I always enjoy the opportunity to pick the brain of a healthcare provider and get their perspective on all things Health IT. I received a bit of enlightenment in a recent conversation with a clinical informaticist. We discussed Meaningful Use, interoperability, “big data”, and other topics that are creating a buzz in healthcare. Our conversation eventually moved to User Experience, and I was pleased to hear he is a big fan and supporter of UX. As we discussed the importance of building usable software, he made an interesting statement (which I’ll paraphrase):

“All those nice designs and patterns don’t matter if the clinicians don’t trust the data in the system.”

The statement was focused on the importance of data integration and interoperability. But the word “trust” really caught my attention, causing me to pause and reflect. Building trust has always been in the back of my mind when I’m designing, but it is easy to forget about it during the daily grind of throwing together wireframes, gathering design feedback, and working with development teams. The problem of the day can narrow focus to the point where I’m looking at a single leaf in the forest. This was a reminder of one of the necessary goals in providing a solid user experience solution.

Building trust in software is especially important in healthcare. As I learned through many early career interviews with anesthesiologists, healthcare providers do not want to deal with a “black box” when it comes to technology: “Why is the system alarming?” “What is wrong with my patient?” “Is your system giving me the right information I need?” There is already enough stress in providing proper care. The last thing they need is to question whether their software is providing the right information in the right context.

The bottom line is no matter what the application does, how many features it has, and how “nice” and well designed it looks: if the users cannot build trust with the system they will not use it.

There are no shortcuts in establishing trust. It is something that needs to be prioritized in the design process. I believe a key factor is to focus on the initial intuitiveness of the application to help make a good first impression. Eventually, steps have to be taken to maintain that trust over time.

Here are some suggestions on how to go about building up that trust:

Do your research: I bring this up all the time when discussing UX. Without doing the proper user research, you will not be able to identify where users may be having issues trusting your application. Do not design in a vacuum. While you are researching:
- Run “hallway tests”: Grab a co-worker (or neighbor, or friend, or family member…anyone really) and have them look at your low-fidelity design. Do they know what they are looking at? Can they figure out what to do? If not - time for some rapid design iterations before grabbing the next unsuspecting test subject.
- Test with new users: First impressions go a long way, and users that are new and unfamiliar to your system are ideal to test how intuitive an application is. New users should be able to navigate and work their way through a well-designed, intuitive application with very little problems. Some errors may initially be expected if the software is particularly complex, but you should observe those errors occurring less and less. If they are still struggling after the second or third task in a usability test, then it may be time to go back to the drawing board.
Provide guidance: Sometimes the task at hand is going to be a little too complex to accomplish without a little help. Great software will provide well placed help text, tutorials, or other guides to help the user navigate through successfully. One of my favorite guides are the videos on my Macbook that show me how to use the trackpad for tasks like bringing up Mission Control and Launchpad. I recommend working closely with whoever is writing up the product documentation to brainstorm creative ways to help users learn the system.
Follow up: Not only do you have to make a good first impression, but you have to keep working and improving to maintain the trust that was gained. Go back and follow up with users that have evaluated your designs. Hopefully the latest application updates addressed the issues they had, and you will be having much happier conversations. Follow up discussions are always a great chance to find new improvement opportunities. But this is also important in order to establish a personal rapport. Users appreciate this attention and knowing that you care about their experience.

Following a good user-centered design process and having empathy for users will naturally make these suggestions much easier to accomplish. I think the effort is worth it - I would much rather have people using the products I have helped design.