How to Create Consumer-Friendly Health IT Session 113, February 21, 2017 Stacy Robison, President and Co-founder, CommunicateHealth Sandy Hilfiker, Director of User-centered Design, CommunicateHealth 1
Speaker Introduction Stacy Robison, MPH, MCHES, CommunicateHealth Sandy Hilfiker, MA, CommunicateHealth 2
Conflict of Interest Stacy Robison, MPH Sandy Hilfiker, MA Have no real or apparent conflicts of interest to report. 3
About Us Small, woman-owned, mission-based health communication company National leader in health literacy Create health information that can be accessed, understood, and used by people in their daily lives Support state, federal, and private organizations 4
Agenda What we know about web users with limited literacy skills Strategies for creating easy-to-use web applications - Write actionable content - Display content clearly on the page - Organize content and simplify navigation - Engage users Testing your site with users with limited literacy skills 5
Learning Objectives 1 Identify common behaviors exhibited by web users with limited literacy skills when reading and interacting with health content on a screen including mobile devices 2 Explain the importance of designing for patients with limited literacy and limited health literacy skills 3 Apply best practices from Health Literacy Online to the design of consumer-facing health IT 6
The bottom line Patients are key members of care team, not just recipients of information. They increasingly express interest in being involved in decision-making and accessing their medical data. How easily patients can accomplish these health-related tasks online depends on the quality of the applications we create. To engage patients in their care, we need to design consumer-friendly tools. 7
Products with intuitive content and design provide a better, more satisfying user experience. Simple, clear information can help patients understand instructions and stay on top of preventive services. Portals with intuitive UX can facilitate sharing of patientgenerated health data. Intuitive UX and plain language can increase opportunities for patient-provider communication and exchange of patientgenerated data. Patients (and staff) will be more likely to use the portal for simple tasks reducing administrative burden. 8
Health Literacy 9
health.gov/healthliteracyonline 10
How the Guide was Developed Original research with more than 700 web users with limited literacy skills Best practices from the literature on cognitive processing and the online behavior of adults with limited literacy skills Principles of web usability Reviewed by subject matter experts in health literacy, usability, and communication 11
All Users Benefit from Improved Usability Comparing time-on-task on the original site with a prototype (designed to support users with limited literacy skills): Time on Task (Mean) Original Site Prototype Improvement High literacy 14:19 5:05 +182% Lower literacy 22:16 9:30 +134% All users 17:50 6:45 +164% Source: Summers, K., & Summers, M. (2005). Reading and navigational strategies of Web users with lower literacy skills. High Literacy Users: 3x as fast with the revised site 93% success rate on revised site (compared to 68% with original) 12
What we know about web users with limited literacy skills 13
14 Prone to skipping and focus on the center of the screen
15
16 Easily overwhelmed and limited working memory
17 Struggle with search
18 More likely to be smart phone dependent
Strategies for creating easy-to-use web apps 19
1 Write Actionable Content 20
Identify patient motivations and goals 21
Poll: How long do you have to grab a user s attention on your website? 3 seconds 7 seconds 10 seconds 15 seconds 30 seconds Web pages with clear value to the user will hold a her attention longer. 22
Write content that: Answers users questions Helps users complete a task Helps users make a decision 23
On every page: Put the most important information first Give specific action steps Prioritize the behavior 24
Writing Which page for Action would be most helpful if your child had asthma? 1 2 3 About asthma Asthma symptoms Prevent asthma attacks at home 25
Prioritize the Behavior 1 Asthma makes breathing difficult for more than 34 million Americans. 2 Asthma in children is on the rise, but with proper treatment for symptoms of asthma, kids and adults can live well. 3 If someone in your family has asthma, start by getting rid of these common causes of attacks: Mold or dampness Cockroaches Secondhand smoke 26
2 Display Content Clearly 27
Limit paragraph size, use bullets and short lists 28
On every page, use: Readable font that s at least 16 pixels White space and avoid clutter Appropriate color contrast 29
Make interactions easy by placing frequently used buttons where they are easy to reach 30
3 Organize Content and Simplify Navigation 31
Create linear information paths Give buttons meaningful labels. Skip generic labels, like Next or Back 32
Make clickable elements recognizable Design buttons that are easy to find and be consistent 33
Use meaningful labels Which link will have information on asthma triggers? 1 Air Pollution & Respiratory Health 2 Indoor Air Quality 3 Asthma and Allergies 34
4 Engage Users 35
Engage users with interactive Invite users to customize content and provide feedback. content Email information to a friend. Print out a lab result. Take a poll or rate the information on the site. Use a calorie or BMI calculator. Enter personal data like age or weight to get tailored tips. 36
Create user-friendly forms Make instructions clearly visible on the page Chunk information into meaningful categories Design for mobile Source: https://www.nngroup.com/articles/form-design-white-space/ 37
Half of online health research is on behalf of someone else 38
Make it printer-friendly! 39
Testing your site with users with limited literacy skills 40
The curse of knowledge 41
Poll: Fill in the Blank Usability testing with 5 participants will reveal % of usability problems. 15% 35% 60% 85% 95% [Source: Nielson Norman Group, 2000] 42
Top 10 Tips for User Testing 1 2 3 4 5 Partner with community organizations to recruit special populations Screen for participants with limited literacy and limited technology use Develop screeners, consent forms, and moderator s guides in plain language Use cash incentives when possible Test whether your content is understandable and actionable 43
Top 10 Tips for User Testing 6 7 8 9 10 Be cautious using remote and online testing Pre-test your moderator s guide Choose a moderator with experience conducting research with limited literacy participants Conduct testing sessions in a setting that is familiar and accessible to participants Test on mobile using the participant s device; ensure Wi-Fi is available 44
Products with intuitive content and design provide a better, more satisfying user experience. Simple, clear information can help patients understand instructions and stay on top of preventive services. Portal with intuitive UX can facilitate sharing of patientgenerated health data. Intuitive UX and plain language can increase opportunities for patient-provider communication and exchange of patientgenerated data. Patients (and staff) will be more likely to use the portal for simple tasks reducing administrative burden. 45
Questions stacy@communicatehealth.com sandy@communicatehealth.com @ CommunicateHlth 46