Summary
Traditional design metrics and KPIs are often geared towards measuring product success. Dark metrics challenge this paradigm by proactively measuring the unintended yet harmful psychological, social, and physical effects of our technologies. The examples within digital health are plentiful. From accelerating burnout among clinicians to widening racial disparities in quality of care, we can only reach the height of our most courageous solutions when we expose our deepest failures.
Key Insights
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Traditional product metrics often ignore the broader individual and societal impacts of digital health technologies.
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Dark Metrics is a framework focusing on measuring disempowerment, exclusion, addiction, and distraction caused by health tech.
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Disempowerment occurs when technology undermines user autonomy, especially in sensitive healthcare decision-making.
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Racial bias in AI can manifest indirectly, as in algorithms using proxies like healthcare costs that perpetuate inequities.
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Co-creating design solutions with diverse voices is critical to proactively identifying unintended consequences.
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Measuring unhealthy engagement requires going beyond 'engagement' metrics to include wellbeing indicators like stress or eye strain.
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Distraction from clinical tools (e.g., EMRs) can reduce quality of care by pulling medical professionals away from patient interaction.
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Embedding racial equity rubrics into the design process helps ensure inclusive user experiences beyond just product visuals.
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Augmented intelligence should support, not replace, human decision-making especially in healthcare.
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Early, collaborative risk ideation exercises like 'premortems' are recommended to anticipate potential harms before launch.
Notable Quotes
"Traditional product metrics focus narrowly on the product itself, missing what success means for the people using our technologies."
"Our tools are meant to support and enhance, not to take over — we call this augmented intelligence at IBM Watson."
"An algorithm that doesn’t explicitly use race but uses healthcare costs as a proxy can perpetuate racial discrimination."
"Exclusion doesn’t have to be explicit — you just have to be indifferent to it."
"The difference between technology and slavery is that slaves are fully aware they are not free."
"Doctors don’t want to be on a machine all day; they want to help people."
"Designing for people means acknowledging where we might be exclusionary and embedding equity like accessibility."
"If the product doesn’t allow people to override decisions or control their data, it’s likely disempowering."
"Collaborative conversations and diverse co-creation help catch blind spots and biases in design."
"We have to ask before building something new: what could possibly go wrong?"
Or choose a question:
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