User experience in virus infection diagnosis

The current 2019 novel coronavirus disease (COVID-19) outbreak makes us once again aware how crucial early diagnosis and early intervention is.
Early treatment is crucial in almost any disease. And very difficult to achieve.

An example like COVID-19, a virus infection with contagious incubation periods of 2-14 days, shows that medicine where symptomatic episodes only are the entry for a patient to enter the health care system is leading to huge impact for that particular patient, but also for society and economy.
The global outbreak (according to World Economic Forum, bigger than previous SARS and MERS).

As a citizen, I am confused. What should I do? - Should I hide at home, avoid any social contacts, bunker food and supplies, and prepare for a longer period in isolation.
At work, teleworking models become more and more popular. And supposedly suddenly web-conferences work, even in settings which were meant to essentially require face to face interaction.

Is this the chance for internet communication tools to raise in importance. Do usability aspects which were insurmountable pains and hurdles suddenly vanish?
I hope that the current situation and raising focus on respective technological tools will lead to more focus on research and development of respective tools and improve on user experience accordingly.

On the other hand, the big problem to solve is early diagnosis or screening of the population for infections during asymptomatic phase of episodes.
A quick literature search was surprising. The proven best tools recommended for screening and early diagnosis are probably also the most expensive ones in terms of cost, and not necessarily the most appealing in terms of user experience.

There are several studies concluding that chest computer tomography should be used for screening and early diagnosis of infected patients. The reported sensitivities are 98%.
For sure an effective approach, however at substantial cost if entire populations shall be screened.
And, for a screening effort I doubt that CT is really a citizen friendly intervention.

One would think that blood or throat swab testing using RT-PCR or similar would be much more suited for screening.

Now, from a citizen user experience point of view, what is needed?
1) an alerting system identifying sub-populations at risk based.
2) an easy test to diagnose if a person is infected or not.

I am sure there are creative ideas for 1). By tracking and measuring social interactions and over time more and more learn how infections spread until one is in the position to actually predict populations at risk.
For 2) an effective testing protocol is required which requires a simply to be collected sample from a citizen, which can be measured in a decentralised setting, providing immediate results, and being able to identify infected patients shortly after infection.

Medical tricorder.

I still believe that it is an illusion to hope for the magic dream of the medical tricorder that detects everything within seconds. That would be user experience. Both, for medical professionals and even more for patients!

The medical tricorder was equipped with sensors and analysis software tailored for medical diagnostic purposes.
A feature set virtually invented in the 1970ies as part of the Starfleet TV episodes.

The tricorder a device delivering maximum diagnostic user experience.

Apple Watch - An interesting platform?

Apple Watch, another neat product out of the Apple factory in Cupertino.

This summer I got my Apple Watch. My intent was to use it for sports and recreational activity. So far I am still wearing my mechanical Swiss watch in professional life. - Why? - I did not find the day to day benefits yet.

Yes, the activity monitoring is interesting, and I keep on taking it as motivational tool for more activity in my daily life.
The tracking, heart beat monitoring, and even communication functionality is useful.
I regularly use this when going for a run, or a mountain bike ride.

But, do I need all the notifications and possibility in taking phone calls or viewing emails and messages on my watch during work?

As you can see, I have ambiguous feelings towards that device. I do not see it yet as my day to day companion. And I am wondering how this will develop.

The device itself is well built. The usual simplistic usability, minimum number of buttons, even navigating the touch screen is going well.
What I am not super comfortable with is the trigger for switching on of the display. Somehow is my wrist movement not reproducible enough so that reliability of switching on is random.

The sensors such as optics and ECG are interesting and I assume there would be more possibility to do with it.
The ECG is a nice feature but I don't see the real use of it. - And there I might not be alone. What does this help unless I am a chronic AFib patient? Hence, for me as an average user there is only the motivation of contributing ECG readings of a healthy individual to the data pool.
What I am wondering is, if there would not be ways to monitor pO2 in blood continuously. And why not body temperature?
I see it very interesting for research purpose to get a data pool of healthy individuals through such a controlled time series data acquisition device. This can help in several disease are research.
The approach is only limited by availability of reliable and robust non invasive sensors, and sensors that do not require an enduser intervention for measurement, such as the ECG.
And how about some blood pressure measurement?

Motivational notifications. This is definitely a way to drive behavioural change and prevention. As usual different people will exhibit different susceptibility to the approach and flavour of implementation.

In combination, given the app capabilities and available sensor measurements, the Apple Watch is an interesting platform for applications serving wellbeing needs. I am wondering what innovations we will see in the upcoming years in terms of sensors for more relevant monitoring of vitals and blood biomarkers. 

The right conclusions

To design ergonomic products, or to provide a best in class user experience, the designers and researchers have to draw the right conclusions.

Conclusions based on evidence, based on data, based on analytics.

How to come up with the data and evidence leading towards respective conclusions and design decisions.

It is important to design some good experiments and take control over how and from what sample the data and evidence is acquired.

