#13. More About Presenting The Questions.

Human/Computer interaction is soft-coded.
Communication is dynamic. Languages change, word meanings change, people change, and medical practices change. Developing a system that is not preconceived to change must mean that either change has not been considered, or that the system has been preconceived to become outdated. Therefore, the best method for the computer to communicate with end-users is subject to change and advancement, along with technology and research into end-use of the individuals who interact with the system.

Nevertheless, we need to start somewhere, so we can accept our own limitations, while making some assumptions about these first few end-users to be studied:

• That they can read.
• That they can use the English language.
• That they have access to computers that are connected to the World Wide Web.
• That they have basic understanding of how to manipulate a computer, keyboard, and mouse (or other third-key device).
• That they have no handicaps that would compromise the efforts of this study.

So, while these opinionated assumptions are enough to get started, we must keep in mind that our opinions have been presented without an evidence base, so we must return to them. These opinions must simultaneously trigger our responses to further the researches into end-users to develop human/computer communication techniques that are more efficient than our first efforts will allow.

Interface tracking is hard coded.
Yet, we can begin by presenting our first interfaces that include the aforementioned criteria:

• That each individual end-user will be identified and instantiated by the first question (For example, "What is your name?").
• That each subsequent interface will be directed at each individual end-user.
• That each subsequent interface will be will be organized and presented in series for best comprehension.
• That each subsequent interface will be in the form of a question, regardless of communication technique.
• That each individual end-user will be able to change their questions.
• That the computer system will record these changes.

It will be important for us to develop a method to track these interface components as they are selected, compiled, amended and further developed. Not only will these interfaces provide a means for the human end-users to interact with their databases, these interface components themselves will become the objects of research; they must be labeled in such a way that a computer can compile them.

Therefore, these initial questionnaire components (let's refer to them as Question Cards) will have assigned alphanumeric serial numbers which may, or may not be visible to end-users. (I can think of no reason to hide these serial numbers from end-users, except that their visible presence could distract them from focusing their efforts of efficiently interacting with the system. That could change; but for now, let's hide these serial numbers in invisible metadata, off of the viewing screen.)

#12. Data Mining In Reverse

Data mining is the process of extracting patterns from data accumulated; however, I must point out that we are set to reverse that trend. This study is being setup to develop a computerized information management system that studies the functions of end-users so that end-users do not need to study the function of the computerized information management system. Therefore, the computer system will be actually mining data that has not yet been accumulated, and the information resources mined are those of the end-users.

Once this information has been accumulated, it can then be further processed.

Therefore, if the entire effect of this study is to provide criteria to develop user-centered software for healthcare informatics, then that must remain our sole focus. Absolutely nothing must impede the effort of providing a friendly end-user experience, lest it undermine our primary goal of attracting willing users to help us to determine if Healthcare = 1/Crisis.

#11. Play 20 Questions With Your Interface.

Most who have played the child's game "Twenty Questions" realize that linear organization of questions can efficiently pinpoint answers; by beginning with the broadest possible scope of questions (EG "Are you an animal?") children can isolate objects and their locations in very few questions.

It is possible for computerized interfaces to submit questions to end-users in this fashion. It is possible to submit the correct healthcare practice questions (in an organized fashion) to the correct healthcare individuals, who can then answer them more efficiently than if the users, on their own, were forced to sort through a large list of questions that also contains questions not relevant to their jobs.

Since a format to receive the information has already been established at the database level, we merely continue organizing the questionnaire information—submitted on an interface structure—in the same format, forwarded to the end-users. Like dealing face-up cards to poker players, it is possible to submit appropriate questions to individuals without handing them the entire deck of the whole questionnaire.

For example, since everyone has a name (or an alias) that has instantiated their accounts, "What is your name, or alias?" might likely be the first question on an interface structure received by individual healthcare workers; the submitted name field will be different in every case. However, the second question submitted to individuals might be a job title (doctor, nurse, respiratory therapist, or the like); that job title will be similar to some, different from others. We now begin to find differences and similarities to study for the purpose of mining information about users to extract interface specifications to better serve these individuals when a user-centered informatics system is developed.

#10. Presenting To The Professionals.

When presenting a successful questionnaire (or any information) to another human being, we must communicate successfully, without blaming those who are trying to understand us for any failure of that communication. If an audience of willing participants does not understand our communication, we are ill served if we assume it is caused by the audience's innate inability to receive communication. If we were to assume that all healthcare professionals were too stupid to understand our failed communication attempts, that opinionated assumption would likely be wrong.

Even if an audience's inability to comprehend a presentation was to blame for a failed communication attempt, under no circumstance does the responsibility for receiving that information rely on the recipient—the successful exchange of information is almost always dependent on the person who submits the information; such is the nature of willingness.

For example, if participants are willing, but information is submitted in a foreign language, then chances for successful information transfer are not very great—and that willingness is lost—obfuscated by the necessity for recipients to learn a new language. Therefore, if we are cultivating a system that is based on the willing and peaceful participation that is inherent to healthcare as a profession, then we must not require end users to do anything, or conform in any way.

Moreover, one fact remains about the class of end users that we have assigned the label Healthcare Professionals (or other) that comprises doctors, nurses, respiratory therapists, and the like—they are varied.

In fact, not only do the individuals vary from one another as proven by their names and titles—their job descriptions vary widely; no singular job description entitled "healthcare professional" actually exists. Doctors have completely different job descriptions than do nurses; respiratory therapists have completely different job descriptions than do dentists, and so on. Job descriptions (comprising tasks) vary from field to field.

Furthermore, even individuals themselves differ from one another within their individual practices within their individual fields.

How ludicrous to assume that one questionnaire to hold all pertinent questions would suffice to address every individual who communicates in every language all the time. That one questionnaire to supposedly contain all healthcare practice would be so immense that no one could ever use it.

Therefore, guidelines to conduct a study of end-users within the field of healthcare (for the purpose of creating a user-centered healthcare electronic information system), must effectively submit different questions to different individuals.