Commentary: HE-75 and IEC 62366 and Cleaning Up the Messes

I received a reminder recently when I was made aware of the International
Consortium of Investigative Journalists' database of medical device recalls of what human factors professionals working in the area of human engineering for medical devices are often called on to do: clean up the mess created by a failed design process that somehow failed to incorporate research. (Note that medical device development isn't the only domain where this kind of failure occurs, however, the impact of medical device failures can often result in fatalities.) The persons responsible for designing an awful, unusable and in some case, useless user interface expect the usability expert to come in, take one look and create a beautiful user interface. This is absurd!

Writing from my own perspective, there is nothing that a usability professional likes to do less than to correct a failed design that resulted from a failed design process. This week I was asked to save a group of programmers and user interfaced designers from the monstrosities that they had created. What was particularly strange was that the leader of the project thought that I could just redesign something by looking at what they had created. It was bizarre. Unfortunately, I had to deliver several harsh messages regarding the design process and the design, that were not well received. (Nevertheless, that is my job.)

Here is the point I want to make clear to anyone who reads this: Process and the resulting design should be considered as two sides of the same coin. The outcome of a good design process generally results in a good design. A nonexistent or poor design process often times leads to a poor design and a design that gets worse with each design iteration when attempts are made to fix problems or incorporate enhancements.

The processes and design direction provided by HE-75 and IEC 62366 can serve as a foundations for research and designing systems with user impacts within nearly any industry, particularly in those industries where the potential for harm is likely.

HE-75 Topic: Cleaning Up the Mess

I received a reminder this week of what usability professionals are often called on to do – cleaning up the mess created by a failed process. Somehow, the persons responsible for designing an awful, unusable and in some case, useless user interface expect the usability expert to come in, take one look and create a beautiful user interface. This is absurd!  It was the "nightmare" come true - something related to one of my other postings: HE-75 topic: Design first and ask questions later

Writing from my own perspective, there is nothing that a usability professional likes to do less than to correct a failed design that resulted from a failed design process. This week I was asked to save a group of programmers and user interfaced designers from the monstrosities that they had created. What was particularly strange was that the leader of the project thought that I could just redesign something by looking at what they had created. It was bizarre. Unfortunately, I had to deliver several harsh messages regarding the design process and the design, that were not well received. (Nevertheless, that is my job.)

Here is the point I want to make to anyone who reads this. Process and the resulting design should be considered as two sides of the same coin. Good design process nearly always results in a good design. A nonexistent or poor design process leads to a poor design. HE-75's design process can serve as a foundation design process for designing user interface in nearly any industry, particularly in those industries where the harm is particularly severe. Where I am currently working, I plan to use HE-75 as one of the foundation documents to set user interface design standards. And as I mentioned, I am not currently working in the medical or medical device industry. However, I have come to believe that in this industry, the level of harm can be significant. Thus, I shall incorporate HE-75.

 

Next time, I'll review so of the literature that might be of some use to the community.

Advanced Technology

I mentioned in an earlier article that I have move out of medical devices for the time being.  However, I have moved out of remote monitoring or remote programming (it is called "remote configuration" where I am now.)

We have been given the go ahead to explore a variety of new and what some may consider, off the beaten path technologies.  Although I shall not be able to discuss specific studies or approaches, I shall be able to discuss how some technologies not currently used by the medical and medical device communities might be useful to them.

I shall have periodic updates on this topic from time to time.

Here are some platforms to consider for mobile technology.  (This is not part of the work that I am doing now.  It is more related to my earlier work.)

Useful Verses Usable

This is a discussion that you are not likely to read in usability texts – the topic of useful verse usability, and the value of each. Just recently I had a discussion with someone on just this topic. Furthermore, I have had numerous discussions with others and each time it surprises me that people often do not know the difference between the two and the value of each.

Useful and Usable

If you go to the dictionary, you will discover that “useful” means “to be of serviceable value, beneficial” and in addition “of practical use.” Pretty straight forward.

