UK General Medical Council’s solution for reducing prescription errors? More usable, better designed forms

The BBC News today has a great example of the impact procedures documents and usable forms can have upon people’s lives. It reports the General Medical Council is is calling for a UK-wide standard prescription chart as the best way to reduce the 9% of hospital prescriptions that contain a mistake. Against common opinion, the study found it wasn’t  doctors fresh out of medical school who were making the most mistakes – the causes were mostly down to poor forms and bad handwriting.  

The chairman of the GMC, Professor Peter Rubin, said:

 ”Prescribing decisions in a hospital setting often have to be made quickly, so it is important that a procedure is as simple as possible to minimise the chance of an error being made.

To avoid confusion as doctors move between hospitals with very different prescribing forms – including paper and electronic – the GMC wants to see a standardised system across the UK.

A Department of Health spokesman said it would continue to look into the benefits of electronic prescribing systems,

 ”taking into account the evidence gained where standardisation of the paper chart has been successfully implemented.”

Dr Hamish Meldrum, of the doctors’ union, the BMA, said:

“It would certainly help if there was greater uniformity in the prescription forms used in the NHS and the BMA would encourage prescribing procedures to be kept as simple as possible.”

 It’s good to see recognition, in such an important area, of the value of good procedures writing and form design.

Training course on Twitter and the Social Web: Developing a strategy for technical authors

We’ve just relased a new training course that explains where the Social Web, and Twitter in particular, can fit into the world of the technical author/writer.

Originally delivered as a presentation for the prestigious User Assistance Europe Conference 2009, it has been extended and converted into a training course, containing videos and demonstrations of software applications, to help it all make sense.

You also get access to the full 37 minute, transatlantic video interview we recently conducted with Anne Gentle, author of “Conversation and Community: The Social Web for Documentation”, where we talked about The Social Web for Documentation.

Can you design your way to a “no user documentation” approach?

Chris Edwards has written an article on product design in the E&T magazine called “The art of avoiding lemons“, in which he looks at whether there is more to product design than simply getting your design to look good or your product to work. He shows there are many situations where brilliantly designed products still fail.

Managing customer expectations

Edwards quotes findings from Elke den Ouden and colleagues at Eindhoven University of Technology and Philips Applied Technologies, who found that half of the consumer electronics products returned to stores worked just fine: the customers simply had not been able to figure out how to get them to operate properly.

According to den Ouden:

For businesses today, the main risk with respect to quality and reliability of new products is not just technical failures, but also failures of a non-technical nature, that is, complaints due to the product not meeting the consumer’s expectations.

He also cited findings from a 2006 report by consultant Sara Bly and a team from Intel Research and the University of Washington, called “Broken Expectations in the Digital Home“. This report listed:

A litany of failure by consumer-electronics vendors to provide products that did what the users wanted. And yet each product surveyed did, at least nominally, what it was designed to do.

Connectivity – A series of unfortunate events

In addition to the broken expectations also mentioned by den Ouden, Bly stated the reasons for these failings were partly due to users being unable to connect one device to another. This complexity issue has also been highlighted by research into how small to medium sized enterprises use IT. Dr Alan Rae’s “Abandoned Heroes” report stated similar findings, where a single individual in the business often had to rely on their own self-taught expertise and felt ill-equipped to carry out the implementation tasks required of them.

Meaningless dialog boxes and error messages

Edwards also claims that users can be stumped by error messages. He quotes Don Norman:

(Product designers) assume perfection, a smoothly operating ticket machine, always performing smoothly and efficiently.

If we also consider Rachel Potts’s article, “3 good reasons software will always need help“, where she argues users may need key concepts and context explained to them, then we may come to understand why dialog boxes such as the one below may need some explaining:

No amount of good design will help you understand a “wiggle factor of 4″, if you have no understanding of the concept of “wiggle factors”.

Different users on the Rogers Technology Adoption Lifecycle Curve will have differing requirements

At last week’s UA Conference Europe 09, IBM’s Mike Hughes made the great point that the adoption of technology over time will have an impact on the effectiveness on your design.

He said that different types of users will have different expectations and needs for documentation. Sometimes, all you need to tell users what is a good choice. At other times, you need to explain how to do things, step by step.

