyan , Bo Ah Kwon , Suzy Thompson and Chris Noessel.

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The visual interface is now your brand

At the recent Interaction 11 conference, I spoke of the growing importance of visual interface design to both brand and user experience in an increasingly digital world. In this new world, visual interaction designers face big challenges and bigger expectations, from both users and clients.



While designing visual interfaces for dense, complex products, designers can also influence brand perception by creating experiences that are both memorable and useful. In my session, I discuss how to design a unique visual interface that puts the needs of the users first; how to add surprise and delight to critical moments of the experience; and how to use craftsmanship and attention to detail to set your design apart in a visually complex medium. Finally, I talk about how visual designers can effectively frame conversations with stakeholders about brand and experience by using personas, experience attributes, and stories to convey design ideas. Enjoy!

Presentation on Slideshare

You can also view a crisper version of the slides on Slideshare: Slideshare.



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Lean UX, Product Stewardship, and Integrated Teams

Several emergent themes in software design and development are converging into a new way of working:

  1. Entrepreneurs understand the strategic value of user experience design in the guise of Steve Blank's customer development and Eric Ries' lean startup
  2. Management are entrusting designers with product management responsibilities as frustrated designers are seeking them out
  3. Agile teams are coming to recognize the contribution of UX as designers learn to function in agile environments

Each of these ideas have significant impact on the way user experience designers approach their work and how businesses structure their design and development efforts. Together, Lean UX, Product Stewardship, and Integrated Teams define a cross-functional, balanced approach to delivering software and services.

Lean UX

Traditional User Experience (UX) design techniques were developed in waterfall environments. Designers conduct research, develop models, derive frameworks, and specify detail with the understanding that they have to get it "right," because once the product enters development, changes are difficult and costly.

Lean UX leverages the highly fluid nature of modern lean and agile development practices. It focuses design and development effort on high value users, features, activities, and experiences, and in so doing, reduces the wasted effort and cost of spending time on issues that don't really matter (or don't matter right now). Teams work to shorten the time between forming design hypotheses, testing them, and learning from the results, accelerating delivery while improving quality. Designing and building from the core out helps tune your product vision in response to stakeholder, market, and user feedback.

Lean UX is not interaction design shoehorned into agile frameworks. Product vision, user research and modeling, and truly evolutionary iteration are central to this approach. It stresses lightweight, collaborative, right-fidelity UX techniques to generate, test, and evolve the design of your product.

Product Stewardship

s03.pngThe responsibilities of an agile product owner are vast, difficult, and conflicted. Typically a role derived from product management, product owners are tasked with fulfilling business objectives; they're expected to identify and represent user needs; they must define and drive the product vision; they need to understand and prioritize development efforts and represent the team to business stakeholders. This is not a job one person can do effectively.

Product stewardship relieves pressure on the product owner bottleneck. A UX strategist assumes the role of Product Steward, pairing with a Product Manager to share the mantle of product ownership. The product manager has a bias towards representing the business, the product steward towards satisfying the user, with a recognition that an interplay of these forces drives prioritization of the team's activities.

Integrated Teams

UX has had difficulty finding its footing in agile development. Design work doesn't always fit the cadence of weekly sprints; designers can feel their job becomes a perpetual state of reactive, tactical design; iterations designers thought meant cycles of improvement turn out to mean a progression of micro-deadlines where "done" means "good enough to move on."

Integrated teams extend full membership to interaction designers, visual designers, content strategists, and anyone else who contributes to shaping the product. Most importantly, these cross-functional teams work in pairs: often as like-disciplined partners, but also as designer/developer pairs. This format reduces communication issues and documentation overhead, develops cross-functional empathy, and gives the whole team increased understanding of product vision.

