In a study done by professionals from multiple companies and universities, family medical practices administered surveys on paper forms and electronically.<ref>James M. Galliher et al., “Data Collection Outcomes Comparing Paper Forms with PDA Forms in an Office-Based Patient Survey” (''Annals of Family Medicine'' 6, no. 2, 2008), 154.</ref> However, the team could not accurately judge the advantage of the electronic form because of problems with the firewall and “institutional computer security issues.”<ref name=galliher158>IbidGalliher et al., 158.</ref> The researchers report that “there does not appear to be an easy solution to these technical issues, especially in instances where the practice is part of a larger organization (eg, university, hospital) that has strict requirements and procedures in place to limit transmission of information between the institution and external Internet Web sites.”<ref>Ibid.< name=galliher158/ref> This example shows where technology itself can interfere with the effectiveness of a form. Also, institutional requirements can limit the design being created by a technical writer.
===Tailoring Information to Federal Regulations===
Sometimes, there are external restrictions on a form or document that could affect the design process. Rita Tomlin, a freelance writer and instructor at San Diego State University, investigates the implications of the Food and Drug Administration (FDA) regulations on medical writing.<ref>Rita Tomlin, “Online FDA Regulations: Implications for Medical Writers” (''Technical Communication Quarterly'' 17, no. 3, 2008), 289, 310.</ref> Tomlin says, “An essential task for the medical writer is to tailor data presentation and document content to the FDA’s expectations.”<ref name=tomlin292>Ibid.Tomlin, 292.</ref> The medical writer is therefore restricted by FDA expectations and not just organizational or personal expectations. Medical writers are expected to come to “an understanding of the FDA’s complex expectations” by “careful reading and interpretation of the FDA regulations and guidance documents.”<ref>Ibid.< name=tomlin292/ref> This is an example of the type of work a form or document designer may have to do. There could be external research needed before form or document design or redesign can occur.
