Tag: healthcare design

Never Waste a (Design) Crisis

Sep 28, 2021

By KIM BELLARD

The Wall Street Journal reported that the American Dental Association (ADA) opposes expanding Medicare to include dental benefits. My reaction was, well, of course they do.

They apparently don’t care that at least half, and perhaps as many as two thirds, of seniors lack dental insurance, or that one in five seniors are missing all their teeth. The ADA prefers a plan for low income Medicare beneficiaries only, although state Medicaid programs were already supposed to be that, with widely varying results between the states.

The ADA is following blindly in the AMA’s opposition to enactment of Medicare, ignoring how fruitful Medicare has turned out to be for physicians’ incomes. It’s all about the money, of course; the ADA thinks dentists can get more money from private insurance, or directly from patients, than they would from Medicare, and they’re probably right.

As is typical for our healthcare system, good design is no match for interfering with the incomes of the people/organizations providing the care.

By the same token, I suspect that the real opposition to “Medicare for All” is not from health insurers but from healthcare providers. Health insurers, a least the larger ones, have done quite nicely with Medicare Advantage, and would probably welcome moving members from those balkanized, largely self-funded employer plans to Medicare Advantage plans.

No, the bloodbath in Medicare for All would be the loss in revenue of health care professionals/organizations missing out on those lucrative private pay rates. As Upton Sinclair once observed, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” Or, as Guido tells Joel in Risky Business, “never, ever, fuck with another man’s livelihood.”

Very little about our healthcare system has been consciously designed. It’s a patchwork of efforts – legislative/regulatory initiatives, tax provisions, entrepreneurial choices, independent design decisions — and many unintended consequences. We should be less surprised at how poorly they all fit together than that some of them fit at all. Find someone who is happy with our current healthcare system and I bet that person is either making lots of money from it, or not receiving any services from it.

10 Design Considerations for Vaccine Credentials

May 10, 2021

By ADRIAN GROPPER

As COVID-19 vaccines become widely, if not fairly, available in different regions, both the public and private sector are working to develop vaccine credentials and associated surveillance systems.

Information technology applied to vaccination can be effective, but it can also be oppressive, discriminatory, and counter-productive.

But these systems can be tuned to reflect and address key concerns.

What follows is a list of ten separable concerns, and responsive design strategies. The concept of separation of concerns in technology design offers a path to better health policy. Because each concern hardly interacts with the others, any of them can be left out of the design in order to prioritize more important outcomes. Together, all of them can maximize scientific benefit while enhancing social trust.

Authenticity

An inspector should be assured that a vaccine certificate was not tampered with and that it was issued to the presenter. This need not imply any privacy risk, or even need a network connection. One such method for authenticating vaccine credentials adds a human-recognizable and machine-readable face photo to a standard 2D barcode. It works with paper as well as mobile phone presentations.

The digital divide

For this concern, paper credentials have equity and privacy advantages. Equity, because paper is cheap and well understood. Privacy, because there is no expectation that a person must unlock and show a mobile phone. Digitally signed certificates that also include a photo, like #1 above, can be copied for convenience without risk of fraud.

We Are All Designers

May 4, 2021

By KIM BELLARD

Raise your hand if you had to go through the Hunger Games labyrinth to score a COVID-19 vaccine earlier this year – figuring out which phone number(s)/website(s) to try, navigating it, answering all the questions, searching for available appointments within reasonable distances, and, usually, having to try all over again. Or, raise your hand if you’ve had trouble figuring out how to use an Electronic Health Record (EHR) or an associated Patient Portal.

Maybe you thought it was you. Maybe you thought you weren’t tech-savvy enough. But, a trio of usability experts reassure us, it’s not: it’s just bad design. And we should speak up.

“Everyone everywhere: A distributed and embedded paradigm for usability,” by Professors Michael B. Twidale, David M. Nichols, and Christopher P. Lueg, was published in Journal of the Association for Information Science and Technology (JASIST) in March, but I didn’t see it until the University of Illinois School of Information Sciences (where Dr. Twidale is on faculty) put out a press release a few days ago.

The authors believe that bad design has costs — to users and to society — yet: “The total costs of bad usability over the life of a product are rarely computed. It is almost like we as a society do not want to know how much money has been wasted and how much irritation and misery caused.”

Whatever the numbers are, they’re too high.

As Dr. Twidale said:

Making a computer system easier to use is a tiny fraction of the cost of making the computer system work at all. So why aren’t things fixed? Because people put up with bad interfaces and blame themselves. We want to say, ‘No, it’s not your fault! It is bad design.'”

He specifically referenced the vaccine example: “When hard to use software means a vulnerable elderly person cannot book a vaccination, that’s a social justice issue. If you can’t get things to work, it can further exclude you from the benefits that technology is bringing to everyone else.”

Why Healthcare Needs Designers

Jan 28, 2020• 2

By TINA PARK, MFA

Designing a functional lamp is simple. Building the Mars Rover is complex. Getting a doctor to ask the right questions so that a patient feels confident about their care in a highly regulated and time constrained environment? That’s complicated.

Healthcare is filled with complicated challenges. Increasingly, healthcare companies and institutions are attacking these challenges with cross-disciplinary teams — doctors, data scientists, marketers, quality officers, financial experts, information technologists, and more. An often missing member of these teams are design leaders. Designers can provide an invaluable role in healthcare, but too often healthcare does not take advantage of all that design can offer.

Good design is invisible. Think about the last time you obtained or purchased something that was well designed. When you get a new blender, you plug it in and turn it on without looking at the user manual, and it works. You don’t necessarily think “Wow, they put that on button right where I thought it would be.” You use it and get on with your day. And every day you use that blender, putting in new mixtures of fruits and vegetables. Sometimes you get a delicious jackpot mix and think this is the best blender ever. Sometimes you get something brown and sticky and you make a mental note never to try that one again, even as you choke it down.