A computer and a patient check-in clipboard

Patient Check-in Plus a Computer Equals…

… A Computer!

Going to the doctor has its administrative challenges. My children recently had their yearly check-ups—meaning filling out 4 identical online forms. These are the same form my wife filled out online last year. Adding insult to injury, we had to fill it out again on paper because of a technical issue. This example is emblematic of the folly of our modern thinking. We keep making the same mistakes. Let’s strive for something better.

Alan Cooper’s landmark book, The Inmates are Running the Asylum, argues that adding computers to a product transforms it into software. The effect is that many products have a human computer interaction element and when not designed as such, fails. The mixture of paperwork and added services like online check-in creates the environment for a poor experience in at least two ways, questionable assumptions and security concerns.

Questionable Assumptions

When doctor records were papers stored in folders, each individual needed his own copy. Today, though each individual still needs her own record, the way each is created and stored has fundamentally changed. For example, think of a family that has several children. An interaction designer, noticing this during research, may build in smart defaults in the family history after the first child’s information is filled out. This of course won’t always be correct, but would make many parents extraordinarily happy.

The type of data requested in the health forms is personal. Yet handing over data is often an expected part of the process. A trusted figure, your doctor or someone employed by her, asks for data and they assume you will gladly hand it over. With a paper form, it is simple to ignore one question, but the unrelenting asterisk in an online form bullies you into providing information whether you want to or not. Using this solution solves data quality issues and is easier than dealing with missing information. Yet, it doesn’t address the fact that sometimes people may not know or choose not to answer a question.

Security Concerns

In the clipboard and paper days, it took a targeted effort for someone to steal a particular person’s medical records. Now the potential data thief works from home and has software to stitch together records across stolen data from across the web. Combining a computer with a check-in process means training staff to fix computer problems, secure records online, and protect against data loss.

While it makes it easier to pull up and share patient data, the list of problems that your local doctor faces is quite long. How secure is the system they’re using? How is access controlled? Is data destroyed after its usefulness has abated? How to keep data from state actors?

Designing for Computers

Late into the computer age, designers computerize everyday objects with the idea that it makes achieving a goal easier. The promises of simplicity are fouled up in a mess of half-baked solutions that don’t take into account the new product is a computer. Designers overlook options to improve the experience. Often, designers expect the analogue experience to translate directly to a digital one. A friend mentioned another such example, the parking meter. It used to be that you find an open spot, pop in a quarter, and enjoy the day. Now, it requires parking, walking to a central location, downloading an app, figuring out what parking spot you’re in, then creating an online account, and finally moving through a checkout procedure. It isn’t as simple as it should be. The addition of a computer doesn’t make it better. It has to be designed.

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