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Contents

1  Interactive Voice Response Systems .................................................................................................... 2 

2  History & Evolution ............................................................................................................................... 3 

3  DTMF vs. Speech Recognition ............................................................................................................... 4 

4  Common Applications ........................................................................................................................... 6 

4.1  IVR in Banks ................................................................................................................................... 6 

4.2  IVR in the Health Care Community ............................................................................................... 6 

5  Attitudes toward Interactive Voice Response ...................................................................................... 8 

6  Voice vs. Visual Interfaces .................................................................................................................... 9 

7  Short‐Term Memory Constraints ........................................................................................................ 10 

8  What about Guidelines or Standards ................................................................................................. 11 

9  Future Directions ................................................................................................................................ 14 

10  References .......................................................................................................................................... 15 

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1 InteractiveVoiceResponseSystems

InteractiveVoiceResponse(IVR)isanapplicationthatallowsacombinationofvoiceinputandtouchtonekeypadselectionandrespondsintheformofcallback,voice,email,fax,orperhapsothermedia,dependingonwhatitisprogrammedtodo.IVRapplicationsutilizetheomnipresenttelephoneinfrastructuretoprovideinformationavailability24hoursaday,sevendaysaweek.Theeaseofsetupandhighavailabilitymakeitcost‐effectiveforbusinesses.

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2 History&Evolution

Technologyischangingthewaypeoplelive.Computershavebecomemoresophisticated,moreprolific,andlessexpensive.Computersshouldmakelifeeasier,moresatisfying,andbetteringeneral.Otherwise,whatwouldbethepointinusingtechnology?Inmanyinstances,computershaveperformeduptoexpectations.Itwouldbehardtogobacktolifewithoutwordprocessors,electronicmail,orspreadsheets.ComputershavemadeitpossibletosearchtheInternetforinformationonbillionsofwebsitesinonlyafewsecondsusingasearchenginesuchasGoogle.Computersareembeddedinmanyeverydayappliancesthatusersdonoteventhinkabout,suchasmicrowaveovensandautomobiles.ComputersoperatetrafficlightsandhavemadeeBaypossible.

Userssometimesmistakenlythinkthatimprovedtechnologymeansgreatereaseofuse.Allonehastodoislookatsomecounterexamplesoflessuser‐friendlytechnology:theincreasingnumberandcomplexityofremotecontrolsfortelevisionandstereoequipment;cellphonesandpersonaldigitalassistants(PDAs)withsomanyfeaturesthatmanypeopledonotmakeuseofallofthem.Personalcomputerspresenttheirownsetoffrustrations.Technologyshouldnotjustgetmorecomplex,itshouldbeeasiertonavigate.Otherwise,whybotherinventingthingsthatpeopledonotwanttouse?

Oneapplicationthatseemstostandoutasanunhelpfuluseofcomputersisonethatmostpeoplehavedifficultyavoiding.Interactivevoiceresponse(IVR)isacomputertechnologythathasbeenchangingthewaypeopleusethecommontelephonesincethelate1970s.Acomputer‐generatedhuman‐soundingvoiceanswersratherthanaliveperson.Thecallerhearsalistofoptionsandchoosesbypressingoneofthekeysonthetelephonekeypad.Overthelastfewyears,therehavebeenawiderangeofapplicationsofIVRsystemsinwhichthetelephoneisusedforinformationexchangeviaacomputer,includingthefollowing:bank‐by‐phone,voicemail,menusystemsforroutingservicecalls,joblines,andvoicerecognitionsystems.Thesuccessofsuchsystemsdependsontheusabilityoftheinterfaceandinteraction,particularlyadequatelevelsofperformance,aswellasadequatelevelsofusersatisfaction.ArelativelysmallproportionoftheresearchinthefieldofhumancomputerinteractionhasbeendevotedtoadoptingprinciplesandguidelinesforthedevelopmentofusableIVRsystems.

