Usability References


User Interface Design – Displays and Use of Color

1. Brown, M. Chapter 4, Color, Human-Computer Interface Design Guidelines. pp.65-77, Ablex Publishing Corporation: Norwood, New Jersey, 1988.
– The chapter covers multiple aspects of color. ie: appropriate uses of color, overuse of color, color meanings, consistency of color coding, recommended color code, etc.

2. Cockerham, K., Hall, S., Rhodes, D. (2002) Whats Your Color? IEEE Industry Applications Magazine, p. 50 -54.
– Page 52 offers direction on using color effectively and pages 52-53 provide information on using colors with ideal contrast ratios.

3. Jubis, R. Effectiveness of Color-Coding in Visual Display. Does Practice Make a Difference? (Defence and Civil Inst of Environmental Medicine) Source: Proceedings of the Human Factors Society, 1990, p 1519-1523
– Two studies examined the effectiveness of color-coding in visual displays. Reaction time and accuracy of responses to statements about the target states were observed for different coding conditions.

4. Lidwell, W., Holden, D., Butler, H. Universal Principles of Design. Rockport Publishers: Gloucester, MA, 2003.
– This offers a compilation of cross-disciplinary design concepts. Every concept is accompanied with an illustration for enhanced understanding.

5. Ling, J., Schaik, P. The effect of text and background colour on visual search of web pages. Source: Elsevier. 2001, p 223 – 230.
– This paper describes which color combinations work best together to increase the speed and accuracy of the user. For example, green on red was poor in terms of speed and performance. Yellow on blue had the fastest reaction time for correction rejection. Generally colors with high levels of contrasts (ie: black on white and yellow on blue) led to better performance then combinations with lower contrast (ie: green on red).

6. Liu, Y (Salvendy, G editor) Chapter 51, Software-User Interface Design in Handbook of Human Factors & Ergonomics, 2nd edition, p. 1699, NY: John Wiley, 1997.
– This is a one-page summary of Interface Design Guidelines.

7. Merwin, D., Vincow, M., Wickens, C. Visual Analysis of Scientific Data: Comparison of 3D-Topographic, Color and Gray Scale Displays in a Feature Detection Task . Source: Proceedings of the Human Factors and Ergonomics Society, v 1, 1994, p 240-244.
– This paper summarizes a fractional factorial experiment with 16 subjects compared four display techniques in the task of searching for features in scientific data sets:

  • Linearized Gray Scale
  • Rainbow Scale
  • Reduced Hue (blue-green-yellow-white)
  • 3D-Topographic Format Viewed in Stereo

The gray scale performed best, followed by the reduced hue scale. Given that the rainbow scale has more distinct colors than the reduced hue scale, the relatively better performance of the reduced hue scale may be due to the greater demands for serial search through more color bands.

8. Nielsen, J., Usability Engineering. New York: AP Professional, 1993.
– A usability engineering guide to software design. Ways to measure and improve usability are discussed. Principles are presented to aid in creating better and more efficient software.

9. Proctor, R., Vu, K. Handbook of Human Factors in Web Design. Lawrence Erbaum Associates: Mahwah, New Jersey, 2005, p 123-124, 273-274, 278-279, 286-287, 349-353.
– These references cover multiple ways in which human factors is applied to web design. Material covered includes: screen design, information organization, designing for universal access, importance of incorporating usability evaluations in the design process, and the cost and benefits of incorporating human factors into design guidelines. Color and design concepts. ie: color aesthetics and contrast, color blindness, meaning of color in different cultures, and basics of screen design, are also presented.

10. Savage-Knepshield, P. Designing for user with color-vision deficiency: effective color combinations, in Universal Access in HCI — Proceedings of HCI International 2001. Mahwah, NJ: Lawrence Erlbaum Associates, Publishers, 2001. p. 521.
– Three findings from the literature regarding the use of color for individuals with color-vision deficit are:

  • lighten light colors, darken dark colors
  • use blue, yellow, white & black if color must be used
  • do not use: cyan with gray, yellow with light green, green with brown, and red with black

11. Schneiderman, B. Designing the User Interface. Addison-Wesley, 1998.
– A comprehensive introduction to human-computer interaction (HCI). Human factors of interactive software, usability testing, test methods to assess interfaces, and effective use of messages and color are a few of the topics covered. A table summarizing the section on use of color is included and can be found on page 402. Greater detail regarding the guidelines precedes the table.

