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Purin, B. et al.: User-centered Design of a PHR: Traditional Web Forms vs. Wizard Forms This slideshow, presented at  Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team Do not miss the next Medicine 2.0 congress on  17/18th Sept 2009 ( www.medicine20congress.com ) Order Audio Recordings (mp3) of  Medicine 2.0’08  presentations at  http://www.medicine20congress.com/mp3.php
User-centered Design of a PHR: Traditional Web Forms vs. Wizard Forms Barbara Purin and Emiliano Ricci FBK, Fondazione Bruno Kessler, Trento, Italy Friday, September 5, 2008 e-Health Applied Research Unit
The  Department of Health   and the  Department of Research and Innovation   of the  Autonomous Province of Trento  (NE Italy)  have funded a feasibility study of a  Personal Health Information Management  ( PHIM )  System   for the  citizens  living in the Province. PHIM refers to activities that support consumers’ access, integration, organization,  and use of their personal health information. PHIM activities rely on the  collection  and  management   of one’s own personal health information collected from each health care provider  plus any health information you want to add. Considerable effort was dedicated to guide and support the management of health information in the System design phase. Friday, September 5, 2008 e-Health Applied Research Unit The Autonomous  Province of Trento The Department  of Health Andrea Civan, Meredith M. Skeels, Anna Stolyar and Wanda Pratt,  Personal Health Information Management: Consumers’ Perspectives.   AMIA Annu Symp Proc. 2006;  2006: 156-160
- Exploring the effectiveness of the  traditional web forms  vs.  wizard step-by-step structure ; - gathering information about problems that users may encounter when interacting with such interfaces; - understanding which system, if any, improve more the data entry process and attracts more users. We focused on  testing usability  and  user experience  of two user interfaces designed and developed to support citizens to maintain  drugs’ information  themselves. Input data forms  and  navigation  are crucial elements;  they would be used consistently in order not to compromise  the use of the System. REMARKS: Widespread and extensive use of  traditional  and  wizard form layouts  for data input and configuration in Web applications.  Friday, September 5, 2008 e-Health Applied Research Unit
PHASE 1:   Informal early evaluation of each user interface think-aloud technique:  observing users while surfing the prototypes and filling the data input forms; post-task questionnaire  based on a Likert-type scale for assessing user satisfaction; debriefing semi-structure interview  for exploring subjective user experience behind what was previously observed.  PHASE 2:   Formal evaluation based on the  comparison   of the two user interfaces Friday, September 5, 2008 e-Health Applied Research Unit   
Interactive, software-based prototypes; scenario prototypes . Scenario prototypes are task oriented ; we decided to fully implemented two important tasks  that cut through the functionalities of the prototypes. No differences between the prototypes as regards the content.   Friday, September 5, 2008 e-Health Applied Research Unit
Stories of common real life drug prescription: - recording a new therapy and specify drug dosage ; - recording a therapy evaluation . Task #1,  Recording a new therapy Goals:   entering new therapy data (drug name, confection, reason for consumption, therapy start date); the task is complete when the form is filled and saved (data are displayed in a not-editable format ). Inputs:  ---  Assumptions:  --- Steps:  the user has to (…) Friday, September 5, 2008 e-Health Applied Research Unit
- overview of all requested information; data fields can be filled at any order; need of vertical scrollbar; - check values before saving data. THE TRADITIONAL WEB FORM BASED USER INTERFACE  (briefly ‘TRADITIONAL UI’) ALL DATA IN A SINGLE PAGE A screenshot of the prototype. Friday, September 5, 2008 e-Health Applied Research Unit
DATA PRESENTED IN A STEP-BY-STEP STRUCTURE list of data entered previously by the user on the top of the page; ordered sequence of small input data forms; NO need of vertical scrollbar; check values inserted in the form before moving from one step to the next one. A screenshot of the prototype. Friday, September 5, 2008 THE WIZARD WEB FORM BASED USER INTERFACE  (briefly ‘WIZARD UI’) e-Health Applied Research Unit