What you can do

I'm terribly excited to be part of this movement to bringing balance to software development teams. You can get involved as well and, in fact, we need you to drive this change in your organizations. I've posted a deck to slideshare.net of a talk I gave at a side event of IxDA11 in Boulder, CO on Feb 8. Feel free to use it to help start conversations at your office and in your communities about how to improve your ways of working. Join a local meetup to talk with others about the integration of design into lean and agile development. Read blogs and follow the emerging voices in the community of lean user experience and balanced teams. Most of all, trust In the power of user-centered design to inspire, delight, and guide your teams forward.

Other resources

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When is design done?

“We don't finish the movies, we just release them.” -- John Lasseter of Pixar

It’s easy to think of design as an ongoing iterative process, a constant refining that never reaches an objective “end.” It is especially easy to think of software in this way. Because code isn’t static, design of software is relatively dynamic, able in many situations to alter direction or incorporate new functionality without overturning initial design-framework decisions. While this can be true, it is also possible for design to reach a state which is done. Not simply done for the next release, but where design reaches finality. The design no longer carries the evolution of the product forward.

done.png

Once design reaches a stage in which the difference between versions is more window-dressing, or a change in interaction approach, rather than a realization of deeper functional improvements, design is done. When the ideas on how to improve a design no longer come, when the designers can no longer see a way to improve the idea, it is done. It isn’t that someone else couldn’t take the idea and evolve it, but that the stewards of the design reach a point where their collective imagination can’t move the product forward.

Design which is not done

It’s easy to find examples of design which isn’t done. Lots of first generation software is released delivering basic functionality. Later versions fill out with functionality, growing to meet the latent potential in the first version. This design isn’t done.

Early designs of Evernote promised much more than was delivered. Successive versions cast and recast the design until the initial flaws could be worked out. Early versions provided little more than a limited word processor that stored stuff in the cloud. The interaction paradigm was a little strange and frustrating. Evernote continues to be a design in process. Functionality continues to evolve and improve with each release; the design isn’t done.

Mature software may not be done either. Photoshop versions 5, 7 and 8 delivered significant design shifts. Paradigms for working with text, the inclusion of vector images and interface for handling of RAW images marked major departures from previous versions. As an 11-year old product the design of Photoshop accomplished remarkable adaptation and revealed the “incompleteness” of prior designs. Of course the design leveraged advances in technology which were not available for earlier versions, but that’s the point. The design wasn’t done, design could still be used to improve the program, to advance what it did and how it did it.

Design of non-software products may also reveal a level of “not done.” A baby stroller from BumbleRide is “done” in the sense that you can purchase one and it works. The design is largely coherent and shows evidence of finish. But even here the design isn’t finished. A comparison of the 2008 and 2009 versions shows significant advancement of the design even though each of the versions was sold as a completed design. Wheels gained quick-release, the safety harness adopted a single button release, and the sun hood extended for more coverage. So is the design done now? I’d argue no. Improvements in ergonomics, materials, and signage all provide ripe areas for the design to continue to evolve.

When it reaches "perfection"

Design isn’t done when it reaches a pinnacle of efficiency or goodness. Done isn’t really a measure of quality or perfection. Many products never reach any level of quality or refinement. They represent evolutionary dead ends, still-born ideas with no potential in which to grow. They are poorly conceived, even if executed well. Crappy products may arguably be done before they are ever built or coded. The lack of vision from the start dooms the product to an evolutionary dead-end before it’s even born. If perfection is the measure of done we don’t have any way to agree on what is perfect or good. Perfect doesn’t give us a way to evaluate done.

When it feels done

Subjective evaluations by the creator may be acceptable in the realm of art. Artists work until the piece is “done;” till they feel the idea has been expressed. Design of products whether software or hardware need more objective measures than feelings. In part, designers need this because the act of creation relies on a whole team, not just an individual. We also need measures because products exist in a marketplace; there are deadlines, ship dates, feature sets, marketing and sales efforts, which require more clarity around when the design will be done.

