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An Affordance is an action possibility available in the environment to an individual, independent of the individual’s ability to perceive this possibility.

-McGrenere and Ho, 2000

Affordance as a concept was imported into the world of design and human computer interaction by Norman (1988). He imported it from the work of Gibson on visual perception. Yet, Norman’s views differ from Gibson’s. For a discussion of these differences and a better understanding of affordance you can review this summary at Interaction design.org.

I will adopt Gibson’s view as it is the most agreed on. (McGrener and Ho 2000). Affordances are properties that can be used by an actor as a human whether these properties are perceived and realized or not. Norman discounts affordances that are not perceived by actors. While Gibson account for all properties that can be acted on whether perceived or not. A designer may design a useful device that a given user can only use some of its features. For example, paper has the affordance of being written on and being carried. Paper has also the affordance of being turned into a paper airplane whether you realize this affordance or not.

In this post, I am proposing that one of the main reasons for poor computerization of manual processes in health care is the poor understanding of computer affordances. There are valid reasons for this suboptimal computerization that I will mention at the end.

I will take you through a scenario. Imagine the presence of a paper form that represents a single encounter with an asthmatic patient. Being a physician, you need to fill out the form and then sign it off. It is expected that you don’t make changes to the form after you sign and date it. This form was computerized. When this form was computerized, computer affordances were ignored. The Designer required physicians to sign off the electronic form to prevent any modifications afterwards. More, the designer did not allow physicians to update signed forms, claiming the need to know who made which updates and assuming that this cannot be offered by computers.

If the designer of this computerized form realized the full potential of computers s/he would have realized that computer forms afford features like the ability to store different versions. More, computers afford the ability to know each update and who made these updates. What Google is trying to do with transforming e-mail through its upcoming product Google Wave is an example of deep understanding of what computers afford.

Now for the excuses for not embracing the full range of computer hardware and software affordances: Technology changes fast. Technology is also complex and expensive. When technology changes affordances change. The adoption of these new affordances will require the understanding of complex technology and expenditure of money. For example, e-ink was introduced in 2002 and only now has it been spreading when Amazon released its e-book, the kindle. This computer technology affords better readability and better mobility due to its long battery life and low weight. Adapting such technology will require the embracing of advances in networking and software development. However, it seems that in health care we are always lagging behind. In healthcare, it is time to be more agile.

In a coming post will discuss some of the ignored paper affordances.

McGrenere, Joanna and Ho, Wayne (2000): Affordances: Clarifying and Evolving a Concept. In: Proceedings of Graphics Interface 2000 May 15-17, 2000, Montreal, Quebec, Canada. pp. 179-186.
Norman, Donald A. (1988): The Design of Everyday Things. New York, Doubleday