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An Island Never Cries – and Never Designs

Today I have several stories, all with the same moral.

A story of teenage angst

“I am a rock
I am an island
I’ve built walls
A fortress deep and mighty
That none may penetrate”
- Simon and Garfunkel, “I am a Rock”

As a high school student I loved this song. I felt isolated and vulnerable, as many high school students likely do, and in Simon and Garfunkel’s music I heard a promise that someday I would be invincible, alone. Of course, as an adult – particularly one working in strategic design – I am hyperaware of the connections humans make and require to survive. We are not isolated creatures; we require community to bring out the best in us.

A story of allergens

A few years ago, I wrote a series of articles for an organization promoting healthy, chemical-free living. One article involved an interview with Jay Harper, of Red Apple Lipstick. They discussed what goes into most makeup, why it irritates so many peoples’ skin, and many other topics I found fascinating, but one statement in particular stuck with me. Jay explained that no chemical works in isolation, and so certain “natural” things that keep a flower (for example) healthy, might still be unhealthy – or even toxic – for a human when taken away from the rest of the flower. Just because something is all natural does not mean works like it does in nature.

A story of healthcare

I recently finished reading The Digital Doctor, by Robert Wachter. The book’s purpose is to explore how technology has changed how our healthcare system, including the benefits as well as unintentional consequences that we (mostly UX practitioners) will need to solve for in the future. As can be expected, a significant portion of the book speaks to EHRs, which play a large role in today’s healthcare digital ecosystem – and for many hospitals, that means Epic.

In Chapter 8 of Epic, “Unanticipated Consequences,” Robert goes into detail about how more than one hospital, after implementing Epic, found that their providers were less capable of handling a code or other “non-normal” situation.” The reason, it turned out, is that Epic made it so much easier to pass information from a nurse practitioner to a primary care doctor to a specialist, that the nurses and doctors weren’t spending as much time together. By not spending as much time together, they missed out on opportunities to learn to communicate as a team, which made responding to a code or other emergency situations much more complex.

The moral: nothing in isolation

Henry Ford is often quoted as saying “If I had asked people what they wanted, they would have said¬†faster horses.” And of course, if someone had developed a “faster horse,” customers would have been disappointed. They would have gotten windburn from the speed, horse manure splattering up to their clothes, and a variety of other unintended consequences.

When we design a solution, we need to not only identify the gaps, but also recognize the things that people like about the current solution (or workaround). We need to understand which parts of the whole work or move together. Nothing exists in isolation, and definitely not our designs.

Marli Mesibov

Marli is a content strategist with a passion for the user experience. Her work spans websites, web applications, and mobile. Marli is the director of content strategy at the UX agency Mad*Pow, and she serves as managing editor at UX Booth, a publication about all areas of user experience. Marli is a frequent conference speaker, and has spoken at conferences including Content Strategy Forum and LavaCon. She can also be found on Twitter, where she shares thoughts on content strategy, literature, and Muppets.

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