Encountering information: serendipity or overload?

After my keynote at ISIC, one of the participants challenged me on my claim that information overload is a "bad thing" (not that I put it quite like that, but I certainly suggested it was something to be avoided). I framed it as a challenge when trying to design to support serendipity. We had an extended discussion about this later that day.

What Eva made me realise (thanks, Eva!) is that encountering exactly the same information can be regarded positively or negatively depending on the circumstances and the attitude of mind. If the attitude is one of exploring and of opportunity then the experience is typically positive. Eva consumes information enthusiastically on a wide variety of topics, and rarely if ever feels overloaded by the sheer volume of information available.

Whether or not information encountering is regarded as serendipitous is another question. A while ago, I gave a PechaKucha talk on the SerenA project; in the talk, I gave an example that I argue was serendipity: I encountered information that was unexpected, where I made a connection between my ambitions and an opportunity that was presenting itself, and from which the outcome was valuable. I also described the "sandpit" process that initiated SerenA – i.e., putting a bunch of academics together in a space that was conducive to ideas generation. Arguably, this experience was positive and creative, but not serendipitous, because it was designed to lead to positive outcomes. So although we could not have predicted the form of the outcome, we expected there to be an unanticipated outcome. So it wasn't serendipitous. Based on our empirical studies of serendipitous experiences, we have developed a process model of serendipity, namely that "a new connection is made that involves a mix of unexpectedness and insight and has the potential to lead to a valuable outcome. Projections are made on the potential value of the outcome and actions are taken to exploit the connection, leading to an (unanticipated) valuable outcome." From this, we also developed a classification framework
based on different mixes of unexpectedness, insight and value that define a “serendipity space” encompassing different “strengths” of serendipity.

So where does information overload fit? Well, as a busy academic, typical of many busy people, new information (however valuable) often represents new obligations:

•  to assimilate the information,
•  to assess its value, and
•  to act on it. 

I recognise the potential value of opportunities, and feel frustrated by my lack of capacity to exploit them all. And because of limited capacity, every opportunity taken means other opportunities that have to be passed over. In addition, limited memory means that even assimilating all the information I "should" know represents a substantial obligation that I can't hope to fulfill. So I feel under constant threat of information overload. And that seriously inhibits my openness to serendipitous encounters.

As recounted in the PechaKucha talk: twenty-something years ago, when my children were 2 years and 3 months old respectively, I came across an advert for a PhD studentship. It was my "dream" studentship, on an exciting topic and in the perfect location for me. Doing a PhD was not in my plans at the time, but was too good an opportunity to miss. And the outcome has been fantastic. It was unquestionably a serendipitous encounter. Apart from the unintended consequence that I now feel constantly under threat of total information overload!

The Hillsborough report 23 years on

I'm listening right now to the news report on the review of the Hillsborough disaster from 23 years. ago. I have heard terms including "betrayed", "dreadful mistakes were made", "lies" and "shift blame" (all BBC News at Ten). There is talk of "cover up", and people not admitting to mistakes made.

Families of the victims seem to be saying that they were never looking for compensation but that they wanted to be heard, and they want to know the truth. Being heard seems to be so important; if we do not hear then we do not learn; if we do not learn then we cannot change practices for the better. Maybe for some compensation is important, but for many others all that matters is that the tragedy should not have been in vain.

Earlier today, in a different context, a colleague was arguing that we need people to be "accountable" for their actions and decisions, that people need to be punished for mistakes. But we all make mistakes, repeatedly and often amusingly; for example, this evening, I phoned one daughter thinking I was phoning the other one, and because I was so sure I knew who I was talking to, and because we have a lot of "common ground", it took us both a while to realise my error. We could both laugh about it. Errordiary documents lots of equally amusing mistakes. But occasionally, mistakes have unfortunate consequences. Hillsborough is a stark reminder of this. Does unfortunate consequences automatically mean that the people who made mistakes should be punished for them? Surely covering up mistakes is even more serious than making errors in the first place. How much could we have learned (and how much easier would it have been for families to have recovered) if those responsible had not covered up and avoided being accountable? Here, I want to use the term "accountable" in a much more positive sense, meaning that they were able to account for the decisions that they made, based on the information and goals that they had at the time.

Being accountable currently seems to be about assigning blame; maybe this is sometimes appropriate – particularly if the individual or organisation in question has not learned from previous analogous incidents. But maybe sometimes learning from mistakes is of more long term value than punishing people for them. That implies a different understanding of "accountable". We need to find a better balance between blame and learning. Unless I am much mistaken.