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3 DTMFvs.SpeechRecognition

DualToneMulti‐Frequency(DTMF)isalsoknownasTouch‐TenetTM.DTMFrepresentsthetechnologyofphone‐basedinterfacesthatrelyonthecallertoselectanoptionbypressingakeyonthestandardtelephonekeypad.AutomaticSpeechRecognition(ASR)referstothephone‐basedinterfacethatallowsthecallertospeakintothetelephonehandsettoselectanoptionorrequestservice.ASRisonlybeginningtobeusedonalimitedbasis.HereisadiscussionofsomeofthelimitationsofASRandjustificationforusingDTMF.

Automaticspeechrecognitioninterfaceshavenotbeenimplementedonalarge‐scaleyetforseveralreasonsincludingcostandthehighrateoferrorsbytherecognizer.Therecognizerisacomputerthatusespattern‐matchingalgorithmstoendeavortocategorizesimilarpatternsindependentofthespeaker.Astatisticalmodelusesthefrequencyofphoneticmake‐upofthespeechinputtoanalyzethemeaning.Inasystemthatacceptsalimitednumberofspeechinputs,therecognizerdoeswell.Ifthenumberandtypeofspeechinputsarenotlimitedorspecified,therecognizermaymakemanyerrors.

Callersoftendonotknowwhatresponseisexpectedofthemandwhattherecognizeriscapableofdoing.Forcallerswithadialect,foreignaccent,orspeechimpediment,ASRsystemsmaynotbeaccessible.Speakersmaybecallinginanoisyenvironmentoronethatdoesnotaffordthemneededprivacy.Ifthecomputervoicesoundshuman,mightnotthecallersassumeitcouldunderstandlikeahuman?The‘HowMayIHelpYou?’experimentalinterfacebyAT&Tisespeciallyproblematicinthisregard.Howdoesthecallerknowwhattosay?

SusanBoycediscussedtheprosandconsofnaturallanguagedialoguesinanarticleinCommunicationsoftheACM.Sheexaminedhowhuman‐likethecomputervoiceshouldbe:shouldithavepersonality,andhowdocallersknowitisacomputer?Resultsofherstudyindicatethatcallerspreferacasualsystemreferringtoitselfas"I."Theinitialpromptwillletthecallerknowthatacomputerisansweringthetelephoneeitherbyexplicitlystatingthatfactorbyhavingasomewhatrobot‐likevoicespeaktheprompt.Severalhurdlesmuststillbeovercome,includingreal‐timeprocessingofcomplexalgorithms.Thisrequiresexpensiveprocessinghardware,butwillbecomemoreaffordableinthefuture.AnothertaskistofindappropriateapplicationsforASRthatdonotrequire100%accuracy.

BenShneidermancontendsthatspeechrecognitionhaslimitedapplicationbecauseofthewayacousticmemoryandprosodywork(prosodyreferstothe"emotional"qualityofspokenwords).Humansthinkinanacousticmode.Speechinputinterfereswiththat.Thehuman‐humaninterfaceisquitecomplex,andqualitiesofthevoice,suchasintonationandpacing,givemeaningtotheactualwordsspoken.Arisingtoneattheendofastatementindicatesaquestion.Still,forsomeinterfaces,speechmaywork.Amoresignificantproblemisthatspokenlanguageinterfereswithshort‐termmemory.Inanexperimenttodeterminewhethersomeadvantageexistsforspeechversusmousecommandsforwordprocessing,researchersfoundthatinthecasewhereshort‐termmemorywasimportant,speechinterferes.

"Theproblemofknowingwhattosaytoaspeechapplicationhastwocomponents.Userscanassumethecomputerwillbeabletounderstandmorethanisactuallypossible,anduserscanbe

