User Centric User Research Experts Develop Guidelines for Personal Health Record (PHR) Applications

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Introduction

User Centric, Inc., has identified several guidelines to be included in a working model for PHR interfaces that will facilitate user adoption. Based on a recent usability study comparing two existing online personal health record (PHR) applications, Google Health and Microsoft HealthVault, User Centric gained a clearer understanding of which features currently work and do not work for users of PHR applications. (Neither Google nor Microsoft commissioned or participated in this study in any manner.)

Figure 1: Homepages of Google Health (top) and Microsoft HealthVault (bottom) as they initially appear to users.

Recommendations

While none of the PHRs studied had a perfect interaction model, the data motivated User Centric to develop a series of best practices to be considered when implementing a PHR. The best practices discussed below are based solely on the issues observed and feedback given by participants, and leave room for further development toward a better PHR.

Since perceived simplicity and ease of use are keys to user preference, a PHR home page should avoid unnecessary visual complexity.
During the usability test, participants showed a strong preference for the layout of Google Health's homepage when compared with Microsoft HealthVault's homepage, mainly due to its simplicity. Google Health used a plain design on its homepage with only critical navigation and a few links prominently displayed. Participants found it "easier to access," "less cluttered," and "easy to navigate." This focus on a few important points allowed users to quickly scan the information presented and find what they came for. A PHR should only display navigation and information necessary to complete core tasks on its homepage.

A PHR should provide strong cues to help users start entering health information.
Since new users will not generally be trained to use a PHR, a PHR application should be designed to support users from their first interaction with it. In the study, participants had difficulty with how to begin entering health information into all three PHRs and indicated they were looking for guidance from the applications on how to start this process. This is especially problematic because the main function of a PHR is to enter health information, and it should be easy for new users to jump in and enter health data. Instead, a PHR should provide a strong visual cue to the user for how to begin entering this information, such as a welcome page, large button or link representing a starting point.

Users should be able to add details about a health item (e.g., medication) immediately after entering its name. However, the number of detail fields displayed at one time should be limited to avoid overwhelming users.
The process of entering data should be as simple as possible, allowing users to enter items quickly while also providing an opportunity to enter details immediately. Both of the two PHRs tested proved difficult for participants in some aspect of data entry. For the most part, Google Health provided a quick path to entering the names of health items, but required users to navigate through multiple screens to add details about those items. On the other hand, Microsoft HealthVault allowed users to add details right away, but the sheer amount of entry fields displayed for each health item was overwhelming for participants.

Both ends of this user experience must be considered when designing the data entry process for a PHR. Participants overwhelmingly preferred to be able to enter details about a health item on the same screen as its name, so a PHR should support this process. However, the PHR must also be designed to ensure that its users are not overwhelmed with the amount of information they need to enter, possibly by limiting the amount of data entry fields displayed at one time.

Medical information should be presented without technical jargon.
Non-technical language should be used by in PHR applications whenever possible because participants were frequently confused by the medical terminology they did not understand. This was especially apparent when medical terms were used as field descriptions in Microsoft HealthVault. By using familiar terminology in links, field descriptions, and other areas, a PHR will provide users with a much clearer idea of what information they are being asked to enter, which will in turn help to ensure the accuracy of users' health profiles.  

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