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My doctor/'s office was just forced to switch to app-instead-of-website for patient interation. Ironically, the old and this new software came from same megacor
by fifticon 2y ago
My doctor/'s office was just forced to switch to app-instead-of-website for patient interation. Ironically, the old and this new software came from same megacorp I work for (different department, same story).
The old web interface was rather good and rather sensible-practical-sane. It was almost as if someone had asked a doctor what he actually needed for his patients, and then understood his answer and also managed to actually implement and deliver it.
The new smartphone app.. Not so much. It looks more like some MBA types managed to solve "what is the cheapest thing we can get away with, lawfully?"
Internally, I know it is because the original dev team has been gutted, development outsourced to india, and just a skeleton crew from the original team manages the chinese-whispers process with the huge indian team.
As a result, the use case flow (IE the only way you can operate it..) of the app, goes as follows:
1 close the app
2 launch the app and sign in
3 do ONE action
4 enjoy the result of the action
5 repeat from 1..
You might wonder why that is.. Well, that is because your software is not allowed to display any errors - because that might indicate there were bugs..
So instead, whenever an error happens, you just display the '... still loading..' animation... forever.
So, technically, there are no errors, no bugs.. "IT IS JUST TAKING TOO LONG TO RESPOND".
(spoiler: it will NEVER respond, because hidden behind the screen, is a series of unhandled web api errors..)
But again, as an "internal" employee, I have seen our management claim all this is a huge success (client paid/pays).
Back to using it: When I have to interact with my doctor, I write the texts on my PC, and mail them to myself. Then I cut/paste them from gmail into this wonderful app.
- Boogie_Man 2y agoAt what point does this constitute a hostile action against the user and what degree of retaliation is appropriate? Open question for everyone.
- PaulDavisThe1st 2y agowhat retaliation are you imagining and against whom? who is even "the user" here?
- TeMPOraL 2y agoDo a little reverse engineering/analysis on the app, to parallel-construct the claims of 'fifticon (as to not require them to leak internal info or become a whistleblower). If it's as bad as it sounds, go to press. Or just dump an expose on Twitter/X to maximize public awareness. > who is even "the user" here? The doctors and their patients. If it's as bad as it sounds, it actively degrades the ability of doctors to provide care, so it quite literally hurts actual people.
- kQq9oHeAz6wLLS 2y agoPeople should instead just vote with you feet and dollars. That'll be inconvenient, but if it bothers you enough, you'll make the effort. A crucial part of this approach is to let your doctor know exactly why you're leaving. If they're losing business over it, they'll look for alternatives. And if the EHR company loses money, they'll look to make changes, too.
- ryandrake 2y agoYea, I wouldn't put up with a doctor that required me to interact with him through an app. I'd switch doctors, and hopefully find a way to let the old doctor know why I'm switching. That's often the hardest part--actually finding an owner who is harmed when a customer leaves.
- azemetre 2y agoUsually when people say vote with your wallet, it means those with more money make the rules. What recourse does an individual have if they live in a rural area with 1 or 3 doctors that all use the same hostile software? Should they suffer because they don't have money or the ability to go else where?
- michaelmrose 2y agoMost people don't have 3 doctors let alone 3 which all use the same niche/bad customer facing software. Those that do should organize to make their displeasure known. Senior decision makers are probably incompetent boobs rather than compete assholes. If they live somewhere with 1 doc they should vote with their feet by leaving before the town finishes dying around them.
- Henchman21 2y agoI’m gonna punt on the question of where the line is for hostile actions and use some past legal justification of “I know it when I see it” and I see it clearly here. The second part is the more interesting question to me: Appropriate reactions would seem to include: - finding a new doctor/practice/provider. Super hard in practice as they seem to be geographical monopolies a la the cable networks - providing appropriately hostile feedback to your current doctors — but this is likely only to garner empathy as the docs have little say over this - stop using smartphones and claim hardship — not sure how this would pan out. Probably not well? - channeling Luigi and murdering the people responsible for our ongoing dystopia Seriously what other options are there? You can either complain to the ether and it goes nowhere. Or you can take up violence and it still likely goes nowhere and you fuck up your life. This is why so many people are content to let the world burn. It ain’t for us anymore anyway.
- EVa5I7bHFq9mnYK 2y agoIs stupidity instead of hardship a legally valid claim? Are cognitively disabled people, unable to operate a smartphone, a protected class?
- Henchman21 2y agoIf the entire world requires smartphones to take part and you are unable to use a smartphone you deserve some protection, yes. If you see other options I’d be happy to hear them?
- EVa5I7bHFq9mnYK 2y agoMy question is can I sue based on that?