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unawareoffunctionalitythatisavailable"(Yankelovich,1996,p.35).Theconstraintsonaspeechsystemincludethesupportofalargevocabularywithaccuracy.Continuousspeechismoredifficulttorecognizethandiscretespeech.Humanstendtoruntheirwordstogether,yetareperfectlyunderstoodbyotherhumans.Theusermayhavetospeakinanunnaturalwayfortherecognizertounderstandtheinput.InanarticlepublishedinTransactions,called"Howdousersknowwhattosay?",YankelovichcollectedsuggestionsforimprovingtheASRinterfacefromuserinterfacedesignersinseverallargetelecommunicationsorganizationsincludingAdamCheyerandPattiPricefromSRIArtificialIntelligenceCenter,StephanGammfromPhilipsResearchLaboratories,FrancisGanongfromKurzweilAppliedIntelligence,JimGlassfromMITSpokenLanguageSystemsGroup,CandyKammandAmirManeofAT&T,DemetriosKarisofGTE,andothers.Mostagreethatthekeyisdevelopingtheprompt.Onedesigner,TroyKamphuisofNuanceCommunications,suggeststhreetypesofpromptsfromimplicittoexplicit,rangingfrompoortobest.

Spokenprompt1:"WelcometoABCBank.Whatwouldyouliketodo?"

Spokenprompt2:"WelcometoABCBank.Youcancheckanaccountbalance,transferfunds,orpayabill.Whatwouldyouliketodo?"

Spokenprompt3:"WelcometoABCBank.Youcancheckanaccountbalance,transferfundsorpayabill.Sayoneofthefollowingchoices:checkbalance,transferfunds,orpaybills."

Itseemssimplerandlesscostlytohaveaninterfacethatmightsoundlikethis:

DTMFprompt:"WelcometoABCBank.Tocheckanaccountbalance,press1.Totransferfunds,press2.Topayabill,press3."

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4 CommonApplications

4.1 IVRinBanks

Interactivevoiceresponse(IVR)systemshavecomealongwaytooffersolutionsforthepurposeofreducingcustomersupportcosts.IVRsystemsallowbanksandsimilarorganizationstooffertheirserviceswithoutthehelpofahumanrepresentative,thusreducingtheneedforcustomersupportstaff.IVRcanalsoprovidecosteffectivealternativestoaccessingbankinginformation,completingfinancialtransactions,andphone‐basedshopping,etc.TherecognitionofIVRinfinancialorganizationssuchasbanksisprimarilyduetothefactthatitcanbeusedbyanyonefromanywhere,offeringuniversalaccessthatdistinguishesthetypeofdevicetheuserhas.

4.2 IVRintheHealthCareCommunity

AnIVRSisinformationtechnologythatlinksapersonwithacomputerdatabaseviaatelephone.Uponeachtelephonecall,theIVRScandelivermedicationandappointmentinstructionswhilethepatientcanrespondtoquestionsverballyorbypressingtheappropriatenumbersonthetelephonekeypad.TheIVRStelephonemessagesareautomatedandthesystemcanbeprogrammedtocontinuetocallapatientuntiltheyhavebeenreached.Therefore,thedeliveryofinformationisnotinfluencedbytheworkloadofhealthcareprofessionals.Withouthavingtocallpatients,healthcareprofessionalsareavailableforothertasks.

IVRSsareincreasinglybeingusedbyhealthcareinstitutionsfordiseasescreening(e.g.depression),diseasesymptommonitoring,behaviormonitoring(e.g.substanceabuse),conductingbehavioralcounseling,assessingmedicationadherence,andincreasingappointmentcompliance.Friedmanetal.(1996)reportedthatpatientsmonitoredbyanIVRSforhypertensionshoweda6%improvementinmeanadherencetoantihypertensivemedicationcomparedtopatientsreceivingusualcare.Feldsteinetal.(2006)demonstratedthatpatientswhoreceivedanautomatedvoicemessagereminderweresignificantlymorelikelytocompleterecommendedlaboratorymonitoringthanpatientsreceivingusualcare(HR4.195%CI3.0‐5.6).ForsterandvanWatraven(2007)highlightedtheutilityofanIVRSinimprovingpost‐dischargemonitoring.

