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Mary at a computer

Meet Mary who has mobility and dexterity difficulties

Mary is 53 years of age and a clerical worker in a hospital. She has had rheumatoid arthritis since childhood with symptoms that can vary over time from mild discomfort to real pain affecting her dexterity and general mobility.

A day in the life of Mary

Mary manages data entry for admissions and discharges in her local hospital. In addition she is a clinical coder whose main duties are to analyse clinical statements accompanying admittance and discharge notifications and assign standard codes using a classification system. The data produced is an integral part of health information management, and is used by local and national governments, private healthcare organisations and international agencies for various purposes, including medical and health services research.

When the rheumatoid arthritis flares up, Mary suffers from swelling, stiffness, and pain, with occasional numbness and tingling in her hands, wrists and elbows. She also suffers from back and neck pain. This makes it difficult to move around and do everyday tasks.

Flexi-time allows her time to exercise to loosen up and to build in days away which she can use when the symptoms flare up badly.

Challenge 1: finding the right input devices for different technologies

For many years Mary used a standard desktop PC with mouse and keyboard. She had a keyboard with a gel pad to support her wrists and this allowed for reasonably effective data entry, mostly without serious discomfort.

The mouse, though, was an altogether different story. It was difficult to grip. The lateral arm movements required, caused pain and discomfort in the wrist and upper arm. It was difficult to maintain a neutral posture while using the mouse and this aggravated the pain in the back and neck.

When the price came down, the hospital replaced many of the desktops with laptop computers. The laptop worked well in some respects. Again Mary found that she could manage the keyboard quite well. The touchpad mouse reduced lateral arm movements and removed the need to grasp the mouse. However, the laptop was quite heavy and carrying it around caused Mary back and neck pain.

To overcome this Mary acquired a lightweight tablet computer. However, it took a bit of getting used to. She found that the way she held the tablet initially caused neck, shoulder and hand issues.

After some research she found that using certain accessories, such as cases and stands, to prop up the device at a minimum 45-degree angle helped her to keep proper spine alignment and reduced strain on her joints whilst using an additional keyboard.

She also invested in a lightweight tripod stand with adjustable height control that gave her the best posture.

Challenge 2: making the right choices with portable technologies

Mary found general interaction with the tablet to be a positive experience. Some hand gestures such as pinching remain a step too far but she has found an app which provides touch assistance for more difficult gestures.

Tapping on a tablet removes the need for mouse movements. However, for big data entry tasks Mary found that constant tapping puts more strain on her hands and forearms compared to typing on a standard keyboard.

A portable Bluetooth keyboard made of silicone which rolls up into her bag has been her best buy to-date along with a medical speech recognition system for tablets. It seems to be accurate and to offer a positive alternative for large data entry tasks where forms can be long and have many fields.


Can you think of any other technological challenges that Mary might face in daily life?


© This text is a derivative of a work created by Dublin Institute of Technology & Πανεπιστήμιο Αιγαίου (University of the Aegean), and licensed under CC-BY BY 4.0 International Licence adapted and used by the University of Southampton. Erasmus + MOOCs for Accessibility Partnership.

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This article is from the free online course:

Digital Accessibility: Enabling Participation in the Information Society

University of Southampton