Ensuring Innovation. By Kevin Richardson, Ph.D. Principal User Experience Architect. 2 Commerce Drive Cranbury, NJ 08512

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1 By Kevin Richardson, Ph.D. Principal User Experience Architect 2 Commerce Drive Cranbury, NJ 08512

2 The Innovation Problem No one hopes to achieve mediocrity. No one dreams about incremental improvement. No one sets out to make things more complicated. Yet governments, corporations and individuals spend enormous amounts of time and money to create new products, services, processes and software that seem to strive toward these ignoble goals. What are we actually buying with all that time and money? With very few exceptions, what we get is something that is marginally better or marginally worse than we had. Neither outcome is too far from the current state. Small steps, in either direction, are common. Large leaps forward require innovation. We always hope for innovation but we accept these marginal changes (improvements, if we re lucky) because we believe that innovation means one big idea. We believe that innovation erupts from the minds of a chosen few creative individuals or, even worse, marketing teams. And, unfortunately, we re ok with that. Over and above the obvious problems associated with the resource costs of slow and steady progress is the fact that innovation occurs unreliably and infrequently. Don t believe me? Make a list of all the truly innovative products, services, processes and software you can think of. It s a pretty small list. Most creations are derivative works that attempt to eke out small improvements on existing designs. Now take a look at how often these innovations occur. They are few and far between. Is this just the way it is? What if there was a way to ensure innovation on every project timeline? A process that, if followed, would inevitably lead to the creation of artifacts that improved people s lives in ways in which they couldn t have requested? What if we could have consistent, repeatable innovation? We can and design holds the key. Design Process Design is a research-based, highly iterative process with a focus on exploring different models of the usersystem interaction. It is not sitting around until a good idea strikes you or comes to you in a dream. It consists of gathering requirements from end users as well as business and technology stakeholders coupled with the rapid creation of exploratory models of how the user and system can interact. It includes fast, early and iterative testing to determine the ultimate form of the design to ensure that the artifact (product, service, process or software) is shaped not only by the opinions of design professionals, but also by the needs, expectations and desires of users. With the end user as a participant in the design effort, stakeholders are assured that the final system design will be accurate and lasting. In slightly more detail, design involves the following 3 steps, repeated as necessary.

3 Step 1 Inform Every effort begins with a thorough understanding of the user. The design team, with backgrounds and training in the fields of traditional design, psychology, anthropology, and human-computer interaction answer the following questions: Who will use this software? The artifact in question is likely to have user groups that differ from one another along many qualitative dimensions (age, skills, desire, goals, etc.). This means that the needs of the community will vary. What are users trying to accomplish? Expectations of how objectives should be completed will not change to suit a poorly designed system. A successful design allows users to perform tasks in natural and intuitive ways. Failed designs require users to adapt and change their behavior to meet the system demands. You can be certain that a sudden, increased need for training means that the system has failed the users. In what context will the system be used? A poorly designed system requires users to dedicate a (large) portion of their attention to understanding and navigating the interface rather than completing a task. In critical situations, the amount of attention (and tolerance) available for deciphering the system decreases exponentially. Additionally, the situational demands will change informational and task flow requirements. For example, a healthcare professional collecting patient information will need to be supported in very different ways when that interaction is taking place in an office compared to an emergency room. What expectations and experiences will users bring with them? Users bring with them many expectations, experiences and preconceived notions of how things should work. It is important to keep in mind that the goals users have for any new system are likely to be quite different from the goals of those responsible for purchasing, installing and maintaining it. The quality of this analysis directly affects the outcome of the design process. Collectively, the information gained in this phase is vital to the design of a system that addresses the varied goals and strategies of its users. Step 2 Discover The design team next works with users and stakeholders to conceptualize various aspects of the to-bedesigned system, examining what will best meet both user needs and business goals. Research professionals on the design team seek to validate and discover the characteristics that best suit the new system, its audiences and their experience. Within a framework of existing systems, artifacts, business and technical requirements, the team considers limitations as well as defines and prioritizes the expectations against which a successful system design will be measured.

4 Step 3 Design (and Test) The Design phase is characterized as the iterative portion of the design process. Through collaboration during this phase, all participants (design team members, users, and stakeholders) are able to provide input and feedback that can influence design decisions. Using this information, designers can create novel and enduring designs that push the boundaries of the existing system while still enabling users to interact with information in natural and intuitive ways. And because these design prototypes can be produced and tested with users quickly, with little to no impact on development, the design team has the freedom to explore new solutions. How does this process translate into innovation? By employing a team of individuals (researchers and designers) trained to elicit user requirements based on what users need to accomplish as a result of their interaction with a particular artifact (physical product, software application or process) as opposed to simply asking what they want, design is able to determine user needs even when users cannot express them ( latent user requirements). This is the core of innovation. Armed with these constraints, the team is able to focus on creating solutions (in the form of design artifacts) that support users in ways they could neither have articulated nor imagined. Data can be explicitly translated into information and presented to users in ways that support their decisions and actions while freeing resources (attentional and financial) to be spent on problems previously hidden or untouched. Disparate systems can be coordinated and aligned. Processes and even entire businesses can be reformulated to serve user needs as well as user wants. Design, therefore, does not lead to mere incremental improvement or increased complexity. It leads, inevitably, to innovation. It can be applied with equal success to the design of software, cars, houses and government programs and incorporated successfully into every project and timeline. That s right. Usercentered, requirements-based design leads to innovation. Let s explore the process of design and the problem of innovation in the context of two real-world problems Electronic Medical Record (EMR) systems and the Federal Emergency Management Agency (FEMA). Electronic Medical Records Developed and honed over generations, the medical profession has created processes, procedures and artifacts that serve healthcare professionals and their patients well. Are there improvements to be had? Absolutely. Are there inefficiencies inherent in the overlap between healthcare providers and the healthcare industry? Of course. Improving the digital systems that support these processes, procedures and artifacts is not the problem. The problem is the poorly informed imposition of a unified technological

