Website

The website selected for this Heuristics Evaluation intended for the Healthcare Group is the Cleveland Clinic Healthcare System at https://my.clevelandclinic.org/. The website represents a medium-to-large services and resource oriented healthcare organization situated nationally with locations primarily in Ohio and Florida. The site serves as an integrated public-facing portal for individuals seeking health form a trusted source – learning further about Cleveland Clinic’s services, access to patient-specific info, and navigating conceptual medical or pharmaceutical info.

User Scenario

Prefaced in our group interest, our user seeks a central destination to fulfill information needs in terms of their healthcare, fulfillment either to gain more knowledge or to further take action with a medical professional. With this in mind, the ideal scenario is to connect all those needs with a user that is a new patient seeking to alleviate a medical condition by discovering more about the condition itself, related symptoms, and concluding the search by making an appointment with a healthcare provider.

Defining the scenario with helpful attributes, our situated user seeks to find more about the treatment solutions for his or her chest pain. With Heart Disease as the highest in mortality and common care, it is most appropriate symptom to simulate (Centers for Disease Control and Prevention, 2022). Our user has already decided to seek an appointment with a medical professional, understanding the intent of visiting Cleveland Clinic as a point of care in addition to a knowledge center as intuitively defined by the organization’s name.

In emulating this scenario, the following steps were accomplished with the current UI:

1. Select “Looking for information about diseases and treatments?” in body.
2. Search “Chest Pain” in the search box and select the first result.
3. Select “Appointments & Locations” as the orange primary button.

Flaws and Heuristics Analysis

In this analysis, Jakob Nielsen’s 10 Usability Heuristics were used as the most universally applicable in testing Cleveland Clinic’s site usability with the specified scenario. With each flaw, inadequate heuristics were identified for improvements. Overall, the flaws identified center around Cleveland Clinic’s lack of contextualizing user needs upon entering the website.

The first flaw, in site navigation, is the lack of context for our user to identify where they can navigate to cardiology specific information. On the homepage in Figure 1, the site only provides two links to enter the “Health Library” to make a search for conditions and symptoms or to select the link stating “Looking for information about diseases and treatments?” in the middle of the page. In terms of heuristics, this issue primarily violates Flexibility and Efficiency of Use, where the site needs to tailor to expert users but also quickly prompt accelerative actions for new users (Nielsen, 2020). The site accomplishes this well with COVID-19 and monkeypox specific links, but fails to address even considering the more common CDC Diseases. Likewise, Recognition Rather Than Recall is lacking for the same reasons and Help and Documentation is initially lacking with

The second flaw, back to navigation, is the over-redundancy of the generic links. While this can aid on other heuristics, it is against Aesthetic and Minimalist Design with more distracting text. Use of light text in primary headers and bold texts in secondary links clash in aiding where to select on conditions or seeking a medical professional. Non-actionable text hidden in headers like “100 Years of Cleveland Clinic” are also present. Dual use of the same links for “Find a Doctor,” “Locations & Directions,” and “Appointments” add to the confusion, only separated by a large middle picture heading. All three links eventually conclude with the ability to make an appointment, but add extraneous details to specialize more on the action steps rather than the care needs.

When selecting “Health Library” the user ideally would enter “chest pain” into the search box centrally located as seen in Figure 2, which delivers an article that has the ideal step highlighted with an orange button to make an appointment, superseded by the 800-number. At this concluding task, this setup, especially when considering “chest pain,” fails the heuristic of Match between System and Real World with the context of the site content (Nielsen, 2020). The knowledge article mentions in paragraph multiple times to reach a medical professional immediately for this symptom due to high concerns of more serious heart disease. However, the buttons remain static in all knowledge articles. With multiple pathways, all steps encourage calling the main number even though there are other options that are buried in the body.

Concluding the scenario, as shown in Figure 3, the user is given an extensive standard operating procedure to make an appointment to visit the Main Ohio Campus, with repetitive calling options and buried action links. This extensive text once again violates Aesthetic and Minimalist Design but also violates Error Prevention and Diagnosis to Recover from Errors (Nielsen, 2020). By expanding contact options less clearly and branching multiple hyperlinks for the purpose of making an appointment, the site risks making the user more lost and reverting back and forward between pages.

