A Usability Cure for HealthCare.gov
The launch of the Affordable Care Act website is making headlines, but not in the way that Washington had in mind. Technical glitches are proving serious and costly, and we’re left wondering how Amazon and eBay can build sites that work but the U.S. government cannot. The truth is, a different list of concerns is a virtual certainty if user experience (UX) is not taken into account. Up to now there hasn’t been much discussion about that.This silence is familiar to me from working with clients in the private sector. Companies sometimes launch websites based on heads-down programming that focuses only on technical requirements, without looking up at the people who will use it. Without extensive UX research, exploration of alternate designs, and user testing, complex websites are destined to fail. Even if you are a world leader.Politics aside, it’s time to focus on repair. The logical starting point is a punch list to resolve the technical bugs. But there also needs to be conversation around the host of issues concerning system usability and the total user experience.Consider the highly diverse and complex user population of HealthCare.gov. The group comprises tens of millions of people with low general literacy as well as low technical and health-care literacy. Users include the young, middle-aged and elderly, the healthy and chronically ill. Moreover, there is a fear factor about choosing the right policy, and a trust factor in buying into a program questioned by more than half of Congress. None of that was taken into account.From a human factors perspective, it is easy to predict that these kinds of emotional issues will lower performance and hamper good decision-making. The best approach for designing a system considers important facets of the audience:
- Value Proposition: Determine various market segments and their major sources of motivation and anxiety
- Abilities: Determine the ability to make a correct decision or choice, with or without assistance
- Limitations: Determine and accommodate cognitive and physical disabilities
On its own, selecting a healthcare plan is confusing and creates high anxiety. Complicating things further, you are asking people to navigate a sophisticated website and enrollment process. These factors almost guarantee that people will engage in some pretty irrational behavior, and it’s not their fault.In a system this complex, the government is never going to avoid every problem. But they can minimize them with extensive user experience research, design and testing. My guess is that there will be very little support to assist people making choices. And without it, the chance of choosing the right health insurance plan is very low.Bill Gribbons is professor of human factors and founder of Bentley’s User Experience Center.