This year's World Usability Day, commemorated yesterday at over 80 events around the world, had an obvious topic for healthcare: the widely-acknowledged fiasco that was the launch of the U.S. government's healthcare.gov website in early October.
David Mitropoulos-Rundus, User Experience Architect at Quicken Loans and director of the annual Internet User Experience conference, gave a lecture on some shortcomings of the website while highlighting numerous principles of good user design that could be employed to improve the experience.
Usability can broadly be defined as the study of the relationship between people and technology, said Mitropoulos-Rundus.
"Over the years, when people asked me what I do - because it is a rather different type of career to have - I tell them that usability is designing products to fit people," Mitropoulos-Rundus said. "It's not just about software, it's not just about websites - it's about anything. It's about the customer experience."
Mitropoulos-Rundus said there are four primary ways in which usability experts contribute to products: making usability requirements, applying best design practices, conducting expert usability reviews and finally performing real usability testing with target users.
These four steps in the process of designing effective products could readily be applied to improve the healthcare.gov website, beyond the fixing of technical glitches already documented by the media, Mitropoulos-Rundus said.
"We've been inundated in the media in the last six weeks about healthcare.gov, but the majority of the coverage is about technical issues, reliability and scalability - things simply not working," Mitropoulos said. "I'm not going to touch on the technical issues; we're going to go beyond the technical issues because they've been covered. We're going to go beyond the technical issues to talk about the human issues.
"There is a usability goal that was created: for up to seven million visitors by March 31, 2014 to be registered using the website. That's been set in stone. Based on the media you would think that's all technical, but based on my analysis there's a lot of usability about it."
Mitropoulos-Rundus underscored the difficulty of constructing such a website that aims to be used by a large number of people from diverse backgrounds with the unenviable task of finding a healthcare coverage plan.
"This is huge - you want seven million people that have minimal to moderate understanding about healthcare coverage to come and be successful at this website" Mitropoulos-Rundus said. "We need to be really careful about how we word things, organize things and present things because we are at risk of very quickly overwhelming people. Healthcare coverage, especially for people that have had jobs at companies that offered them one or two options, is very complex."
Mitropoulos-Rundus went through different aspects of the website and highlighted confusing and redundant icons on numerous pages that detracted from the user understanding. He also demonstrated that the process of creating an account was more convoluted and counter-intuitive than it should be, with the second-to-last step sending not one, but three confirmation emails to the user's inbox.
"I would say, of the seven million people that need to register between now and the end of March, having three emails in their inbox is going to be pretty daunting," Mitropolous-Rundus said. "And especially when one of them says, 'You have made the following changes to your marketplace subscription.' I just applied. Why would I get an email telling me I just made a change? Why would I get three emails? It's not just about the website, it's about the whole customer experience - and emails are a part of that. I should only receive one email."
Another major usability problem with the healthcare.gov website was its ineffective attempt to brand things and add acronyms, Mitropolous-Rundus said. For example, the "SHOP" marketplace for small business owners uses an apt acronym, but it actually stands for the Small Business Health Operations Program.
"There was a weak attempt to brand things, and that weak attempt failed miserably," Mitropolous-Rundus said. "The lesson here is that if you're going to brand something and label something, commit to it and be strong about it. This was weak and it fell apart, like the process."
Mitropolous-Rundus concluded that if the site's creators had followed a more coherent usability process in designing healthcare.gov, much of the confusion could have been avoided.
"I conducted a usability review and I literally have enough material where I can give a full-day workshop on usability and design using the healthcare.gov website, and that's just me - one usability expert doing a review."
Contact Henry Gens at hgens@nd.edu
