Seth Godin, a prominent entrepreneur and author who was named the “the Ultimate Entrepreneur for the Information Age” by Business Week, said it best in his post on empathy, addressing the catch-22 that experience researchers help to resolve: as important as it is to business (leaders, marketers and designers) to be able to effectively empathize with your comsumer, it takes more than imagining life through someone else’s eyes.
It takes realizing that, regardless of your best intentions, the most reliable statistics or hottest trends, you won’t get to someone else’s truth unless you ask them to tell you their experience first-hand.
Godin wrote: “If I were in your shoes, I know what I would do. The problem is this: if you were in my shoes, I wouldn’t be me, I would be you.”
He continues, “As soon as you bring your beliefs, expectations and worldview to the table, you’ve lost the ability to imagine what someone else would do in this situation. All you’re doing is imagining what you would do.”
Designing for a New Perspective: Human Computer Interactions in Healthcare
My recent experience leading a diverse design team in Human Computing Interactions under the guidance of Dr. Annalu Waller (an expert inthe field of Augmentative and Alternate Communication (AAC) who established the first AAC assessment and training centre in South Africa before joining the University of Dundee) was revelatory; not the least in part because we failed early in our assumptions, and had to recover… quickly.
Despite warnings to cut a wide-swatch around health-related projects due to the ethical considerations and red-tape, our team sought to understand how to improve communication during the healthcare experience for older adult in-patients, and were motivated to design a more intimate and personalized patient communication interface.
Our aim was to identify key communication scenarios that could be improved to support a patient’s recovery and engagement and decrease stress.
In the process of co-designing with our participant group, some close to 90, we had our eyes opened to the wide gap between well-intentioned design and design for real people.
Here are the 5 lessons we learned.
Lesson #1 Fail Early
We sought to validate and design for this proposition: older adults face increasing health challenges which may increase medical care; the hospital experience and jargon may be unfamiliar and isolating; social support networks can increase recovery. We imagined someone like our grandmother in the hospital, empathized with her (afterall, who hasn’t been bewildered and lost navigating modern healthcare) and believed our design solution lay in tightening close communication networks.
We were wrong.
We discovered, for our participant group of active older adults spanning 55-90, the biggest obstacle to recovery was not lack of social support – it was instead too much of it. Increased flexibility in hospital visiting hours meant that recovering patients were taxed by being at the whim of these longer visiting hours during which they were essentially “on call” for drop-in visits by well-meaning loved ones instead of enjoying the rest crucial to recovery. The conundrum: both patient and visitor often need to cut the visit short, but have no way of expressing it. In a nutshell, while technology can increase the pace and variety of connections, empowering individuals means offering the ability to choose to equally disconnect – politely.
Our new design aim was catalyzed by our assumptions being turned upside down. As a result, we focused our subsequent design stage on rapidly prototyping a Skype-like video communication system that could provide a flexible and granular response interface to allow for alternate answering methods to control or limit communication between patients and their loved ones.
Lesson #2 Design Research is Design
We had a variety of research methods; our first broad swath of semi-structured interviews focused on understanding the dynamics of strong communication and the meaning of family support networks.
Out of our reams of interview notes, we were struck by just three sentences that seemed to swim against the tide.
- One interviewee in particular mentioned that technology can as effectively block or obscure communications as aid it – and this was said positively.
- Another person recounted watching his mother pass away, someone who always was known for being beautifully put together and a wonderful host, and how it was devastating to her not to have her best face on, or eventually, not have the energy to speak to her guests.
- The third mentioned that phone calls can actually be confrontational and that letters might provide a needed sense of space between individuals.
While a skill of design researchers is to navigate complex data for patterns, sometimes the onus is instead to identify idiosyncracies – and follow our gut. Our decision to focus on just three sentences out of hundreds led us to our insight to design for creating space from communication.
Lesson #3 There is Never Enough Time
As the project lead, I spent a considerable amount of time scoping out the project management and delivery timeline which ideally would have spanned over 6 weeks for research and design. Due to ethical approval, in reality we needed to deliver in less than half that time – 3 weeks.
