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Healthcare.gov and Computer Programming

Ruth Haag • Nov 19, 2013 at 3:00 PM

I am to the point on the Healthcare.gov website where the program produces a screen which says “What you would like to do today, Ruth?”  However, like so many others, I have not been successful at signing up for health insurance.  My sister recently told me that the orchestrators of this website claim that they are bringing in the “A team.”  Interesting that they didn’t start with the “A team.”  Some computer programs are so well written that we can use them with ease.  Google, Amazon, and Yahoo come to mind.  Others seem to be written with little understanding of the end-user.

Gathering data in spite of the patient

My husband Bob has been visiting many doctors over the past year and at each visit his blood pressure is taken.  I noticed at our family doctor’s that his blood pressure was much the same as the reading that I got at home, but at the specialist’s office his blood pressure was always high.  I began to look for differences in the office visits and have decided it is the computer.  When we arrive at the specialist’s office, the person at the check-in window begins staring at a computer screen and then asks if Bob’s address and telephone number are the same as last time.  When we arrived at our family doctor’s office the person at the window would smile and say “Hi, Bob.”  At the specialist’s office we would go into the examining room and the nurse would ask many questions, all the while typing into the computer, often stopping in frustration over a window that opened or closed at a time that she didn’t want it to.  After this computer interaction, she would take Bob’s blood pressure, and it would be high.  At the family doctor’s office the nurse in the examining room would talk to us about what we had been doing recently, and then she would take Bob’s blood pressure.  It would be lower.

Some computer programs are written with a focus on getting data input correctly, which I suspect is the explanation of the program being used at the specialist’s office.  With the focus on gathering the data, the actual reason to have the data is lost.  Instead of talking with the patient to determine how they are doing, a clipped list of questions is asked in the order that the program wants them to be asked.  If the patient tries to give data in another order they are asked to wait until the computer-generated questions have been answered.  It seems like the computer has taken the center stage and the patient and doctor are just bystanders.  Now the doctor can show me a the screen and confirm that Bob’s blood pressure has been high every time the computer has been involved, but that really doesn’t have anything to do with Bob’s condition or treatment.

On a similar note, our daughter commented on Election Day, that our “secret ballot” really doesn’t seem so secret when the lady supervising the scanning of the ballot into the box watches it intently while it is being input.  Her goal, I am sure, is to have the ballot scan correctly, but in the end she is able to read each person’s ballot after just having confirmed each person’s name.  Not so secret, anymore.

Good computer programs

There are some great computer programs in use.  Most self-checkout systems at stores work well, although they do require a full-time staff member to be present to solve any problems that come up.  Our library has added a self-checkout option and, after a few glitches when it started, it has come along nicely and works well.  These uses of computer programs help to reduce the number of staff needed while providing the service to the customer that is the end-goal.

Bad computer programs

On the other hand, I have yet to find a library card catalog program that is as good as the old card system was.  It used to be that if you wanted to find something in non-fiction, you could go to the card catalog and look up the topic and find the general number for the books that you wanted to browse through.  Now, if the computer terminal that you find is free and working, you can type in your topic but you are forced to choose a specific book, going through several screens before you can find the general number for the section of books that you would like to browse through.  Clearly the programmers never used the old system, and never have enjoyed browsing library shelves.

I guess I will wait for the “A team” to fix Healthcare.gov. and then give it a go again.

Do you have any funny stories about your computer interactions?

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