Design Recommendations

To address the homepage, the simplest step is to reduce redundancy of main navigation links in the header to aid in Aesthetic and Minimalist Design. By removing duplicated links, making the remaining ones more bold or accented, and reducing the length of the picture heading, the site is more visible to body content below the heading.

In place of the secondary redundant links, using icons and titles for different specialty areas such as “Heart,” “Cancer,” “Respiratory” and “Infections” can contextualize the user’s search in the Health Library for more information about their condition. By using more generic terms for the specialties, the user understands the topics better to drill down.

When presented the knowledge article for “Chest Pain” like in Figure 2, there should be more more call to action buttons with the common one to “Call to Make an Appointment.” Primarily for this article, flagging certain ones as high risk can have a button to “Call 911 for Emergency” in red to highlight if the user is experiencing the symptom. These can hyperlink to a phone call in-browser or on the mobile device. More importantly, the semantics of the buttons apply intent more in line with real world and the system.

Lastly, to avoid errors and provide clarity with less clutter with the end page shown in Figure 3, content can be reduced with the inclusion of action buttons mentioned previously and simplifying the step-by-step article only about what the user expects after they make the appointment. Selecting the action button can also prompt the user with a new load page saying “thank you for reaching out” and then provide the guide below. This facilitates feedback and lets the user diagnose what occurred when they placed the call.

Future Considerations and Conclusion

Architecturally, it is apparent that the initial design elements of Cleveland Clinic’s site are mainly to alleviate a less sophisticated appointment management platform. The requirement to be a MyChart account holder as a current patient or use a 1-2 day delayed web form are poor substitutes compared to a direct phone number. With the careful design of a linear oriented new patient appointment system on-site, many of the flaws listed can be alleviated. Likewise, approaching linearly aids in successful steps in the scenario by curating actionable steps from condition to appointment scheduling.

Word Count: 1,198

References

Access anytime anywhere. Cleveland Clinic. (2022). Retrieved September 26, 2022, from https://my.clevelandclinic.org/

Centers for Disease Control and Prevention. (2022, September 6). FASTSTATS – leading causes of death. Centers for Disease Control and Prevention. Retrieved September 27, 2022, from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Nielsen, J. (2020, November 15). 10 usability heuristics for user interface design. Nielsen Norman Group. Retrieved September 19, 2022, from https://www.nngroup.com/articles/ten-usability-heuristics/

Backlinks

Group Assignment 1 – Healthcare

Individual Assignment #2: : HEURISTIC EVALUATION

Website Selection

South Georgia Medical Center – https://www.sgmc.org/

I have selected the South Georgia Medical Center (SGMC) website for the assignment 2 heuristic evaluation. This website represents a small but surprisingly comprehensive medical center and hospital located in Valdosta, Georgia. The website serves as it’s public-facing virtual destination for those seeking information relating to its services in patient care, employment opportunities, patient portal access, its medical residency program, public health and hospital census data, and community events.

Retrieved from: https://www.sgmc.org/

Scenario Description

The scenario that I chose to center my heuristic evaluation on is that of an individual who is attempting to discover more information about South Georgia Medical Center’s palliative care program and what services the program provides. Palliative care is defined by the U.S. National Institute on Aging as “specialized medical care for people living with a serious illness…meant to enhance a person’s current care by focusing on quality of life for them and their family,” (NIA, 2021). Palliative care is different than hospice care, as hospice care does not contain curative treatment as part of its care planning and is designed for patients that will be terminal in the short term, typically within six months (NIA, 2021). I approached the SGMC site evaluation somewhat unconventionally based on the framework described by in Nielsen, as I was a single individual conducting the evaluation acting as both the evaluator and the observer with no additional participating evaluators to aggregate findings with (Nielsen, 1995). In the scope of these roles, I am evaluating my use of this website as a first-time user for this specific scenario without the possibility of guardrails or hints provided by an observer by requesting guidance – I am on my own as an evaluator.

