Travelling from Nidhi to Niddy

I recently moved to the Manayunk neighborhood of Philadelphia to join Intuitive Company’s research and strategy team. I want to share a recent experience with you today, because it may seem familiar and made me wonder what “user experience” really means to some companies in today’s world. Companies seem to focus on the digital side of things, but is that really all there is? Gaining access to those digital products is great, but help when you need it is just as integral. Here’s my story.

  Moving can be stressful. Once you’ve gone through the challenging task of finding a place to live, you still have to pack, move, and unpack. But then the real adventure begins.

  You have to go through the process of transferring electric and/or gas services. If you’re lucky you might be able to do all this over the phone or online. If not, get ready to take time off to stand in a line at those offices to show them the paperwork to get it all sorted out (I swear, I am who I say). Done and done, now the ONLY thing left is to get Internet. That’s easy; you do a little research and decide on a good service that you can afford. I went with a particular company because they were at the right price point and they had even received an Emmy Award for User Experience and Visual Design in some of their core products. As a UX professional, I was pretty impressed by this achievement.

  Anxious to have Internet, I started the process of getting my new service installed. I called them up to give them details, but that’s when things started heading downhill from a “user experience” perspective for me. I called them to set up an appointment and they told me they’d come out to my place some time between 3-5pm. Okay.

  I left the office early that day to be available for the technician. No one came or even called during the anticipated time frame. So, I called the number given during my earlier conversation with them only to find out that I am supposed to call another helpline. Before I could dial the other number, I received a call from the technician. Here’s how it went down:

My conversation with the technician

  At 9:30 pm, I called Customer Service to tell them about my frustrating experience. While I was going on and on about it, the representative cut me short by saying that they can come the next day between 7-9 am. Note how they fail to apologize even once in my interactions with them so far.  As expected, no one came until 9 am the next day. I furiously called them back to cancel my request. I was then told that a technician is working RIGHT NOW at my apartment. I panicked as I was already at work, and called a friend to look over the installation in my absence (God bless him!). The technician offered a $20 credit for our ‘troubles’, which felt more like he was belittling my frustrations.

  This whole process made me consider what “user experience” means to companies in today’s world. Where does it begin and end? Is it just the digital experience? Does a company’s UX team pay no attention to the experience of “getting the services”? (Answer: No, because that group sits in a different part of the building most of the time). They claim to understand what the user wants, but it seems to be missing a very big chunk of the real experience.

  From some online research, I found that the UX team at this particular company is focused on developing and designing the TV experience, but is leaving out the service aspect of their products. A simple feedback loop for the user in my scenario would have saved so much confusion and running around. I later found out about their recent effort to create an app that prevents these issues, but it also misses the mark because it tries to replace rather than support the experience. One thing that we believe here at Intuitive is that the digital experience is not just about human-computer interaction, it’s about human-to-human interaction (just ask Jes – it’s her favorite thing to say at cocktail parties). The digital experience should enhance our human interactions, not fully replace them.

UX can and should go beyond the digital. It’s the “strategy” part of what we do at IC during a research and strategy project. We seek to understand as much of the user’s interaction with a tool as we seek to understand about the interaction users have with the world around them. We consider the relationship users have with both the products and the services a company offers and find strategic ways to help one support the other. Whether we’re thinking about the role of customer service representatives or your financial advisor, UX strategy needs to consider the holistic experience of the end user. 

Design projects are like a roller coaster and at times ambiguous. Past few weeks I had a hard time just laying down my next steps. I revisited everything I had done in past 18 weeks and I knew what I wanted, I just couldn’t figure out how I could reach there. Classic design dilemma..

Something that I missed recently was starting to form the big picture again. You see in a design process one must converge and diverge multiple times to move towards impact. From my several interviews, I developed a deep understanding of quandaries of a healthcare giant and its effects on its employees. I also found a niche in middle management to work with, but struggled to diverge again after focusing. Its 3 am right not and I am enlightened by this diversion already. Pinning down all the problems discussed so far by the employees to initiate or implement innovation, I found myself surrounded by things I have experienced myself as a designer. Separation from key stakeholders, lack of a decision maker, no time to design, uncoordinated collaboration are just some of the many problems that both managers and designers face in the process of innovation.