Patients' perceptions of infusion devices

Having recently had two friends-and-relations in hospitals on infusion pumps (and one on a syringe driver too), I have become even more aware of the need to take patients' experiences into account when thinking about the design of devices. To the best of my knowledge, there have been no situated studies of patients' perceptions of infusion devices. I should emphasise that this is not a formal study: just an account of two articulate people's experiences of having glucose, saline and insulin administered via infusion devices.

Alf (not his real name) felt imprisoned in his bed by the fact that the devices were plugged in to the wall. He hated being confined to bed, and would have been perfectly capable of making it to the bathroom if he hadn't felt attached to the wall. He didn't like to ask the staff whether the devices could run on battery for a while so that he could move around.

This contrasts with stories that others have told us: of patients being seen out with their infusion devices having a smoke outside the hospital, chatting up a fellow patient in the sunshine, and even going to Tesco's to do some shopping with drip stand in tow. I suspect this reflects people's amount of experience of receiving medication via infusion devices.

It also contrasts with some of our observations in situated studies, where we have found that devices are run on battery for extended periods of time because there are too few sockets available, or simply to allow the patient to move around more freely.

Manufacturers generally take the view that devices should remain on mains power except for very short periods, which is a position somewhere between Alf's sense of imprisonment and some other observations. As pumps get smaller and more portable, it should be possible for patients to feel less imprisoned by their devices, but this creates new challenges of improving battery life, adapting the physical form of stands to make them easier to move around with, and making sure that batteries get re-charged reliably (which depends on there being sufficient power sockets as well as good notifications of when charge is getting low).

Bert has a cannula in the crook of his elbow, and almost every time he moves his arm it sets off the occlusion alarm. He has learned to silence it, but it only stays silent for a short period and then alarms again (he hasn't worked out how to restart the pump). In a previous informal observation, we noted the same problem; because patients are not meant to touch their own device controls, nurses are understandably reluctant to tell patients how to restart them; in the previous observation, we found that knowledge of how to restart the pump was passed around the ward by the patients who had been in there for a while to the more recent arrivals. Some pumps will automatically detect that the occlusion has been cleared and restart themselves.

However, Bert hates having this happen while he's eating, and would really like to be able to suspend the infusion while he eats, then restart it again afterwards. In our observations, we have noted pump operation being suspended while the patient has a shower: nursing staff are able to achieve this effect, but the patient himself is not. Bert feels capable of taking responsibility for more of his own care than he is being permitted to, and finds that frustrating.

The one-size-fits-all approach to infusion device design, which removes both power and responsibility from the patient (who often has the time and the intelligence to take a more active role in their own care) may improve safety by reducing variability. However,  it may also reduce resilience and it definitely degrades the quality of the patient experience by concentrating it all on busy, multi-tasking clinical staff.

Situated interaction from the system perspective: oops!

I am in Tokyo, to give a talk at Information Seeking In Context. Blogger infers that because a post is being composed in Tokyo, the author must understand Kanji. Result:

I have just experimented by pressing random buttons to enlarge the screen shot above from its default illegible size. It is quite gratifying to discover that it is still possible to compose a post, add a link, add a graphic, and maybe even publish it as intended. But believe me: it's taking a lot of effort. I am interacting with what appear to me to be squiggles (though of course those squiggles have meaning for readers of Kanji), and I can only guess the meaning from the graphical layout and positioning of the squiggles.

This is an amusing illustration of the dangers of computing technology being inappropriately "situated". The system has responded to the "place" aspect of the context while not adequately accounting for the "user" aspect. I fully accept that the physical environment presents information to me in Kanji, and that I sometimes fail to interpret it correctly. I don't expect the digital environment to put the same hurdles in my way!

Inarticulate? The challenges of health information seeking

Showing impeccable timing, three people I care about have fallen ill at the same time. To make sense of what it happening to each of them, I have been doing a lot of internet searching. And it has become really clear that – as a lay person – some health information needs are much easier to satisfy than others. Paradoxically, it's the more technical ones that are easier to work with. Or more precisely: the ones for which a key technical term is provided (e.g. by a clinician).

In one case, we were told that Bert (not his real name) needed an angioplasty. I had no idea what one of those was, but a quick search on the query term "angioplasty" gave several search results that were consistent with each other, comprehensible and credible. Following up on that and related terms has meant that I now (rightly or wrongly) feel that I understand fairly well what Bert has gone through and what implications it has for the future.

In a second case, Alf (also not real name) told me that the excruciating pain he had been experiencing had been diagnosed as gallstones, and in particular a stone that had lodged in the bile duct. The treatment was a procedure (not an operation) that involved putting a tube through his nose and down into his gall bladder and removing the stone. Any search that I tried with terms such as "gallstones", "removal", "nose" led to sites about "cholecystectomy" (i.e. either laparoscopic [keyhole] or open surgery). We both knew that Alf had not had an operation. It took hours of searching with different terms to find any information that even approximately matched what Alf and I knew. Eventually, I tried terms involving "camera" and "gallstones", which led to "endoscopy". As I type, I believe that Alf had a "endoscopic retrograde cholangiopancreatography". I can't even pronounce those terms, never mind spell them. But if you know the terms then there are pretty good descriptions of what they involve that really helps the lay person to make sense of the treatment.

