What I learned doing a real competitive audit for a fake app

Creating fake things can really teach you about reality

I’m currently getting a certification in UX Design, and it involves creating a fake app for our portfolio. At first I thought it was extremely lame. I never liked fake assignments, they give me shivers. Spending my precious time in something that will give nothing back to the world (or myself) always seemed stupid, so I always try to take something out of this kind of experience. I could find something real to develop using what I’m learning, or I could enjoy myself and embark on something that could give me real knowledge. If I was in more advanced stages I would take a volunteer job, but as someone prone to burnout and with enough already on my plate, I decided to have fun.

I don’t know what your idea of fun is, but mine is learning things that I could use to discuss with bullies and people who refuse to learn about reality and choose to say stupid things. One of the most controversial subjects here in Brazil is our health system, a complicated and bureaucratic mess in which those who have the best health insurance have the best care and those who don’t suffer through long lines, rude doctors and despair. I recently found out that more than 90.000 patients are currently waiting for orthopedic surgery in our public system, and there’s cases in which a person had to wait 11 years to get it. Eleven years. Things are not very good in the private sector either: a person in need of elective surgery can wait up to 21 business days to get approval from her insurance. A friend of mine gave up and chose to do physical therapy and pray for the best. It was a spine surgery and he has average health insurance. A few years ago I had to do a cholecystectomy and was only able to because the doctor lied on the form and said it was urgent.

With that in mind, I decided to do a customer service app for a hospital, and invented Saint Mary’s, “the best fake hospital in the world”. Research was a bliss and a challenge: since I’m passionate about the subject, I was able to read and learn a lot, but reading and learning more that I already knew made me sick to my stomach. It’s impossible not to get a little disturbed and enraged when you see the reality in numbers. I grew up poor, and we only had health insurance for a short period of time when Lula was president (good and prosperous times!). It was enough time for me to get my surgery, but most of my life, I lost days and nights on the gigantic lines of public hospitals and clinics. Even on those insured times, we didn’t have access to the best, and the only difference is the waiting period goes from months to weeks. If you’re in pain or suffering but are not dying enough for the E.R., you better pray that God helps you. It’s difficult to be an atheist in Brazil: without God, there’s not much left. That might explain why religion is so strong here.

Since my hospital is a fake, I chose competitors from my neighborhood. I live in a big kinda rural neighborhood, and most of the residents are from classes C-D, the brazilian middle class. Here in Campo Grande we only have 2 or 3 big hospitals, the rest are small specialized clínicas de bairro or medium size hospitals. I chose two direct competitors and one indirect (a dental clinic). I was not ready for what I was about to find out.

First, it’s like accessibility doesn’t exist here. All websites had small text, bad contrasting and poorly written copy (too big, too small, too confusing or all of these options). Most of them had text as images, and none of them offered any translation options. Branding — when it exists — tends to be consistent, but that consistency has no good use if the content and flow doesn’t help, right?

When online scheduling was available, it was through poor third party systems, and some of them didn’t work properly on mobile devices. In Brazil, only 40% of the population have home computers, so it’s really important to prioritize mobile experience. I was shocked to realize that UX is really a new concept here, and most of the companies didn’t seem to have grasped the trend or invested in it. I work as a graphic designer in a major hospital here, and they refuse to change anything, doing posters with illegible chunks of text and lives that could put the biggest insomniac to sleep. It’s difficult to discuss, since designers tend to be seen as machines that do magic, and not like professionals with knowledge and skills, even in big corporations. It’s hard to implement changes when they have to pass through a lot of conservative bureaucratic-loving old people. One day we’ll get there!

The user flow was chaotic in most of the websites and apps I visited. If the websites were a maze, you would never get out, I’m sure. Multiple redirects, pop-ups, unclickable buttons and all sorts of dead ends lead me to believe that calling the hospital would be less stressful. And so I did.

The experience was the same as it always was: annoying waiting music, crowded lines and unhappy attendants. During my research, I discovered a lot of cool initiatives in health care, like the use of smartwatches to monitor cardiac patients (this is being implemented by a public university with a small group of patients in public health care), but the reality is most of these discoveries and technologies will only be available to a small minority, while the rest of us will keep spending a lot of time and energy trying to schedule appointments and exams and manage everything with the rest of our lives. But what if it could be different? What if anyone could easily schedule an appointment or — even better — talk to a doctor and avoid the dreadful trip to the hospital? The competitive audit was done, but I was still curious, so I kept researching to find out how the other side lived. Seeing the websites and apps of the major players, my major feeling was disappointment. What a waste of money! They provide the basics without nothing new, different or inventive. They meet the smallest set of needs they can, but since everything is so behind, who cares, right? Well, I care and I’ll keep researching.

With everything, I feel the biggest lesson I learned during this competitive audit was this: there’s no use to the better of systems, if the persons involved don’t care about others. I dream of a future in which UX is a common thing here, but more than that, I dream of a future in which empathy exists and no developer builds unusable websites, because they are a waste of money and resources. We endure a lot as Brazilians, and maybe it’s starting to affect us.There’s a lot of excellent professionals in health care, but their drive and passion get lost in this sea of bureaucracy and processes that doesn’t make sense. I don’t know where Saint Mary’s will lead me, but one thing I’m sure of: in my fake hospital’s fake app, you can schedule an appointment with only a few clicks. How many Rio de Janeiro hospitals can say the same?