A New Perspective on UX: The Indirect User Experience Ole Andreas Alsos Norwegian University of Science and Technology Trondheim, Norway +47 915 44 825 ole.andreas.alsos@idi.ntnu.no ABSTRACT that setting. We also discuss implications on how the user Computer systems are first and foremost designed for interface can be designed to accommodate the needs of the single users in traditional desktop situations. The needs of indirect user. the indirect users, those who are not using the system BACKGROUND directly but are yet affected by it, are often overlooked. Traditionally, an end-user is considered as the person who Based on empirical findings from two usability evaluations directly interacts with an information system. However, in a hospital simulator with physicians and patient actors, end-users, as defined by Faulkner [2], can be (1) direct this paper discusses how changes in user interface can users, who use the system themselves, (2) indirect users, affect both the user experience of the primary user and that who ask other people to use the system on their behalf, (3) of the indirect user. Finally, it discusses implications for remote users, who do not use the system, but depend on the designing for the indirect user output, or (4) support users, who ensure that the system works for others, such as direct users. Categories and Subject Descriptors H.5.2 [User interfaces]: User-centered design, We choose to use a simpler and more straightforward end- user categorization. We divide end-users into (1) direct General Terms users and (2) indirect users, where the first category Human Factors includes primary users and all other stakeholders who directly interact with an information system. The latter Keywords includes end-users who are not directly interacting with the User Experience, UX, indirect user experience, CSCW, system and corresponds to Faulkner’s [2] indirect and mobile remote users. A number of HCI publications refer to a 1997 draft of ISO INTRODUCTION 9241-11:1998 [3]. This version contained reference to Most ICT systems are primarily designed for primary indirect users: “[Satisfaction is] the comfort and users, users who are working independently in traditional acceptability of the work system to its users and other desktop situations. User experience, as defined in ISO people affected by its use”. However, this reference to 9421-210 [1], is first and foremost associated with the indirect users was omitted in the final version (see [4] for primary user: “[It is] a person's perceptions and responses an example). that result from the use or anticipated use of a product, system or service". METHODS The needs of indirect users, users who are not using the The empirical grounding for this position paper come from system directly but yet affected by it, are rarely in the two simulation-based usability evaluations of mobile minds of the system designers and developers. This is systems for hospitals [5,6]. Both evaluations were normally unproblematic for traditional systems designed conducted in a simulated hospital environment with for single users. However, as collaborative and mobile multiple users; real physicians and patient actors in the systems are becoming more common, the use of such hospital beds. systems will have effects on people outside the sphere of In the first evaluation, we explored several ways of letting the primary user. While most systems have clear roots in doctors use handheld devices together with bedside the needs of the primary users, there is often little or no mounted patient terminals for viewing x-ray images focus on the indirect users. together with the patient [5]. In this paper we seek to define the indirect user experience. In the second evaluation we explored interaction Further, drawing on usability evaluations of mobile devices techniques for a handheld medication system, one paper used in a realistic hospital setting, we identify in what ways based and three mobile patient record systems [6]. the design of the user interface affect the indirect user in In the two evaluations, both the physicians and the patients were present on the patient terminal. The increased were interviewed about aspects concerning the user complexity of the GUI confused some patients. They rather experience of the mobile devices. In this case, the patient is preferred the versions where these controls were moved the indirect user. onto the PDA. RESULTS DISCUSSION Below some of the observations from the experiments The findings from the evaluations gave new insight related related to aspects of the user experience for primary and to the user experience. indirect users are presented. User experience is relevant for indirect users. The The new technology increased UX for the primary studies demonstrated, not surprisingly, that technology had users: Although the physicians in general were confident an impact on the user experience of the physicians, who and comfortable with the paper chart, they preferred using were the primary users. Further, our observations indicated the mobile device. A number of functions and attributes, that the system design also had an impact on the indirect such as pocket size, error prevention and undo users. The patients had some sort of user experience; they mechanisms, contributed positive to the UX. had strong perceptions and responses about the system, although they had not used the systems directly themselves. Action transparency: When moving patient records from paper-based media to mobile technology we observed that Indirect user experience defined the physicians’ actions were less visible for patients, i.e. the Based on the findings that UX is relevant for indirect users, indirect user. While it was easy for the patient to see I attempt to define the indirect user experience based on the whether the physician was adding, searching or obtaining ISO 9241-210 definition [1]: information with the paper chart, all actions appeared similar with the mobile device. This was considered Indirect user experience is defined as a person's negative by the patients. perceptions and responses that result from another Nonverbal communication: The physical form factor of user's use of a product, system or service. the paper chart allowed the physician to use it as a channel for nonverbal communication (i.e. signal that the Having defined indirect user experience, we present a consultation was