June 2017

Volume 32 Number 6

[Don't Get Me Started]

I’m Still Flying, Part 2

By David Platt | June 2017

David PlattLast time, you remember, I was telling you about our UX design project with Zak Kohane of Harvard Medical School. Herewith the exciting conclusion:

Our project was designing the UX; not coding it, but determining what ought to be coded. We only had 10 sessions to get it all done. My students and I performed a straightforward, albeit intense, application of the Plattski Protocol™ that I published in my book, “The Joy of UX” (Addison-Wesley, 2016, joyofux.com).

We started, as always, with “Step 1: Who?” We analyzed the user population, quickly realizing that the patient isn’t the user, the patient’s caregiver is. We developed two personas: one for a family member caring for an aging relative (which we called the singular case), the other for a professional monitoring 100 patients as part of a medical practice (the plural case).

The next night we tackled “Step 2: What?” We wrote detailed UX stories, so very different from Agile development stories because they’re told from the persona’s viewpoint, not the program’s. Then we moved to “Step 3: Sketch It.” Each student used Balsamiq to sketch out a mockup design of each case, constantly receiving feedback from me and the other students.

The most important step, and the one that gets omitted most often in practice, is “Step 4: Try It Out.” There is no substitute, none, for trying your mockups on actual users. The sooner you do this, the easier and cheaper it is to make the corrections that you will surely need to make. As Disney’s Pocahontas sings: “When you walk the footsteps of a stranger, you learn things you never knew you never knew.”

How did we find test users? Easy. The students themselves knew plenty of good candidates. One student’s mother had spent years caring for aging relatives. Another student’s wife had a friend who worked with congestive heart failure (CHF) patients as a visiting nurse. They were happy to help us, honored—as most test users are—that we valued their opinion. We set up simple video connections with each of them using Google Hangouts, showing them the best of the student mockups, asking them to imagine themselves using it. “Mrs. X, imagine that you are monitoring your mother for weight gain, exacerbating her CHF. Here’s the app, where do you start?” “Well, the weights are obviously shown here, and this one is obviously today’s, so I look …”

As always, the test users gave us vital infor­mation: “I like [this]. I hate [that]. I don’t understand [this other]. And by the way, did you ever consider [such and such]?” As always, we said, “Damn, I never for a microsecond imagined [whatever].” And as always, within 30 seconds, our amazement mutated into, “Well, duh (head slap), what could be more obvious?”

Then back to Balsamiq. Fix the sketches. What didn’t the test user understand? It’s not their job to decipher things, it’s our job to clarify them. Change that label’s wording. They don’t need this control here; move it to another screen. Try it out. Present. Critique. Improve. Repeat. It was the most intense three weeks I’ve ever spent at Harvard.

Zak came to our last class to see our results. Each student presented their design (one of these examples, from Julie Dubela, is shown in Figure 1). Zak was astounded. After the first two, he said, “You know, we doctors don’t have anything remotely like this.” After four, he said, “We really need this.” And at the end he gave us what I think he considers the ultimate accolade: “Something like this would make us better doctors.”

Dr. Kohane raved about the ability to track daily weight changes
Figure 1 Dr. Kohane raved about the ability to track daily weight changes.

So where to now? I’m not sure. This obviously has huge potential. We could start a monitoring business, telling insurance companies: “Don’t pay us a nickel up front. We just want half the money that we save you.” Anyone up for a startup?

I’ve written before of the huge economic pressure building up behind the dam of medical informatics. (See my February 2013 MSDN Magazine column, “What’s Up, Doc?,” at msdn.com/magazine/jj891060.) This project could be the first major crack.

David S. Platt teaches programming .NET at Harvard University Extension School and at companies all over the world. He’s the author of 11 programming books, including “Why Software Sucks” (Addison-Wesley Professional, 2006) and “Introducing Microsoft .NET” (Microsoft Press, 2002). Microsoft named him a Software Legend in 2002. He wonders whether he should tape down two of his daughter’s fingers so she learns how to count in octal. You can contact him at rollthunder.com.

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