My COVID19 Test–an impressive experience–until we get to the results - Web Directions

[I’m mindful at a time where so many around the world are making their voices heard about the treatment of people of colour and indigenous people everywhere this post may seem a little self indulgent. Hopefully there’s some timeliness and value in recounting my experience this week of how the results of my daughter’s and my COVID19 test results were conveyed]

Tuesday morning two of my daughters and I woke up with the symptoms of a very mild cold.

And since in Australia we’re recommending aggressively testing for COVID19 with even the mildest symptoms of any respiratory disease, and given it is free, and at least where we live very easy to get tested, we went straightway to do so.

We drove to a testing location about 15 minutes away, no appointment necessary, and were tested without getting out of our car, in total maybe 20 minutes.

All that was smooth and professional, and even though my daughters who are realtively young were a bit anxious about it, it all went fine.

All in all a very impressive effort. Well done NSW Health.

How do I get my results?

But of course the most important thing is getting the results. That bit didn’t go so well (the results were fine, as we’ll see, its the process of sending them that was the issue.)

We gave the testers an email address and phone number along with other identifying details. We were told to socially isolate ourselves, and that we’d be messaged by text in 48-72 hours, and if we’d not heard by then to call a hotline.

A couple of hours later I got an email from NSW Health.

This was for one of the three of us and I never received an email for the other two–perhaps the system only allows a single patient per email address (since the email address is your username).

Anyway, let’s create our new password

Now, don’t start me on the security question bit. That’s for another day.

The page refreshes when you succeed providing this confusing experience. In essence the identical page, with a success message.

Let’s click our link to login now (honestly why am I not logged in already? Why the need for this step?) We’re taken to a new page.

Now because when I created my password there was no field for the username, Safari’s passwords feature treated the date of birth as the username. If I choose this option (which I want to as I created a password the browser chose and stored, as I do for every new password I create where it’s possible to do so) it pre-populates and immediately auto-submits the form using the date of birth, not my email address as the username.

So we get

Because my email is actually the username, despite my only being told that in the email 37 steps ago.

Oh, and one last thing, here’s what the login form looks like on my phone

I give up, let’s give SMS a go

Honestly, at this point I gave up (I’ve since been able to, with considerable effort, actually log in). Fortunately, there was another option. So I texted “my result” to the number provided, as instructed in the original email.

Here’s what that process looks like (my answers elided)

Let me just say out of the 3 people I ended up creating a response for, I misentered at least one date of birth and one collection date. When you make a mistake you simply have to complete the process, and then when asked to confirm whether the details are correct, say No.

There’s no acknowledgement that I’ve said I made a mistake. I can’t imagine it would be a tonne of work to respond to the ‘no’ (there was a considerable lag in responding to the first hence the second ‘no’) with a canned “Not to worry, let’s start over” or similar.

Anyway, started all over, went through the process from the top, seemed to all go smoothly.

So, we’re registered then?

Not so fast

These messages all came back to back, no interaction on my part. Is my daughter I registered? Is she not? And what is this unique passcode–why do I have it, what would I need it for?

Keep in mind we are waiting for the result of a test which could have significant repercussions–from self-isolating for 2 weeks, to, depending on my age and medical history (I’m 53, and pretty fit and well, but still) a potentially life-threatening illness. Potentially causes of not inconsiderable anxiety.

Cognitive overhead at times of considerable stress is something we really want to avoid giving our users.

But we are good to go now yeah? You already know the answer right? We’d better try again to be sure.

Why must my surname be 8 characters? (it doesn’t, something was clearly awry, since I got this message when entering a date a bit later as well, which does need to be 8 characters (even though I had got the date right).

But there are other significant anomalies. When I finally managed to create my account, because my result was by that time now available, I wasn’t asked for my passcode (or even given one), but was simply given the result right away. Here’s the whole of that interaction (my details elided)

However, for one of my daughters, whose results were also already available at the time I created her account, I did need to enter a code that had just been created to get the results.

And the results were

All in all, 33 steps to get this welcome, but still not particularly clear, message

First it begins with the qualifying “at this time”. Which I understand. I may have returned a positive if I had tested earlier. Or I may in future test positive.

But it makes for a very complex sentence. At a time of potentially genuine anxiety, for a potentially significant number of people whose first language isn’t English. A message not made clearer by the construction of the remainder of the sentence. And that’s not to even consider whether everyone is immediately able to understand what a “negative” test is–after all, negative things aren’t always good news.

I’ve known several people over the last two months who’ve been tested for COVID19. Each of them went through a different process in receiving their results.

• I’ve known several people over the last two months who’ve been tested for COVID19. Each of them went through a different process in receiving their results.
• The first quite early in the outbreak was tested at their GP, and was called by the GP about 6 days later.
• One, about 6 weeks ago attended a walk-in clinic in a major public hospital in Sydney, and was simply sent an SMS to the number they provided. No need to register
• One attended the same drive though clinic we did, about a week ago, was not sent an email and was called with their results.
• One only this week at a privately run pop-up testing clinic received their results via SMS with no need to register.

Without doubt these are uniquely challenging times for public health professionals and systems. But it seems the way in which people are being sent their results is actually getting worse over time. Why was there the need to call with our results? I suspect because the online and sms-based systems are causing considerable confusion. Around 5,000 people a day are being tested in NSW, which makes for a lot of phone calls.

Why when 6 weeks ago at a major public hospital, and this week at a private publicly funded pop-up clinic could someone receive, without any input from their test results, where others have to go through we have a complex, confusing, clearly not well-tested process?

We’re immensely fortunate in Australia those managed, though social isolation and increasingly aggressive testing, and from what I hear from those who know an incredible contact tracing effort by our state health departments contained the spread of COVID19.

But if testing, and positive results had been an order of magnitude greater? At what point would this system simply collapse as it has elsewhere?

Good, research based human centred design is central to our modern lives. And it starts with the question–do we need this feature, or system at all?

I’m genuinely grateful for this amazing service. Hopefully the last, and in some ways the most important part, how we convey this vital and anxiety inducing information can get fixed. By doing less.

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