e-Health researchers  and  software engineers  (8 people) working in the Bruno Kessler Foundation (FBK) and  not involved in this work , were asked to find the usability problems with the interfaces  without specifying any set of general principles to follow .  We were interested in the point of view of  skilled users  with  no training or experience in usability engineering .   Friday, September 5, 2008 e-Health Applied Research Unit they were asked to review the system interfaces and to perform the tasks by  working separately  and  without assistance ; a  brainstorming  was then performed to point out problems and suggestions . THE EVALUATION PROCESS:
   CONTENT : some specific, local problems as regards labels, combo boxes’ values, and radio buttons; NAVIGATION : navigation problems from screen to screen; drug information needed to being organized in  Main data ,  Dosage , and  Therapy evaluation  web tabs; reminder functionalities about  end therapy  and  drug assumption  were added to the prototypes.   At the end of this evaluation, the two prototypes were  refined  according to the comments and suggestions. Friday, September 5, 2008 e-Health Applied Research Unit
8 participants [1] ( women ) recruited among the administrative personnel of the Bruno Kessler Foundation (FBK).  INCLUSION CRITERION:   skill in using the web   (use of Internet from more than 1 year and for at least 1 hour per week)  [1] Nielsen, J.  “Why You Only Need to Test with 5 Users”,  http://www.useit.com Usability test participants’ characteristics COMPARISON TEST: - 4 of them  used first the traditional UI   and then the wizard UI; - the others  used first the wizard UI and then the traditional UI. Friday, September 5, 2008 e-Health Applied Research Unit 0 4 4 Reason for using the Internet Only at home Only at work Both 2 4 2 Time spent using the internet Less then 3 hours per week 3-6 hours per week More than 6 hours per week 0 8 Internet experience Less than one year More than one year 5 3 Educational qualification High school Univesity 3 1 4 0 Age range (years) 19-29 30-39 40-49 More than 50
DATA GATHERING:  reports were transcribed in a world processing file; a content analysis was performed.   Users were encouraged to “think aloud” commenting on any difficulties they encountered while performing the tasks. ( Kushniruk, A.W., & Patel, V.L. (2004). Cognitive and usability engineering methods for the evaluation of clinical information systems. Journal of Buomedical Informatics, 37, 56-76 ) CODING CATEGORIES: navigation, graphics, layout/screen organization, color, resolution, meaning of labels,  understanding of system instruction/error messages, consistency of operations, overall ease of use, response time, visibility of system status, data not displayed, data entry Friday, September 5, 2008 e-Health Applied Research Unit
Friday, September 5, 2008 Total  usability  problems  by category e-Health Applied Research Unit
Friday, September 5, 2008 - Chart 1 -  Usability problems funded by the subgroup of participants  that  used first the traditional UI  and then the wizard UI. - Chart 2 -  Usability problems funded by the subgroup of participants  that  used first the wizard UI  and then the traditional UI. e-Health Applied Research Unit
At the end of the tasks, users were asked to fill a questionnaire for assessing  user satisfaction . COLLECTED DATA: questions were based on the seven-point Linkert semantic scale;  each response was converted to a numerical value in the range [-3,3]. FINDINGS:  the user satisfaction is basically positive (1); no statistical differences between the two interfaces (2).  Friday, September 5, 2008 e-Health Applied Research Unit 1,05 0,925 0,4 0,6 1,7 2,3 1 0,4 1,3 1,3 -0,3 0,4 2 0,8 1,8 1,8 0,2 0,1 MEAN (range [-3,3]) 1,625 1,125 2 2 2 2 1 1 2 2 -1 2 2 2 3 3 -1 -2 pleasant 0,75 1,25 0 0 1 3 2 0 -2 2 -2 1 2 2 2 3 1 1 I like  0,75 0,875 0 1 1 2 0 0 2 0 2 -1 2 2 2 2 -1 -1 satysfying 1,375 0,875 0 0 1 2 0 0 2 2 -2 1 2 0 2 2 3 3 engaging 1 0,75 0 1 2 3 0 0 2 1 0 0 2 1 2 2 -1 -1 comfortable 1 1,125 1 2 2 2 1 1 1 2 1 -1 2 1 2 2 -1 -1 clear 1,75 0,875 2 2 2 2 0 0 2 1 -2 2 2 0 2 2 2 2 interesting 0,625 0,75 -2 -2 2 2 2 -1 2 2 1 0 2 0 1 2 0 0 intuitive 1,5 1 2 2 2 3 2 2 1 1 -2 -1 2 -1 2 3 1 1 easy to use 0,125 0,625 -1 -2 2 2 2 1 1 0 2 1 2 1 0 -3 -1 -1 easy to understand MEAN w   MEAN p p w w p p w w p p w w p p w w p p = traditional web form w = wizard web form User H User G User F User E User D User C User B User A USER & SYSTEM INTERFACE   QUESTION