 It’s was early morning for the Center for Innovation at Penn Medicine. Everyone was prepping up for a collaborative work session with the Abramson Cancer center on a new project. The team arrived a little low in numbers but high in spirits. Introductions begin and the CFI team thought that getting update on the work done on previous projects would be great; the cancer center has worked with them on 4 projects in the last year. After a 30 sec. silence, Patrick Higgins, the operational manager of the cancer center broke the silence by reporting a not so successful process towards implementation of the outcomes of the project. The entire team looked a little unhappy but not surprised at all. Later when asked, it was the ‘doesn’t this always happen in this organization!’ look that the CFI team got from Patrick.

To address a scene just as described above, I initiated my thesis research  to understand middle management's quandary in carrying out innovation at healthcare organizations.The project designs ways to illuminate the impediments that middle management faces during their functions of innovation within large healthcare organizations; in addition it designs tools to assist in facilitating removal of these impediments. 

 My expectation from Beirut was for it to be much similar to India. However, that wasn’t the case. Beirut to me was a melting pot of eastern and western culture. At the first glance, the honking and traffic took me to streets of New Delhi while Hamra Street, café culture and the English speaking younger population reminded me of the US. It was an interesting experience. All four of the team members lived in a single apartment and only one of us was fluent in Arabic, Armenian and French (the three main languages of Lebanon). Interacting with a variety of people, trying to submerge in a new culture and exploring the vast topic of trust. Trust in various forms and how it changes was an intriguing topic to discuss with people especially when the first reaction of everyone used to be “Trust? What about it?” (Eyes wide open with curiosity and sometimes even a smirk!)

To me the most important aspect of the project was understanding when we needed most help in the process, how we resolved problems and co-creating design tools with the local population. That’s the key to any experience. It would have been a nightmare without our Lebanese friends in Beirut who actively supported us not by just being our translators at times but really giving us those meaningful insights into the culture helping us understand and absorb it through our work. I cannot imagine how it would have been if my two Lebanese friends weren’t there when Hezbollah detained us.

While exploring the notion of trust in Lebanon, we also explored how deeply it is embedded in our work as human centered designers. When we first start gaining insights into a project, diverge upon its context in a larger environment and start connecting the dots, it’s very easy to get overwhelmed. Sometimes the information pool or the related fields are so vast, we start doubting whether our research will have a meaningful outcome or not. Being a designer, the key is to trust the process that it will lead us to a clearly defined problem and help us have a measurable impact by the end. While the process is daunting and vague at times, synthesizing our learning, failing fast and failing often gives us valuable insights that help us understand more and proceed further in the right direction.

One can’t attempt to overly prescribe the process and that makes it difficult to talk about the work emerging from it. This human centered process of design is rigorous and dependable but the vagueness it sometimes carries makes it difficult to get buy in from the stakeholders which affects its success. While our research, we struggled with processing all the information and stories we collected in a meaningful format. Scaling and developing a measurable metrics for our learning objectives would be my next steps for this experience. It was a lot of learning, an entirely different culture and the same design process.

Hey Ankur,

Thanks for writing in!

Hi Palak,

I honestly think that nobody reads my blog except a very few people I know and my professor (:D) but I am glad you found it of any use. Design is still a growing profession (the research part of it) and I guess we all are still trying to figure out its applications and limitations. What field are you working in currently?

Thanks a lot for writing in!

Best,

Last week began with a lot of running around among different locations of the University of Pennsylvania Health System. As part of our domestic utilization research, we interviewed a variety of Penn employees to test our assumptions in order to form a valid experiment. The usage of boundary objects made our interviews way more efficient and clear. After presenting the employees with a brief of the project and what we have found till now, we introduced them to all the prototypes quickly. A detailed conversation about each of them followed.