Otherwise, data could infer some conclusions as described on the right. - The perfect explanation for the extinction of dinosaurs. - Same might apply with babies and storks...

Latency - No. 2

As discussed in my earlier post - Latency - No. 1 - latency times in today‘s computerized products are a true pain to user experience.

There are different ways of handling it, if it can not be shortened down enough by design.

The most common one is the spinning icon.

However, there is also the traditional solution through good documentation and user guidance.

The good old SOP - standard operating procedure.
Do‘s and dont‘s ...

See to the right - recently found at the breakfast buffet in a tourist hotel in Ticino, Switzerland.
If it truly solves the problem - I doubt it!

At least for me it didn‘t work out. It took me longer to find my language to read - I can read and understand them all - and act on it, than to make everything wrong already in parallel while not waiting for the slow machine to take its time.

Yes, it‘s well documented. And yes, I was the one, impatiently not following the SOP. And, yes, if you would follow it - just slow down - the user experience would be pretty seamless and clear.

As user experience, UX experts usually generate evidence by observing and testing a statistically relevant sample of users. Here, the job obviously has been done. Otherwise nobody would have solved the problem with such a nice SOP in four languages and four colors.
And, from a user end it is always hard to get product design changed in a true user centric way. Once a product is launched, in most cases, there is no room for user centricity and agility to adapt to it any longer. Quality in UX is then only measured in terms of units sold or generated revenue.

In the example given above, a very nice SOP, written by a very pragmatic and customer focusing person, will prevent the manufacturer of the coffee machine from going out of business due to poor UX. What a success!

My new iPad Pro

I recently got an Apple iPad Pro. - Yes, the one with the fancy pencil, and the fancy keyboard.

Once again I was impressed by the overall user experience. Starting with the evaluation phase in the internet. Reading through the specifications and reviews. The lean product photography is already appealing and raises the desire to hold respective product in my hands.

Why do I want to buy an iPad Pro? - My old iPad Version 4 is seven or eight years old. Performance is getting limited, and that bulky pen with the balloon rubber bubble tip was a great user experience increasing usability especially when reviewing articles back then but not necessary today any more.

Why am I reaching limits in performance of that old iPad 4? - Probably mainly because my user behavior changed somehow. I am more often switching between apps, I am having several apps simultaneously open, and pushing the resources of that device. Everything else is working fine. It has been one of my best devices bought ever.

And then that fancy Apple Pencil on the new devices. - A gadget designed to the maximum of usability. But to experience this I need to go to the shop. No e-commerce will make me feel that experience over the internet. Haptic feeling and my biggest fear - will it work for left handed people - drives me to the next Apple shop.

But it‘s not only the hardware of this device which sounds appealing. It is also the imagination of what new possibilities such a setup could open up to me.
All my private and professional office in a small pocket, the possibility to do work wherever I am, bringing creative ideas - yes, the fancy pencil functionality again - to my digital devices as soon as possible...

I am walking into the shop. I tell the seller that I am interested in buying an iPad Pro. He asks me if I would be using it mainly for private or rather for business. My answer is - both!
Yes, private and business is blending more and more.

I am deciding quickly and walking out the shop with three well designed clean white packages. Spent some money on a new device which should bring some more joy to my life.

Am I a victim? - A victim of consumption? - Or, a victim of excellent usability and user experience design? - How did this all influence my buying decision?

Develop for the better - The new Netflix App swiping left and right experience

Netflix, a company known for innovation, creativity, and user experience.

Their recommendation system has been developed in a co-creational way using crowdsourcing in order to match best user experience. This competitional approach even made it into a Harward Business Review. This, as an example of user centricity and focus on the client.

And now, with the newest release of the Netflix App on the Apple TV I am back in stone age when it comes to swiping through these recommendations. - Why? What happened?

The entire user interface is built to scroll left and right for selection within one of my automatically identified favourite categories. And to scroll up and down for selection of respective categories.

And now, this "home", "search", ... menu bar has been moved to the very left and pops up every time I want to swipe left in order to go back while scrolling.

Going back, since the invention of computer terminals and the back space key, probably the most widely used function. The functionality of reflection, of reassessment, and of reconsideration.

I am wondering, what would happen to usage statistics, if you would take this "going back" feature away from the user experience.

So, Netflix in a way did, and probably knows these figures.

What I do not understand is, what designers expect me now to do? - Why has this been implemented?

Do they expect me not to reconsider any more? 

Meaning, always move forward, don't look back, think only about what is coming and do not reflect what you have experienced a fraction of a second ago.

Do they want me to not remember the order of my favourites in "My List"?

Why doing it this way then? Would this not be easier with just randomly sort and resort those lists in the same way grocery stores work against our consumer habits by changing the place of items in the shelfs from time to time?

Do they want me to quit from Netflix on Apple TV? 

If I get annoyed by non intuitive behaviour of the user interface, I will spend less time on the app, I will get stressed, and - since Netflix is rather part of recreational phases of my life - I will not turn back.