My thoughts

For simple, commonly known actions in a closed environment, you probably can design your way to a “no user documentation” approach. Good design can also lead to less documentation. However, customers may expect to do more than that with a product and, in those situations, documentation can play a key role in meeting those expectations.

Transatlantic video interview with Anne Gentle on the Social Web for Documentation

We’ve just uploaded a 15 minute extract from a transatlantic video interview I recently conducted with Anne Gentle, where we talked about The Social Web for Documentation

The sound is a little patchy on the first slide, but it improves afterwards.

A longer, 37 minute, version will be available to anyone who purchases the Cherryleaf Learning Zone service.

Is search dying? Your manual within 140 characters?

Internet Psychologist Graham Jones wrote an article last week, in which he stated, search is dying, and is being replaced by sharing information socially.

“So worried is Microsoft about Google that they haven’t realised that Google is not their real competition any more. It is the likes of Twitter and Ecademy…Google already knows this. Much of their labs work and their adaptations of what they already offer are geared to sharing information socially. They realise that search as we know it is dying. Microsoft is so focused on fighting Google, they haven’t realised they are on the wrong battlefield.”

Let’s assume Graham is correct. Where does this leave online user assistance?

Since Online Help was introduced, technical communicators have provided hypertext links, key word search and an index to help users find information.

Today, there is greater emphasis on key word search (finding stuff via Google), and we’ve seen a few authors add tag clouds too.

So how could online user assistance (“Help”) be shared socially? Is it likely that someone will respond to each question by tweeting a link to a particular page in a Help file?

That’s incredibly labour-intensive. For Support teams to answer queries via Twitter might be less time-intensive than responding to emails, but it may be difficult to provide an answer within 140 characters. Most likely, they could provide to links to places where the question is answered.

We’ve talked about the emergence of “landing pages” in Web based Help (so have Michael Hughes and Matthew Ellison),  and that may be a less intensive way to guide people to the information they need. By this I mean, point people towards say 6 landing pages, from which they can be guided quickly to the information they need.

It may also be difficult for users to pose their questions within the limitations of Twitter.

A more likely scenario, I believe, would be to create Twitter avatars. The fictional characters from “Mad Men” post regular tweets about their imaginary lives. If Don Draper and Peggy Olsen can tweet, then why not create a personas for your customers and let them do the same? Billy the Beginner and Patty the Power user, for example? Their posts could guide customers through the key tasks via a series of daily Twitter posts. 

Of course, this is more than about how to best use Twitter. It’s about social networks, the ideas from the Cluetrain Manifesto and Web 2.0 ideas of syndicating content, collaborating with your user base and aggregating content.

Graham Jones concluded by saying ”just concentrate on providing and sharing good material”.  Technical Authors can help the organisation provide good material. What we may all have to work out is how we can share this material in more effective ways.

Why you should write Help for your competitors’ products

At our “Developing your career as a technical author”  course yesterday there was a great discussion about meeting the needs of “Generation Y” – the part of the working population under 27 who have grown up with the Internet. It’s a group that makes up about 13% of the working population.

We talked about the fact that they acquire so much of  their information from the Web. From many of them, if Google can’t find your content, it doesn’t exist.

This led me to think, if your competitors’  Help is not available on the Web, then why not write it for them?  With the majority of Generation Y using Google to find Help, there’s a good chance they would end up reading your version of Help.

This gives you the opportunity to explain the complexities of a particular competitor’s product and contrast it with your company’s offering. You could end up persuading prospects to buy your product instead of those of your competitors. You might even win some of your competitors’ customers.

Lessons for technical communicators from the telecommunications sector

It’s often useful to look at the economic and technological pressures in other industries, to see if the trends emerging there are relevant to the technical communications/publications sector. In recent Blogs, we’ve covered the issues emerging in education, but the telecommunications industry might also provide some useful insights.

Lee Dryburgh, organiser of the Emerging Communications Conference, has been interviewed by Skype Journal.com  about how he see the future of telecommunication. The key points in this interview are:

  • Widespread deployment of a method of communicating, long cultural embedment, extreme ease of use and very low barriers to usage, means it’s not going away in a big way, at any time least soon.
  • We are seeing software offer a new stronger “Relationships” between people. Distribution is relatively zero-cost and it achieves unprecedented scale.

