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Can usability heuristics be used to evaluate patient experience?

I don't remember when I first learned about the concept of "usability", but I haven't been able to let go of it ever since.  Usability is basically the ease with which something can be used to serve the intended purpose.  For example, a usable website is one that gets you the information you want in an efficient, simple manner.  A door knob is usable if it turns easily and opens the door.  Systems and processes can also be examined with a usability lens - did the customer have to wait long at the register?  Did the automated phone system eventually lead you to a person to address your question?

So given all that, I got to thinking about the usability of healthcare for patients.  How might that be evaluated?  Might frameworks for evaluating web/interface usability at least give us a starting place? So, using the 10 Heuristics for User Interface Design developed by usability expert Jakob Nielsen, I will attempt to draw surface-level parallels.  (My comments are italicized.)

Visibility of system status  - The system should always keep users informed about what is going on, through appropriate feedback within reasonable time.  (How many times have you sat in an exam room with no idea when you would next see someone, or who they might be and what they might do to you?  Hopefully it's not just me, or I'm going to get paranoid.)

Match between system and the real world - The system should speak the users' language, with words, phrases and concepts familiar to the user, rather than system-oriented terms. Follow real-world conventions, making information appear in a natural and logical order. (This has medicine written all over it. Ever tried to understand the notes your doc is typing in your medical record?)

User control and freedom - Users often choose system functions by mistake and will need a clearly marked "emergency exit" to leave the unwanted state without having to go through an extended dialogue. Support undo and redo.  (This is an interesting one. An example of this might be if someone requested a physician's help with quitting smoking, and then changed their minds.  It brings up the issue that usability from the patient's standpoint may not always be what's best for the patient.)

Consistency and standards - Users should not have to wonder whether different words, situations, or actions mean the same thing. Follow platform conventions.  (Having trouble coming up with a unique example for this one - anyone else have ideas?)

Error prevention - Even better than good error messages is a careful design which prevents a problem from occurring in the first place. Either eliminate error-prone conditions or check for them and present users with a confirmation option before they commit to the action. (Imagine calling to make an doctor's appointment and asking them to confirm that all of the error-prone conditions have been eliminated - ha!)

Recognition rather than recall - Minimize the user's memory load by making objects, actions, and options visible. The user should not have to remember information from one part of the dialogue to another. Instructions for use of the system should be visible or easily retrievable whenever appropriate. (Physicians who turn the computer screen toward patients while they are typing, and refer to notes throughout the encounter, may be addressing this heuristic.)

Flexibility and efficiency of use - Accelerators -- unseen by the novice user -- may often speed up the interaction for the expert user such that the system can cater to both inexperienced and experienced users. Allow users to tailor frequent actions. (Could a patient-managed Personal Health Record be an accelerator?)

Aesthetic and minimalist design - Dialogues should not contain information which is irrelevant or rarely needed. Every extra unit of information in a dialogue competes with the relevant units of information and diminishes their relative visibility. (This is a complicated one!  I'm thinking of patient literacy - what does this patient need to know?  What does this patient want to know?)

Help users recognize, diagnose, and recover from errors - Error messages should be expressed in plain language (no codes), precisely indicate the problem, and constructively suggest a solution. (Error messages as diseases?)

Help and documentation - Even though it is better if the system can be used without documentation, it may be necessary to provide help and documentation. Any such information should be easy to search, focused on the user's task, list concrete steps to be carried out, and not be too large. (Patient education literature, for example.)

It seems as though some heuristics work better than others, but overall, I think there might be something to this with more exploration and unpacking of ideas.  What do you think?