User’s opinions  about the  preferred interface   were gathered during the  debriefing phase  of the tests. FINDIGS: Friday, September 5, 2008 1 user was not able to state the preferred interface because in her opinion the two interfaces were similar. e-Health Applied Research Unit 4 3 # PREFERENCES “ it is easier to use ”; data are entered step-by-step; it calls your attention on the data you are entering; “ I see both data entered previously and information required by the form to be filled ”  WIZARD WEB FORM more comfortable; (plenty of) data in a single page (“ in a wizard form I don’t know which information will be required in the following step ”); data are aggregated;  TRADITIONAL  WEB FORM REASON WEB FORM LAYOUT
No one user interface seems to prevail against the other. The most frequent usability issues encountered by the users were related to clearly-defined content and navigation problems. Friday, September 5, 2008 The incidental preference coming from the debriefing interview was founded on  subjective impressions . e-Health Applied Research Unit
Repeated cycles of  design-testing-measure-redesign   allow pointing out wrong design assumption  about a system   that could cause usability problems later. Friday, September 5, 2008 Comparison tests  ( different prototypes matched against each other ) avoid to commit too early to one design that could reveal its faults only later. The two prototypes are going to be  refined   according to the founded usability issues; then a usability test with participants ( both women and men )  less skilled in using the web  will be performed. It could be interesting to evaluate the two interfaces  after people have used one of them for a period of time. e-Health Applied Research Unit   
e-Health Applied Research Unit Thank you for your attention Friday, September 5, 2008    http://www.fbk.eu    http://ehealth.fbk.eu

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User-centered Design of a PHR: Traditional Web Forms vs. Wizard Forms [5 Cr2 1100 Purin]

  • 1. Purin, B. et al.: User-centered Design of a PHR: Traditional Web Forms vs. Wizard Forms This slideshow, presented at Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009 ( www.medicine20congress.com ) Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at http://www.medicine20congress.com/mp3.php
  • 2. User-centered Design of a PHR: Traditional Web Forms vs. Wizard Forms Barbara Purin and Emiliano Ricci FBK, Fondazione Bruno Kessler, Trento, Italy Friday, September 5, 2008 e-Health Applied Research Unit
  • 3. The Department of Health and the Department of Research and Innovation of the Autonomous Province of Trento (NE Italy) have funded a feasibility study of a Personal Health Information Management ( PHIM ) System for the citizens living in the Province. PHIM refers to activities that support consumers’ access, integration, organization, and use of their personal health information. PHIM activities rely on the collection and management of one’s own personal health information collected from each health care provider plus any health information you want to add. Considerable effort was dedicated to guide and support the management of health information in the System design phase. Friday, September 5, 2008 e-Health Applied Research Unit The Autonomous Province of Trento The Department of Health Andrea Civan, Meredith M. Skeels, Anna Stolyar and Wanda Pratt, Personal Health Information Management: Consumers’ Perspectives. AMIA Annu Symp Proc. 2006; 2006: 156-160
  • 4. - Exploring the effectiveness of the traditional web forms vs. wizard step-by-step structure ; - gathering information about problems that users may encounter when interacting with such interfaces; - understanding which system, if any, improve more the data entry process and attracts more users. We focused on testing usability and user experience of two user interfaces designed and developed to support citizens to maintain drugs’ information themselves. Input data forms and navigation are crucial elements; they would be used consistently in order not to compromise the use of the System. REMARKS: Widespread and extensive use of traditional and wizard form layouts for data input and configuration in Web applications.  Friday, September 5, 2008 e-Health Applied Research Unit