He’s talking about telephony and Skype, but couldn’t that also be true for paper and Web-based online Help?

Dryburgh sees a new phase emerging that will have deeper impact yet.  He said:

“Phase two is built around an economic model that puts human time and attention at a premium. It’s the opposite of what we experience today with telephony, where human time and attention is wasted.”

“Phase two is about intention-based economics. It’s focused on fulfilling intentions and desires … I’m not saying we need to become psychologists and anthropologists. But what we need to build for is access to ever more personal information, i.e. about the human behind the endpoint. Privacy does not exist looking long-term. Ever more personal information is the new currency, which underlies intention-based economics, and people will increasingly trade it for free access to services. “

“If any of this seems abstract at the moment, think about what makes Google money, Ad Words. Google provides search free to the consumer in order to gain eyeballs (mass attention) and takes the search parameter to try and deduce intention. It then sells that attention and intention data upstream to advertisers.”

Could this also happen in the technical documentation arena? Would seeing technical documentation in the context of new economic ideas, such as  intention-based economics  and the economics of attention, affect how and what was created?  Would it change the nature of conversations with management and marketing?

“Push me, Pull me” dilemma for technical authors

There are a number of posts on various Blogs, at the moment, concerning documents as conversation and moving beyond the traditional manual. Some of the comments suggest implicitly  that technical authors (aka technical writers) could end up having to resolve two conflicting views regarding communicating with users. 

The problem is that many technical communicators work in hierarchical organisations where “authority” is key. Staff (and users asking for support) are expected to follow.

However, many parts of Web-based content are not based on authority or hierarchy. It’s a network, collaborative in nature.

For an organisation with a “behind the firewall” culture – protect your intellectual property, no access to Facebook etc – that’s a really alien way of thinking.

So many technical communicators – particularly those working in large traditional companies – might, in the near future, have to deal with two different and opposing “Weltanschauungen” (viewpoints).

It may be a tension that will never go away. I hope a compromise can be reached. I think it’s possible there will be mediated/edited comments and conversations of certain topics within an overall user assistance solution.

Is the future of education also the future of technical communication?

I stumbled across another great video of Michael Wesch talking about the issues facing educationalists.  Many of the problems they face are the same as those faced by people involved in producing user assistance.

The video is here

Dubbed “the explainer” by popular geek publication Wired because of his viral YouTube video that summarizes Web 2.0 in under five minutes, cultural anthropologist Michael Wesch brought his Web 2.0 wisdom to the University of Manitoba on June 17 (see video above).

During his presentation, the Kansas State University professor breaks down his attempts to integrate Facebook, Netvibes, Diigo, Google Apps, Jott, Twitter, and other emerging technologies to create an education portal of the future.

I particularly liked these slides:
 

He argued these beliefs were no longer correct,(apart from the first statement).





It’s possible the solutions for the future of education will also be relevant for the future of user assistance. Whether it answers all the questions remains to be seen.

Why bother with end user documentation for Web Applications?

In Rahel Bailie’s excellent presentation at the STC Conference (“The New Face of Documentation“), she looked at the “No Documentation” approach to software user assistance. This, she summed up, as the ”we don’t document it; we just fix it” view of software development.

She argued that a “No Documentation” approach doesn’t lead to no documentation. Users soon start to share their tips, tricks and information. They generate the content they need. The consequence of this is that the software developer loses control of user documentation – what is said, and which pages users view when they search in Google.

She made a good case for the need for user documentation where:

  • The application or system is complex
  • Training is needed
  • You want to guide users to additional features or services
  • The concept or process is not familiar to users
  • Assistance needs to be embedded in the User Interface

I think that’s a great analysis.

She covered a number of topics we’ve looked at in this blog: the impact and role of Twitter; Web 2.0; component based authoring of re-usable topics; user generated content; and an ecosystem approach to user assistance.

It’s clear that technical authors can produce more than just paper manuals. I’m sure in the next few years we’ll see technical communication evolve, as software developers embrace and master these new technologies, and user assistance, in some form or another, will still be needed.