1. Designing user-friendly, usable
healthcare documentation:
switch to minimalism!
www.ci3m.fr
Scientific Conference on Strategic Development
And Performance in Healthcare Institutions
National Guard Health Affairs,
King Saud bin Abdulaziz University for Health Sciences
Riyadh, KSA
30 January 2013
Marie-Louise Flacke
Instructional Designer
CI3M, Rennes (France)

2. Healtcare documentation
• Help the User* perform a
TASK !
• Usable: to the satisfaction of
the end-user
(…not the device manufacturer!)
________________________________
*(medical staff, home-based patients…)
Company
LOGO

3. Safe and risk free
• Usable documentation
• Understandable, accessible
• Ensures risk free usage
(of the product)

4. Focus on the audience needs!
• Clear, precise, useful information
Skip obvious, useless information

5. Infobesity?
• No time for infobesity!
Minimalism: “In fact, the shorter and more lean
the text, the more likely it will be read.“
(Dr. JoAnn Hackos, Comtech Services)

6. Writing for medical staff (needs)
• Provide only the information needed to
perform a task
• Eliminate useless and distracting
information
• Prevent burying the useful procedure in
long, descriptive concepts!

7. Design process - 4 steps
1. Focus on action-oriented approach
2. Ensure you understand the user‘s world
3. Provide troubleshooting information
4. Help users find information they need

8. 1. Action-oriented
• User‘s objectives?
• Perform a scan?
• Make an injection?
• Perform an endotracheal intubation?
• Action, Tasks ->procedures !

9. 1. 1 - Action and tasks
• Skip
• Introduction, Overview,
• General information
• Preamble
• About…
• Provide opportunity
to act!

10. Example ;-(((

11. Useful information (re-writing example)
1. Setting the purification parameters
2. Checking water quality
3. Understanding the LED messages
4. Ordering consumables
5. Performing monthly maintenance

12. Procedures, no bla-bla
• The more effectively procedures
address real tasks, the more
successful they are in meeting
user needs.
• (Dr. JoAnn Hackos, Minimalism updated, 2012)

13. 2. Understand user’s world
• Understand « user’s domain »
• Audience
• Environment
• Language
• English
• Terminology
• Plain language
• Real goals
• Don’t focus on product features… but on
user’s goals!

14. 2.1 Define audience
• User profile?
• Age
• Experience
• Literacy (computer? Hand-held
device? Wordless illustrations?)

15. 2.2. Define terminology
• End user‘s vocabulary?
• excipients? posology?
• Skip synonyms!
• Define abbreviations
• Maintain consistent phraseology
• Controlled Technical English

16. Non-technical language
• The ICH* E6 guideline states that:
“The language used in the oral and
written information about the trial,
including the written informed consent
form, should be as non-technical as
practical and should be understandable
to the subject …”
* ICH= International Conference on Harmonisation of
Technical Requirements for Registration of
Pharmaceuticals for Human Use (ICH)

17. 2.3. Design meaningful titles
1. Ordering needles
2. Contacting the support team
3. Checking product applicability

18. 2.3. Instruct
• Skip description!
• Instruct!
• Talk to the end-user!
• Write „Task-oriented“ = >Verbs!
• „Reset button“
 „Reinitializing the system“

19. 2.4. Skip „symbols & screen copies“
• Reduce screen copies!
• Use symbols sparingly

20. Screen copy needed?

21. Understandable symbols?

22. Universal symbol?

23. 2.4. Reduce legal verbiage
• Skip useless warnings!
• Consider possible mishapps:
• Provide instructions
• Entrust legal verbiage to Legal
Department

24. Warnings and Notes?

28. Operating the system
1. Make sure the patient room is free of flammable anesthetic
mixture with:
• air
• oxygen
• nitrous oxide
2. Switch on...
___________________________________________
Checking maximum continuous use
After 168 hours of continuous use, you must cycle the power.
1. Switch to standby power
2. Connect the device to battery
3. Let it charge for 24 hours

29. Connecting a computer
You can connect the device to a computer to store patient
data.
1. Connect the computer to the USB port located on the right of the
display panel
2. Make sure the USB port located on the rear is free of any external
connection.
This port is for internal factory use only.
___________________________________________
Checking temperature
It is essential to cross-check the accuracy of the patient
temperature.
1. Switch on the System temperature display
2. Use an oral or tympanic thermometer to cross-check the
temperature

30. Useful legal clauses?
• Objection:
• Legal clauses protect our institution against
lawsuits.
• Response:
• Including legalistic clauses does not afford
protection against lawsuits.
• On the contrary, complex consent forms have
been the basis of legal action by research
subjects even in the absence of physical harm

31. 2.5 Insulting user‘s intelligence?

32. Obvious green color?

33. User‘s intelligence?
• Skip „stem sentences“ (glue)

34. Documentation for a safe use?
• Task-oriented
• Audience-focused
• Terminology savvy
• Instructions-based
• Symbol and warning-free
• Respecting user’s intelligence

35. 3 - Troubleshooting
• Provide on-the-spot information
• Provide a Troubleshooting section
• Use « Hints » instead of « Warnings »

36. 4. Finding information
• Find information quickly and accurately
• Table of contents
• Brief
• Precise (task-oriented)
• Index
• Search does not replace index!
• Write meaningful topic titles

37. 4.1 Searching for instructions…
One Flight Operation Briefing Note (FOBN)
described a technique for landing in strong cross-
winds that would have been suitable for the
Hamburg landing in question.
The Flight Operation Briefing Note was not part of
the official operating manuals.

38. 4.2 Easy to read?
• Typography
• No capital letters
• Lay-out
• Margins
• Justified text: no!
• Frames: no!
• Colour
• background
• Font size

39. Test !
• Perform usability tests
• Use readability test tools
• Add eye-tracking survey!

40. Conclusion
• User-friendly documentation:
minimalistic, usable
Safe use of medical device!
Reduced misunderstanding,
Reduced calls to
Hotline/Emergency , etc.

41. Bibliography
• Writing about medicines for people, David Sless
• A Practical Guide to Usability Testing, Dumas J.,
Redish, J. Intellect Ltd.,
• Applying principles of plain language to health
websites, Ginny Redish - http://tinyurl.com/68qpvuw
• Minimalism: Creating Information People Really
Need, JoAnn Hackos - http://tinyurl.com/35m36qs
• ICH Efficacy Guidelines
• http://www.imarcresearch.com/blog/bid/185145/Literacy-and-Informed-
Consent-In-Understandable-
Language?goback=%2Egde_119837_member_132201590

42. Questions?...
flacke@orange.fr