  • 5. PHASE 1: Informal early evaluation of each user interface think-aloud technique: observing users while surfing the prototypes and filling the data input forms; post-task questionnaire based on a Likert-type scale for assessing user satisfaction; debriefing semi-structure interview for exploring subjective user experience behind what was previously observed. PHASE 2: Formal evaluation based on the comparison of the two user interfaces Friday, September 5, 2008 e-Health Applied Research Unit   
  • 6. Interactive, software-based prototypes; scenario prototypes . Scenario prototypes are task oriented ; we decided to fully implemented two important tasks that cut through the functionalities of the prototypes. No differences between the prototypes as regards the content. Friday, September 5, 2008 e-Health Applied Research Unit
  • 7. Stories of common real life drug prescription: - recording a new therapy and specify drug dosage ; - recording a therapy evaluation . Task #1, Recording a new therapy Goals: entering new therapy data (drug name, confection, reason for consumption, therapy start date); the task is complete when the form is filled and saved (data are displayed in a not-editable format ). Inputs: --- Assumptions: --- Steps: the user has to (…) Friday, September 5, 2008 e-Health Applied Research Unit
  • 8. - overview of all requested information; data fields can be filled at any order; need of vertical scrollbar; - check values before saving data. THE TRADITIONAL WEB FORM BASED USER INTERFACE (briefly ‘TRADITIONAL UI’) ALL DATA IN A SINGLE PAGE A screenshot of the prototype. Friday, September 5, 2008 e-Health Applied Research Unit
  • 9. DATA PRESENTED IN A STEP-BY-STEP STRUCTURE list of data entered previously by the user on the top of the page; ordered sequence of small input data forms; NO need of vertical scrollbar; check values inserted in the form before moving from one step to the next one. A screenshot of the prototype. Friday, September 5, 2008 THE WIZARD WEB FORM BASED USER INTERFACE (briefly ‘WIZARD UI’) e-Health Applied Research Unit
  • 10. e-Health researchers and software engineers (8 people) working in the Bruno Kessler Foundation (FBK) and not involved in this work , were asked to find the usability problems with the interfaces without specifying any set of general principles to follow . We were interested in the point of view of skilled users with no training or experience in usability engineering .   Friday, September 5, 2008 e-Health Applied Research Unit they were asked to review the system interfaces and to perform the tasks by working separately and without assistance ; a brainstorming was then performed to point out problems and suggestions . THE EVALUATION PROCESS:
  • 11. CONTENT : some specific, local problems as regards labels, combo boxes’ values, and radio buttons; NAVIGATION : navigation problems from screen to screen; drug information needed to being organized in Main data , Dosage , and Therapy evaluation web tabs; reminder functionalities about end therapy and drug assumption were added to the prototypes.   At the end of this evaluation, the two prototypes were refined according to the comments and suggestions. Friday, September 5, 2008 e-Health Applied Research Unit
  • 12. 8 participants [1] ( women ) recruited among the administrative personnel of the Bruno Kessler Foundation (FBK). INCLUSION CRITERION: skill in using the web (use of Internet from more than 1 year and for at least 1 hour per week) [1] Nielsen, J. “Why You Only Need to Test with 5 Users”, http://www.useit.com Usability test participants’ characteristics COMPARISON TEST: - 4 of them used first the traditional UI and then the wizard UI; - the others used first the wizard UI and then the traditional UI. Friday, September 5, 2008 e-Health Applied Research Unit 0 4 4 Reason for using the Internet Only at home Only at work Both 2 4 2 Time spent using the internet Less then 3 hours per week 3-6 hours per week More than 6 hours per week 0 8 Internet experience Less than one year More than one year 5 3 Educational qualification High school Univesity 3 1 4 0 Age range (years) 19-29 30-39 40-49 More than 50