In the third case, Clarissa (not real name) was incredibly tired. Her doctor had dismissed it as "a virus". I've seen a virus being defined as "a condition that the doctor can't diagnose in detail but isn't worried about". But this "virus" had been around for weeks. What is happening? Well most internet searches that involve the word "fatigue" and any other symptom seem to lead to results about "cancer". That's not what you want to find. And it's not what I believe. I'm still trying to make sense of what might be affecting Clarissa. I don't have a good search term, and I can't find one.

Health is an area that affects us all. We all want to make sense of conditions that affect us and our loved ones. But there is a huge terminological gulf between lay language for describing health experiences and the technical language of professionals. If you know the technical "keys" then it's easy to find lay explanations, but the opposite is not yet true: if you only have a lay way of talking about health experiences then there's no easy way to tap in to a sophisticated health information understanding. This isn't an easy challenge; I wonder whether anyone can rise to it.

"He's got dimples!": making sense of visualisations

Laura's baby is due in 2 months, so time to get a 3D scan... and the first thing that Laura told me after the scan was that "he's got dimples!" I'm sure that if there had been any problem detected, that would have been mentioned first, but no: the most important information is that he has dimples, just like her. But for the radiographer doing the scan, it's likely that dimples came way down the list of features to look out for (after formation of the spine, whether the cord is around his neck, how large his head is...). Conversely, when her uncle looked at pictures from the scan, his main comment was about the way it looked as if there was a light shining on the baby. And I wanted to know what the strange shape between chin and elbow was (I still don't know...).

People look at scenes and scans in different ways, and notice different features of them. They "make sense" of the visual information in different ways. Some are concerned with syntactic features such as aspects of the image quality. Some are more concerned with the semantics: what it means (in this case, for the health of the child, or what he will look like). Yet others may be more concerned with the pragmatics: how information from the scene can inform action – this might have been the case if the scan were being used by a surgeon to guide them during a live operation.

Scanning technology has come on in leaps and bounds over recent decades: the ultrasound scan I had before Laura was born was difficult to even recognise as a baby as a still image: a naive viewer could only make sense of the whole by seeing how the parts moved together. Advances in technology have meant that what used to be difficult interpretation tasks for the human have been made much easier. And they have made more information potentially available (I didn't even know whether Laura was a boy or a girl until she was born, never mind whether or not she had dimples).

New technologies create many new possibilities – for monitoring, diagnosis, treatment, and even for joy. In this case, they've made the user's interpretation task much easier and made more information available. The scan is for well defined purposes, and the value of the visualisation is that it takes a large volume of data and presents it in a form that really makes sense. There is lots of information about the baby that the 3D scan does not provide, but for its intended purpose it is delightful.

The right tool for the job? Qualitative methods in HCI

It's sad to admit it, but my holiday reading has included Carla Willig's (2008) text on qualitative research methods in psychology and Jonathan Smith's (2007) edited collection on the same topic. I particularly enjoyed the chapters by Smith on Interpretive Phenomenological Analysis and by Kathy Charmaz on Grounded Theory in the edited collection. One striking feature of both books is that they have a narrative structure of "here's a method; here are its foundations; this is what it's good for; this is how to apply it". In other words, both seem to take the view that one becomes an expert in using a particular method, then builds a career by defining problems that are amenable to that method.

One of the features of Human–Computer Interaction (HCI) as a discipline is that it is not (with a few notable exceptions) fixated on what methods to apply. It is much more concerned with choosing the right tools for the job at hand, namely some aspect of the design or evaluation of interactive systems that enhance the user experience, productivity, safety or similar. So does it matter whether the method applied is "clean" Grounded Theory (in any of its variants) or "clean" IPA? I would argue not. The problem, though, is that we need better ways of planning qualitative studies in HCI, and then of describing how data was really gathered and what analysis was performed, so that we can better assess the quality, validity and scope of the reported findings.

There's a trade-off to be made between doing studies that can be done well because the method is clear and well-understood and doing studies that are important (e.g. making systems safer) but for which the method is unavoidably messy and improvisational. An important challenge for HCI (which has always adopted and adapted methods from other disciplines that have stronger methodological foundations) is to develop a better set of methods that address the important research challenges of interaction design. These aren't limited to qualitative research methods, but that is certainly one area where it's important to have a better repertoire of techniques that can be applied intelligently and accountably to address exciting problems.