Anumberofhealthinformationsystemshavebeenusedtocommunicateoralanticoagulant(OAC)informationtopatients,andthreestudieshaveusedportabledevicesthatareconnectedtoanticoagulationclinicdatabasesusingtheinternet.TheHAT(homeautomatedtelemanagement)systemrecordsself‐monitoringpatients'INRresultsinahomeunitdevice.Dataistransmittedtotheclinicwhereaphysicianreviewstheinformationandforwardstheirinstructionsbacktothepatients'homeunitdevice.Comparedtothesesystemsofanticoagulationmanagement,anIVRSisprimarilyappealingbecauseofitsgeneralizability.PatientscanbemonitoredbyanIVRSwithoutbeingself‐monitoredorrequiringemailorcellulartelephoneaccess.AnIVRScalledINRRELAYhasbeenusedtocommunicatewithOACpatients.INRRELAYwasdevelopedin2000bystaffattheanticoagulantclinicofthePathologyDepartmentinBasildonandThurrockNHSTrust.Onadailybasis,theclinicsendsareportofpatients'latestmedicationandappointmentinstructionstoINRRELAYservicestaff.Theservicestaffthenprogramsthecallingsystemtodelivertheautomatedtelephonecalls.INRRELAYalsocallspatientsiftheymissanINRappointment.In2000,staffatthe

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clinicconductedanobservationalstudyandconcludedthatbothpatientsandstaffweresatisfiedwithINRRELAY(Cervi,2006).

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5 AttitudestowardInteractiveVoiceResponse

Boren(1993)conductedasurveytomeasureattitudestowardIVR.Accordingtohisfindings,attitudesweresomewhatnegativetowardtheuseofcomputerstoanswerthetelephone.Remarkstotheresearcherwereoftwokinds.(1)Thetechnologyisnew;surelyitwillgetbetter.And,(2)voicerecognitionwillreplacekeyentrywithinafewyears.

Twoearlierstudiesweredoneinthe1990stoexaminetheacceptanceofInteractiveVoiceResponseSystems.Onesurveyincluded800adults(Settle,Dillon,&Alreck,1999)andtheotherincluded912adults(Katz,Aspden,&Reich,1997).Bothsurveysusedanextensivelistofstatementsthatrespondentsansweredbyindicatinghowmuchtheyagreeordisagreewiththestatementbymarkingonafive‐pointLikertscale.ThestudybySettleetal.employedaconveniencesampleusingstudentstodeliverandcollecttheself‐administeredquestionnairesfromshoppingmalls,neighborhoods,etc.Aneffortwasmadetosampleequalnumbersofmenandwomenandparticipantsfromeachdecadeoflifefromthetwentiestothesixties.Theresultsindicatedthatonlyonevariable,age,madeasignificantdifference.TheolderparticipantshadmorenegativeattitudestoIVR.

InthestudybyKatzetal.(1997),asurveyquestionnairewassenttoarandomsampleof5,000namesandaddressesacrosstheUnitedStates.Thirteenpercentwerereturnedbecauseofaddressproblems.Responseratewas21%oratotalof912surveysreturned.Therespondentswerenottrulyrepresentativeofthepopulationasawholesincethelowerincomegroupswereexcludedbecauseofaddressproblems.Nevertheless,theresearchersfeltthatthisstudywasagoodexploratorymeasureofattitudestowardIVRsystems.TheyfoundthatthetwomostsignificantpredictorsoflikingIVRsystemswereexperiencewiththelastelectronicsystemencounteredandage.WomenlikedIVRsystemsmorethanmen,youngdidmorethanold.EducationorincomeleveldidnotyieldsignificanceforlikingIVR.TheresultsfromKatzetal.aresummarizedinTable1.

Table1.ResultsforElectronicVoiceResponseSystems(Katzetal.,1997,p.134)

Gender Age EducationLevel IncomeLevel

Likingfor Women>Men Young>Old High=Low High=Low

Frustrationwith Men>Women Old>Young High=Low High>Low

Foundconvenient Women=Men Young>Old High>Low High>Low

Thereisaneedofresearchtofindawaytoimprovethetechnologyinterfacesothatitcouldbetterserveeveryone,includingmembersoftheoldergeneration.Alluserswillultimatelybenefitfromdesignsthatarebetterforolderadults(Vanderheiden,1997;Vanderheiden,1990).The2000censusforU.S.householdsshowedthatthehighestmediannetworthwasforpeopleinthe70to74yearagebracket.Themessagetomarketingisthatolderconsumershaveplentyofmoneytospend.Productsusedtobetargetedtoamuchyoungeragegroup.Butadsnowfeatureactorswithgreyhairpromotingcarsandelectronicequipment(Greene,2004).