  While it was very easy for people to visualize possible solutions, these conversations revealed some new and confirmed our older findings. The pictures below could speak more than words to support the previous statement:

    Following each input from the user with a why led us to some more discoveries. In our previous research we found that informal social networks are one of the strongest factors in choosing a doctor in Penn system, however these networks have to be more organic and natural in there formations. When it came to getting direct recommendations from the co-workers, people clearly expressed trust issues. There was also a prominent concern about their privacy as majority of people refused to talk face to face with a person (care expert) when it came to choosing a doctor. While people laid stress on being able to talk to a human over a helpline, they were concerned about that person being able to give their name a face when it came to meeting a care expert.

    A very important aspect of this research was that till now in our research we had found issues related to finding a doctor and logistics around them. What we came to know from these prototypes is that there is a larger issue of scheduling. People do not get appointments easily and there is a wait time for months at some practices. Our idea for finding a doctor then re-framed to scheduling in order to load balance among popular and newly acquired practices, so that people could get easy and quick appointments. At our interviews with people from scheduling department, people stressed on the fact that employees have no idea of the wait time and it’s often so long, they prefer to get their care elsewhere. Our other interviews only confirmed the issue. Almost everyone added Find a doctor: By nearest appointment time to our mobile app prototype.

    There was a general concern around the ownership of content of the recommendations if provided. As it might just reveal the negativity in this large health system that could have a harmful impact on the organization. “We need to safeguard our physician reputation”, as per an employee. Also, a discussion around the starring system of recommendation vs. the comment one led us to understand different preferences which were also dependent on the age, gender and role of the employees. Another interesting reason people turn away from using the present web service for scheduling is the unavailability of detailed expertise and background of the doctor, types of patients they accept and the wait time for new patients. Although people preferred a technology based solution as it could be on their schedule, the end goal for the technology (as per the users) should be for them to connect to someone who could answer their extra questions or just as a reassurance and added trust. We can never ignore the importance of a human interaction, can we? It always has to be by the people, for the people to the people.

Steve Krug in his book ‘Don’t make me think’ lays down the three very simple yet very difficult to follow usability laws for web/usability designers.

  Don’t make me think.

It doesn’t matter how many times I have to click, as long as each click is a mindless, unambiguous choice, and

Get rid of half the words on each page, then get rid of half of what’s left.

    He also rightly puts the three facts of web life as follows:

We don’t read pages, we scan them.

We don’t make optimal choice we satisfice (satisfy+suffice), and

We don’t figure out how things work. We muddle through them.

  Though the above laws and facts speak to the context of web usability, I think these principles are universal in terms of design. The book also talks about the example of stamped mail and metered mail that I experienced first-handedly two weeks back. I was not so amused to stand confused in front of two mailboxes with a business reply envelope. Is it stamped or metered? I thank the gentlemen who guided me to eventually drop it in the right mailbox but what would have happened if I would have dropped it in the wrong mail box. It immediately got me thinking of providing a visual clue for not so familiar users. With postal system having one of the most diversified users, it sometimes seems like not designed for the same.

Revisiting our brainstorming session to come up with more concepts for prototyping, we redefined three of them to fit into our approach. Focusing on ways to find a doctor using the informal social networks as a means to the end, we wanted to present to users three different ways of interaction. Another brainstorming session with my team-mate led to consolidate three interactions that could be developed into prototypes. To validate our assumptions, we decided to present the users with the three prototypes and spark a conversation about why they would choose one over the other, or what they liked about a particular prototype and what not.

    To develop a hierarchy of qualities according to preference and facilitate a meaningful conversation, we needed a more interactive prototype. This time coincided with our second Design Sprint for the semester which circled around communities of practice, communities of interest and boundary objects and their usage in design process.

  ‘Boundary objects are objects which are both plastic enough to adapt to local needs and the constraints of the several parties employing them, yet robust enough to maintain a common identity across sites. They are weakly structured in common use, and become strongly structured in individual-site use. These objects may be abstract or concrete. They have different meanings in different social worlds but their structure is common enough to more than one world to make them recognizable, a means of translation.’

