Lean Documentation: Personas in Twitter

What would you do if you find out that your users are following you on Twitter? Would you read them, listen to them, attend their petitions? 

I’ve asked myself hundred times why we need to create heavy amount of documents even  when we’re using Agile methodologies like Scrum or Lean UX. Documents, in the most classical way are pure literature, graphs, concept maps, sketches (maybe), and tables with data and some lines of code.

Using social networks to document, share and make content alive might be a good strategy for a long life and fast-pace changing project.

One funny example is the Cat User Story twitter profile. Of course, it is made for un, but it could be found both funny and useful for some nice projects like animalvitae.com, is your user like after an animal? 🙂

Eventually, I’m an active follower of some real people that looks like “my target users” to know more about them, so why not to create a “fake” profile to support the user requirement definition for a specific design process?

Personas as Twitter profiles

This is only an experimental practice, so here is the list of actions that I’ll try:

  • User personal data
  • User picture – likely smiling
  • Header picture – my user in a daily scene of his/her life
  • Bio – the quote to resume the main goal of the user
  • Followers – Profile where to find additional information about user’s activities
  • Tweets – (daily) User stories, acceptance criterias, and personal and professional details to know the user better.

[Book] Communicating the User Experience

If I think I’m good at something in this field is communicating the UX. Whilst I admit I’m terrible creating icons, creating visual metaphors or talking with customers, I really think that as part of my leading role I got to become a good “UX messenger”.

I borrowed this book looking for a complete guide of document support and this is what I found.


The books is divided into the following chapters:

  • Personas
  • Task Models
  • User Journeys
  • Content Requirements
  • Site maps
  • Wireframes
  • Usability Test Reports
  • Funnel Diagrams

Firstly, I miss reading something about interactive prototypes or Hi-Fi designs as documents. Although they both are mainly considered deliverables, those kind of assets are also part of the message. Actually, if we follow the agile principle, they’ll suffer modifications and enhancements so initially they’re an hypothesis too about what we want o achieve.

Secondly, I’ll remove the user manual inside each section which explains how to make the specific artifact using Power Point or Omnigraffle. If you need to learn this at the moment you read this book something is wrong either in the need or in the book audience. 

As a final though, this book reminded me a lot the one called “Communicating Design” which seemed to be oriented only on web site documentation but it is better focused on explaining document assets.

Good points in it

Nevertheless, there are still some good reasons to get and read this book in my opinion.

  1. Excellent introduction and clear definitions about the main types of documentation used throughout a project lifecycle
  2. Good examples of the key components of each document
  3. Perfect for beginners, including other UX specialists which have spent more time in other areas like Visual Design, Graphic Design or UI Design and need to support their design communication skills

So my advice is don’t buy the book, just “borrow” it 😉


Design is not a post-it in your wall

Design is not a post-it in your wall

The other day in the office, after a card-sorting session someone said that my team designed with “post-it”. This statement was almost as harmful as “programing with Word” which is, by the way, an evidence of over-documenting and bad-delivery strategy.

Nevertheless, that anonymous comment made me think how far from reality it is, and now I get some conclusions

  1. Card-sorting and any other analysis technique is used to reduce uncertainty, therefore we’re not designing but trying to understand the information which other team members cannot provide: user’s mental model.
  2. Using post-it, paper-sketches, pens, and … voice, it’s the most basical way of communication between team members, so before creating a bug-management-system maybe someone should try to let the others know which kind of information they need to make the work ready to go.
  3. Design is not a post-it in your wall, neither what happen after writting a line of code.

The saddest part of this story is that those kind of comments are made by people who doesn’t design, neither code, nor analyse, only manage time from others.


Facebook-like EMR (Part II)

Facebook-like EMR Hi-Fi

In my previous post, I published a simple mock-up to introduce the idea of an Electronic Medical Record looking like Facebook social network.

We initially saw how taking advantage of this website could help to contribute for a better tool for doctors, nurses, and patients.

In this second part of the exercise, we can see as well the hi-fi prototype where the visual design will allow us to make new musings.

Top Bar

Notifications will lead the activity of users under specific contexts.This space would be used in a similar way, so we would expect to see there:

  • New patient admissions
  • New results
  • Prescription modifications
  • Activity of another physicians on my patient’s profile
  • Events notifications
  • Automatic clinical alerts

The search box will index patients, activities and tasks. This way, finiding a patient grouped under a particular list or jumping to the a functional module will be quick and simple.