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6 Voicevs.VisualInterfaces

Interactivevoiceresponsesystemsposemanyusabilitychallengesduetothenatureoftheinteraction.IVRisaserial,temporal,andcontinuousinterfacedependentuponvoiceandaudiocues.Theselimitationsarebestseeninjuxtapositionwithvisualinterfaces.

Voiceinterfacesinvolveadynamic,sequential,andtemporalpresentationofinformation,inwhicheachpieceofinformationis"removedfromusableaccessveryrapidly"andreplacedbyanotherpieceofinformation(MullerandCebulka,1990).AccordingtoMullerandCebulka(1990),themajordifferencebetweenvoiceandvisualinterfacesisthatnavigationinavoiceinterfaceconsistsofgoingforwardandbackwardandisnowherenearasrichaswithvisualinterfaces.

Withvisualinterfaces,agreatdealofinformationcanbepresentedsimultaneously(MullerandCebulka,1990),withthecapabilityofusingvariousdimensionstopresentinformation.Thesedimensionsincludesize,shape,color,shading,andothers.Voiceinterfaces,ontheotherhand,arelimitedtoserialpresentationofinformationandaverydifferentrepertoireofmethodsfortransmittingthatinformation.Forexample,audiocuescanbeusedtodenoterelativedistancesorboundariesofimages,andvoicequalitycanbevariedintermsofgenderandpitchtorelatemoodsandintentions.AsStevens(1993:p.179)pointsout,the''humanvisualsystemisadeptatquickly,holisticallyviewinganimageorapageoftextandfindingadesiredpieceofinformation.…Ontheotherhand,objectsthathaveintrinsicconstanttemporalratessuchasaudioandvideoaredifficulttosearch."Indeed,ResnickandVirzi(1993:p.421)identifythetemporalpresentationofinformationasthecriticalfactorwhichdistinguishestheir"analysis[ofIVRinteractionstyles]fromanalysesofmostvisualmenusandforms."

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7 Short‐TermMemoryConstraints

Thememorydemandsofvoiceandaudiointerfacesarehigherthanforvisualmenus.Visualinterfacesallowforagreaternumberofcuesandprovidetheuserwiththeopportunitytorefreshtheirmemorybyglancingatascreenonwhichalargeamountofinformationisbeingpresentedsimultaneously.Voice,however,isserialandtemporal,withlimitednavigationandpresentationcapabilitiesthatrequiretheusertoholdtask‐relatedinformationinshort‐termmemorythatisalreadyfullofinformationconcerningtheirlocationandoptionsinthevoiceinterface.

Hart&Staveland(1988:p.141)definedthenotionofworkloadas"ahypotheticalconstructthatrepresentsthecostincurredbyahumanoperatortoachieveaparticularlevelofperformance."GiventheconstraintsplacedonauserbyanIVRsystem,mental(orcognitive)workloadcanbesaidtobehigh,specificallywithreferencetoshort‐termmemory,andthe"limitationsofhumanprocessingcapacity"(Waterworth,1985:p.221).Edwards(1988)corroboratesthisconclusionbystatingthatmostoftheproblemsencounteredbyusersinhisstudiesonaudioandvoiceinterfaceswererelatedtotheextraloadimposedontheuser'smemory.Thedemandsplacedonshort‐termmemorybyvoiceinteractionscanalsocurtailexplorationoftheIVRsystem(Bradford,1995),thusinhibitinglearningandconsequentlyreducingusability.