On the other hand, the definition of “usable” is “capable of being used” and “convenient and viable for use.” Also a straightforward definition.

However, if you probe more deeply into the definitions, you will note that “useful” is the first, necessary quality of a tool or system. It must be useful or why use it? Usable is a quality of a tool or system. However, it is not primary in relationship with the quality of the being “useful.” It is secondary. Necessary, yes, nevertheless, it is still secondary.

The usefulness as a quality of a tool or system is not addresses in HE-75, or any other usability standard that I have encountered. (If any one knows of a standard where usefulness is addressed, please add a comment to this discussion.) Usefulness is assumed.

However, I have learned that in the real world, the usefulness of any tool or system should not be assumed. It should be tested. Furthermore, with complex systems, the fundamental capabilities of a system or tool are often useful. However, not all of the capabilities of that system may be.

I direct experience with a remote monitoring system where the primary or fundamental capabilities of the system have clear use. However, with each release of this system, as more capabilities are added, the useless capabilities may be on the verge of out numbering the useful ones.

Bottom Line

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  Usefulness is always more important than usability. If it is not useful, it is fundamentally worthless or at best, excess baggage, and a drag on the actual and perceived quality of the tool or system.
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  Usefulness should never be assumed. It should be demonstrated. I know of too many projects where usefulness was not demonstrated. This lead to capabilities being developed that waste time and money, and can damage reputations.

HE-75, Usability and When to Prototype and Usability Test: Take 1

Prototyping and Testing will be a topical area where I shall have much to contribute.  Expect numerous articles to appear on this topic.

I had a discussion a few days ago with one of my colleagues who has worked as a user interface designer, but has little knowledge of human factors.  He was completely unaware of the concepts of "top-down" and "bottom-up" processes to user interface design.  I provide for you the essence of that discussion.

Top-Down Approach

The top-down approach begins with a design.  Most often the initial design is a best or educated guess based on some set of principles.  Could be aesthetics or "accepted" standards of good design, or something else.  The design is usability and/or acceptance tested in some manner.  (Anywhere from laboratory testing to field-collected data.)  In response to the data, the design reworked.  The process is continual.  Recent experience has suggested that the top-down approach has become predominant design methodology, particularly for the development of websites.

Top-down is a valid process, particularly for the deployment of new or unique products where the consequences of a failed design do not lead to serious consequences.  It can get a design into user hands more quickly.  The problem with a top-down approach (when practiced correctly) is that it relies on successive approximations to an ill-defined or unknown target.  To some degree it's similar to throwing darts blindfolded with some minimal correction information provided after each throw.  The thrower will eventually hit the bull's eyes, but it may take lots and lots of throws.

The top-down approach may have a side benefit in that it can lead to developing novel and innovative designs.  Although, it can have the opposite effect when designs are nothing more than "knock-offs" of the designs from others.  I have seen both coming out of the top-down approach.

Bottom-Up Approach

HE-75 teaches the use of a bottom-up approach where first one defines and researches the targeted user population.  Contextual Inquiry is also a bottom-up approach.  Since I have already discussed researching the targeted user population in depth, I'll not cover it here.  

With the bottom-up approach, the target is clear and understood.  And tailoring a design to the user population(s) should be a relatively straight forward process.  Furthermore, the bottom-up approach directly addresses the usefulness issue with hard data and as such, more likely to lead to the development of a system that is not only usable, but useful.

Useful vs. Usable

I'll address this topic more deeply in another article.  It suffices to say that usability and usefulness are distinctly different system qualities.  A system may be usable, that is, the user interface may require little training and be easy to use, but the system or its capabilities are not useful.  Or, and this is what often happens particularly with top-down approaches, much of what the system provides is not useful or extraneous.

Personal Preference

I am a believer in the bottom-up approach.  It leads to the development of systems that are both usable and useful sooner than the top-down approach.  It is the only approach that I would trust when designing systems where user error is of particular concern.  The top-down approach has its place and I have used it myself, and will continue to use it.  But, in the end, I believe the bottom-up approach is superior, particularly in the medical field. 