When the time or money runs out

For consultants, work is “done” when the contract (time) is up. Projects are scoped to meet specific deadlines and requirements which fit those timelines. Design deliverables are iterative, each pass we give moves a level deeper and we work out more of the design details. We give great value for our time, but design is “done” when we run out of time. Our design is rarely done in the sense that every detail has not been worked out, all the possible problems have not solved. We work down from larger more fundamental patterns and frameworks, iteratively filling in the details. The big picture may be done when we deliver, but often it is internal product owners or developers who will actually “finish” the design.

When the requirements are met

It could be argued that design is “done” when the initial requirements have been met. It’s done enough to release a version, but it’s not really done. After the product ships the design team refines the design, adding in features or fixing issues which shipped in the previous version. The designers work to fulfill the full potential of the product. As long as their work produces advancements the design isn’t done.

When innovation plateaus

Design is done when its evolution plateaus. A couple of versions are released with little more than rearranging the deck chairs. Rework or changes to the interface reflect passing fashions rather than fundamental shifts in direction or functionality. Innovations in the marketplace or in technological breakthroughs are not incorporated or addressed in the design. Evolution grinds to a halt, the product ceases to advance in meaningful ways.

Design continues on many products long after the design is done. Design effort is wasted in chasing a market rather than leading one. Products become bloated with features which compromise the clarity achieved when the design reached “done.” Features are designed which don’t evolve the product; they complicate the vision reaching to be all things to all people, ultimately hobbling the product. The design of Microsoft Word has delivered little beyond version 5.1. It is a quite usable word processor, but the design for word processing was solid in 1991, in the subsequent releases little was advanced. Features where added that did little to improve the word processing experience. The design also failed to take advantage of shifts in the marketplace or technology. Five versions later Word is still largely a pretty good word processor. While much has changed in the interface switching interaction paradigms from menus to the ribbon can hardly be thought of as a fundamental shift in functionality. Word hasn’t evolved so much as changed it’s wardrobe.

Some products manage to react to changes in technology or marketplace. The design accommodates changing needs and opportunities. The product evolves through design to include new functionality, utility and continues to add life to the product. While Adobe Acrobat Pro has struggled with its share of bloating and incessant updates, the design of the program has continued to evolve. From humble beginnings of a reader/writer for portable documents, Acrobat has incorporated new functionality unimaginable when the product was initially designed; OCR of text, automatic creation of interactive forms, document markup, digital signing and distributed workflows. The integration of this new functionality has stumbled at times, but Acrobat X delivers a coherent, usable evolution of a product that is more than 17 years old. What was just latent potential in the embryonic design of the first versions of the product has been realized.

Some products are so deeply bound to a specific paradigm that the only reasonable evolution is an entirely different approach. The original design is done. A new product, with a different design, is created to address new technology, and a new marketplace. The original iPod‘s design is done. The scroll-wheel/menu design of an mp3s player was groundbreaking and brilliant, and it was well-executed. At some point it became clear that this design was done; it couldn’t evolve while maintaining the same core design. The only road forward was to abandon this “done” design, and adopt a new paradigm. The result was the iPod Touch. The shift was more than simply adding a bigger screen with touch input; what the product could do radically shifted.

Why does it matter?

It is important to acknowledge that design can reach a place of “done.” If we don’t, we may end up fooling ourselves that we are moving products forward when we are really just treading water. If we can’t step back and evaluate whether a design is done, we may continue to put effort into a product which we can’t improve. We will continue to release products that don’t help people achieve their goals, or worse--damage great products by bloating them with features no one needs. Knowing when the design is done allows us to recognize when our efforts will be productive and when our efforts will be wasted. When design is done it’s time to move on, to take up new challenges or products and start designing again.

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Creating informal learning environments

In the field of exhibition design, the quality of User Experience makes the difference between success and failure. Unlike products or services with clunky interactions that we may grumble about but continue to use, a museum exhibit that is inaccessible is simply an expensive rock.

Want to explain plate tectonics to a 12-year old in a way that might inspire a budding geologist? Or convey the intricacies of the circulatory system to a kindergarten-age doctor-to-be? Your communication goals and audience have been identified, now comes the hard part—creating a fertile environment where learning can happen. When designing exhibits for museums or science centers, exhibition designers consider interaction, experience, interface and, critically, environment.

