When people think about healthcare technology, they often focus on functionality. Does the software meet regulatory requirements? Does it support the right clinical workflows? Can it integrate with other systems?
These questions matter. But there is another factor that can be just as important: how easily people can use the software in the first place.
In safety-critical environments, usability is not a finishing touch added at the end of development. It is fundamental to helping people make accurate decisions efficiently and confidently.
History has repeatedly shown that poor usability can have serious consequences.
One widely cited example is the 1992 Air Inter Flight 148 accident. The aircraft’s Flight Control Unit used a single control for two different functions, so the same entered value could mean either a gentle descent angle or a dangerously rapid rate of descent – with only a small indicator showing which mode was active. Although the accident resulted from multiple contributing factors, the interface design increased the likelihood of a critical misunderstanding at a crucial moment.
Aviation and healthcare are, of course, very different disciplines. Yet they share an important characteristic: professionals making high-consequence decisions under significant time pressure through software interfaces that sit between intention and outcome.
When usability is poor, software demands more mental effort than it should. It increases cognitive load, encourages workarounds and creates unnecessary barriers to efficient, confident decision-making.
As C.W. Johnson explored in Why did that happen? Exploring the proliferation of barely usable software in healthcare systems (2006), poor usability is more than an inconvenience – it can become a patient safety issue. As clinical systems grow more capable, they often become more complex. Users naturally develop workarounds to complete routine tasks, meaning usability challenges frequently become accepted as part of everyday work rather than recognised as opportunities for improvement.
We found evidence of the same pattern within our own products.
It’s easy to assume that years of daily use naturally lead to complete familiarity with a platform. Our research suggested otherwise.
We observed that valuable functionality designed specifically to save time was often going unused, even by users with more than eight years’ experience. As clinical software evolved to include more functionality and increasingly feature-rich interfaces, useful functionality could become less discoverable among competing controls, tabs and information, while familiar workflows remained the default – even when those workflows were less efficient.
One example involved referral management within DXS Point-of-Care.
Many users completed referrals before they were truly finished so that they would appear in the patient’s record and could be passed to another member of the team. Although Point-of-Care already allowed draft referrals to be assigned directly to colleagues, many users were unaware that this functionality existed.
Instead, users duplicated the referral, completed the remaining information in the copied referral and then submitted it – solving the immediate problem but introducing duplicate records and unnecessary administration.
The issue wasn’t the functionality itself. It was how easily users could discover and use it.
Across much of the clinical software industry, development understandably focuses on regulatory compliance, interoperability, clinical safety and delivering new functionality.
Usability often improves incrementally rather than being treated as a discipline in its own right.
We recognised the same challenge.
Much of this research was carried out as DXS Point-of-Care evolved into an increasingly capable clinical decision support platform. SMART Referrals became progressively more sophisticated, supporting richer clinical logic, more advanced workflows and greater flexibility for NHS organisations.
As those capabilities evolved, they continued to deliver significant value while reinforcing the importance of making increasingly sophisticated functionality intuitive and easy to use. Without careful design, features intended to simplify everyday work can become harder to discover, while routine tasks require more effort than they should.
Those insights now directly inform the ongoing development of DXS Next-Gen, where usability research sits alongside engineering and clinical expertise to help shape how new functionality is designed, tested and delivered.
We concluded that improving usability required more than redesigning individual screens.
It required changing how we develop software.
Rather than treating UX as something considered once development was complete, we established a dedicated UX practice and made usability a core discipline alongside engineering and clinical safety.
Today, research begins long before requirements are finalised.
Ideas are explored with clinicians and administrative staff – building on the collaborative design principles discussed in our article, Co-design with clinicians: protecting precious time – before workflows are validated and prototypes are tested prior to development.
Rather than relying on assumptions, we seek to understand how people actually work and use those insights to inform design decisions from the outset.
This benefits our development teams, but more importantly it benefits the organisations using our software.
For healthcare providers, intuitive systems support faster adoption, reduce training requirements and help teams realise the full value of the functionality already available.
For clinicians and administrative staff, they reduce cognitive load and allow more attention to remain where it belongs – on patient care.
For us, UX is no longer a stage in a project or a visual refinement applied at the end of development.
It is an ongoing discipline embedded throughout the product lifecycle.
Research informs design.
Design informs development.
User feedback continues to shape future improvements long after software has been released.
This continuous cycle allows us to build products that evolve alongside the people who rely on them every day.
This is an area we plan to return to in future editions.
We look forward to sharing more of what our research uncovers – the assumptions we’ve challenged, the changes we’ve made, and the lessons we’ve learned from designing clinical software around the people who use it every day.
Because the best healthcare software isn’t defined by how many features it contains.
It’s defined by how naturally those features support the people using them.
Interested in learning how DXS Next-Gen combines user-centred design with intelligent referral pathways to improve clinician experience and maximise the value of digital transformation? Get in touch – hello@dxs-systems.co.uk
