Healthcare Case Study:

No UX Testing Allowed: Improving Pharmaceutical Websites with a Human Factors Heuristic Evaluation

At Marketade, our first inclination is always to test with real people. But every now and then we’re dealing with circumstances where moderated UX testing (or even unmoderated UX testing) is definitely off limits. Just because we can’t hear directly from consumers, however, doesn’t mean that we can’t think through their concerns and create a better experience for them.

In this case, by choosing the right analytical framework, we identified ways to improve several health-related websites. Our team anticipated human needs and reactions while considering essential design and content usability principles.

Challenge: Pharmaceutical websites with low performance metrics — and special restrictions on consumer testing

A multinational pharmaceutical company had recently launched several drug-specific marketing websites, then revamped their messaging. However, they suspected that deeper usability issues limited the effectiveness of the websites. In particular, they were dissatisfied with the conversion metrics and concerned that the websites were not optimized for browsing on mobile devices.

The company’s ad agency hired us to conduct a UX evaluation on 4 websites for 2 different drugs, one for major depressive disorder (MDD), one for a common gastrointestinal condition. For each medication, the company had created a consumer-facing website and another website designed for healthcare professionals who might prescribe that drug. (In this case study, I’ll concentrate on the consumer side of the project, but we applied a similar strategy to the healthcare professional sites.)

When we looked at the metrics for the MDD-focused consumer website, our client’s suspicions were confirmed. Over 90% of site visitors exited the homepage without visiting another page. Although mobile visitors accounted for almost 85% of total site traffic, they only accounted for around 50% key conversion actions. The website — particularly the mobile version — was under-performing. It was up to us to figure out why and how to fix the problems.

Now, this is usually where we’d recruit consumers who used these medications (or similar) and get their feedback on the websites. Not this time.

Due to FDA regulations, our client told us that moderated research with consumers was strictly verboten. We’d be legally bound to report some pretty harmless and banal consumer comments about the drugs. Even standard, uncontroversial UX testing with representative users exposed our client to an unacceptable amount of risk.

So we agreed to evaluate the websites by drawing on best practices and prior research instead. But what approach to take?

Action: Conduct a heuristic evaluation with the human factors framework

Based on past experience in the pharmaceutical industry, we decided to examine the websites through the lens of human factors theory. Here’s how we contextualized the approach in one of our reports:

“Human factors are psychology, physiology, and ergonomic science combined to understand how humans interact with machines…. [This approach] helps us understand the different types of loads placed on a person as they interact with a system. Reducing these loads allows the person to work faster with fewer errors.”

The 3 “loads” in human factors theory are:

• Cognitive load, which requires processing, applying, and/or memorizing information.
• Visual load, which involves taking in visual information.
• Motor load, which involves clicking, tapping, pinching/swishing, and all the ways you physically maneuver to control a device.

As Susan Weinschenk summarizes in 100 Things Every Designer Needs to Know About People, “Each load uses up a different amount of mental resources…. You use up more by asking [people] to think or remember or do a mental calculation (cognitive), than when you ask them to look at something on a screen (visual).”

With this heuristic lens in mind, among other design and content best practices, we reviewed the websites according to the following steps:

• Put yourself in the mindset of the user. Brainstorm potential questions and goals. (Also consider which actions the client wants the user to take.)
• Use the website and attempt to complete those goals and find answers to the questions you brainstormed.
• Make note of obstacles that prevent you from achieving those goals or learning what you need to. Which human factors load category (or categories) do they fall under?

In this case, we were reviewing websites that addressed sensitive subjects like mental health and potentially uncomfortable digestive issues. So we were careful to consider emotional reactions as part of the website’s cognitive load.

Result: UX enhancements anchored in an understanding of burdens on users

When we presented our findings to our client, the human factors framework helped us evoke the burdens that these drug-related websites were potentially imposing on visitors. Instead of merely running through a checklist of violated best practices, we could tie our findings to the lived experience with powerful, empathetic reasoning.

Here are some of our top recommendations for the websites (and how they correspond to human factors theory):

• Make hero images smaller and do not duplicate images across different pages. This recommendation aimed at reducing both the visual and the cognitive loads. The large images drew the eye away from the text. More importantly, the repeated images could spark confusion between pages; at a glance, it was not clear that a new page had loaded. On mobile devices, smaller hero images might reduce the motor load, with less scrolling required from a user looking at a tiny screen.
• Add a clear, persistent call to action button for the top consumer goal/conversion action. CTAs were often buried under multiple blocks of content on mobile, increasing the cognitive load on task-driven users.
• Simplify the navigation. Prioritize the most popular categories/headings instead of burying them in a hamburger menu. Multi-tiered navigation heightened the cognitive load. On mobile, users also had to tap the screen additional times to access important content through a hamburger menu; this architecture heightened the motor load.
• Shorten sentences. Break up long paragraphs and/or incorporate bullets. Use plain language. Avoid footnotes for explanations. While it’s tempting to apply the human factors loads primarily to design, dense content is a surefire way to overwhelm users’ cognitive load. Consumers typically find it challenging to parse medical jargon, complex sentences, and long blocks of text. Footnotes break the flow of their reading and comprehension patterns.
• Organize content on pages so that sections flow clearly into one another. Long pages, dividers, animations, and unusual spacing around graphics create an awkward scrolling rhythm and heighten the motor load on mobile users.
• Remove distracting animations. One of the websites featured several cheery GIF-style animations for aesthetic rather than educational purposes. Not only did they take up space, but they also didn’t stop moving. They continued to wiggle in the background, drawing the eye away from important information and calls to action. To reduce the visual load on users, we advised replacing the animations with still images.
• Eliminate clutter on the sign-up form so the primary CTAs are clear. The vital sign-up page for a patient savings program was not immediately apparent on the page, heightening the cognitive and visual loads.

In short, the design and content we reviewed seemed to aim for what Therese Fessenden calls “surface delight.” These medical websites prioritized atmospheric visuals, twee metaphors, and vaguely inspirational copy. By trying to amplify the surface delight, these websites placed a heavier burden on consumers and healthcare professionals alike. Will your consumers believe that your products will make their life better if your website makes their lives more difficult? Probably not.

By contrast, deep delight, notes Fessenden, “can be best achieved with streamlined workflows and reduced pain points.” The human factors analysis framework not only indicated ways to optimize websites for conversion, but also to foster that deep delight.

The conceptual framework helped us zero in on the burdens and make recommendations to lighten those loads. Offering a smoother, more intuitive experience will enable the company to build trust among consumers they hope to treat and assist.

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