"How bad UX killed Jenny" by Jonathan Shariat

My wife, a nursing student, was sharing with her teacher about how passionate I am about technology in healthcare. Her teacher responded that she thought we need less technology and told a story why she felt so strongly that way. I would like to share this story with you.

Jenny, as we will call her because the patient's name was never shared, was a little girl who had previously been in the hospital ward for cancer for four years and was discharged. Then a while later she relapsed and had to be given a very strong chemo treatment medicine. This medicine is so strong and so toxic that it requires pre-hydration and post-hydration for three days with I.V. fluid. However, after the medicine was administered, three nurses were attending to the charting software to enter in everything required of them and make the appropriate orders, missed a very critical piece of information. Jenny was supposed to be given 3 days of I.V. hydration. But the three nurses, with over 10 years experience, were too distracted trying to figure out the software they were using, they completely missed it.

When the morning nurse came in the next day, she had died of toxicity and dehydration. For two shifts, she had missed her hydration and all because the three, very good nurses, were stuck trying to figure this out…

Note: The large black arrow is from the screenshot I found.

This screenshot I found is similar to the one my wife uses every day. I can't imagine what the UI must have looked like years ago.

Here are a few more I found, dates unknown:

These interfaces were used every day by hospital staff taking care of people’s health.

When most of us design a User Interface, and fail at basic usability, the worst that happens is that our product fails. Yet, when the designers of this system, or even an airplane’s cockpit, fail at their design, there are real physical harms. With so much on the line, you would think these industries would have hired the best designers in the world to carefully craft the User Experience. But they don’t.

Being a designer who is very passionate about what I do, this hurt. In all honesty, I don't think I've ever felt this emotional about any bad design I’ve encountered. I feel angry and sick when I look at that interface above. I start to think about the other stories that have been shared: like an ebola patient being sent home accidently, a pilot accidently plotting the wrong course killing crew and passengers, and so many other stories like them. I even think about my poor in-laws who are 60+ trying to navigate the government sites to pay for their ticket, or find information about government services for their son.

We can’t stand by while people’s lives, health, & rights suffer because of bad design.

There are some real, very serious UX problems out there for us to tackle. For now I don't know exactly how to change it, but here are some practical steps of things you can do in the mean time if you feel the same:

  1. Get a job. When searching your next job, take a look at a non-profit, government, healthcare, or other “not as glamorous” areas that need our skills. It might not be designing a chat app for teens but it may save their lives.
  2. Redesign it. If you want a redesign project, many of these interfaces could use a facelift. Find one you think needs improved, design it and send it over.
  3. Start it up. If you're an entrepreneur looking for a startup idea, look no further. The healthcare system is stagnant and people are desperate for change. Why not jump in and disrupt the system worth billions? Katelyn is doing it.
  4. Make a sound. Hate the DMV site, did they mix up your medication order, can’t find how to access something? Send them an email, give them a call.

If you are already tackling this problem. Hit me up, I'd love to help any way I can. I'm @DesignUXUI on twitter. I'd love to hear any ideas people have about this.

This featured article was originally published online here. Geneix received Jonathan's permission to re-post his blog, we believe that the issues he highlights are critically important. At Geneix we place a huge emphasis on User Experience and User Interface design. Creating software that is intuitive, clear, well-designed and easy to use. 

FIVE Fundamentals Of User Experience Design

1.     Be clear
"Delight the eye without distracting the mind." - Google

Ensure that your interface has ‘preferred actions’ so the user always knows what they should/can do. Design for the majority of your users and let extra functionality be discovered as needed (e.g. through hover controls, information layering) without delivering everything all at once.

Use visual cues, as little copy as possible and always provide defaults (undo/redo/home).  Promote visual clarity with well thought-out information hierarchy so the most important information is always clearly displayed and accessible with no effort.

Our flagship product, Interact, contains huge amounts of detailed and complex information (drug and gene). However it’s clear interface and strong visual cues ensures that users are at no point overwhelmed with content.


2. Be consistent
"Things that look the same should behave in the same way, and an action should always produce the same result." - IBM

A consistent design is actually simpler for users because it re-uses components, behaviours, colours, and aesthetic to reduce the need for users to rethink.  Users are already familiar with many of the components used throughout apps and the web, so complying with these patterns will make the system simpler and clearer right from the start. When a design is consistent and clear it relies on recognition not recall – reducing a users memory load and the amount of ‘work’ they’re expected to do. It’s important to keep interaction results the same (manage users expectations) and encourage exploration by keeping key elements predictable. 

When building Interact we made extensive use of colours that we knew users would recognize and associate with. In reliance on this recall our app communicates it’s most important information visually so users simply have to scan the page.


3.     Give users control 
"Allow users to personalise their experience. People love to add personal touches because it helps them feel at home and in control. Provide sensible, beautiful defaults, but also consider fun, optional customisations that don't hinder primary tasks." - Google Android

When people feel out of control, they simply don’t have a good time. This doesn’t mean that you can’t surprise people; it means that users need to feel like they are always able to take the next step (or bow out) at their request. Some users will be experienced and skilled, they will want more control over their journey (car driver) than a novice or casual user (train passenger) who may prefer to feel guided and safe - see Theo Mandels car vs. train analogy. Good UX designs accommodates for both and recognizes that users deserve the right to change their minds and take the car one day and the train the next.

Control can come from several places, such as allowing users to dictate the pace, path and level/detail of detail (choosing to ‘deep dive’ for more information). It can also come from interface customization; personalizing something for you – even a little change like picking a colour – helps users to feel more in control. Provide meaningful paths and exits so users feel the design is forgiving also helps them feel more in control and able to navigate away from a linear user journey.

As mentioned above Interact contains a wealth of complex information. A casual user can quickly use the app to check for a drug interaction within seconds. Likewise they can also use the app to customize doses etc., compare and explore several drugs simultaneously, read in-depth information about interactions or access entire drug monographs. Both users will follow the same steps but the their journey and the depth of the knowledge gained will be entirely different. 


4. Make conversation
"Use real world behaviour and user testing to aid the development process." GOV.UK

UX is a conversation. As UX professionals we are creating a dialog with users in which the goal is to find out how we can best help them do what they want to do. Therefore, UX becomes a service that is constantly reacting to the changing needs of our audience – it is not a one off product. The conversation is both how we deliver and how we find out how to make it better. 

Since day one we have worked closely with our users, responding to feedback and implementing suggestions. When Interact is released we will continue to react to the changes needs of our users and the environments in which they operate.


5. Be friendly 
"Delight me in surprising ways: A beautiful surface, a carefully-placed animation, or a well-timed sound effect is a joy to experience." - Google Android

Users should be able to relax and enjoy exploring the interface of any software product. Even industrial-strength products shouldn’t intimidate users so that they are afraid to press a button or navigate to another screen.

It’s also critical to establish the proper tone of voice in messages and prompts. It is important to assign no blame for errors or problems. Poor message terminology and tone encourages users to blame themselves for problems that occur, effecting their confidence and experience. Constant alerts that bombard the users can also lead to user fatigue.

Interfaces today and in the future must be more intuitive, enticing, predictable, and forgiving than the interfaces we’ve designed to date. It’s time we moved onward past user-friendly interfaces to user-seductive and fun-to-use product interfaces, even in the healthcare environment.