Page 71 - Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

HeALtH LiteRACY, eHeALtH, AnD CoMMUniCAtion

• patients who are healthy and rarely use the system;
• patients who fully understand what you are trying to do (may be
health care professionals themselves); and
• patients who have no idea what you are trying to do.

The difficulty with the focus group approach is that one can end up
with “group-think.” That is, people begin agreeing with each other even
if what they hear is not actually how they do things. Furthermore, people
may say that they do things in a particular way but when they are actually
observed, they are doing it differently.
In user-centered design one figures out what patients are trying to
do, designs something that one thinks will allow patients to accomplish
their tasks, tests the design with the patients, and then evaluates whether
the design worked or not. The resulting feedback is then used to refine
the system design as necessary. One does not need a fully functioning
prototype to evaluate a design; one can use ideas and drawings on paper
for the tests.
The best approach is probably one-on-one contextual design. In this
approach one goes into the field to talk with patients. During such inter-
views one might accompany patients to physician office visits and watch
their interactions with physicians. One might even, accompanied by the
patient, look through the patient’s medicine cabinet.
An important part of user-centered design is producing a task analysis,
because such an analysis crystallizes the design work. In a task analysis one
lists all the tasks that are observed and then prioritizes the tasks based on
how important each task is to the patients. This helps define the scope and
focus of the product.
In terms of scope, for example, even though survey after survey has
shown that the thing patients most want to be able to do is refill their
medications online, and even though project designers knew it was a
high priority for patients, the decision was made to not include that in
the personal health record. That decision was made because the task was
too large to accomplish for every single health organization in the com-
munity, and the Shared Health Plan is a community-wide resource. It was
an intentional decision, therefore, to leave that tool out of the scope of the
PHR product.
Task analysis also serves to keep design and development work
focused on the task at hand. It is easy to get off track because there are so
many interesting and wonderful features that can be tried in this arena.
A task analysis, however, focuses designers on what patients are trying
to accomplish. This focus clears a great deal of static from the design
process.
Most importantly, when one has user research and a task analysis

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