Smartwatches and the triage nurse problem

Despite the ever-ongoing increases in available processing power predicted by Moore’s law, human beings can only pay a finite amount of attention to what’s in front of them at any given moment. Plenty of people realize this, especially concerning the rise of smart watches: at Google I/O recently, we were told that ‘the average Android user pulls their phone out of their pocket 125 times per day.’ Presumably, this is too many times, and Android Wear will alleviate this burden for us to some degree. But let’s not forget why we pull our phones out of our pockets- often because we’ve received a notification about incoming information that may be important. If seeing, processing, and dealing with that notification takes even a fraction of our second of our attention away from our task at hand, then that information has successfully stolen our attention for that second.

Now, if those notifications were showing up on our wrists instead of in our pockets, do you really think we’re going to be less distracted by them? Sure, it may appear logical for your watch to become your local hub for push notifications: it’s right there in front of you, all the time. But although you may save a second or two from not having to physically retrieve your phone, those seconds are a rounding error compared to the amount of time you spend dealing with your notifications, not to mention the time and effort required to refocus on whatever you were doing before. Forcing push notifications closer and closer to our daily workflow may be efficient from an information retrieval point of view, but a horribly inefficient use of your limited attention and field of focus.

Consider the following thought experiment. Which of these two things would be more useful?

  1. A small bracelet with no screen, no buttons, and no way to interact with it whatsoever- but that vibrates when something truly important on your phone requires your attention, and at no other time;


B. A full-resolution, fully interactive Gmail app, on your wrist.

If you answered B, you may be undervaluing your time and your ability to focus. In fact, I genuinely think that product A would be really useful. It would help solve one of the biggest unsolved problems we have in our daily routines: what I call the triage nurse problem. Let me explain:

Our brains are a little bit like the emergency room in a hospital. At the ER at any given point in time there are a certain number of doctors available, and some number of patients arriving in ambulances that need to be dealt with. There are usually more patients coming in than doctors available to deal with all of them immediately. But thankfully, not all of these patients are in urgent, life-threatening situations- some have broken legs but are otherwise fine: they need to be dealt with, but not right this second. That’s why there’s a triage system: patients who aren’t in critical condition can be prioritized accordingly, and heart attack victims who are rushed in by ambulance can skip the line. The job of assigning priority goes to the triage nurse, who (despite often being on the receiving end of frustration from those being bypassed in line by more critical patients) performs a vital job for the ER to function as a unit.

Now, replace ‘patients’, with ‘push notifications on your phone’. Do you ever receive a big pile of notifications all at once, glance at them and decide they can wait until later, and only then realize that one of the emails buried in there was time-sensitive? That’s because it didn’t get properly triaged. And it’s why we pull out our phones all the time when we feel them vibrate- we know that usually it won’t be important, but have to check just in case. Will having those notifications on your wrist instead of in your pocket solve that problem? No it won’t! You’ll eliminate the physical retrieval problem, but not the fact that your attention and focus will still be interrupted a tiny bit each time you glance down at your watch. Right now, the current push notification setup is akin to ER doctors having to walk into the waiting room and find out on their own which cases are the most urgent. The solution to this problem is NOT to move the waiting room closer to the ER, so that the doctors have to walk less distance! Yet that’s what we’re doing with smart watches. It’s stupid. Smart watches should make us less distracted, not more.

I’m convinced that if smart watches are going to be truly useful to us, they’re going to have to solve the triage nurse problem. They will need to actively sort through the incoming notifications that demand your attention, assign some sort of priority, and then feed those notifications to you in the right order at the right time. If your smart watch could alert you whenever something actually important happens, then not only would you be aware of those events, but you could also confidently ignore all of the other crap in your notification tray until you have the time to properly sort through it. And as a bonus, you won’t need to take your phone out of your pocket so often! Just like the ER example, the best solution isn’t to bring your notification tray closer to your eyes, it’s to free you from having to look at it so often.

So, who’s in a better position to solve the triage nurse problem: Apple or Google? I don’t know the answer yet, but we’re going to get an idea soon. As Ben Evans and others have pointed out, up until now both Apple and Google have been kept busy filling out the ‘basic necessary functions’ of a smartphone, and iOS and Android have looked fairly similar as a result. But at the most recent WWDC and IO conferences, we’re starting to see some hints that Google thinks of Apps and the Web very differently from Apple, with some profound implications about how notifications will work in the future. Apple seems to think that Apps are gradually replacing the Web, and the information you see on your smart device will be fundamentally classified by what App Silo it originated from. (Even though iOS apps have finally been de-Siloed, in that they can finally talk to each other, but they’ll still have clearly defined boundaries.) Google, on the other hand, sees that line blurring further and further until there may not even be a distinction between Web-based or App-based tasks or information. In a few years, it may not matter so much where a notification comes from so much as what information it contains. Classification of incoming information will become a question of content, not of source. That’s very exciting to me. And Google’s certainly in the best position to classify incoming information based on importance- Apple may build nicer products, but Google knows more about you.

It remains to be seen which smartwatch platform will make for a better user experience, but I’d bet that Google’s strategy has a better shot at solving the triage nurse problem. If that bet holds true, then even though Apple will probably build a beautiful, universally praised iWatch that will appear superior in all sorts of ways, I’d still bet on Android Wear for pure usefulness in the long run.

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