Museum visitors are on their feet, distracted by their surroundings and often curious to get on to the next thing. Unlike the individual who has chosen to read a magazine article or browse a website, a visitor hasn’t made a commitment to the experience or decided to engage in the content. Exhibits must entice and engage visitors, quickly, in spaces that facilitate that engagement.

A few mildly frustrating museum visits and several positive discussions with colleagues led me to consider how we construct the settings in which learning happens. Part of this is about thoughtful design, but much of it is about creating an appropriate space and then getting out of the way. These are my suggestions:

Provide resting places.

A well-placed bench allows parents to rest and watch while children explore or participate at their own pace. A seat is a space for wound-up kids to settle for a minute or for adult visitors to consider what comes next. Many museums forget (or engineer out) this simple yet fundamental factor in a visitor’s experience.


Allow for collaboration.

creative_world_cheryl_mccoy.gif
This exhibit can be controlled by one, or more than one, visitor. (California Science Center, “Creative World”)

Provide exhibits or activities that don't require multiple users, but accommodate more than one user. Consider ways to provide multiple users with an enhanced experience. Most visitors to science museums come in school groups or with family members, and they often move in bunches throughout the space.


Don't frontload information.

Deliver the main message and pique curiosity. Let visitors opt in. Good exhibits provide opportunities for discovery and reward the explorer (or motivated learner) with something extra. Answer questions when they are most likely to be asked and provide interesting chunks of information at the time a visitor is most likely to wonder and say, "Cool!” Conversely, if you give it to them all at once their eyes glaze over and you’ve lost them.


Recognize there are different types of learners

Or, at the very least, recognize that there are different ways that people like to learn. Successful exhibits use a variety of techniques to communicate messages and engage visitors. These could involve various senses (environmental audio, choreographed lighting, even aroma stations) or offer different points of access to the same information (colorful graphics, hands-on interactives, theatrics, media pieces, or full body-immersives).


Let them get their hands dirty.

Provide a space and materials for exhibit related projects. This can be docent-led or not. Enhance learning by pairing an exhibit with materials and challenges that allow for creativity, invention, or even innovation. This could be a simple cart, with changing activities that can be restocked or rolled into the gallery when appropriate. If a subject excites a visitor, get them involved.


Limit text and avoid the urge to be comprehensive.

This is tougher than it sounds for the subject matter experts involved in creating the exhibit. Visitors, particularly young visitors, need to know this isn't school. So, don't teach and don't test. As a general rule, if it is fun or compelling, a game or a challenge, they will engage on their own. A visitor who gains an interest in a subject will explore and learn more beyond the walls of the museum. A visitor bombarded with too much information or made to feel stupid has been turned-off to the subject.


Design interactions with a low barrier to entry.

chabot_space_cheryl_mccoy.gif The interaction seems obvious; you should turn the knob and look inside. (Chabot Space and Science Center, “Destination Universe”)
Handles should look like handles. Cranks should look like they turn. Don't make visitors waste their energy figuring out how the exhibit works before they even get to the content. Your design may be clever, it may be beautiful, but if the interaction isn’t obvious you have succeeded in hand-crafting visitor frustration. Sometimes we miss the mark and create an exhibit that is compelling, but not immediately intuitive. These exhibits inspire “creative misuse.” Instead of visitors connecting with the content, they spin the wheel, bang the handle or jump on the sensor. They may have fun, but a learning opportunity is lost and often an expensive exhibit is wasted.

What else should we consider when designing informal learning environments? This conversation is ongoing, behind the scenes at science museums and exhibition design studios. It continues on blogs, in classrooms and at conferences. As an exhibit developer working to answer this question, I’ve been humbled to discover that the best way to find out what works is to grab some kids and bring them to a museum.

All images courtesy of West Office Exhibition Design.

You’ll find discussions about designing informal learning environments here:

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