How can better User Interface design save lives?

By David Griffin, Principal Consultant, Manufacturing Innovation & Automation at 42T

We’ve learnt a lot from the enforced restrictions that came with the pandemic, especially with respect to using IT to replace in-person contact. Remote working and telehealth are two areas where we experienced changes that might have otherwise taken a decade to happen. 

The challenge was ensuring that all members of society could benefit. But how well did we do? And how can we improve?

Well-designed social apps & IT support better health outcomes

In September 2021, Greek researchers published an extensive study conducted on older subjects considered vulnerable by virtue of both their age and some co-morbidities.  One study they referenced revealed that 37.1% of older adults had experienced depression and anxiety during the pandemic, with potential knock-on effects for physical health.

These researchers used a telehealth platform to carry out cognitive training and evaluation.  They measured how well the subjects got on with the platform itself, along with recognised scores for mental well-being and traumatic experiences regarding the pandemic. Their findings indicate that IT can have a profoundly positive effect, but only if it is designed to be easy to use.

To unpick their conclusions (and those of other papers referenced in their publication):

• Older people suffered worse in the pandemic (both physically and psychologically) if they were already exhibiting 'frailty' which is defined not just in physical terms but also in psychological resilience
• Psychological factors such as a feeling of autonomy and access to social networks (in the broader sense) significantly contribute to reduced frailty
• The use of appropriate IT support can provide increased social interaction and autonomy, especially in times of enforced physical isolation
• Although use of information technology by this age group has increased significantly in recent years, there are still barriers based on: negative attitudes, lack of knowledge and experience, age-related changes such as vision impairment, hearing loss and greater limitations in memory and physical capacity (e.g., fine motor difficulties)

Or, to put it in simpler terms

• Staying socially connected through periods of physical isolation is crucial for reducing psychological (and physical) frailty
• Those who were able to easily use IT products had better outcomes; but many still struggled with usability and non-inclusive design
• We could hugely benefit the health outcomes and quality of life of older members of society by designing IT products better, making them easier to use

At the margins, lives may have been saved during the pandemic if Facebook and other “indispensable” social apps were more senior-friendly.

We often talk about 'ease-of-use' or 'intuitive' but what does that mean for the elderly?

Physical, sensory and cognitive decline can all contribute to older people feeling alienated by a product or system. It’s relatively easy to understand physical characteristics of a user group (such as visual impairment or reduced motor skills) and think about how a physical product or UI might cater for those. 

But when developing the user interface of an app or IT tool, cognitive aspects can be overlooked.

• Cognitive overload can cause frustration, use errors, and even impact other senses

Cognitive load can be understood as the amount of working memory that is taken up with a particular activity.  Many older people have reduced capacity in this respect.  Furthermore, seniors experiencing cognitive overload can become disorientated, even suffer balance issues.  Cognitive capacity is not constant throughout the day or week. For example, some medical devices for self-administered drug delivery can seem easy to use when demonstrated by a healthcare professional, but be too difficult to use once the patient is back at home, resulting in resistance and poor adherence.

• Whether something is 'intuitive' depends largely on the past experience of the user 

A 1970’s rotary dial telephone might be impossible for a child raised on modern touchscreens to use without guidance, but completely obvious to anyone middle aged or above.  Anyone who offers IT support to an elderly relative will be familiar with the disruption caused by unexpected changes to a user interface (be it a phone screen, email client or a computer OS).  Many people gravitate towards the familiar in later life simply to avoid the cognitive load of re-learning.

Design, test, iterate

With a new product or interface, the gold standard for usability might be that a representative target user can use the product correctly, first time, with no training or instructions, while in a representative life situation. Which almost sounds like the definition of a test, albeit an expensive one to correctly set up. Short of setting up that test, how can we evaluate the cognitive usability of a new product or service?

It’s possible to simulate impairments such as loss of visual acuity or manual dexterity using tools such as those created by the Inclusive Design group at University of Cambridge. But the less tangible factors that influence usability are harder to simulate and test during development. This is where heuristic evaluation can help.

Heuristic evaluation with a cognitive focus

To start out, there are some simple questions we can ask about our product:

• What does the person need to already know?   

For example, a touchscreen interface may use widely accepted UI functions, but which assume you’re already familiar with a modern smartphone.  

• What does the person need to find out or discover?   

Are there things which will require exploration of the interface or reading of instructions?  Or icons that are not immediately self-explanatory?

• What cognitive skill will the person need to learn?   

If you think someone will quickly get used to a product, you’re admitting there is some learning involved.

For a more detailed evaluation, tools such as Nielsen and Molich's 10 heuristics can be extremely valuable for assessing a user interface against some straightforward rules.

There’s no substitute for early testing with actual users, of course, but by taking the time to objectively analyse what you’re asking a user to do, it’s possible to identify and tackle possible challenges (and to compare different candidate solutions).   And the sooner you do that, the better chance you have of making something real people can use as part of their real lives.

How do we do it at 42T?

We consider who will be using the product from the very beginning. Nothing beats testing - but considering various users, their process and how they might think through the use of the device throughout development will help ensure success.

Our trained facilitators can help you gather insights into how real people use and interact with your product, and draw actionable and meaningful conclusions about how to improve the design.

Our team of usability experts, product designers and engineers apply an iterative approach to developing new products. Prototyping, simulation and testing are key to how we develop highly successful products. By using these tools to address technical, usability and commercial risks along the way, we give our clients confidence in the products they choose to develop.

If you would like to find out more, please contact Craig:

craig.townsend@42T.com | +44 (0)1480 309461 | LinkedIn: Craig