Patient Banner

The patient banner is now taking a considerable amount of space: Is is really needed? Well, If we follow the idea of having patients accessing to their own profiles, it would be nice to have this personlizable. This way, patients would create a human connection between them and their clinical staff. I think the balance between the clarity of a customizable banner and the used space make of this a valuable area.

Thumbnail area will show the teaser of each content type (clinical domains). This way the patient banner won’t be only an area to ensure the patient identification but to highñight a meaninful set of content related with the latest activity of the patient.

What about the ‘Like’ buttton?

What would ‘Like’ mean in a clinical context? It might be pretty controversial saying ‘Like’ under a patient diagnosis. However, there are other social actions which could provide a helpful support to the care activity.

  • Notify
  • Comments
  • Share

Notifications could be triggered automatically by events or due to a professional opinion. A notification doesn’t express an emotion, but a objective idea. It’s not a bad idea having a mechanism to communicate subjective feelings but here we shouldn’t make an error by this Facebook ‘positive-thinking’.

About the prototype

The opinions, ideas and suggestions shared in this article and in the ‘Facebook-like EMR (Part I)’ one only represent me (Carmel Hassan).

This prototype has been made adapting the icons of Jigsoar. The shown data is fake and the girl in the picture is me! I know I know…


Facebook-like EMR (Part I)

Facebook-like EMR (Part II)

In 2008, Bob Watcher wrote an article called “Why the medical record needs to become more like Facebook” where lay down the idea of having the social network as the mirror for a new Electronic Medical Record (EMR) User Experience (UX). A collaboration and social framework to provide better care to patients while keeping useful information between physicians and nurses.

He was not the only one; already in 2007, Robert Nadler established a high-level model remarking out the core functionalities that it could have EMR software. However, it was not intended to get only a Facebook-like UI but a real social site to connect Patients and Doctors.

The idea is not new; many authors – doctors and software engineers – have continued talking about this idea with no final proposal.

After the latest Facebook re-design I don’t know if those authors would still maintain the same opinion about this topic, anyway I do think it’s a very very interesting approach even assuming any usability issue that Facebook could have. So here are my two cents.

A Design Proposal

Users & Profiles

If a clinical solution would need to completely work like Facebook, every user (physician, nurse, etc.) would have their own user porfile. However, the analysis of having a EMR looking like Facebook timeline suggests that the profile page is planned to show only patient data. Why would we need to see a nurse profile, then?

Following this idea, the Home page would be reserved for (primary) users and the Profile pages for showing the electronic medical records of patients (secondary users).

A possible extension would be allowing the access to the EMRz by Patients, so they could also check their own EMR online by themselves. In this case, we could consider them as secondary users not as part of the network community, but just to contribute to their own medical history and keep a direct communication between them and they’re care providers.

Social network

Social activity will be generated by clinicians considering patient-centred documentation based on Profiles. As suggested before, there are two main social groups: the one created by clinical staff only, and the one where patients and clinicians would interact.

Social interaction is the key point of this proposal and it underpins the main usaibility goals:

Profiles: Patient Timeline

Facebook profile pages have been re-design to look more like a real timeline where any important event is chronologically displayed. In this example, right side will be used to show a summary of the most important event types associated to the patient medical history like Health issues, Allergies, Diagnosis, Requests and Results, Progress Notes, Prescriptions and any other clinical subject. On the left side, any user (doctor, nurse and the patient) could add comments anytime.


Privacy should have a strong presence here, since having restricted-access data is a valuable feature that doctors, nurses and patients. They all will need to control the visibility of the data they entered in a fashionable way. Although setting permission in Facebook is pretty hard and unclear to get control about which type of users see which type of patient data or personal comments is still a requirement. This could be done seeing users by their role, applications as domains, and groups as teams. Still, patients are a special kind of user which will have direct access to his own record.


There’s a weak line which separates the Facebook familiarity advantage into the most confusing UI for a productivity tool and it’s called “enjoyment”. The idea of this Facebook-like EMR was to promote some typical behavioural patter of users when interacting with a social network like:

  • Safe Exploration
  • Microbreaks
  • Habituation
  • News Stream
  • Other people’s advice
  • Personal Recommendations

However, there are some other existing activities that the clinical staff usually does and this UI is not oriented to

  • Changes in Midstream
  • Keyboard only
  • Streamlined repetition activities

Nevertheless, the app integration approach of Facebook suggest me to become a good exercise to imitate outside the UX field.


The content is not about what people think or feels, but what physicians and nurses make, diagnose, treat or provide to patients. The language of the user interface should be adapted to the purpose in order to ease the kind of content expected to be entered.