This can not be the goal!

So, what were they thinking?

Do they want to teach me to think prior to scrolling?

Slow down, decelerate, relax, ... If so, it does not work!

Now, how was the situation before deployment of respective change a couple of weeks ago.

Same, issue hit the end user actually while scrolling up and down in a way. Just, that the "home", "search", "settings", ... menu bar was seamlessly part of the rest of the experience. Integrated into the categories of favourites. And given the usage of respective functions, I am not sure why this was not a good solution.

I can understand that technically this was not the most logic way of doing it. But it worked.

Or was I just part of one subgroup of users who perceived this implementation as intuitive, while a majority of end users did not.

Is this the struggle with usability? - On one hand everything gest more granular and more personalised. On the other hand, when it comes to simplicity and reaching populations of users with simple implementations one needs to make tradeoffs in disfavour of certain populations.

Is this what is happening here? Is this what I am experiencing as a Netflix user on Apple TV? - Am I traded off against a statistical majority of other users?

Never mind. The current solution feels so odd that I can not imagine above scenario to be true. - But, who knows?

Latency - No. 1

Latency Definition. Latency is the amount of time a message takes to traverse a system. In a computer network, it is an expression of how much time it takes for a packet of data to get from one designated point to another. It is sometimes measured as the time required for a packet to be returned to its sender. (reference: link)

Everybody working with computer systems is facing latency problems.

The time the computer needs to start in the morning - Windows welcoming the user for several seconds.

The time the washing machine takes to be ready to start the program when switched on.

Do you know that feeling? - The TV system asking you "Please Wait...", then "System downloading software upgrade...", "System updating...", "System rebooting...", ... your impatience levels are raising, until you finally get a TV image just to notice that the weather report you wanted to watch is over and you are supposed to consume some publicity instead.

Who guarantees that the reading of your newest smart watch is not compromised by latencies in the management of its computing resources?

Latency, now even when starting up your car, the coffee machine, the vacuum cleaner, ...

One of my favourites is when pushing the power on button on the remote control of my TV screen. The time it takes until the TV shows a visible reaction is so long, that usually I happen to press the button a second time which makes the TV to switch off again. There is no way of seeing wether the first push is doing the job or not!

Another example are SW applications with long response times. Leading to the user clicking around and inducing more and more actions to the system leading to even worse response.
The worst is if typing on a keyboard and the characters showing up on the screen are substantially delayed.

How much latency are we willing to accept?

On one hand we believe that digitisation is improving productivity, reducing inefficiencies, making us more productive and effective. On the other hand we are facing more and more time of enforced delays at steps of our working processes where we have many needs as users, but absolutely no need of waiting.

“For example, Amazon calculated that a page load slowdown of just one second could cost it $1.6 billion in sales each year.” (reference: link)

Already in the very beginning of broader prevalence of computer systems impact of response times on human performance have been performed. There are many studies on the subject being performed in the 1970ies and 1980ies (see: link). These studies have been focusing on response of command entry on keyboards, and response of database requests.

Now, with more and more digital technologies entering our daily life. What are impacts of response and latency times in our life processes?

Is it truly offering added value if my washing machine has a digital control unit which takes 10 seconds to start up compared to the electromechanical version 10 years ago which was instantly ready? - The time prognosis on completion of the washing program is still inaccurate by +/-10 minutes both in the digital and in the electromechanical world.

Having a backward camera on the car which activates when switching to the rear gear is definitely a major improvement compared to the cumbersome navigation by turning your head in non-anatomical positions and looking through small mirrors on the side of the car. But it only helps if switching on the backward camera does not take longer than a couple of tenths of a second.

Or DAB radio. Yes, it is beneficial to have good quality or no signal at all. No tweaking of signals with difficult to manipulate buttons. But, what is the benefit of having to wait several seconds when switching radio channels. In the analog world this was instantaneous with mostly acceptable instantaneous sound quality.

There are many examples where we are limiting ourselves by accepting latency times in the context of technological advancement.
Why are we doing so?
Is it because we are most likely driven by technological fascination and not necessarily by user experience.
Also, the willingness to accept latencies as reality is often too high because end users are not in the position to change anything. And adaptability of users to the current situation of response is quite high.

Nevertheless - for me focus on efficient response and low latency times is one of the most important aspects when designing user experience.
We should always ask ourselves what it we would have to accept in alternative solutions. If these alternatives are old analog or mechanical solutions. We should challenge if accepting longer response times than the mechanical solution can truly be part of a beneficial solution.
If we want to sell the digital solution as a major benefit in efficiency gain for a previous process. Then the tolerance on waiting times should not be too big.

An easy rule of thumb could be something like:

If the system's response times are longer than the reading, inspecting, and thinking times of the user, then it is definitely adding pain to the user experience.
If the response times are longer than the time required by the user between two manipulations then this is definitely not adding value but becoming a stress factor.