  • 13. DATA GATHERING: reports were transcribed in a world processing file; a content analysis was performed. Users were encouraged to “think aloud” commenting on any difficulties they encountered while performing the tasks. ( Kushniruk, A.W., & Patel, V.L. (2004). Cognitive and usability engineering methods for the evaluation of clinical information systems. Journal of Buomedical Informatics, 37, 56-76 ) CODING CATEGORIES: navigation, graphics, layout/screen organization, color, resolution, meaning of labels, understanding of system instruction/error messages, consistency of operations, overall ease of use, response time, visibility of system status, data not displayed, data entry Friday, September 5, 2008 e-Health Applied Research Unit
  • 14. Friday, September 5, 2008 Total usability problems by category e-Health Applied Research Unit
  • 15. Friday, September 5, 2008 - Chart 1 - Usability problems funded by the subgroup of participants that used first the traditional UI and then the wizard UI. - Chart 2 - Usability problems funded by the subgroup of participants that used first the wizard UI and then the traditional UI. e-Health Applied Research Unit
  • 16. At the end of the tasks, users were asked to fill a questionnaire for assessing user satisfaction . COLLECTED DATA: questions were based on the seven-point Linkert semantic scale; each response was converted to a numerical value in the range [-3,3]. FINDINGS: the user satisfaction is basically positive (1); no statistical differences between the two interfaces (2). Friday, September 5, 2008 e-Health Applied Research Unit 1,05 0,925 0,4 0,6 1,7 2,3 1 0,4 1,3 1,3 -0,3 0,4 2 0,8 1,8 1,8 0,2 0,1 MEAN (range [-3,3]) 1,625 1,125 2 2 2 2 1 1 2 2 -1 2 2 2 3 3 -1 -2 pleasant 0,75 1,25 0 0 1 3 2 0 -2 2 -2 1 2 2 2 3 1 1 I like 0,75 0,875 0 1 1 2 0 0 2 0 2 -1 2 2 2 2 -1 -1 satysfying 1,375 0,875 0 0 1 2 0 0 2 2 -2 1 2 0 2 2 3 3 engaging 1 0,75 0 1 2 3 0 0 2 1 0 0 2 1 2 2 -1 -1 comfortable 1 1,125 1 2 2 2 1 1 1 2 1 -1 2 1 2 2 -1 -1 clear 1,75 0,875 2 2 2 2 0 0 2 1 -2 2 2 0 2 2 2 2 interesting 0,625 0,75 -2 -2 2 2 2 -1 2 2 1 0 2 0 1 2 0 0 intuitive 1,5 1 2 2 2 3 2 2 1 1 -2 -1 2 -1 2 3 1 1 easy to use 0,125 0,625 -1 -2 2 2 2 1 1 0 2 1 2 1 0 -3 -1 -1 easy to understand MEAN w   MEAN p p w w p p w w p p w w p p w w p p = traditional web form w = wizard web form User H User G User F User E User D User C User B User A USER & SYSTEM INTERFACE  QUESTION
  • 17. User’s opinions about the preferred interface were gathered during the debriefing phase of the tests. FINDIGS: Friday, September 5, 2008 1 user was not able to state the preferred interface because in her opinion the two interfaces were similar. e-Health Applied Research Unit 4 3 # PREFERENCES “ it is easier to use ”; data are entered step-by-step; it calls your attention on the data you are entering; “ I see both data entered previously and information required by the form to be filled ” WIZARD WEB FORM more comfortable; (plenty of) data in a single page (“ in a wizard form I don’t know which information will be required in the following step ”); data are aggregated; TRADITIONAL WEB FORM REASON WEB FORM LAYOUT
  • 18. No one user interface seems to prevail against the other. The most frequent usability issues encountered by the users were related to clearly-defined content and navigation problems. Friday, September 5, 2008 The incidental preference coming from the debriefing interview was founded on subjective impressions . e-Health Applied Research Unit
  • 19. Repeated cycles of design-testing-measure-redesign allow pointing out wrong design assumption about a system that could cause usability problems later. Friday, September 5, 2008 Comparison tests ( different prototypes matched against each other ) avoid to commit too early to one design that could reveal its faults only later. The two prototypes are going to be refined according to the founded usability issues; then a usability test with participants ( both women and men ) less skilled in using the web will be performed. It could be interesting to evaluate the two interfaces after people have used one of them for a period of time. e-Health Applied Research Unit   
  • 20. e-Health Applied Research Unit Thank you for your attention Friday, September 5, 2008  http://www.fbk.eu  http://ehealth.fbk.eu