ending by closing the chart). This was further analysis of our findings. harder with the PDA, and was considered negative by the Firstly, the observations showed that even if UX was patients. improved for physicians, it had in some cases negative Doctor-patient dialogue: The user interface of the mobile effects for patients. device increased legibility and allowed the physicians to Improving the user experience for the primary user can undo and prevent medication errors. On the other hand, the have negative consequences for the indirect user. user interface had poor information overview and unfamiliar interaction techniques. This required much of Second, we also observed that when the indirect user the physicians’ attention. According to patients, it affected experience was improved, it sometimes created problems the doctor-patient dialogue and decreased their satisfaction for the physician. of the consultation. Negative patient experience: In some of the design Improving the user experience for the indirect user can solutions of the first evaluation the doctor controlled the have negative consequences for the primary user. patient terminal through the PDA. While this was seen as a major benefit from the perspective of the physicians who We consequently are faced with tradeoffs between the could hide information on the PDA and display public needs of the primary and indirect users. information on the PDA, it was perceived as negative from Impact of social factors on indirect user experience the perspective of the patients. They perceived the PDA as As shown, the indirect user experience was influenced by a mystical thing and did not like that things were hidden for the user interface of the system. However, there may also them. be other factors affecting the indirect user experience. Positive patient experience: In other design solutions the Firstly, the user experience may differ because they have physicians controlled the system through the patient different roles and interests in the situation. Second, they terminal. Unintentionally it allowed the patient to control are in a social context where the indirect user is the terminal. For the patient this was perceived as an experiencing (at least) two things; the direct user’s improvement. For the physicians, however, it became interactions with the system, and the direct user’s social harder to control the system because they had to bend over interactions. the patient to use it. Implications for design User interface complexity: In some versions of the first Accommodating the needs of the indirect users is evaluation, the controls for changing information content important. In the context of a ward round with a physician and a number of patients, a positive indirect user CONCLUSION experience can have positive effect on the doctor patient When designing information systems that have effects on dialogue, which is important for the treatment and care of people beside the primary user, the designer and the patients [7]. In the context of business, for example a requirements engineer must address the need of all types of travel agent serving a traveler, an improved indirect user end-users. This includes the needs of the indirect user, and experience can have positive effect on the customer implies that one has to design for the indirect user experience. In business, this often means returning experience. Sometimes this implies that the designers deal customers and increased revenue [8]. with conflicting needs between the direct and indirect users. Below we suggest some implications for design based on the findings from the evaluations: REFERENCES Give system feedback to the indirect user: By increasing [1] ISO 9241-210:2009. Ergonomics of human system the action transparency (i.e. increase visibility of actions) interaction - Part 210: Human-centred design for or providing system feedback also to the indirect user, one interactive systems. International Organization for can increase the indirect user experience. Standardization Support non-verbal communication: Indirect user [2] Faulkner, X. Usability Engineering. Palgrave experience is correlated with the ability of the primary user Macmillan, 2000. to communicate with the indirect user. The system can [3] ISO 9241-11:1998. Ergonomics of human system hinder this communication, especially the non-verbal interaction - Part 11: Guidance on usability aspects when the system occupies the hands of the primary specification and measures. International Organization user. Therefore, the physical form factor of the device for Standardization needs to afford nonverbal communication. [4] O’Grady, M.J., O’Hare, G.M.P., Sas, C. Mobile agents Use the language of the indirect user: By presenting the for mobile tourists: a user evaluation of Gulliver’s information for the primary user in the language of the Genie. Interacting with Computers 17 (2005). indirect user, the primary user can be guided to use simpler terms and communicate on the same level as the indirect [5] Alsos, O.A., Svanæs, D. Interaction techniques for user (i.e. physicians use terms like “blood sugar level” using handhelds and PCs together in a clinical setting. instead of “glucose”). Proc. NordiCHI ’06 (2006) 125-134. Provide a tailored GUI for the indirect user: If feasible [6] Alsos, O.A., Dabelow, B., Faxvaag, A. Doctors’ and necessary, an additional device/GUI with information Concerns of PDAs in the Ward Round Situation — tailored for the indirect user should be provided. This will Lessons from a Formative Simulation Study. Methods give the indirect users a version of the information where of Information in Medicine. unnecessary complexity is trimmed away. [7] Ong, L. M. L. de Haes, J. C. J. M. Hoos, A. Implications for software development M. Lammes, F. B., Doctor-patient communication: A Indirect user experience also has some consequences for review of the literature. Social Science \& Medicine, how we develop software: 1995. 40 (7): p. 903-918. Design for the indirect user: Address the needs, and [8] Peppers, D., Rogers, M., Return on customer: creating include the perspective of the indirect user into maximum value from your scarcest resource. 2005. requirements. This can ensure positive user experiences for Currency indirect users. Evaluate with the indirect user: Indirect users should be present when the system is evaluated, and their opinions should be collected.