Our lessened timeline did not lesson the accessibility guidelines that we needed to meet within our project; it simply meant we needed to quickly identify ways to be twice as active in less time.
Lesson #4 Versatility
Versatility is design’s biggest strength. Not only did our team of four span the globe: Florent from France, Jay of China, Assiya from Uzbekistan and myself from the United States; we had diverse experiences from engineering, programming, finance, marketing, research. This meant we had different experiences of working and relating. For some, it was the first time doing design research (or even an interview); for others, it was the first time designing. It was an eye opener to realize that although we were about to embark on human-centered design, part of our team didn’t understand the need for experience research or codesigning with participants. By failing early in our well-intentioned assumptions, we quickly learned the value of listening, observing and working closely with our participant group to identify unmet needs we may not have initially perceived.
Our team structure was equally dynamic.
We needed to quickly adjust our design protocol and roles to accommodate our different perspectives and tempos. Eventually, we designed a reliable team protocol in which a team member independently led a stage each week with the following week’s lead to back them up, so there would always be a smooth handoff. The rest of the team would support unconditionally. This sense of trust and go-with-the-flow willingness allowed for individual strengths to flourish in their own capacity, as well as having a support network for feedback if it was needed. Our shortened timeline meant we had to often treat each design or research session as a series of mini-sessions, preparing to test several short design scenarios or methods to create a comprehensive picture of the design issue. Often, this preparation allowed us the versatility to move quickly to another method (or linger) based upon the participant’s response.
Lesson #5 Focus is Ubiquitous.
In three weeks of fast-paced research and design, our project tagline changed from “Creating Connections for Recovery” to “Building Space for Recovery.”
The current Skype interface only allows for users to answer or not answer a call. Based upon our co-design process, we realized the need for increased granularity: we eventually created a skype-like interface that offers users a possibility to answer calls in a few ways: they can answer the call, they can put the call on hold, they can send a message, or they can reschedule the call, in addition to not answering the call too. Our process worked with a variety of older adult users (over 50+ years) to co-design and evaluate a system that was simple, clear and easy to use in addressing possible unmet needs in current technology.
We also learned that while the uncertainty of the length and timing of visitors can compound an already uncertain health scenario, this doesn’t have to be the case: It’s highly possible to imagine a calendaring function within the skype system to allow heavy users to moderate and schedule their calls.
We found that while one might imagine patients wanting long, touching conversations with their loved ones: it’s often practical – they want to know if Fido, their dog, is alive and well, or to that they might need something from their home. We envisioned the ability to have a memo function to capture these needs, and reordering the contact list to focus on relevance of responsibility (for example, it may be less important for a patient to contact their daughter than their housesitter).
While some of these design iterations are particular to our group of potential in-patients over 50 years within Scotland, particular functions such as the granularity of answering or calendaring would be useful across the population of skype-users.
Future Design scenarios can also include:
- The development of a hybrid in-patient visitor system to regulate both incoming calls as well as in-person visitors
- The development of a “Virtual Waiting Room” to alleviate in-room/in-person congestion and fatigue
- A more robust multi-user scheduling system that would allow for a concentration of visitors at a useful time, and also better visits for shared rooms
Moving Beyond “Healthy Connections”: Designing a New Communication Space
The web population of over-50s is now getting on to the internet faster than any other.
Nielsen / NetRatings research tells us that people who are aged 50 and above connect to the internet more frequently than all other age groups. The data also shows the average time spent online by this group is higher than for others. (Groves, 2002)
While the adoption of new technologies by users over 50 may be on the rise, the reasons for doing so are unique. Adoption of new technologies is multi-faceted; Learning how, why, and when particular individuals want to connect (or not connect) is invaluable to creating products for real people with real needs.
In our final presentation, I noticed Dr. Waller chuckling. When asked about it later, she said simply: I had the same problem.
By focusing on real users, in their own words, we learned that despite the modern hoopla of “more, faster, better” – perhaps there is enough connection in a world of too many connections. And sometimes, technology can add a human element – in this case the ability to say “I love you, but now isn’t a good time”… simply.
Human Computer Interaction: Creating Space for Recovery Through Skype