Heuristics in Healthcare Software (or lack thereof)


Ever since I have delved into thinking more and more about software design in healthcare, I always have flashbacks to my days as a junior clinician when I first encountered the health system. I recall the first time I ever picked up a friend's iPhone and was immediately taken aback by how intuitive the design was. Clicking into a button did exactly what I wanted it to do, the symbols such as the search button, the home button and all that were frankly, quite similar and familiar already. Learning how to use an iPhone was easy-peasy. 

Nielsen's Heuristics are considered the general principles in user interface design and when looking at his list of principles to consider when designing software products, it's all quite intuitive and makes sense. These are:

  1. Visibility of system status - i.e. if the page is loading, there should be a loading bar
  2. There is a match between the real world and the online world i.e. calendar icon looking like a calendar - this helps with familiarity and learning
  3. User control and freedom - the user needs to have the freedom to 'undo' an action that was unintended
  4. Consistency - you shouldn't have to reinvent the wheel, given the plethora of mobile apps these days, there are some design patterns that can be replicated and these are more often than not, familiar to the user
  5. Error prevention - remember those days when you say in your emails 'please see attached' and you forget to actually attach the file? well, outlook and gmail reminds you to do so when they detect you typed the keyword 'attach' and haven't actually attached a file - that's preventing an embarrassing error!
  6. Recognition over recall - it's like google predictive search.... 
  7. Flexibility of use - have different options for basic vs advanced users
  8. AESTHETIC AND MINIMALIST DESIGN - need I say more? no.
  9. Help users recognise and recover from errors i.e. uh-oh sorry the password doesn't meet standard etc
  10. Help and documentation - have accessible help for users to navigate to.

Nielsen's heuristics are rather intuitive and logical, I definitely believe that these principles should be underlying any software that is developed for users. 

Anyway, coming back to my clinical days, I recall having to attend training to use this piece of software and thinking how absolutely ridiculous that sounded. I had always considered myself as a proficient user of new software because eventually, I would be able to stumble my way through the software and achieve what I wanted. I was always the type to reverse engineer things so that I could find my steps back. Little did I know that this would be a hallmark for how well designed that software was because if it was really well designed, you wouldn't need to actually attend a class for it. Imagine going into an organisation and no longer needing to attend any training for using basic software - it would save a lot of time and money. I digress. 


An example of healthcare software

Please stop, my brain hurts!

I decided to actually draw the piece of software that I would use in my clinical days. Please excuse my messy writing but honestly, this is such a cognitive overload! There are multiple task-bars at the top, which already is overwhelming for the user and violating any terms of minimalist and aesthetic design. Already as you open the tabs, there are multiple windows in the same area, trying to communicate vital medical information. It's not well depicted in my picture, but I remember that there were multiple ways to navigate the interface to find the same information. Some of frustrations that I had were:

  • Not being able to find things quickly
  • Needing to sift through different consult notes by expanding each note and then needing to collapse it
  • Feeling overwhelmed by the amount of clinical data on the one page 
  • Not knowing how to do some things, because the action was hidden under another tab. Finding that tab had to be taught to me by an experienced user.

Thinking back, I learnt how to use this programme over time because I had to, but thinking it from a UX point of view, there are a multitude of pain points that are risky for clinical care.

But the biggest risk factor that I can identify would be Cognitive overload - not being able to locate the proper information can lead to errors in patient care. In such a high risk environment, delivering the correct information at the right time when clicked in the right area should be a priority. Providing clinicians with the correct information in a dashboard that doesn't dumb down the information nor complicate it, will allow them to make quick judgements and create a more integrated seamless environment for connectivity to the internet of things. The future is endless with possibilities for achieving amazing patient outcomes, let's start with design, shall we?