Data entry is one of the most challenging features in healthcare apps. The smarter the application, the quicker the data is entered. The whole phylosiphy of Facebook puttin atention into every single details should be adopted also to create content such as vital signs, prescriptions, a soap note, or a discharge letter. As an example, below there’s a list of content with different natures which depends on the context of use, the user role and the business model.

  • Task Oriented
    • Notifications
    • Lists of patients
    • Lists of tasks
    • Scheduled activities
    • Events
  • Content Oriented
    • Patient history summary
    • Patient evolution
    • Patient current health status and diagnosis
    • Clinical decisions
    • Procedures
  • Process Oriented
    • Treatments
    • Protocol based care planning
    • Admissions and discharge
    • Scheduling
    • Follow-up

What’s next

This is only the first part of the exercise. For the second part I’ll try more mock-ups and the high-fidelity prototype adding more details also in the content used in this sketch to get a better idea about how crazy (or not) is the proposal of being inspired by Facebook to create an electronic medical record.

There’s also an important gap where Facebook has no direct answer: clinical safety and episode-related information. We’ll talk about it also for the next post.

By now, how realistic do you think it is?


Going back to deliverables – The Smart Communication

Deliverables within a classical SLDC are not simple parts of the product or the alpha-version of it, but key communication tools between gateways that support the understanding across the people and the stages which are part in a project.

UX Deliverables are back al though Lean UX methods are an amazingly helpful approach for creating, for ideation, and getting solutions into reality. However, since every design is nothing but an hypothesis, they need to be described to understand every design decision, every assumption, and every detail that could be out of the scope of the proposal.

It is true

you don’t solve problems with design documentation

however documents are your point of iteration, your tool for expressing ideas, and the way to move forward your project during the time and the involved stakeholders.

Do not feel overwhelmed by the design deliverables, just use it in favor of the process without killing the agile flow of creativity and execution.


Clinical Risks and Design Decisions – How usability can save lifes

Information technology has made possible to improve healthcare services by increasing productivity, getting more accessible services, and automating daily care activities – among others. However, the software itself allows getting a better patient care at the same time that it opens a door to clinical risks. It is a responsability for designers to avoid hazards as well as design rich-interactive solutions.

As you know, it is part of the process of making design decisions: user centred design to ensure usable products. UCD, UX and Usability have a lot of meanings and aspects that influence in reducing the errros that clinical staff could make by only interacting with the software.

I’ll give some examples of how the main topics of usability could avoid clinical risks:

Visibility of system status

Working with the right patient in the right time. Keep always visible the patient information that will help users to identify it without any doubt.

Match between system and the real world

Use clinical language as much as you can to help to understand the purpose, the scope, and to support the clinical process. Clinical procedures has specific names which require clarity unambigously.

User control and freedom

Provide multiple visualization modes to ease the data understanding. Allow performing activities in different orders to get adapted both users and business process. The more natural the process is for the user the more confident s/he will feel.

Consistency and standards

Respect familiarities with the real world activities and with previous software solutions. Clinical staff is very hard-working with protocols and routines, consistency could be boring but effective.

Error prevention

Provide clear points of interaction and valuable data for decision-making. A correct labeling and control aesthetic will help to easily understand how the data can be managed, as well as a correct data presentation will avoid performing wrong actions.

Recognition rather than recall

Reduce the workload by creating recognisable solutions. Do not stress the user with a lot of information to be remembered.

Flexibility and efficiency of use

Provide shortcuts and give a chance to experts, the more efficient they’ll use the solution the more time they’ll spend providing care. Allow users workarounds.

Aesthetic and minimalist design

Minimal design will simplify the data presentation and a good aesthetic will increase the content meaning to facilitate the interpretation and the decision-making. Use aesthetic to provide meaning and avoid decorators that mix up the patient information.

Help users recognize, diagnose, and recover from errors

Allow undo actions for the most critical actions: prescribing medications, deleting patient data, managing patient history, etc. A mistake should be able to be recovered by a an undo action or a rollback process.

Help and documentation

Describe how every care activity can be achieved by your solution. Show main conflicts and risks if there are any dependency between them.

These are only some clues about how putting attention in usability can help to reduce the amount of clinical risks. Lately, every data that is presented in a screen and every allowed interaction between users and clinical software it’s a potential risk to provide a wrong care to patients. Undoubtlely, there are many other hazards non-UI-related that can end up in a catastrophic situation.

Nothing is free of hazards, but good design decisions can save time, costs, and even lifes.