16 Aug Latent Messaging: Between Intention and Interpretation

One of my favorite insights from design research was about how objects convey a range of latent messages. I was struck by how seemingly good intensions are open to unexpected and negative interpretation.

During a recent project in designing a stool collection kit, we wanted to
know more about providing information on the use of the kit. We offered
reminder notices over email, a telephone hotline, and websites for more
information. We thought we were being helpful. Our focus group said

“Extra information makes me feel like the test is more complicated than it is.”

In a similar instance, when we were discussing how useful a pair of gloves and a mask were in the kits, participants said this:

“Providing gloves and masks makes me wonder why I need it since I don’t use them during my regular bowel movements.”

Again, we thought we were being helpful. We thought we were being sensitive to the hygienic needs. However, we inadvertently conveyed a sense of confusion.

Ultimately, we wanted to communicate a sense of simplicity and trust. For this part of the project, we forgo the mask, but included the gloves. Some patients found it useful. Some people didn’t but appreciated the consideration. I don’t think we can anticipate every possible latent message, but we can at least move closer to creating the perfect blend of patient-friendliness.

  • B Oryshkevich MD MPH
    Posted at 21:48h, 16 August

    I do not think that you can separate the little thing from the big thing when it comes to conveying messages. I mean if one is in a professional environment, the whole environment projects professionalism, care, attention to detail, and most importantly attention to the patient.

    Esprit de corps creates professionalism and styles of behavior and concern which makes the patient feel at ease in a difficult situation.

    I also think that one should not use the white coat or the gloves to make the patient feel that the situation is more complicated than it is. Some informality is important especially in take home instructions. Common sense is too. Obviously, infection control and hygiene are critical.

    But I remember diagnosing a tuberculosis infected HIV infected physician. The physician was clearly in denial. He was seeing patients while coughing and losing weight.

    He coughed up a sixteen ounce cup of sputum during his visit with me. I was afraid that I would convert my PPD since we did not do the protocol of isolation and UV light immediately. But, on the other hand, I decided to do everything in the clinic before he went to the ward. We got a microscopic sputum diagnosis of AFB before he left his cubicle. That simplified his work up on the floor and he was immediately sent to where he needed to be. Working in an inner city hospital, I was told when entering the patient’s room by the supervisory physician that he did not believe in the physician’s weight loss and symptoms.

    The important thing is to listen to the patient and address the medical issue at hand. Messages are important but only part of the picture. Even mistakes can lead to positive results if one addresses the patient respectfully. I remember a thirty something patient coming in for a flu shot in a year that there was a scarcity and the indications were for people over sixty five and with extraordinary conditions. This patient looked healthy and I immediately told him that he looked too healthy to get a flu shot. He took off his hat and he had an IV line in place for chemotherapy for a brain tumor. So, I congratulated him on well he looked under the circumstances and that he had fooled me; the patient was pleased even though I had clearly spoken too quickly.

    Perhaps, the point that brings these two cases to mind is that the intention of the doctor conveys the message as well as the natural symbolism. The unexpected can happen at any moment. One should first worry about what needs to be done and do to right by the patient rather than simply worry about the impression.

    Bohdan A Oryshkevich, MD, MPH

  • cleveland orthodonti
    Posted at 07:39h, 17 August

    different people, different interpretation..and sometimes our good intentions are mis interpreted, but i think it’s better than not showing some effort to provide a better service

  • Health Magazine
    Posted at 08:40h, 18 August

    Interesting point on conveying simple messages. Evidently, more information creates confusion and may make people to commit mistakes.

    It was indeed a good thing by simplifying the process, the message has reached clearly to the participants in stool kit trials.

  • Innovation in Healthcare » CONSTANT BETA
    Posted at 16:06h, 19 August

    […] but also simplifies the complex world of patient care. Here is an example of a post on the design of a stool-collection kit. A very unsexy topic but the learnings shared from Mayo Clinic’s focus groups are […]

  • erdahlp
    Posted at 10:17h, 20 August

    Excellent post! Being cognizant of latent messages, coupled with the ability to discern the difference between a given message and the intent of that message may indeed be the key to success in life.

    I’ve spent the brunt of the past 30 years of my professional life designing, building, and supporting software systems. I can’t count the number of times I’ve heard “I know I told you …, however, what I meant was …!”. Over the years I’ve learned to mitigate this risk (though not completely solve it) by adding additional emphasis on “requirements validation” as a necessary step for any project I’m involved with. After all, you are rarely going to end up in Minneapolis if you think you’re supposed to be going to Denver.

  • bleach vostfr
    Posted at 20:30h, 26 September

    Great information with a very interesting point of view..I really liked the way how your deliver yourself…..more power to your. hope to see a lot more very interesting blog post here.

  • Caroline Webster
    Posted at 16:31h, 16 October

    A good way to differentiate the two. Just stumbled on this article today and it’s really helpful and informative. I’ll share this with my colleagues

  • Cars Dublin
    Posted at 06:53h, 08 December

    Interesting comment about a simple hygiene safety could be conveined by some as confusing, sometimes more information intended to help can make things less clear!

  • HCG Wholesale
    Posted at 19:01h, 15 December

    It’s important to remember, you can’t please everyone all of the time. There will always be someone complaining, someone finding flaws in the system. What I have found, you can never over-document or instruct.

  • HCG Diet Homeopathic
    Posted at 19:05h, 15 December

    Remebering the 4 learning styles when giving instructions – is important, and not just in the classroom. Most patients follow those learning styles in all areas of life.

  • Software Downlaods
    Posted at 02:04h, 21 December

    Hi carolinelu!

    Its all depends upon ourselves. we don’t have to bother about others, some may like it some may not, but making blend with patients really important.

  • accident claims
    Posted at 11:03h, 26 December

    The unexpected can happen at any moment. One should first worry about what needs to be done and do to right by the patient rather than simply worry about the impression.

  • Mela
    Posted at 08:02h, 29 December

    Great post,,, that I like from this topic because the discussion is straightforward and detailed. Hope I still want to return to this page when there are new updates.

    Thank you for your advice

  • Ljiljana
    Posted at 09:36h, 24 January

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  • zombieville usa
    Posted at 15:54h, 09 August

    I agree with your Latent Messaging: Between Intention and Interpretation | Mayo Clinic Center for Innovation, superb post.

  • RobertP
    Posted at 20:01h, 30 January

    I am often amazed at what one person interprets from a communication, especially when considering what the other person intended!