- Henchman21 2y agoIf you’re a protected class I would assume yes. IANAL this is not legal advice and this is not a real situation anyway
- meristohm 2y agoI tend to push back against this nonsense pretty firmly, and would go so far as to request paper documents be sent, as "I don't have a device up to the task" (which sometimes is true, as I use old hardware until I luck into a handmedown or the thing breaks). I get that paper and postage and time are costs. So is user time and stress level.
- AStonesThrow 2y agoIt will be an uphill struggle for you to claim obsolescence. The general public are currently being trained with administrative assistant/clerical skills in order to do this labor for companies unable to support a workforce. Your card transactions are now your responsibility, not a cashier's. Your menu ordering is in your hands from the cloud, not a waitress you can harass. Your vehicle's vital functions, safety mechanisms, and accessories are all on you, in motion or at rest. All your paperwork is cloud-assisted but you're the secretary and they're going paperless so you'd better have a nice printer, too. Your mobile apps are living rent-free in your home/pocket and you've got limited authority over their resource usage, especially if a coin miner or botnet is part of your package deal. Currently I'm struggling with my ISP because apparently the providers in USA are segregating/unbundling Mobile Wireless service and moving toward stricter metering/throttling of data and bandwidth, so it would seem that this Mandatory Smartphone also demands an Unlimited 5G plan to match.
- bryanrasmussen 2y agowhen the functioning of the app means that people with disabilities, including cognitive disabilities, will be denied medical access, and the retaliation is probably a lawsuit appropriate to your jurisdiction, if your jurisdiction does not support accessibility legislation then you're probably out of luck.
- 7thaccount 2y agoAt the doctor's office I'll just ask for paper if there is no real website. Apps freaking suck. I probably won't be able to do this forever though. Example of enshitification #456249
- reaperman 2y agoI often can no longer ask for a menu at restaurants that expect me to scan a QR code. Well…I can ask, but they don’t have any to provide.
- null0ranje 2y agoI just leave restaurants that have gone to the online-only menu. It's usually an indicator that there are other terrible cuts in service and quality going on as well.
- serial_dev 2y agoI leave because I go to a restaurant to enjoy a meal with my family and friends and to connect. Forcing everyone to stare at their phones for the first five minutes is a bad start.
- dwedge 2y agoIt makes it easier for them to regularly increase pricing without printing new menus. I wonder if any restaurants are doing A/B testing with pricing
- mopenstein 2y agoI'm not generally evil, so I never would have thought of doing this. Therefore it must be the correct answer.
- Marsymars 2y agoI’ve thought of this - if there’s no paper menu available, to avoid tracking, I always just search for the restaurant and navigate to the menu from their webpage rather than using a QR code.
- ericjmorey 2y agoI've stopped submitting all electronic forms for medical purposes. I simply don't want to chatbot my health concerns to anyone. So I don't. I also stopped signing anything in the waiting room.
- otterley 2y agoWhat are you going to do when they refuse to provide care because you won’t fill out or sign forms?
- onetokeoverthe 2y agothey took an oath not to refuse.
- otterley 2y agoDoctors take an oath to do no harm. With few exceptions, they are not required to treat patients. If you were correct, you could get cosmetic surgery for free and with no prerequisites, assuming it wouldn’t harm you.
- bluedino 2y agoMy hospital system has a surprisingly decent web app. I can log in and see my appointments, pre-register for office visits, view lab results, medications, request appointments, do virtual visits... The amazing stupid part is when I have to sign in at the actual doctor's office. They have an iPad which does some sort of remote/citrix setup, resulting in a frustrating experience that is full of lag where you interface with what might be their actual EMR system.
- zo1 2y agoOh I think the only reason they did that is because that was the "hip" and "schnazzy" UX flow that everyone signed off and loved because "oh this will be amazing for users". So apps, and even websites, have just become ways to market and push to users. It's not about functionality or enabling the user. Another, maybe smallish, manifestation of this that I've seen is that devs, UX, and everyone involved is so downright hostile to direct "links". Devs because it forces them to think about what stupid react/angular router they want to use, devops has to do URL-rewrites, PMs are worried about the "additional scope", and UX folks' brains absolutely explode that there is no "flow" to the entity (it just pops up, omg). Instead you, as the user, are forced to click through the search UI or to type the right thing, to trigger the flow or whatever, before you get to that entity you want. You can't just create it as a link, and thereby enabling users to have "emergent" behavior of sharing links or emailing them, etc.
- ndriscoll 2y agoThe perpetual spinner thing happened at my last job too, and I developed the opinion that putting a spinner into your site at all is a sign of incompetence. For any normal CRUD app, it should take milliseconds to do whatever task. Even with network delays, 150 milliseconds is a reasonable upper bound for end-to-end processing. If you have an animation at all, then your thing is either ridiculously slow or broken. Either way the animation is a crappy attempt to paper over a bad job.