HE-75 Touch Screen Recommendations

I have found HE-75 to be one of the best human factors standards ever produced.  However, I have found their analysis and recommendations regarding touch screens lacking, and out of date.  To place a perspective on the HE-75 touch screen recommendations ... in the late 1980's and early 1990's, I ran a user interface design and implementation project inside of a larger project at Bell Laboratories.  To make a long story short, one of the user interfaces we needed to design and produce was a touch screen interface.  The touch screen used a CRT as a display device and it was as flat as we could make it.  In addition, the distance between the touch screen surface and the display was about 35 mm.  When I read of the issues related to touch screens and the recommendations in HE-75, I experience deja vu and I feel as if I've been transported back to that time.

Some of the most significant advances in user interfaces have been in the areas of display technology and touch screens with respect to hardware and in particular software.  Apple Computer has been a leader in combining the advances in both display technology, touch screen design and touch screen interface software.  I would have expected the HE-75 committee to have incorporated these advances and innovations in touchscreen software into the standard.  However, what I have found appears to me as ossified thinking or ignoring what has transpired.  

People in the medical field are using smart phones with their advanced touch screen interfaces in their medical practice.  Smart phone touch screens and now the Apple iPad have become the de facto standard in touch screen technology.  My previous article related to consistency ... here's a consistency issue.  Is it wise to suggest that medical device touch screen interfaces look and operate in a way different from the accepted standard in the field?  I know this is not a simple question, but I think it is one that will need to be addressed in future editions of HE-75.

The Return: The Value of Consistency

I have been distracted for a couple of months ... working to find and land another consulting contract.  I have completed that task.  However, it is outside of the medical device industry.  I am not completely happy with the situation, however, having a position outside of the medical device industry does afford some freedom when commenting on it.

Another reason for the significant gap between my last post and this one has been that I was working on a long and intricate post regarding hacking or hijacking medical device communications.  The post began to look more like a short story than a commentary.  The more I worked on it, the longer and more convoluted it became.  At some point, I may publish portions of it.

This experience with the article that would never end has lead me to change the way I'll be posting articles in the future.  In the future, my articles will be short - two to four paragraphs.  And will address a single topic.  I think that some of my posts have been too long and in some cases, overly intricate.  I still plan to cover difficult topics, but in a format that is more readable and succinct.

Consistency in User Interfaces

When it comes to making user interface "usable," the two qualities are 1. Performance and 2. Consistency.  Performance is obvious.  If the interface is slow, unresponsive, sluggish, etc. people will not use it.  Or those who are stuck with using it will scream.  Consistency is somewhat less obvious and more difficult to describe.  However, when you encounter a user interface that has changed dramatically on an application that you thought that you knew, you understand the value of consistency. 

Recently, I encountered a newer version of Microsoft Office.  Gone are the pull down menus, the organization of the operations and tools has changed dramatically.  Frankly, I hate the new version.  If I had encountered the newer version of Office as my first encounter with Office, I know that my reaction would be different.  The new version is inconsistent with the older version.  My ability to transfer my knowledge about how to use the newer version is being hindered by the dramatic changes that have been made.  

Consistency is about providing your users with the capability to reapply their knowledge about how things work to new and updated systems.  Operations work the same between applications and between older and newer versions.  In the case of the new version of Word, I am grateful that once I have selected a particular operation, such as formatting, it essentially works the same as the older version.  However, I have tried to use the newer version of PowerPoint and it's drawing capabilities.  I have not yet been successful and am a drawing tool that I know how to use.

Consistency has a side benefit for the development process as well.  When operations, layouts, navigation, etc. become standardized, extending the design of a user interface becomes easier, less risky and less likely to be rejected by users.  The effect of creating consistent user interfaces is similar to having a common language. More on consistency and HE-75 in a later post.