Theshort‐termmemoryconstraintsalsohaveimplicationsforthetypesoferrorslikelytobecommittedduringaninteractionwithanIVRsystem.Huguenardetal.(1997)identifytwomainclassesoferrorsassociatedwithphone‐basedinteractionsthatoccurduetodemandsplacedonshort‐term,orworking,memory.ThefirstclassoferrorincludesthoserelatedtoinformationlossinwhichusersforgetinformationneededtocompleteataskcausedbylimitationsinSTMcapacity.Thesecondarechoiceerrorsinwhichtheuserselectsthewrongoptionwhenpresentedwithasetofchoices.Choiceerrorsarecloselytiedtonavigationthroughthevoiceapplication,especiallymenu‐basedIVRsandreflectgettinglostorlosingsightofthegoalsoftheinteraction.

Voiceinterfacesplaceextrademandsonshort‐termmemoryduetolimitationsinnavigationandsimultaneouspresentationofinformation.Thesedemandsincreasethelikelihoodoferrorsandtheperceptionofcognitiveworkload.ThesechallengestotheusabilityofIVRsystemsmaybeaddressedbyoptimizingthedesignoffileinteractiontominimizeerrorsandworkload,andbyprovidingdesignerswithguidelinesandstandardstoenhancetheconsistencyofIVRsystems.

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8 WhataboutGuidelinesorStandards

Expertsininteractivevoiceresponseandhumanfactorshavebeencallingforthedevelopmentofstandards.Theprocessisslowedbyseveralfactors.IVRresearchinacademiaissketchy.Withnotableexceptions,veryfewpapershavebeenpublishedonIVRstandardsorguidelines(Buie,1999;Gardner‐Bonneau,1999;Virzi&Huitema,1997).AnotherreasonthatIVRguidelinesarenotavailableisthatthetelecommunicationscompaniesthatperformresearchareunwillingtosharetheirdata.AthirdreasonisthattheexistingIVRsystemsareinconsistent(Killam&Autry,2000).Theideaofgettingeverybodytogetherandagreeingonstandardsisquitelikelyapipedream.

Morerealistically,severalhumanfactorspractitionershaveproposedguidelinesdevelopedfromtheirknowledgeofhumanfactorsprinciples.Killam&Autry(2000)wereaskedtoimproveaworkinginterface.Inanexperiment,theresearchteamdidusabilitytestingwith32participantscomparingtheworkinginterfacetotheproposedimprovedinterface.Ninetypercentoftheparticipantspreferredthenewinterfacealthoughtheydidnotknoweitherinterfacewascurrentlybeingused.Participantswereabletonavigatetheimprovedsystemfasterandwithfewererrors.Asaresultofthisstudy,KillamproposedalistofguidelineswhicharelistedinTable2.

Theresearchersfoundsomepositiveresultsforusingtheseguidelinestoimproveanexistinginterface.Theyweretestedasawholesonothingcouldbeinferredaboutanindividualguideline.SomeoftheguidelinesinTable4makesense;somedonot.Forexample,referringtoguideline#6,wouldprovidingapausebeenoughorevenappropriatetoencourageearlyselection?Killammayhavebeentryingtoprovidemenuswithfeweroptionsinordertopreservethecapacityofshort‐termmemory(STM).Infact,theexperimentinthepresentresearchshowsthatanadditionalitemdoesnotinterferewithSTM.Callersmayprefertohavethelistcontinuetotheendratherthanpausing.Guideline#9,offeringanoptiontopausethesystemwhileadditionalinformationcanbeobtained,doesnotseemtohavecaughton.Mostcallersshouldeitherbepreparedorshouldhangupandcallagainwiththeneededinformation.Itmightbehelpfultotellthecallerwhatinformationtheyshouldbepreparedwithrightawaysotheydonothavetolistentothemenusandthenfindoutthattheyneedtohangupandcallbackwiththeinformation.

