Microsoft HealthVault is an "online service that lets you gather, store, use, and share health information for you and your family, putting you in control of your health information" (www.healthvault.com). The tool purports to cover an important gap in complex health systems by serving to reduce errors in making health decisions, keep personal health knowledge in the users' hands, and empower users to take charge of their health in a constructive way.

An expert evaluation of Microsoft HealthVault was done to identify where the site design works well and whether the site contains any usability problems and how to remedy the issues. The issues found are organized by application area and prioritized based on severity with recommendations on how to improve the overall usability of HealthVault.

Expert Evaluation Methodology

We first evaluated the desktop version of HealthVault individually. We placed ourselves in the perspective of a HealthVault user, going through and exploring the application with our own information, while capturing screenshots and noting down potential usability issues that could be troublesome for users. Next, we discussed our individual findings as a group and compiled them into a document that showed the findings that we discovered both uniquely and collectively. We worked to come to a consensus on which items are potential usability problems for users, backed up by justifications, and we created actionable recommendations and severity ratings for each problem.

Project Scope

The Testing was focused on the following key areas of the website. Since the Home Page Dashboard and Health History were some of the most important areas of the websites, we focused on these sections:
1. Login

2. Home Page

3. Basic Profile

4. Health History Globally (Allergies, Appointments, Medications, Family History)

In addition, there were some key findings that were applicable to the general website, layout, navigation, information architecture, etc.

Executive Summary

The evaluation revealed that HealthVault has some well-designed features, but the design is compromised by many usability problems that should be addressed to improve user experiences. The key points are summarized below:

1. Application
-The Application has a visually pleasing color palette.

-Visual feedback such as highlighting the link background on hover over will make it easier to distinguish static labels from links.

2. Home Page Dashboard

-Shortcuts and Paths such as Recent Records, Appointments, allow experienced users improve efficiency.

-Home Page Tiles does not allow for customized tile arrangement although the Layout appears to afford this functionality.

-Tile labels are inconsistent with the main navigation labeling.

-New user's are guided through the setup process by a “Let’s Get Started” Window which can be improved by streamlining with a step-by-step instructions that is currently in the Help section.

3. Health History

-Links such as "save", "save and add another", and "cancel" are more helpful when they are at the bottom of the input form.

-Buttons to move Up, Down and Close Button are on the Top Right Corner and are easily missed.

-The Allergies, Conditions, Family History, and Medications sections within Health History all exhibit unique problematic design traits that are discussed in detail within our report.

Findings

Home Page/Dashboard - What is Working

-The "Let’s Get Started" window at top of the home page with directive on how to get started is a good conceptual start for addressing new users and how to help them learn the application.

-Quick print option at the top is helpful for user and provides efficient means for returning user to quickly access information via printing.

-Color scheme (white, teal, grey) is professional and aesthetically pleasing.

-The windows for Health Messages (presumably from medical professionals) and Updates are quick and easy to find, and they should even be amplified more.

Home Page/Dashboard - What can be Improved

Visual Design and Layout Problems

The home page and navigation menus globally would benefit from some changes to font color and sizing and screen element layout. We identify some specific problem examples below. 

Problem 1: Left side navigation links appear in black text when user is on relevant page. These navigation links are otherwise dark green similar to value of the black active text.

Justification: There is not much visual difference between activated links in navigation and non-activated links as value difference between black text and dark green/aqua text is minimal. Thus, there is very little feedback on the state of a link in the navigation to orient user.

Severity: Medium

Problem 2: Font size of "current" and "all" links on Home Page is similar to the size of the headings (Measurements, Current health, etc) on the current page.

Justification: User may confuse the heading Measurements as an active link.

Severity: Low

Recommendations for Problems 1 and 2: Differentiate color scheme/styling/size of labels, links and active page so that they are unmistakably distinct from each other.

Functional Problems

Problem 3: Labels on tiles of home screen are not always consistent with the labels for the same items in the left navigation. For example, Steps is a tile option, but Steps cannot be directly accessed in left navigation.

Justification: User will experience difficulty learning where information is located and how to access it efficiently. User may miss a function altogether.

Severity: Medium

Recommendation: Create consistency between left menu and default tile structure.

Problem 4: Home Page Tiles cannot be moved around. User can only turn tiles on/off via “Manage Tiles” option.

