Carnegie Mellon Develops Java Programming Tools
Employing Human-Centered Design Techniques

Hello, let me introduce myself.  My name is Robert Cadena and I’ve been working in the software industry for over 9 years.  To be more precise, I’ve actually worked on the web side of software development for all those many years with a brief foray into desktop programming, so I’ve been working with UIs hands on since the first internet bubble burst.   I used to work on university websites, startups, and then entertainment movie websites.  Then, one day, I got a job working for a nanotech company creating a user interface targeted at scientists and, although I always thought UI was very important, it wasn’t until I actually saw real people, trying to control and monitor giant machines using my UI that I realized what an impact UI can have, and I’ve used that realization to guide all my future projects.

A few years later I started my own company with a friend, focusing on Adobe Flex.  We won an award form Adobe and our application was used by many developers.  Soon we were working for Adobe and other major companies to customize our application for their employees.  For a year, I also wrote a column for the RIABuzz, a newsletter about RIAs published by Adobe.  Fast forward two years later and now I’m leading the creation of my new company, AppliedUX, a user experience consultancy and development shop.

Now that the history lesson is out of the way I want to tell you what this blog will be about.  One, it is a place where I can write about AppliedUX projects and initiatives but, of more interest to me and to you, it is also a place where I will write about topics related to UX theory and the real world meet.  So, many times you’ll see blog posts evaluating new technologies or discussing interesting findings in the world of human computer interaction, user experience, and development.

Let me start with a really interesting case.  Here’s a study from 2005 where a hospital implemented a Computerized Physician Order Entry (CPOE) system.  Basically, instead of filling out paper forms, physicians and other care providers, typically at a hospital, enter instructions for patient care, like drug treatment, therapies, procedures, &c. on a computer.  The benefits seem obvious; order entry should decrease errors as programs provide constraints and other checks like making sure there are no adverse effects from drug interactions, or preventing a doc from entering a drug to which the patient is allergic.  It should also speed up care, or at least speed up communicating the order.  For example, one could imagine that instructions could be transmitted from an ambulance to the hospital while the patient is in transit or, more simply, even just allowing the order to be transmitted through the hospital instead of having to phone it in or hand delivered to the nurse or doctor.  Anyway, there are a ton of benefits, yet this study shows that the implementation of a CPOE into a hospital coincided with an increase in the mortality rate of patients admitted to that hospital.  That’s crazy!  But how?  Here’s one example:

“The usual “chain of events” that occurred when a patient was admitted through our transport system was altered after CPOE implementation. Before implementation of CPOE, after radio contact with the transport team, the ICU fellow was allowed to order critical medications/drips, which then were prepared by the bedside ICU nurse in anticipation of patient arrival. When needed, the ICU fellow could also make arrangements for the patient to receive an emergent diagnostic imaging study before coming into the ICU. A full set of admission orders could be written and ready before patient arrival. After CPOE implementation, order entry was not allowed until after the patient had physically arrived to the hospital and been fully registered into the system, leading to potential delays in new therapies and diagnostic testing (this policy later was rectified). The physical process of entering stabilization orders often required an average of ten “clicks” on the computer mouse per order, which translated to 1 to 2 minutes per single order as compared with a few seconds previously needed to place the same order by written form. Because the vast majority of computer terminals were linked to the hospital computer system via wireless signal, communication bandwidth was often exceeded during peak operational periods, which created additional delays between each click on the computer mouse. Sometimes the computer screen seemed “frozen.”

− Unexpected Increase in Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System

Multiple clicks to get something done.  Network traffic congestion.  Change in hospital procedures.  I’m not familiar with the system so I can’t comment on why something required 10 clicks to get anything done.  Maybe with practice or training users can get more proficient at entering instructions (tabbing between fields is still not something many people do when filling out a form!)

There were more problems.  Nurses and doctors were required to be on separate terminals to enter information.  The policy for drug dispensing was changed and centralized.  Craziest of all, but understandable, doctors and nurses were “locked out”, presumably from the particular order, while the pharmacist was processing the order.  It makes sense, because you don’t want the order to change while the pharmacists processes it.  But, it makes me wonder, how they handled that aspect before, and why there was nothing in place in the new system to let them do this.

The study is a great read, unfortunately it’s behind a paid subscription site.

So, what do these kinds of stories say about UX and HCI?  I use these stories and cases to guide how I approach HCI and UX.  They remind me that behind the fancy technology and flashy graphics the most important aspects of these disciplines are the people, the humans and the users, and what they want to do.  User experience must take into account the users needs, their existing work-flows, their expectations, needs, and wants into account.  How do we design a system that lets the user accomplish their task while making it easier, safer, and faster?  That’s the number one guiding principle behind AppliedUX.

On my next post I’ll gather some thoughts on user experience and agile practices.