  Our aim now was to create these boundary objects that allow us as the designers to build a shared understanding with the community of stakeholders we are engaging through the project. Our three final prototypes fell into three categories of interactions: Human-Technology- Human, Human- Analog artifact- Human and Human- Human (direct). One  could say that this was another form of research, but our hope was also to find out which interaction users prefer in this context and why. Starting from paper prototypes, we designed these boundary objects as fun representations of scenarios where people could move things around according to what experience they find perfect. Lots of magnetic buttons, clay and what not to provide the employees a chance to not only respond and re-arrange but re-create the prototypes if they wanted. We were also looking for what kind of details people look while finding a doctor so suggestive as well as empty elements were provided in each prototype.

  Paper prototyping

  Scenario building

  Our final deliverable as decided now would be recommendation for an ‘experiment’ by the end of this project. An experiment would constitute the qualities that lie higher in the hierarchy of preferences with a measurable outcome. Thus, we would be providing Penn with a framework with measuring points that could be launched to test outcomes and be implemented if successful. So, what would be the qualities of our experiment?

                      One of the major aspects of Design thinking is to change behaviors, the foundation of it being a people-centric process. The most exciting thing about the design thinking is that not only it aims at behavioral changes to develop practical and sustainable scenarios; it is also affected by the nature, intensity and complexity of human behavior. The cognitive science of human behavior almost redefines Design for me.

  “Although many people perceive design to be about appearances, design is not just about the way things look. Design is also about the way things are used; how they are committed to the world, how they are produced.” – John Thackara

    The paradigm shift in the role of designers today makes design as one of the most responsible profession for creating a sustainable future. The role of designers today is to focus on relationships, connections, communications and interactions to develop mental models/metaphors to make sense of the bigger picture. Being empathetic to people and situations they should be able to map present natural, cultural and human resources to co-create new services, design tools for sharing and connect various actors in complex systems with behavior change as both cause and effect of Design.  

We finally figured out how to diverge meaningfully with the help of our Penn team. There was one thing that we were missing in the process of prototyping. And that was the thought that people respond more to the ‘quality’ a prototype has than the value it possesses. For each problem statement there could be defined set of qualities that the potential solution would contain in parts or in whole. 

  For example, a potential solution for the problem: Information is confusing would contain some or all of the following attributes:

It would provide the user with mindless access to information

It would be available at the moment of need

It would be relevant to user’s needs

It would be personalized for every user

And, it would demonstrate organization

  Recording what qualities are more important to people in a particular prototype would hint towards their priorities, thus leading us to very informed decision making in this prototyping phase of our project. Getting a sense of what the users respond to the most, or their priorities would be ideal for an iterative process. Bam! That’s our big idea- Reverse Brainstorming (as my team-mate calls it).Following this method of discovery, we revisited our problem statements and started listing down the qualities that a potential solution would contain for each of them. There were obvious overlaps but that might not necessarily suggest its importance.

  In interest of time and efficiency, we decided to focus on two prototypes (not problems) that we found to be most valuable and approachable in the context of our project and expanded upon them taking in consideration of the qualities generated earlier. Our hope was to then present them to our users to identify what they like and dislike about each element and base our iteration on the elements most preferred. Just to mention again, we were looking for valid feedback on the elements/qualities and not the form/content of the prototype.

Prototyping for finding a doctor

        However, what we did was not what we were supposed to do. We still hadn't focused on one and only one problem to develop prototype on. In such case, people tend to respond to the form of the prototype again which wouldn't serve our purpose at all. So, we decided to ‘really’ focus this time to two problems: Finding a doctor and under-utilization of informal social networks (For more details on problem statements, refer to my previous post). Among these two problems we further decided to focus on finding a doctor utilizing the informal social networks. A lot of things in such a big health care system are dependent on recommendations from co-workers. So, the question became, “How might we harness the power of these informal social networks to help people find a doctor more efficiently and turn to Penn’s services?”