12. Strickler, Z., Neafsey, P. (2002). Visual Design of Interactive Software for Older Adults: Preventing Drug Interactions in Older Adults. Visible Language, 36(1), p 4-28.
– This reference discusses the development of the visual component of an educational software program targeted for adults aged 60+ years. A focus group of 12 was used to elicit feedback on various aspects of the user interface. Loss of color perception made colored text difficult to read and at least one participant was not able to distinguish between hues close in value.

Human Factors Engineering

1. Liu, Y (Salvendy, G editor). Chapter 51, Software-User Interface Designin Handbook of Human Factors & Ergonomics, 2 nd edition, p. 1699, NY: John Wiley, 1997.
– This is a one-page summary of Interface Design Guidelines.

2. Norman, DA. The Design of Everyday Things. New York: Doubleday. 1998.
– An entertaining book on bad designs (e.g. computers to tea pots) that people face everyday. This book is full of many examples on how well-designed objects are hard to find in our aesthetically oriented culture and the need for self-explanatory design.

3. Sanders, M., McCormick, E. Human Factors in Engineering and Design, 7 th edition; p 113-127. McGraw Hill, 1993.
– Basic human factors and ergonomics concepts are extensively covered. These concepts are broken up into five parts: Information input, human output and control, workplace design, environmental conditions, and human factors applications. Included are color recommendations. Graphic representations and symbols are discussed about on pages 117-125. On pg. 125 – 127 color coding is discussed.

Usability in Health Care

1. Allen, M., Currie, L., Bakken, S., Patel, V., and Cimino, J. (2006). Heuristic evaluation of paper-based Web pages: A simplified inspection usability methodology. Journal of Biomedical Informatics, 39(4):412-423.
– The methodology behind developing a simple heuristic evaluation is discussed. Results of the heuristic evaluation are explained along with the benefits.

2. Bate, P. and Robert, G. (2006). Experience-based design: From redesigning the system around the patient to co-designing services with the patient. Quality and Safety in Health Care, 15(5):307-10.
– Patients provide designers with a user’s viewpoint of the healthcare process through their experiences. This article explains the importance of healthcare designers using patient knowledge and how to go about obtaining and incorporating it.

3. Berg, M. Patient care information systems & health care work: a sociotechnical approach. International Journal of Medical Informatics, 1999; 55:87-101.
– A sociotechnical approach is used to give insight on the development and evaluation of healthcare information technologies (HIT).

4. Coiera, E, et al. (2006) The safety and quality of decision support systems. Methods of Information in Medicine. 45, Suppl 1: 20-5.
– This article offers a literature review of decision support and electronic prescribing systems. Information technology evaluation criteria such as (1) usability (2) performance of software and (3) socio-technical and cognitive interactions are discussed.

5. Despont-Gros, C., Mueller, H., Lovis, C. (2005) Evaluating user interactions with clinical information systems: A model based on human–computer interaction models. Journal of Biomedical Informatics, 38(3):244-55.
– This article proposes a model for dimensions involved in user evaluation of clinical information systems (CIS). This model reviews information systems, existing models and frameworks, and HCI literature.

6. France, D., Throop, P., Walczyk, B., et al. (2005). Does patient-centered design guarantee patient safety?: Using human factors engineering to find a balance between provider and patient needs. Journal of Patient Safety, 1(3):145-153.
– This article discusses the development of a survey to measure the patient-centered design approach taken on a recently opened free-standing children’s hospital. Results from this survey show the importance of incorporating human factors early in the design process.

7. Hvannberg, ET, et al . (2007). Heuristic evaluation: Comparing ways of finding and reporting usability problems. Interacting with Computers, 19 (2): 225-240.
– This paper compares and contrasts Nielsen’s heuristics, Gerhardt-Powals cognitive principles and two media of reporting a usability problem to see which is the most effective and efficient. All of the items being compared are types of support for structured usability problem reporting.

8. Ginsburg, G. (2004). Human factors engineering: A tool for medical device evaluation in hospital procurement decision-making. Journal of Biomedical Informatics, 38(3): 213-9.
– Human factors helps enhance patient safety by aiding hospitals in the purchasing of medical devices.

9. Johnson, CW. (2006). Why did that happen? Exploring the proliferation of barely usable software in healthcare systems. Quality and Safety in Health Care, 15: I76-I81 Suppl. 1.
– Usability problems created by complex computer applications, used by clinician and support staff, both directly and indirectly effect patient outcomes. This paper discusses how training can help staff make good decisions when selecting computer interfaces by understanding the implications of poor interface design.