Usability Flaws

The first usability flaw discovered is that the landing page is not branded with the full name of the organization, South Georgia Medical Center, and instead only displays the organizational acronym, SGMC. This lack of brand awareness connecting the more generally recognizable full name with the acronym violates the usability heuristic #2 match between system and the real world, as the website’s current state assumes that the user is familiar with identifying this organization by its acronym, which they may not. Due to this lack of identification, it is possible that an individual in the evaluation scenario could be confused about whether they have even arrived at the correct website after searching for a “South Georgia hospital” and being presented with two very similarly named organizations “Southeast Georgia Health System (SGHS.org)” and “South Georgia Medical Center (SGMC.org)”, two different health systems that are over 120 miles away from one another. When an individual visits the physical location of a South Georgia Medical Center campus or building, the full name is displayed outside (https://www.sgmc.org/about-south-georgia-medical-center/our-mission-vision-and-values/), and similarly, when an individual calls the main telephone line for SGMC, it identifies itself through its full name not an acronym. The website failing to follow real-world conventions by clearly identifying itself on its landing page violates usability heuristic #2 match between system and the real world.  

The second usability flaw that was encountered during the evaluation was in the medical service listing page while attempting to locate information on palliative care. The list of services contains “palliative care” in two different locations and the information that each links to is different, with no mechanism on the service list page or the following linked pages to explain the difference and route to the other. This flaw represents a violation of usability heuristic #4 consistency and standards and #7 flexibility and efficiency of use. The first link displays “Hospice/Palliative Care” and links to an external website for an organization called “Hospice of South Georgia” with no explanation of its affiliation to SGMC. The second “Palliative Care” listing in the services links to a SGMC page that very briefly describes the program, defines the difference between hospice and palliative care, and requests personal contact information to receive more detail about the program. The service list having two listings for palliative care violates usability heuristic #4 consistency and standards because it requires the user to click on both links to ascertain what the difference between the two are and even then, it is not readily apparent. This violation causes unnecessary confusion for the user and negatively impacts the user experience in a context that is likely serious and emotional. Furthermore, this design also does not allow the user to be routed from the palliative care page to the hospice care site, despite the effort made to make the user understand the difference. By not providing a link from the palliative care page to the hospice care site and vice versa, the design violates usability heuristic # 7 flexibility and efficiency as it requires the user to navigate between both links from the service list inefficiently despite acknowledging a confusing semantic difference.

Retrieved from: https://www.sgmc.org/our-services/  

Recommendations

The first design recommendation that I propose is to include a prominent display of “South Georgia Medical Center” on its landing page front and center. Additionally, I recommend including the full name under the website home icon located on the top left of the website throughout. Through the inclusion of these recommendation design optimizations, users can enjoy a higher level of brand awareness and thus less confusion regarding the website they are viewing while seeking information from this specific healthcare system.

The second proposed design recommendation is to remove the “Palliative Care” from the “Hospice/Palliative Care” link on the service list; the inclusion of it creates unnecessary confusion in the user experience. I also recommend creating a section on the remaining “Palliative Care” linked page that describes this available service through the affiliation with Hospice of South Georgia with a link to that website’s palliative care page in addition to the palliative care service option that SGMC provides independently. Additionally, on the SGMC palliative care page I recommend including a link to Hospice of South Georgia’s website in the section defining the difference between palliative care and hospice for navigational convenience.  

Retrieved from: https://www.sgmc.org/our-services/palliative-care/

References:

Nielsen, J. (1995). How to Conduct a Heuristic Evaluation. http://www.nngroup.com/articles/how-to-conduct-a-heuristic-evaluation/

U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Aging. (2021). What are palliative and hospice care? Retrieved September 23, 2021, from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care#palliative

Target Website

https://www.gmha.org/

Guam Memorial Hospital Authority (GMHA) is the largest medical facility that serves the general population of Guam and the surrounding Micronesian islands.

Scenario – Acquire contact information about a GMHA Facility

In this analysis of the GMHA’s website usability, the most likely scenario involves a stakeholder (in this case, the user) searching for contact information about services offered at a GMHA facility. Such services can include radiological, urgent care, laboratory, physical therapy, and so forth. This scenario also considers how a user might approach navigating GMHA to reach their intended information through the various healthcare providers regarding said services.

