you are not the user

In every role that I’ve had, I’ve had to remind myself and my team that we are not our users.  When you’re a software engineer creating a software application, it’s very easy to see yourself as the user.  It was true when I worked at IBM on databases, it was true when I worked at Microsoft on Office:Mac, and it was true when I worked at VMware on vSphere.

In each of those instances, while we as the application development team did use our applications in one way or another, we weren’t representative of our real users.  We had more knowledge of how computers and software work in general.  We had more knowledge of how our specific applications work, and many other related applications too.  We were far more likely to use our software deeply.  When I was at Microsoft, I learned that, as an organization, we sent and received significantly more email than other organizations of our size and general structure.  This meant that I couldn’t project from my usage of Outlook to other users.  I had more email, I had more folders, I had more events on my calendar, and I was far more likely to use deep features in that application.

I find myself having a similar conversation in healthcare user experience.  We are very patient-focused.  Being patient-focused is excellent.  We have a lot of empathy, which is also excellent.  In using the term “patient”, we can project ourselves into the situation — after all, we’ve all been patients at one time or another.  My doctor refers to me as her patient, even when I’m just in for a checkup.

But I am not the patient here.  When I project myself into the patient’s situation, it is easy to forget that I probably differ from the real patient.  I am a reasonably healthy and well-educated 39-year-old married woman in Silicon Valley.  Not only that, but I have also learned quite a lot about how healthcare works in the past few months.  Most patients don’t have the benefit of the knowledge that I have acquired.  And if I’m considering the user experience for the patient, they are probably not, or are no longer, a reasonably healthy person.

This point is very important.  Someone who is reasonably healthy is better able to make well-informed decisions.  We have a limited amount of cognitive resources available.  There are only so many decisions that we can make in a day.  That’s why habits are so powerful: a habit is (at least!) one fewer decision to make in a day.  If you always have a latte and a banana on your train ride to work1, you don’t have to expend cognitive resources thinking about what to have for breakfast that day, and thus you have more cognitive resources to use later in the day.  People who are in pain or who are stressed have fewer cognitive resources available to them than people who aren’t in pain or stressed.

In creating a healthcare user experience, I have to remember that our patients have probably had a life-altering diagnosis.  They could have had a long and difficult journey to get to that diagnosis.  They are probably tired, and in pain, and stressed.  They are already dealing with a difficult situation.  We have to create a healthcare user experience that doesn’t have an undue cost of cognitive resources at a time when the patient has few, if any, to spare.

  1. Yes, I have just described my morning commute.