Justification: User may have expectation that can move and customize position of tiles rather than only turn them on/off from experience with other tile based apps. The user may want to see the upcoming appointments, medications on the top.

Severity: Low

Recommendation: Implement Home Page so tiles are re-arrangeable in addition to option to turn them on/off. “Manage Tiles” option should offer click-and-drag to customize layout. Consider offering option to reorganize default tile structure via card sort and/or treejack.

Problem 5: New user is shown “Let’s Get Started” window that does not contain step-by-step instructions for how to proceed as new user beyond tips about the existence of four general functions within app.

Justification: User may have other items s/he would want to add beyond four areas or prefer step by step instructions.

Severity: Low

Recommendation: Replace "Let’s Get Started" content with step-by-step instructions for how to begin using app. Direct user's attention to the help button "?" on right side of header with examples of step by step instructions available to user in that section.

Health History - What is Working

Globally within the Health History areas, there is consistency in heading layout among all pages. This helps orient users as they move from section to section within Health History.

Across all Health History areas, the layout of the information within List View is concise and legible. User can efficiently view a summary of each record.

Quick print option for each Health History category is a useful method for users to quickly download/print info for that category. Function is easily identified within main navigation for each Health History area.

Add forms for Health History, particularly Family History and Medication are generally intuitive, and fields appear to capture most vital information.

Health History - What can be Improved

Globally within Health History, there are visual design and layout problems, as well as functional problems.

Problem 6: "List" and "Resources" links at the top of each page are too close together and the size of the font is similar to the page heading.

Justification: Legibility of links and labels is compromised when too little space exists between links and similar font and sizing between links that act as secondary navigation and a page header may confuse the user.

Severity: Low

Problem 7: The "save", "save & add another", "cancel", "add", "print", "export", "import", and "delete" links on a page are in plain text form. The color change when hovering over these links isn’t as obvious or vibrant.

Justification: Without obvious visual distinction between what is an active link for user to interact with and what is a static header, user may click on headers or miss active links and experience difficulty finding items within app.

Severity: Low

Problem 8: When choosing to add a record on a page within Health History, the add page that appears when click add has the “save” link at the top highlighted green as if it’s pre-selected.

Justification: User may misunderstand the state of the form by assuming the application has already saved and may not take the step of actually clicking save.

Severity: Medium

Problem 9: The "save", "save & add another", and "cancel" links on a page are at the top.

Justification: Typical practice for forms is for "save" and "cancel" functions to appear at bottom of the form to allow the user to save once they complete the form without having to scroll to the top of the page. This helps the user avoid forgetting to save the form.

Severity: Medium

Problem 10: When examining an individual record within a Health History category, the buttons to toggle back and forth to other individual records within a category and the button to exit the record detail view back to list view are located along the far right of the application header.

Justification: User may not notice these buttons as they are visually far away and disconnected from information items and other navigations items within app. User will use back button are main navigation and miss the efficiency the individual record toggle buttons afford.

Severity: Medium

Recommendations for Problems 6, 7, and 8:

-Adjust CTA’s (Color, Text, Alignment/Spacing) in the Navigation Links and Headings of Health History. Consider how to distinguish between Headers and Links using: font styling, font sizing, color schemes to differentiate links, spacing between links, and adding a highlight over a link when one hovers over the link. Links should never appear to be highlighted before the user hovers over or clicks the link.

Recommendation for Problem 9:

-Regarding link positioning, move "Save", "Save & Add Another", and "Cancel" to bottom of forms.

Recommendation for Problem 10:

-For review record detail views, move individual record toggle arrow buttons and "X" exit button closer to navigation.

Functional Problems

Problem 11: Pages within Health History category are completely blank without sample records and without any instructions or prompts when new user visits each page.

Justification: A new user might become lost or confused at the absolute lack of information or guidance here.

Severity: Low

Recommendation: Implement adaptive content on each Health History subpage dashboard based on experience:

-If no entries yet, give specific initial instructions on first steps on how to create an entry within each Health History page.

-If at least one entry already stored, then remove initial instruction and give List View.

Problem 12: Resources page option appears with most Health History sections and the page contains links to other applications.

Justification: Within context of the app, "Resources" may be misunderstood. Resources could be mistaken by user to be resources to help user fill out information in application for the section the user is currently in or user could understand resources to be medical information relevant to category within app.

