Recently, a family member spent some time in a hospital following an emergency operation, giving me a chance to experience healthcare from the other side. The surgeon did a great job, the hospital staff was uniformly helpful and competent, and the facilities were great. But there was one small part that didn’t measure up.
During our stay, we were asked to participate in a patient quality survey, something which I was happy to do, both because patient surveys are part of the many of the interactive care plans we build at Wellpepper, and because I have an odd affinity for survey-filling, a condition which I’m assured is not yet classified in the DSM-5. Unfortunately, the quality survey was the lowest quality part of our visit, for a few reasons.
The survey was delivered on an iPad outfitted with a soft case and an asset tracking device. Maybe it was because I’d read too many articles about Hospital Acquired Infections, but I kind of gave this device the side-eye in its squishy soft case. I decided that if I had to go out somehow, filling out a survey would at least let me go out as a hero. I’m sure it was fine, but hard plastic and some obvious evidence of disinfection would have made me feel better. There were vendors selling nice UV charging boxes at HIMSS this year – seems like these should just be everywhere at a hospital, even for patients and their families to use with their own devices.
Security vs Usability
Right after the iPad was delivered, a group of docs stopped by to round. By the time they’d left, the iPad had locked itself and prompted me for a PIN. If I was anyone else, I might have just given up here, but I thought I’d be helpful and try the top few most frequent PINS. I didn’t make much progress (+1 for security), so I had the nurse call in some IT person who unlocked it. This person put the iPad in a kiosk (“Guided Access”) mode. However it also prevented the iPad from sleeping. Now I was in a race against the battery to get the survey completed.
Why Do I Have To Tell You This?
It’s weird how our expectations evolve with the medium of communication. If this was a piece of paper on a clipboard, I’d be more understanding about writing down how long we’d been at the hospital and how long I’d been planning this unplanned emergency operation. But on a tablet? Shouldn’t you be telling me this stuff? Imagine if you could only add friends to Facebook by entering their email addresses, DOB, and full name. Instead, they recommend people, even to the point of recommending someone I happened to say hi to at a coffee shop the other day. On the one hand, I know there’s a terrible data silo problem at health systems, particularly for EHR data. On the other hand, getting the admit date and length of stay isn’t a probabilistic graph traversal recommender problem – it’s a one-liner SQL query.
Electronic surveys could be truly helpful with even basic steps to reduce the survey-filling burden. How many times have you written your name and DOB on a hospital form? But sadly the industry hasn’t been able to crack this nut yet.
On sitting number three, I grabbed the iPad – battery now half drained – and tried to resume the survey. This survey, like many, was web based. Unfortunately, the iPad had lost its WiFi connection, and was now asking whether I wanted to resubmit the form. I gambled on “yes”, which was not the right answer, because now I was told I needed some kind of code to get back into my survey. I don’t know if the information I’d completed already was saved, or lost into the ether. In either case, it was clear that I’d gone as far as I could go, so I set the iPad aside and wondered whether someone would stop by to collect it before its battery ran out.
The Future Of Electronic Forms
So, I’m sorry Unnamed Hospital. I really wanted to help. I was going to be your best customer (remember, I like filling out forms). But it was one hurdle too many, between the logistics, the security-over-usability posture, and making me answer questions you knew the answers to. In the end it was your WiFi network that robbed you of my input.
Of course, it doesn’t have to be this way. I’m pretty sure the health IT community is going to figure this out. With a little user-centric design thinking the electronic experience could actually be helpful for patients. A little more critical thought about security vs. usability could reduce user frustration. And eventually hospital WiFi will be consistently awesome. Perhaps eventually I’ll even be allowed to use my own device. It might be covered with germs, but at least they’re my germs.