Guideline#13isdirectlycountertogoodhumanfactorspractice.Readingbackasocialsecuritynumberorcreditcardnumberwithoutthepauseswouldmakeitmoredifficultforthecallertoconfirmthecorrectnumber.Mostpeoplethinkofthosenumbersaschunksratherthanastringofnineorsixteennumbers.Perhapsindividualguidelinesneedtobetested.Whatseemsobvioustoonehumanfactorsprofessionalmayseemincorrecttoanother.Itwouldseemthattheprudentthingtodowouldbetodesignaninterfaceanddousabilitytestingonit.Guideline#7requiresanexplicitactionforallmenusratherthanallownoactiontobeanassumedselection.Manycallershopethatbynotmakinganyselection,theywillbeconnectedtoanoperator.Exceptinrarecases,anoperatorshouldbeavailable.Havinganoperatoravailableconformstoguideline#2whichsaysthatthesystemshouldbeoptimizedforcaller‐efficiencyratherthanforsoftwareefficiency.Guideline#8,theoptiontocancelthechoiceandreturntothepreviousmenu,seemsreasonableand,infact,desirable.Theotherguidelinesseemtohavemerit.

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DaryleGardner‐BonneauagreeswithKillamthatguidelinescanbedevelopedusinghumanfactorsexpertise(Gardner‐Bonneau,1992;Killam&Autry,2000).Gardner‐Bonneaupresentedapivotalpaperatthe1992meetingoftheHumanFactorsandErgonomicsSociety,entitledHumanFactorsProblemsinInteractiveVoiceResponse(IVR)Applications:DoWeNeedaGuideline/Standard?ShesuggeststhatmanyoftheproblemsinIVRsystemsarearesultofpoorscriptingordialoguedesign.OtherproblemsoccurbecauseIVRisusedinapplicationsthatdonotlendthemselvestothetechnology.BusinessesthatimplementIVRareoftenontheirownindevelopingthescriptingandroutingofcalls.Thepersonwhoimplementstheinterfaceismostlikelynotahumanfactorsspecialist.Theapplicationisdrivenbycompanyneedsratherthanbycallerneeds.

MostoftheproblemsrelatedtotheIVRinterfacecouldbeavoidedwiththecarefulapplicationofhumanfactorsprinciples(Gardner‐Bonneau,1992;Killam&Autry,2000).DevelopingastandardforIVRisachallengingundertaking.Yettheapplicationdevelopersneedguidelinesinordertoprovideacceptableandefficientinterfacesfortheusers.Gardner‐Bonneaurecommendsseveralgroupsthatcouldundertakethisproject.ThelogicalfirstchoiceistheCommunicationsTechnicalGroup(CTG)oftheHumanFactors&ErgonomicsSociety.TheCTGhasadiversemembershiprepresentingtelecommunicationcompaniesandotherbusinesses.TheAmericanVoiceInput/OutputSociety(AVIOS)mayprovidesomesupportbutdoesnothavethehumanfactorsrepresentationtoaccomplishthetask.

Table2.GuidelinesfortheDesignofIVRSystemsDevelopedbyKillam(2000)

1. Develop and maintain a consistent mental model of the system for design and operation, how the system should be integrated with other IVRs within the same organization, and how the system should be integrated with other forms of customer support (e.g., web, email, and post).  

2. The system should be optimized for caller‐efficiency rather than for software efficiency.  3. Provide a simple greeting and a high‐level main menu before proceeding to the caller's issue to ease 

the caller into the participant matter.  4. Provide both location and progress feedback by announcing the name of each menu before giving the 

options.  5. Present menu options in "specific‐to‐general" order to avoid callers picking a broad category before 

hearing a later, more specific category.  6. Provide a pause in each menu after the substantive options and before the general options (e.g., "To 

repeat the choices press ... ") to encourage early selection in menus.  7. Require an explicit action for all menus rather than allow no action to be an assumed selection.  8. Provide the ability to cancel the last menu selection and return to the previous menu.  9. Inform callers about information they will need to complete a transaction at the top of each 

application and provide the ability to "pause" the system to get this information as well as the option to hang up and call back when the information is obtained.  

10. Use inflection to highlight distinguishing information in explanations and menus that are similar.  11. Use timeout for user data entry but also accept caller‐entered terminators.  12. Use consistent wording for all confirmation messages to encourage cut through.  13. Read back user entered data confirmation quickly and without formatting information (e.g., 

simulated pauses in a social security number).  14. Design the most frequently used path through the system to use the first, or earliest menu choice 

possible.  15. Provide a streamlined path through the system, where possible, by allowing repeat callers to bypass 

explanations and other non‐essential information.  