Severity: Low

Recommendation: Dissolve "Resources" and Indicate "Related Apps" in its place. Provide more context to how a resource is useful for the user. For example, a retail pharmacy app (CVS, Walgreens, etc) could be presented in relation to medications to highlight that the third party app's ability to provide medication refill reminders.

Problem 13 & Justification: Default state of free note field in Health History Add forms is closed. Default closed state may cause user to miss this field and fail to add information.

Severity: Medium

Recommendation: Change "Add a note" field so that it is always expanded.

Problem 14 & Justification: Overall, Allergy Add form is clear and concise for user entry of allergy information. However, the order and labeling of the form fields (Name, Reaction, Type, etc.) and inability to enter more than one reaction or treatment may cause user to spend more time and effort than necessary to fill out or not fill out the form completely. Default state of free note field as closed may also cause user to miss this field and fail to add information.

Severity: Medium

Recommendation:
-Relabel “Name” to “Allergy Name”.

-Relabel “Type” to “Allergy Type”.

-Allow “Reaction” field to be multi-value.

-Reorder form to: Allergy Name, Allergy Type, Reaction, First Observed, Treatment, Does Treatment Stop the Reaction

Health History: Conditions

Functional Problems

Problem 15: First field on Condition add form is "Name".

Justification: When adding a new Condition, the Name label is not clear. Name of person? Name of condition? User is presented with suggested conditions once the user begins typing, but if user does not attempt to type anything into field, user is not prompted and must recall a condition rather than recognize it. Some conditions have names that are difficult to recall even for a user diagnosed with the condition.

Severity: Medium

Recommendation:

-Remove generic "Name" field at top of form.

-Add more intelligent, complex first field to form, where you can see a hierarchy of conditions in a categorized submenu, and select a condition from an easily navigable structure (Example 1: Skeletal Condition → Broken Bone → Foot → Right; Example 2: Infectious Disease → Skin → Chicken Pox)

-Add "Quick find" field for expediency or if user is unsure of category of condition

Health History: Family History

Functional Problems

Problem 16: Advanced Info is collapsed by default when adding an entry and label for Advanced Info toggle is smaller than other labels and headers on form.

Justification: User may not see Advanced Info toggle and may unknowingly fail to fill out information for this section on form.

Severity: High

Recommendation: Eliminate Advanced Info toggle and remove collapsible functionality. Ensure all fields on form are visible as default.

Problem 17: Within Family history add form, "Relationship to you" drop down options are listed in alphabetical order.

Justification: User will most likely be adding family health history information about immediate family members and will need to scan back and forth the long list of thirty relationship options to find the most immediate family options.

Severity: Low

Recommendation: Reorder the "Relationship to You" pull-down menu to list immediate family options first (i.e. Mother, Father, Sister, Brother, Son, Daughter... before extended family)

Problem 18: In Medications, when user chooses "View details" option from three dot icon menu, one of the options along the top of the Medication edit form is "X no longer taking". The "X" icon is also used within app to exit the current subpage and can also be seen on the top right corner of the Medication details screen.

Justification: The graphic "X" before "no longer taking" does not further clarify the meaning of the label. The user may confuse the "X" for exiting the screen and mistakenly mark a medication record as no longer active by clicking it. No other link within app uses a graphic to clarify meaning.

Severity: Medium

Recommendation: Remove graphic "X" from beginning of label "no longer taking".

Problem 19: Once user enters the type of medication in first Medication add form field, subsequent related fields such as strength and dosage do not pre-filter options to what is possible for the type of medication.

Justification: Inefficient and takes more time for user to search through unnecessary options in fields after medication is entered. Also, increases risk that user will enter incorrect information as options are not limited to possible options in subsequent form fields.

Severity: Medium

Recommendation: Create a "smart" Medications form where previous answers should influence possible answers in future questions. Also, only provide options that make sense based on which medication is being described, as the form progresses.

Problem 20: On Medication add form, there isn't a field to specify whether medication should be taken before meal, after meal, etc.

Justification: Some medicines are taken on an empty stomach and some (such as antibiotics and some analgesics) are taken after a meal or with food.

Severity: Low

Recommendation: Add a drop down with options to add before a meal, after a meal, and not applicable.