Underestimating the Consumer

It's true - Parkland Hospital in Texas has installed airline-type kiosks in its ED area.

I'm not sure I'd go that far...in my vision of a dream hospital yesterday I imagined using these self-check in machines for surgery pre-registration.

Criticism from the medical community in the blogosphere has raised several key points about the use of consumer-controlled tech in the hospital setting, namely:

• What are they NUTS? Asking ED patients to self-identify and map out symptoms? They might as well put out a candy jar with pre-signed scripts for Demerol...

• Patients with 'true' emergencies will be bleeding all over the touch screens, and I can just see the sentinel event/M&M report now: "Patient expired trying to type last name while bleeding out post MVA."

• Non-emergency patients with communicable diseases, nasty flus, flesh-eating bacteria, or other disgusting things will smear their grossness all over the screen, making it unusable for anyone else (hello? have you people SEEN the public bathrooms in EDs lately?)

• And my personal favorite (drum roll please)..."Consumers" with an average literacy level little above a middle-schooler will not know how to use this new-fangled technology, so it won't work.
  

All are interesting points, no doubt about it.

And obviously if you're using kiosks in the ED, a patient's self-entry of symptoms shouldn't supercede a good ol' fashioned triage.

But it's the last bullet I want to focus on for now; the one that assumes consumers will not be able to figure out the system and employ it efficiently.

This is the worst kind of hypocrisy from medical staff members who use a 1-10 pain scale with emoticons and expect consumers to successfully navigate the managed care environment and rabbit warrens that are most hospital floor plans.

To those who underestimate consumers, I offer these examples that 'overestimated' consumers and successfully innovated for new products and services that have become market leaders (or just pretty darn nifty):

• Starbucks: Who the heck would order a double whip skinny triple whatever with sugar free vanilla before this Seattle chain took over the world (literally)? They created a market for 'luxury' coffee drinks where consumers were happy (relatively speaking) with convenience store sludge. If you build it they will come...

• Apple: I-what? Who wanted a mini player that just regurgitated songs you'd already bought in a random order? The Shuffle and other iPod models again created a market where one didn't exist. And guess what? The consumers figured it out just fine.

• Google Earth: Pictures of the planet? Outside a National Geographic back-issue? Google Earth has enthralled thousands with satellite images of our Big Blue and Green. Does it make them money? Who knows. Who cares? It's pretty darn cool.

• Your local library: Now most of us can hop online for free at local libraries and renew books, search the card catalog, and bypass that tricky Dewy Decimal thingie. Pure brilliance. This faculty was formerly available only to highly educated librarians, who have masters and doctorates related to all this good bibliophile stuff. But even elementary-schoolers who are first generation Americans and speak very little English are picking up this system using foreign language versions (Spanish).

Let's simplify things a bit though.

No matter whether you can read or write in English (or speak), all of us not visually impaired can head into a McDonald's and pick what we want from the menu and order. And there are systems to accomodate the sensory-challenged.

How? Using the most basic of human communication - picture and point.

With check-in kiosks we just switch up the format a bit...it's not picture and point but rather picture, point, and click.

For us to believe consumer based innovations in the hospital setting won't work is a form of underlying elitist bias that underestimates the consumer and simultaneously reduces the chance of patients and consumers advocating for system-level change.

Give us our fair share of responsibility. Or, if you prefer, give us more thingies to buy. With choices we've never seen before we tend to reach for wallets faster. Even with bloody fingers.