5 solution to replace these processes, procedures and artifacts. The problem is the loss of opportunity to innovate on those processes, procedures and artifacts. The Problem with EMRs Fundamentally, the goals of any EMR are to decrease errors, increase efficiency and reduce cost. These are the same goals put forth by builders of factories and assembly lines at the dawn of the industrial revolution. Still, they are laudable, if pedestrian, goals for a society that pays billions of dollars for health care annually. The real issue is that, while attempting to improve the healthcare system through the insertion of technology, a unique opportunity for innovation continues to be missed. The design, development, purchase and installation of EMR systems, plus time spent training health care professionals to change their behaviors in order to adapt their processes to fit their new electronic systems amounts to many millions of dollars. In response, medical task forces, reporters and healthcare professionals are sounding the alarm that their new, much touted Electronic Medical Record systems are difficult to use, slow them down and, in many cases, not as good as the processes they had used in the past (Bresnick, J. (2013). EHR Usability, Satisfaction are Falling Among Physicians. Retrieved from EMR systems have failed to live up to their potential for a number of reasons: Order-taking style of requirements gathering, focus on development, feature lists over usefulness, basic usability You get the picture. One reason, however, deserves special mention Subject Matter Experts. Subject Matter Experts As a way of addressing the problem of users and their stubborn refusal to use systems that do not support them, clever companies have inserted the role of Subject Matter Expert (SME) into the mix. In the medical industry, this means making sure that software development teams employ clinicians (MD, RN, etc.) whose role is to describe what the application needs to do, what data is required and how it should be presented. While this might seem like a step in the right direction, these individuals are fundamentally like any other user group they are not skilled design professionals and their appointment to this role in the design process is flawed. It is flawed because the job of the SME is specifically to act in place of users. Experts are, at best, providing what they believe to be user requirements or, at worst, their own requirements. The point is that they are not providing user requirements. In addition, Subject Matter Experts are also asked to make decisions regarding design. I want to be clear on this point; experts are not qualified to design any more than designers are qualified to be subject matter experts. Subject Matter Experts might be able to prevent basic problems introduced by well-meaning but professionally isolated developers; they are unlikely to introduce any sort of innovation.

6 Federal Emergency Management Agency (FEMA) FEMA has an ongoing initiative to become more innovative in its response to disaster relief. Traditionally a very government-centric organization, FEMA has, in recent years, decided to refocus their policies and procedures by taking a survivor-centric mindset (Lucus-McEwan, V. (2011). FEMA Focus: Survivor Centric Mindset. Retrieved from On the surface, this sounds like an excellent way to improve how FEMA responds in the aftermath of an emergency. But let s look at the details. Survivor-Centric Requirements Gathering Key to becoming survivor-centric is the collection of a new set of requirements. Key to innovation is the process that determines how such requirements are collected. From the FEMA website: FEMA recognizes that the best solutions to the challenges we face are generated by the people and the communities who are closest to these challenges. It is essential that these partners are invited to the table to actively participate in thought-provoking discussions. That is why we are reaching out to state, local, and tribal governments, and to all members of the public, including the private sector, the disability community, and volunteer community, to seek their input on how to improve the emergency management system. FEMA wants to hear your ideas and suggestions, to both explore best practices and generate new ideas. FEMA (2013). FEMA Think Tank. Retrieved from Based on my description of what s needed to ensure consistent, reliable innovation, it is obvious that FEMA s approach to requirements gathering is nothing more than order taking on a grand scale. Innovation is almost certain not to be generated by the people and communities who are closest to the challenges. Personally, I don t want my national disaster relief plans crowd-sourced. While FEMA deserves praise for recognizing the need to become more innovative in the ways they provide relief to disaster victims, the path they are following will not succeed. Asking people what they want will only give you what they know. Asking the entire country what they want will produce so much noise that discerning any meaningful patterns will be all but impossible. And we will ignore the very real possibility of such an invitation resulting in enough self-selection bias (groups and individuals who feel they have a vested interest are more likely to respond) to limit even incremental improvements. Designing for Innovation An innovative system is the result of a well-defined design process. That process includes the expertise of an interdisciplinary team with individual backgrounds in graphic design, fine art, architecture, cognitive psychology, anthropology, human-computer interaction, and other fields. This kind of design team has the training and experience to bridge the gap between business, technology and human requirements. They practice a design process that is mindful of the features, functions and legacy systems that must be somehow united, implemented and maintained. They are equally mindful, though, of who will be using

7 these systems (doctors, emergency response professionals, the general public), where they will be using them (an emergency room, a field command center, a neighborhood school), and what they need from technology to improve rather than impede outcomes. This process of eliciting requirements coupled with fast, iterative design exploration allows the creation of artifacts that go beyond matching features to a checklist. It provides a pathway to innovation. The nature of the artifact to be designed (product, service, process or software) doesn t matter. To ensure innovation, the process of design must be followed. Anything else is doomed to result in small, expensive, time-consuming steps rather than large leaps forward.

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