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Perhapsstandardsarenotwhatisneeded,afterall.Inthisexample,Schumacher,etal.(1995)relaysthefollowingexamplefromacurrentISO/IECvoice‐messagingstandard.

Thestarkeyisusedtobringtheusertoacontrolmenu.Thecontrolmenucontainsseveraloptions.Theusercanpress7toreturntoamainmenu,9toforceadisconnectfromtheinteractivevoiceresponsesystem,0togethelp,and#toexitthecontrolmenuandcontinueforwardintheinterfacefromthestatetheuserwasinpriortoreachingthecontrolmenu.Pressing*againinthecontrolmenuwilleither(1)cancelthecurrententryinprogressandissuethepromptplayedpriortotheentry,iftheuserwasininputmode(enteringdataintothesystembeforereachingthecontrolmenu;or(2)reverttothebeginningofthecurrentoutput,iftheuserwasinoutputmode(receivingdatafromthesystem)beforereachingthecontrolmenu.(1995,p.255)

Thisstandardseemsunnecessarilycomplicatedtothepointofbeingridiculous.Oneoftheguidingprinciplesofhumanfactorsistokeepitsimple.Schumacher,Hardzinski,&Schwartz(1995)suggestedthatthelackofpublishedguidelinescontributestothevariabilityinthequalityofphone‐basedinterfaces.Theywentontopresentwhatguidelines,standards,bestpractices,andempiricalresearchwasavailableatpublicationin1995.However,thepointisthatthereisnouniversalagreementonstandards.Everysystemacallercomesacrossisanewinterface.

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9 FutureDirections

InterestingusesofIVRtechnologybesidesvoicemailandautomaticcalldirectinghavebeendeveloped.Someoftheseauditoryinterfacesincludepsychologicalscreeningandassessment,accesstoinformationaboutgovernmentservicesandmatters,self‐managementofemployeeinvestments,andprovidingaccesstographicaluserinterfacesandscientificinstrumentstothevisuallyimpaired.IVRsystemsareubiquitousandwillcontinuetobeso.

Inanumberofsurveys,theattributesofage,gender,experience,andcognitivestyleswereidentifiedascharacteristicsthatarelikelytoaffectperformanceandsatisfactionwithIVRsystems,eitheroverallorinresponsetoparticularinteractionstyles.TheaudienceorintendeduserpopulationforanIVRsystemmaybegeneralorclearlyidentifiable.Ifthepopulationisgeneral,thentheinteractionshouldbedesignedtobeusabletoeitherthelowestcommondenominatororthewidestscope.Iftheuserpopulationisclearlyidentifiablewithrelativelyfixedcharacteristicsorparameters,thenguidelinesaboutusabilityrequirementsofthoseuserswouldbemostvaluableindevelopinganoptimizedIVRsystem.Anotherwayknowledgeaboutthedemographicsandexperienceleveloftheusermaybetakenintoconsiderationisintheuseofprofiling.

Furthermore,thereisaroleforIVRSsinthehealthcarecommunity,butthetechnologymustbeoptimizedbeforesuchorganizationsinvestinitandimplementitonalargerscale.First,theautomateddialoguesmustbecarefullydesignedandperiodicallyrefined.HealthcareinstitutionsshouldcollectandreviewpatientfeedbackontheIVRSdialogue.Simpledialogueisessentialforeffectiveness.Second,IVRSsshouldbeprogrammedtore‐attempt'failed'callsafteracoupleofhourshavepassed.Finally,anIVRSshouldallowuserstoselectthetelephonenumberthatwillbeusedtocontactpatients.Thisoptionwouldimprovestaffusability.Nonetheless,implementinghealthinformationtechnologyischallengingandrequirescooperationbetweenthetechnologycompanyandthehealthcareinstitution.Dedicatedandadaptivestaffmembersfrombothpartiesareessentialtodesigning,implementing,andevaluatingthistechnology.

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