- bluefirebrand 2y ago> For any normal CRUD app, it should take milliseconds to do whatever task. Even with network delays, 150 milliseconds is a reasonable upper bound for end-to-end processing This is only really true with stable, high speed internet connections. We still cannot take for granted that everyone has that, especially not in rural areas and double especially not on mobile devices
- akdor1154 2y agoAnd when your users are in the same continent as your backend.
- maximilianthe1 2y agoAlso, inside buildings in very urban areas
- rapind 2y agoAlso in my house in the first world because our telcos are an order of magnitude worse than third world telcos.
- n_plus_1_acc 2y agoHello fellow german
- nayuki 2y ago> my house in the first world because our telcos are an order of magnitude worse than third world telcos Hello fellow Canadian
- Tanjreeve 2y agoIt's kind of annoying the article burns up all the space talking about various discounts and benefits you get from Apps. Aka far less of a problem as they're optional quid pro quo and doesn't talk about the creeping enshittification of those functionalities. Im fine with a council making an option to do important things through an app. But I'm not fine with it being compulsory and I'm even less fine with it being some non functioning trash made in a software sweatshop that doesn't provide a contact number when it goes wrong and noones ever on the hook if it's dysfunctional. It rarely if ever actually improves functionality or makes important things self service. It more often reduces what I can actually do but with a flashier interface for "computer says no".
- _Algernon_ 2y agoCompanies need to be held accountable for their negligent behaviour
- Henchman21 2y agoHow? What do you propose?
- deleted 2y ago[deleted]
- _Algernon_ 2y agoHolding C-level executives criminally liable for the actions of the company would be a start.
- fsckboy 2y agoeye-for-an-eye, any time a company's app is showing a customer a spinner, the c-suite's phones should also be showing spinners
- joquarky 2y agoSubstantial dilution of shares rather than monetary penalties.
- kraussvonespy 2y agoFeels like this well written piece by Atol Gawande is relevant if you haven't seen it. I showed it a couple of years ago to my very competent and conscientious doc and she got PISSED. She talked about how she spent literally half of her doctoring time working through poorly designed menus in {epic, cerner} to carefully document everything she could about the patient, only to discover that most doctors don't pay attention to any of that info. https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers https://www.newyorker.com/magazine/2018/11/12/why-doctors-ha...
- amarant 2y agoI was really expecting your personal usage of the app to involve invoking developer privileges, and inserting your text through the much more user friendly UX of DBeaver.. I can't decide if I'm disappointed or relieved
- arp242 2y agoThe annoying part is that website can just be used as an app. For a booking app we don't need native performance; just a webpage-inside-an-app is fine. In most cases, it should be fairly straight-forward and cheap to make this work. What happens is they hire some contracting firm and they go "whole thing will have to be redone" so they get more work, and that's how you end up with a "solution" like this. Basically the software equivalent of: https://www.youtube.com/watch?v=Gq6WME576ZE https://www.youtube.com/watch?v=Gq6WME576ZE
- koolba 2y agoWhat’s even more asinine is the website can be updated without publishing to an app store. You always have the latest version and all these apps are just a thin veneer on some CRUD endpoints anyway.
- yurishimo 2y agoThis is the entire philosophy behind all of the apps run by DHH/Basecamp. The web should be the default and native apps should only be used for software that just isn’t possible through the web (yet).
- brookst 2y agoThe problem is that users much prefer native apps. The idiomatic UI, the use of OS specific capabilities (even if the same result could be done without), the appearance of better performance because the app launches before a network connection is made. We can opine all we want about how things should work, but the ground truth is a good native app has higher user satisfaction, more engagement, whatever metric you want other than development cost/non-customer concerns. It’s very hard to tell users they should feel differently than they do, no matter the technical or philosophical high ground.
- tonyhart7 2y agopeople here is web biased, people forgot that mobile world exist and I can tell you navigating web in mobile vs native mobile app is like heavenly different if people commenting from web dekstop perspective I can see that point, but from mobile?? where hardware processing power and network is sometimes unreliable??? huft
- m463 2y agoI had kaiser permanente and had google/doubleclick tracking through the entire website, including investigating conditions, doctor communication, and test results. I complained, they played dumb, but eventually they came up with "the website is a convenience". I stopped using it. The app was much worse. A couple years later, other people must have complained https://www.classaction.org/news/kaiser-permanente-shares-website-visitors-info-with-third-parties-class-action-says https://www.classaction.org/news/kaiser-permanente-shares-we... https://www.classaction.org/news/data-breach-lawsuit-says-kaiser-permanente-disclosed-info-of-13.4-million-patients-to-microsoft-google-twitter https://www.classaction.org/news/data-breach-lawsuit-says-ka... I believe the same thing happens with apps and websites provided by other health care providers, but nobody investigates and nobody cares.
- stodor89 2y ago> So instead, whenever an error happens, you just display the '... still loading..' animation... forever. Gotta love how everyone copies the nasty things Apple does (hi beach ball of death), but not the good things Apple does.