The illuminating example I'm going to tell you about is Medicare's new prescription drug price-comparison engine, which is sponsored by the U.S. Department of Health & Human Services (HHS).
A Prescription for Confusion
Medicare beneficiaries — essentially, all Americans over 65 — are eligible to purchase a new kind of prescription drug discount card on June 1. To help seniors choose one of the 40 different national cards or 33 different regional cards, all of which have wildly divergent prices and policies, HHS launched on May 3 an ambitious price-comparison service at its Medicare.gov site.
This service, I'll grant you, is a well-intentioned attempt to help seniors access an enormous database of 10 percent to 17 percent drug discounts offered by each card provider and its participating pharmacies. But the implementation is such a mishmash that I fear even computer experts will find it difficult to comprehend.
A price-comparison search engine such as Medicare's should need the answers to only two questions: "What prescription drugs do you buy?" and "What ZIP code are you in?"
Instead, users of the service are confronted with a virtual interrogation:
• Just the Facts, Ma'am. The first page of the service asks users such questions as whether they belong to "TRICARE," "FEHPB," or "Medicare managed health plans (but not Medicare+Choice or Medigap)." Huh?
• Wasn't I Just Here? Additional pages inquire about your assets, your monthly income, and whether you're an American Indian. These points apparently qualify you to receive information about other programs, although I never saw any pointers to such info in my tests of the service.
• All Right Already. After wading through several more screens, you're finally asked how far you'd be willing to travel to buy your prescription drugs, whether you'd consider buying from a mail-order pharmacy, and whether you'd accept identical, generic alternatives to brand-name drugs.
When you finally get to the price comparison, it's in the form of a massive chart that lists dozens of discount-card programs. You can select a comparison of a smaller number of offerings. But when I did this for just five cards in one metropolitan area, the result was an even longer 43-page chart with identical information on hundreds of local pharmacy branches.
The Solution is Simplicity
I solicited the advice of Jakob Nielsen, principal of the Nielsen Norman Group and a respected user-interface expert. He'd never visited the Medicare site before — but once he had, he wasn't shy about expressing an opinion.
"There's too much information being dumped on people," Nielsen said. "Even the first page is a huge, long, scrolling thing with a lot of very complicated information."
When I asked for a response from a public affairs officer at HHS's Centers for Medicare & Medicaid Services — his name can't be published due to departmental policy — he recommended a backup plan. "What they need to do if they can't navigate it [the site] is call 1-800-MEDICARE [1-800-633-4227]," the spokesman said. "Those lines are pretty swamped right now," he added, apologetically. The best way to get through, I was advised, is to call after 5 p.m. Eastern Time on weekdays.
Learning From Price Comparisons Gone By
The problems with Medicare's user interface could have been avoided if the agency had emulated today's successful online travel sites. Popular services such as Travelocity and Orbitz no longer even require you to enter the dates on which you wish to travel. Just enter your origin and destination cities, and the sites show you the cheapest dates on which you can book flights.
As an experiment, I re-designed the Medicare search results. The new interface would require no input from a user other than a list of prescription drugs purchased and a ZIP code. Modeled on Orbitz' air-fare price grid, the result is shown below:
In the fictional example above, questions about travel distance, generics, and mail-order are unnecessary. The price grid answers these questions automatically. Users can easily scroll down or click any price link to see more details, if desired.
Actually, I discovered something like this that's already on the Medicare site. The first page of HHS's questionnaire has a small link to a Quick Search page. This alternative page asks only for your ZIP code and the names of your prescription drugs, while still providing helpful income-qualification information.
Unfortunately, Medicare's Quick Search page leads you to the same overwhelming chart of pharmacy branches and prices as before. But at least you get there a lot quicker.
According to the San Francisco Chronicle, some problems with the service can be traced to a no-bid contract the government gave to DestinationRx, a pre-existing price-comparison site, which now makes up the core of Medicare's database.
The confusion is a shame, because seniors — and anyone else who happens to check on prices through the Medicare service — can save hundreds or thousands of dollars a year by finding the most inexpensive sources for their prescription drugs. (You should also search for savings at such sites as PillBot.com and BenefitsCheckup.org.)
At the same time, your company might be able to save millions of dollars by learning from the mistakes of the Medicare site — and not making those same mistakes on pages that you expect actual customers to use.