Heuristic violations based on the scenario

In consideration of the suggested scenario, utilizing Jakob Nielson’s 10 usability heuristics is most applicable in testing GMHA’s website usability. The scenario aids in this heuristic evaluation by detailing the steps that a user would likely perform based on their information needs. For instance, a user’s health concerns would prompt them to seek out medical services from the largest healthcare facility in Guam. The first step a user would take is to browse GMHA’s website seeking relevant contact information regarding their health concerns with a specific medical facility at GMHA. On the homepage, they would seek any icons, links, or directories hinting at where they could locate such information. This approach should provide them with the relevant information from GMHA that would allow them to contact the appropriate healthcare facility. However, these steps are difficult to accomplish based on the identified usability flaws. Following is a brief overview of those usability flaws with their associated heuristic violation based on the said scenario:

#	Location	Usability Flaw Explanation	Heuristic Violated
1	Homepage	A cluttered homepage disorients the user. Phone directory poorly placed	#8: Aesthetic and minimalist design
2	Areas of Care	All links lead to the same location confusing the user	#1: Visibility of system status
3	Areas of Care	Complicated menu design hinders the user	#8: Aesthetic and minimalist design
4	Areas of Care	No contact information for any medical facility shows little concern for the user	#2: Match between system and the real world
5	Find a Provider	No clear feedback that a provider could not be found. No user recovery	#1: Visibility of system status #9: Help users recognize, diagnose, and recover from errors

1. Homepage: Cluttered information

Based on the selected scenario, a user would be most interested in locating contact information for a GMHA medical facility. However, this information is difficult to find on the homepage. GMHA hosts a multitude of information on its homepage that can quickly disorient the representative user. Namely, there are too many links and action commands that populate the user’s screen making it needlessly difficult to locate relevant information to continue. What’s more, if the user scrolls down the page they could find the contact information but it’s too easy to skip over the link since it’s objectively dull. In its current state, GMHA’s homepage provides low information utility thereby reducing its website usability and information scent. These usability flaws directly violate Nielsen’s eighth heuristic for aesthetic and minimalist design.

2. Areas of Care: Burdensome Drop-Down Menu

Following the next logical step in the scenario, the user scans the homepage looking for whatever link most likely directs them to a specific medical department. They click on ‘Areas of Care’ and a drop-down menu displays links to various GMHA healthcare facilities. This menu makes it difficult for the user to locate the appropriate GMHA healthcare facility. The most obvious way is to click on the right-facing angle bracket to scroll for additional medical areas. However, if the user needed to locate the ‘Radiology’ department, it would take much longer because of clicking multiple times with the current alphabetized menu design.

This usability flaw directly violates Nielson’s eighth heuristic on aesthetics and minimalist design. The menu forces the user to navigate through irrelevant information until they can find what they wanted initially. Namely, the interface has too many unnecessary elements that hinder users from quickly finding relevant information thereby increasing its ‘noise’.

3. Areas of Care: Poor System Status Visibility

Continuing the scenario, the user will have selected the desired healthcare department and be directed to another webpage. The user expects to find information about that specific department. However, the webpage does not direct the user to the right department. Rather, the user is directed to all the GMHA medical departments along with brief descriptions and pictures of each. Given this unfortunate usability flaw, the user that painstakingly clicked through multiple departments to select ‘Radiology’ could have clicked on ‘Care Units & CIF’ and been directed to the same webpage. Added to that frustration, the user would at this point realize that they didn’t need to select the right department because it was all located on the same webpage, to begin with. This feature was only intended to search for the desired facility on this webpage to make it ‘easier’ for the user to locate it sooner. However, pictures in the drop-down menu behave inconsistently which may or may not indicate system failure. For instance, while clicking ‘Pediatrics’, the system will function as intended. Yet, other links like ‘Radiology’ will break the system which resorts back to the ‘Areas of Care’ page confusing the user as to what happened. Therefore, this usability flaw violates Nielsen’s heuristics of system visibility since it erodes the user’s trust because of little feedback as to what the system is doing.

