Imagine a world where healthcare software is as intuitive as it is powerful. This isn't a pipe dream; it's a necessity. What if the key to revolutionising healthcare isn't just in the features, but in the design that delivers them? The right design can not only improve our healthcare system but could also save lives.

I'm Kieran Oldham, Co-Founder, CTO, and CPO of MyOpNotes, a clinical software company revolutionising surgical documentation and data usage for improved patient outcomes. With a background covering various aspects of digital product development, and with a particular focus on medtech, I've seen firsthand the transformative power of good design. In this article, I'll draw on my experiences to argue for a new paradigm in healthcare software: one where form does not follow function, but rather form is a central component of functionality.

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Escaping the Catch-22: Why Functionality Isn't Enough

In the realm of healthcare software, functionality has long been the undisputed king. The more features, the better... right? This mindset has led to a landscape cluttered with software that, while robust, is often unintuitive and cumbersome. Design is often treated as a secondary concern, considered a 'nice-to-have' rather than a necessity.

Why? Like many other industries, healthcare has grown accustomed to complex, feature-heavy interfaces. Complexity is equated with capability and simplicity with inadequacy. This creates a paradox: clinicians complain about complex, clunky software, but dismiss more intuitive designs as 'too simple' or 'not robust enough.'

This catch-22 creates a self-perpetuating cycle. Software developers, aiming to meet the perceived demands for complexity, continue to create cumbersome systems. Meanwhile, clinicians, faced with these complex systems, become further entrenched in the belief that simplicity equates to a lack of functionality. The end result? A healthcare ecosystem rife with inefficiencies, frustrated users, and missed opportunities for better patient care.

Contrary to popular belief, simplicity in design is far from simple to achieve. True simplicity is the pinnacle of good design and requires an in-depth understanding of the problem and surrounding workflows. Simplifying complex processes is not about stripping away features or dumbing down the interface, it's about dynamically abstracting away unnecessary complexity based on the current context. This can involve computational solutions, educated assumptions, or even just prompting the user at the right moments.

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From Interface to Outcome: The Ripple Effect of Poor Design

The consequences of poor design in healthcare software extend far beyond mere inconvenience. They create a ripple effect that touches every facet of healthcare delivery, leading to a host of problems that are both costly and dangerous.

Poorly designed interfaces can result in incomplete or incorrect data entry. This compromises everything from patient care to hospital reimbursements. In our work at MyOpNotes, we've discovered a concerning number of key medico-legal documents within the NHS lacking essential information, such as patient identity or diagnosis. I experienced the repercussions of this first-hand. After an operation in early 2023, I was sent home without a discharge summary, medication, or follow-up information. When I returned the next day, the hospital had no record of my visit, risking severe complications in my recovery.

Inadequate design also necessitates extensive training for clinicians, adding complexity to their demanding roles. This elongates the onboarding process for new staff and increases the IT burden of maintaining these systems. The time spent navigating cumbersome interfaces could be better used for patient care. Moreover, the cognitive burden on clinical staff is often overlooked, leading to burnout and high turnover rates, which exacerbate the industry's challenges.

Learning different IT systems is in my opinion one of the most stressful parts about being a doctor in the NHS.

In short, the ripple effect of poor design isn't just an aesthetic issue. It leads to inefficiencies, errors, and significant burdens on an already strained healthcare system, ultimately affecting the quality of care patients receive.

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A New Paradigm: Form Is Function

We've dissected the problems stemming from a functionality-first approach. Now let's pivot to the solution: a design-centric model. In the following sections, we'll explore how this approach not only addresses but also transcends the issues we've discussed, focusing on three key areas: application architecture, accessibility and usability, and workflow efficiency.

• Application Architecture: When design leads development, the architecture of the software itself becomes more efficient. This approach allows for a fine-tuned backend tailored to the interface. The result? Faster data transmission and a more responsive application, particularly crucial as we transition into the era of cloud-based healthcare solutions.
• Accessibility and Usability: Current accessibility standards often focus on individual elements like font size or contrast but overlook the overall user experience. A design-centric model extends these standards to create more intuitive interfaces that require less user training and technical ability, thereby reducing the cognitive burden on end-users and providing a more accessible platform for all clinicians.
• Streamlining Workflows and Improving Patient Care: Healthcare software should act as a co-pilot, aiding clinicians in their day-to-day tasks rather than hindering them. A design-centric model can make this a reality by creating intuitive, context-aware interfaces that guide clinicians through repetitive tasks, highlight key information, and even suggest next steps. This reduces cognitive load, minimises the risk of errors, and allows clinicians to focus on what they do best, ultimately leading to better patient outcomes. Take the aviation industry as an example, modern cockpit design has significantly improved both efficiency and safety by reducing visual complexity, contributing to a reduction in global fatalities from 913 in 2014 to 104 in 2021. Serving as a compelling parallel for what can be achieved in healthcare software.

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Putting Theory into Practice: A MyOpNotes Case Study

How does this apply in the real world? Let's explore how I used these principles to build MyOpNotes. Take surgical smart templates for instance, our flagship feature that enables surgeons to write more accurate operation notes faster. This was built starting with design, which then led to functionality.

We first conducted extensive research on the surrounding workflows. We performed interviews with hospital management, surgical teams, researchers, clinical coding departments, IT teams, and other key stakeholders. We gathered and analysed existing paper templates from consultants across all specialities, and we looked at surgical registries and various audits until we had an intricate understanding of the problem and its significance.

We began work on our first iteration of designs. They were good and covered all bases but we concluded they were too visually complex. According to the "function over form" philosophy, this is where most would typically start development. Instead, we continued to iterate, each time simplifying what we had without removing functionality. As complexity was reduced, patterns emerged. We uncovered common field groups, sections dependent on certain conditions, and fields that added detail or covered unusual scenarios but were not always necessary.

Identifying these core patterns allowed us to build the application around them. Effectively, the designs specify our feature list and backend functionality for us. Without this, optimised features that have become critical to overall usability and flow would have been replaced by numerous unintuitive and clunky menus that require staff training and provide room for error.

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Leading the Charge: The Future of Healthcare is Design-Centric

The future of healthcare software is poised for a design-centric revolution. As we look ahead, the integration of emerging technologies like AI and Machine Learning offers unprecedented opportunities for innovation. But the key to unlocking this potential lies in good design. Here are some simple ways you can start adopting a more design-centric approach for your software today:

1. Understand the Problem: Ensure you have an intricate understanding of the market you are supplying that goes beyond the skin-deep requirements.
2. Prioritise Design: Make design a core part of your development cycle, not an afterthought. Use it as your foundation and everything else will follow.
3. User-Centric Approach: Involve end-users throughout the entire process to create more intuitive workflows and interfaces. But remember, not everyone is aware of their actual needs.

By embracing a design-centric approach, software suppliers stand to gain not just in terms of market competitiveness but also in the quality of healthcare delivery.

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Final Thoughts

The transformative power of good design in complex software cannot be overstated. The future of healthcare is at a pivotal moment, and the choices we make today will shape the industry for years to come. I urge founders, developers, UI/UX designers, and clinicians in the healthcare industry to reevaluate their approach and consider the transformative power of good design. Together, we can redefine healthcare, improving the quality of care for patients everywhere—now and for generations to come.

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This is the first in a series of articles where I'll draw on my experience in the MedTech industry to cover everything from design and development to business and strategic aspects. If you're keen to elevate your work through design or have any questions, don't hesitate to reach out. Stay tuned for more insights and actionable advice—let's redefine healthcare and improve patient care, together.

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