10. Kushniruka, A., Patel, V. (2004) Cognitive and usability engineering methods for the evaluation of clinical information systems. Journal of Biomedical Informatics, 37(1), p. 56-76.
– This paper discusses how a methodological approach is used for the evaluation of health information systems. This approach uses both cognitive science and usability engineering theories along with a focus on assessing human computer interaction and the usability of computer systems in laboratory and naturalistic settings.

11. Lilholt, Lars H, et al. (2006). Development of methods for usability evaluations of EHR systems. Studies in Health Technology & Informatics. 124: 341-6.
– This article combines laboratory tests and field studies to identify usability problems. Some of the methods used for combination were: think aloud, scenarios, video and screen recording, debriefing and others.

12. Lilholt, Lars H, et al. (2006). Predicting changes in workflow resulting from healthcare information systems: Ensuring the safety of healthcare. Healthcare Quality, 9, Oct.: 114-8.
– A new health care information system can cause changes in the workflow and medical errors. This paper discusses how simulation-based analyses can be applied to identify changes and errors that may result due to this new technology.

13. Miller, R., Waitman, L., Chen, S., Rosenbloom, T. (2005) The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt. Journal of Biomedical Informatics, 38 (6), p. 469-85.
– This article discusses evaluation of CPOE by: what type of intervention to create; when to introduce the intervention into the user’s workflow, and how disruptive, during use of the system, and the intervention might be to end-users’ workflows.

14. Patterson, E., Doebbeling, B., Fung, C., Militello, L., Anders, S., Asch, S. (2005). Identifying barriers to the effective use of clinical reminders: Bootstrapping multiple methods. Journal of Biomedical Informatics, 38(3), p. 189-99.
– This article discusses a multiple method approach used for identifying barriers in clinical reminders. Some barriers identified were: ease of use issues, accessibility of workstations, and administration benefiting more than providers from clinical reminder use. Potential implications for improving clinical reminders are discussed.

15. Pizziferri, L., Kittler, A., Volk, L., Honour, M., Gupta, S., Wang, S., Wang, T., Lippincott, M., Lia, Q., Bates, D. (2005) Primary care physician time utilization before and after implementation of an electronic health record: A time-motion study. Journal of Biomedical Informatics, 38(3), p. 176-88.
– A time-motion study was used to assess whether EHRs take physicians longer than paper-based systems. Physician thoughts on EHR were collected through a survey.

16. Rau, G., Schecke, T., Langen, M. Visualization and Man-Machine Interaction in Clinical Monitoring Tasks. Source: Proceedings of the First Conference on Visualization in Biomedical Computing (Cat. No.90TH0311-1), 1990, p 268-72.
– The “at a glance” enabled design of an anesthesia information system user interface with the use of icons and redundantly color-coded shapes is discussed.

17. Robinson, D., Heigham, M., and Clark, J. (2006). Using failure mode and effects analysis for safe administration of chemotherapy to hospitalized children with cancer. Joint Commission Journal on Quality and Patient Safety, 32(3): 161-166.
– The article discusses how Failure Mode Effects Analysis (FMEA) helps identify risks. Further discussion explains how strategies were developed to reduce these risks.

18. Shah, S. and Robinson, I. (2007). Benefits of and barriers to involving users in medical device technology development and evaluation. International Journal of Technology Assessment in Health Care , 23(1) : 131–137.
– This article offers the results of a literature review to identify the resources needed to incorporate user involvement in the development and evaluation of a medical technology. Benefits and barriers to this approach are discussed.

19. Wilson, A., Hewitt, G., Matthews, R., Richards, S., and Shepperd, S. (2006). Development and testing of a questionnaire to measure patient satisfaction with intermediate care. Quality and Safety in Health Care, 15(5):314-9.
– This article assesses if a questionnaire can be used to determine the key elements of patient safety satisfaction. The process of how the questionnaire was developed and how it was piloted are discussed.

20. Zhang, J., Johnson, T., Patel, V., Paige, D., Kubose, T. (2003). Using usability heuristics to evaluate patient safety of medical devices. Journal of Biomedical Informatics. Pgs: 23-30.
– A modified heuristic evaluation was used to assess software usability, patient safety, and usability problems of infusion pumps.

21. Zhang, J., Patel, V., Johnson, T., Chung, P. and Turley, J. (2006). Operating manual-based usability evaluation of medical devices: An effective patient safety screening method. Joint Commission Journal on Quality and Patient Safety. Pgs: 214-220.
– This article explains how human errors cause medical errors and how users can be trained to reduce these errors. Heuristic evaluations and extended hierarchical task analysis are two user methods that are discussed for error reduction. These approaches help identify and predict medical problems.


Overview, resources and guidelines on different aspects of usability can be found at