4. Areas of Care: Medical Facilities Lack Expected Information

This last step in the scenario is the largest disappointment to the user. Locating their desired GMHA medical facility yields little information about it. A user in this scenario would expect at least the department’s contact information but to no avail. This usability flaw is a blatant disregard for user empathy in showing that GMHA cares about its stakeholders by simply providing highly relevant contact information under a webpage that explicitly states, ‘Area of Care’. While this information could be found on GMHA’s homepage, it’s obscurely placed amongst a plethora of similar-looking links making it unnecessarily difficult to locate this information.

As a result, this lack of contact information directly violates Nielsen’s heuristic of matching between the system and the real world. By not providing contact information, such as phone numbers, emails, or GMHA building locations, for this specific webpage, there exists a mismatch in expectations between GMHA’s website and its stakeholders. Such information should appear virtually on GMHA’s website as it does on contact cards, brochures, and other reading material in the real world.

5. Find a Provider: Results show blank white space

While this scenario differs slightly in its steps, the objective remains the same for the user. That is, they need to acquire contact information through a GMHA provider instead of a medical facility. Taking these steps, the user would click on ‘Find a Provider’ from the homepage. Another drop-down menu will display prompting the user to search for their provider through various means. The usability flaw arises when the user types in the last name, ‘Flores’ into the search box and selects ‘Search’. They are directed to a screen with GMHA header information and blank white space underneath ‘Find a Provider’. There is no indication or message that the system could not find a provider based on ‘Flores’.

This usability flaw directly violates Nielsen’s heuristic for users recognizing, diagnosing, and recovering from input errors. That is, the system should use plain language to notify the user of not being able to find a medical provider with that last name. Additionally, the system did not provide any solutions (or any indication) for recovering from said search criteria. Added to these usability flaws, the system’s lack of communication (feedback) to the user erodes their confidence in it. This demonstrates another heuristic violated–poor system visibility for the user.

Recommended Design Improvements

1. Re-work homepage design layout to better reflect the ‘essentials’

Reducing action commands on the homepage such as “GMHA in the News” and “Watch the Video” will improve readability by reducing ‘noise’. This will also keep users focused on locating essential information from the homepage. Additionally, the GMHA facilities phone directory must be clearly identified without requiring users to scroll down the page. Providing this directory in an easily identifiable way on the homepage greatly improves its aesthetics without frustrating users’ experience.

2. Minimalize the drop-down menu interface

The current menu layout does not present all the “essentials” that users need to make informed decisions. Therefore, it must be minimalized. Namely, removing all pictures, which can be considered ‘noise’. Additionally, presenting all GMHA medical facility directories immediately on the same menu with clear visibility (not at all like the homepage footer link arrangement). There will be an aesthetic element added to draw user’s attention to the medical facility directories. By implementing these two solutions, users will have better information scent that will keep the content and visual design of the menu layout simple.

3. Re-work programming logic to function as intended

The Area of Care webpage displays a long list of every GMHA medical facility. This webpage already has programming logic that will locate the appropriate facility based on the user’s selection from the drop-down menu. However, most selected facilities do not direct the user to their respective information on the webpage. If the user selects, “Pediatrics”, then the system will function as intended. Re-working the programming logic to function as it does for “Pediatrics” will tremendously improve webpage usability as it will improve system communication and user trust. Currently, the system simply resorts back to the top of the webpage (or anywhere else depending on the selected facility) with no clear feedback as to what happened, which leaves users confused and frustrated.

4. Provide contact information

Following real-world etiquette, providing contact information on the webpage matches GMHA’s interface with it. That is, users will know that GMHA is empathetic to their needs by displaying each medical facility’s contact information. Such information includes phone numbers, email addresses, and building locations. This approach solidifies expectations in the system with the user thereby improving website usability.

5. Provide system feedback and allow the user to recover from their search results.

Use plain language that clearly indicates the provider was not found based on the user’s search criteria. Additionally, the system must provide a link directing them back to the prior webpage. Providing immediate feedback for search tasks allows users to quickly assess their search results to make better decisions thereby improving system visibility. If the system could not find a provider, displaying a link that directs the user back to their search helps them recover from errors sooner in acquiring the right medical provider.

WORD COUNT: 1784