User Murder Index (UMI): The time and effort it takes to block information that can save someone’s life
Caring about or ignoring User Experience (UX) in healthcare can directly save or take lives. Healthcare professionals routinely need access to scientific medical evidence and information to make decisions. If the information is not available in one click or tap, the patient can die.
Click, tap, scroll, zoom in, zoom out, log in, verify you are human, copy, paste, enter, and finally, there is the paper that you and your university paid for, which requires many actions to get access to it!
The Murder Scenario #1
I introduce the kill scenario specifically for the publishers who intentionally make access to life-saving information harder and harder, even when you or your organization have paid for it.
Imagine you are a clinician who has a critical patient in a hospital bed, and you need to make a decision; however, each patient is unique, and to make a decision, you need more information. It happens that you or your organization actually have access to this information online via subscription. You have paid for it. You only have a few seconds, and those few seconds can determine the patient’s life or death or if the patient will fully recover or will need assisted living devices for the rest of their life. Seconds are important, and each extra click, scroll, or reCAPTCHA is a bullet in your patient’s head or heart. You find the information and click on it; it needs a login; you log in, it needs reCAPTCHA, you solve the reCAPTCHA, the paper is open, and you have to scroll. The patient passes away. The patient could’ve lived if you had access to the information in one click.
The patient is dead because publishers rather kill the patients than give one-click access to the information you have paid for!
In this case, the patient is the Secondary User, and the Healthcare Professional is the Primary User.
It may seem extreme, but it is the everyday story of us trying to access the information we have paid for. Even if you have logged in and the publishers know who you are based on your name, institute, device, and IP address, they will not give direct access to the full text.
The Murder Scenario #2
I also call this scenario “Gradual Death by Torture.”
Obviously, the publishers don’t kill you completely because that would be a crime to take all the years left of your life, so instead of years, let’s take seconds or minutes of your life. Isn’t that a crime? No, it is not. So, if you gradually take/waste someone’s life, it is not a legal crime, but it is an ethical one.
If you have millions of users and waste 30 seconds of their time every day, you literally and collectively kill a few people every day. That’s how important UX is. That time could have saved a few doctors from gradual death!
The Murder Scenario #3
How do Researchers/Authors Kill Patients and Users?
- They publish in non-open-access journals.
- When they publish in non-open-access journals, they don’t share accepted versions of their papers freely online.
User Murder Index (UMI)
UMI is the number of actions a user must take between finding the document that contains the answer and accessing this answer minus one action.
It is expected that accessing the information requires at least one action (tab or click), so we deduct one expected action from the total number of observed actions.
If Ne is the number of expected actions and No is the number of observed actions, UMI is No minus Ne (Ne = 1).
UMI = No — Ne
The best information providers and publishers have a UMI of zero, meaning that the users can access the information with one action (click/tab). The higher the UMI, the higher the chance of the publisher to murder more and more users.
Why Do Commercial Publishers Love Sci-Hub?
The principle of least effort, Zipf’s law, and Donkey Theorem state that organisms tend to choose the path of least resistance or effort.
I commend commercial publishers who are aware of this principle, as well as their User Murder Index (UMI). They push ethical users to use Sci-Hub for papers published up to 2019 to access the full text simply because Sci-Hub requires much fewer steps and should be used as the Gold Standard to be beaten or compared to. Alexandra Elbakyan to rescue.
If you have to choose illegal access (via Sci-Hub) to a paper for ethical reasons (saving someone’s life, pain, or cost of living), what should you do? As a systematic reviewer, I asked this question from myself everyday.
Other Examples of Murder from the Lovely Publishers
PDF Starts with Advertisement
Some publishers even add advertisements on the first page of their PDF, even if you have paid for that PDF. Scroll to death. So, not only do you pay to see the advertisement, but they also avoid putting unnecessary advertisements on the last page to make sure your time and patient’s life are truly wasted.
PDF Starts with Extra Information Page
Some publishers add an extra information page before the title and abstract. Scroll to death. The page contains the publisher’s logo, bibliographic information, times cited, DOI, and all the other things that will not save the patient. This unnecessary page can be at the end of the PDF.
Vertical Tables in Horizontal Pages
Many don’t have PDF editors. Producers can rotate the wide tables to appear as vertical PDF pages rather than horizontally. But that would be a service to the users who have paid for it; why should publishers ever do that?
Conclusion
Using words such as Murder and Torture may seem extreme, but they are as extreme as they should be to raise awareness. As a clinical librarian in an emergency department, I witnessed an occasion in which the patient was close to dying only because we could not access the full text we paid for.
I hope the publishers start caring about User Interface and User Experience and stop killing patients and researchers. Should we start campaigning to make one-click access a law?
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