As discussed in my previous post, we defined the values related to the 6 problem statements and drew connections in between them to better understand the guiding forces behind those problems. We presented our findings till now to the entire team at the Center for Innovation last week. In addition to the problem statements we also presented six different prototypes that we narrowed down from our brainstorming session with earlier.

  One of the prototypes developed

  After we presented those, we used voting system to understand what makes most sense to the employee population at the same meeting and received great feedback. This meeting/presentation was a huge success as the team was ecstatic about the research findings and wanted to promote the structure of research by us. Out of the six prototypes, one related to each problem, we were able to funnel down to the three most accepted ones. These prototypes were mere representation of the guiding values and we were thinking of ways to explore more around them as our next steps.

    After this meeting which as I mentioned earlier, we received more feedback from our team at Center for Innovation. We were told to step back and dive deeper. What could diving deeper means? Aren't we doing that? This moment was one of the most challenging as well as frustrating moment for us as the moment we were close to focus, we were again guided towards more divergence in order to focus again. Understanding what they meant opened a whole new world of possibilities for us. When the team voted during the meeting, they responded to the format of the prototype, its feasibility and effectiveness as opposed to the values incorporated. Also, trying to prototype for all the problems wasn't really possible in the given time frame of a month (time left to wrap up the project) for us.

In my previous post, I mentioned sound as a reliant system for feedback in products and systems. While all the sound contributing to become noise is still less noticeable in personal life, an ironical example would be the fact that a hospital environment, the place where quiet is most essential, is the one place it’s least likely to be found.

    Medical and communications technologies are behind increasing noise levels. Communications fill the air with that most distracting of sounds—human speech—and patients and healthcare workers find themselves raising their voices ever louder in an effort to be heard. Within patient rooms, monitoring and life-sustaining equipment continually beeps and whooshes around patients’ beds or even around their heads, erupting into alarming sounds sometimes occasionally, sometimes regularly.

  ‘Since 1960, average daytime hospital sound levels have risen from 57 decibels to 72 dB, while average nighttime levels have jumped from 42 to 60 dB—all far exceeding the World Health Organization’s recommendation of 35 dB as a top measure for sound levels in patient rooms.’

  The role Design plays or could play in such ever growing scenarios should be more than designing sound masking systems and environmental design strategies. For me as a human centered designer not only it is important to understand the perception of noise by patients but it is equally or more important to bring a behavioral shift in accountability of the staff for an issue that is personal to them as well.

The process of analyzing data is fundamentally different from the process of creating ideas. We have seen a huge mismatch in the qualitative and quantitative data set. We tried to address this mismatch by more rigorous synthesis. As mentioned in my previous post, what people say is not what people do. Following the qualitative data and collaborating with the team at Penn Medicine, we incorporated the team’s viewpoint in our process of problem definition. To me, since they are also a part of the employee population at Penn, it’s like getting direct feedback from the users- which is the very essence of user-centered design.

  To bridge the analysis-synthesis gap, last week, we had a collaborative brainstorming session with our team at our studio. The discussion with the team was really helpful in finally pinning down the key problem statements to inform our coming prototypes. Since we haven’t been giving any preference to any particular problem and carrying it all forward. Now is the time to narrow down our research and really focus on the problem that matters the most to our users. How do we do that?

    We structured our session on the ‘Elito’ method. In this method we combined our observations and judgments as problem statements, defined value to each problem and conceptualized prototype concepts based on those values. Incorporating the ‘value’ element in each problem defines which drives a user to consider something as a ‘problem’. We now have our 6 main problem statements speaking out loud why the primary care services at Penn are under-utilized by its employees.

  Our next step in the project is to parallel prototype the concepts for these problem statements. We would we addressing each value by a prototype to test among the users first. And based on the results we would funnel down the values that are most important to the usersto redefine our focus problem statement. Followed by that we would again diverge into a pool of concepts produced addressing our focus value(s).