A clinician can know which field comes next before they look at the screen. They have done the same sequence hundreds of times and the movements have become automatic. Then an update moves a field, changes the order of inputs, or adds a step.
The new interface may look cleaner. The functionality may work exactly as intended. The clinician now has to stop and think about something they used to do without hesitation. That costs time when someone is working through a long list of patients, handling interruptions, and keeping pace with a shift.
Jeremy Leitmeyer, Software Engineer and IT Admin at Estenda, has seen how easily development teams overlook those habits. The way people have learned to use a system is part of the workflow. What they do without thinking should shape what you build, improve, or leave alone.
How to Design Clinical Software That Fits a Real Shift
Watch how clinicians actually use the software before making changes
A team can spend hours on requirements, map the intended user journey, and agree on a design that looks logical. Watching someone use the existing application reveals what those discussions miss.
A clinician might enter information in an unusual order, move between screens in a way nobody anticipated, or lean on a shortcut that is not visible in the interface. Those behaviors build up over years with the same system.
Jeremy sees this as critical with legacy applications.
"Not just with functionality but how the users typically progress through the app and how they build a mental progression that becomes second nature," he explains.
That progression only shows up through direct observation. A clinician might enter information in a particular order because it matches how they read a patient's record. Rearranging those fields can make the screen look more organized to a developer and create extra work for the person who knows the original sequence.
"I think conversations and live demos help bridge this gap," Jeremy says.
A live demonstration lets developers see the habits for themselves and ask questions while the work is happening. It also shows which parts of the software help and which cause frustration. That matters in custom healthcare software development, particularly when improving an established application or putting a new interface in front of an existing clinical process.
Preserve familiar input sequences when they help clinicians work efficiently
Working with Indian Health Service (IHS) staff shows why the order of information matters. During a visit to Phoenix Indian Medical Center (PIMC), our team spoke with readers and imagers who used the software as part of their regular work. The staff "really stressed how the flow of the inputs should stay the same" because they had built muscle memory around the existing process.
They knew where to go next and what to enter without stopping to think about each step. Changing that sequence slows them down. Developers underestimate this, especially when looking at an older interface that would clearly benefit from visual improvement.
A form with a different field order can look more intuitive in a design review and still interrupt a routine someone spent years learning.
Familiarity alone is not a reason to leave a workflow untouched. Some processes carry unnecessary steps, confusing interactions, or safety problems that need fixing. The point is to know what users depend on before you decide what to change. Teams that understand which interactions have become habitual make better calls about what to preserve, what to improve, and how to introduce changes without creating new problems.
Test input methods with people who weren't involved in building the software
Developers spend their days inside the applications they create. They know what each component does, why a feature behaves a certain way, and what the user is supposed to do next. That familiarity makes it hard to judge how the software will feel to someone coming at it fresh.
"Similar to my point above, sometimes as a developer you think a solution makes perfect sense until you watch a user implement it into their flow," Jeremy says.
He recalls delivering software that seemed straightforward to use. Once a nontechnical user started working with it, the input method turned out to be more complicated than he expected.
"We then had to redesign the input method to be more user-friendly," Jeremy shares.
The functionality made sense from a development perspective. The way information was entered did not. In clinical software that gap matters because users repeat the same actions all shift.
A form might need extra clicks to reach the fields people use most. An input method might be obvious to someone who knows the underlying system and confusing to a clinician concentrating on patient care. A new step might interrupt a sequence that used to feel natural. These show up when the people who will use the software are the ones testing it.
Watch where users hesitate, which actions need explanation, and whether people finish tasks without someone from the development team guiding them.
Account for interruptions, task switching, and staff handoffs
Clinical work rarely runs in one uninterrupted sequence. A clinician is entering information when a colleague needs them. Another task becomes urgent. A patient encounter means leaving a record unfinished and coming back later. That shapes how software should handle navigation, incomplete work, and task status.
A clinician halfway through documenting an encounter needs to switch to another patient. Depending on the application, they have to save their progress, return to the right record, and see what has already been entered. If the application makes it hard to recognize where they left off, they review information again or repeat steps.
Handoffs add another layer. When one staff member starts a task and another finishes it, the software has to make the relevant information and task status clear to the next person, within their authorized access.
Questions worth answering during design are:
Can users return to unfinished work without losing their place?
Is it clear which information has been entered, reviewed, or finalized?
Can another authorized staff member see what still needs doing?
Does moving between patients or tasks require unnecessary navigation?
Are users warned before an action discards or overwrites information?
The answers depend on the clinical workflow, the software's intended use, and the risks involved. These situations are worth observing during user research, because people develop their own ways of handling interruptions that never make it into a requirements document. A system can perform perfectly in an uninterrupted demonstration and still break down for someone switching between several tasks during a shift.
Validate the workflow with clinicians before the software goes live
A development team may have confidence in a feature because it meets the agreed requirements and passes functional testing. That doesn't necessarily tell them how well the feature will fit into someone's routine.
Jeremy emphasizes the importance of understanding how people already use the application rather than relying on assumptions about how they should use it. For clinical software, this means testing the actual sequence of work with representative users before releasing significant changes.
Some helpful steps include:
Observe routine tasks: Ask clinicians to complete the activities they regularly perform, using realistic scenarios and appropriate test data. Pay attention to the order in which they move through the application.
Ask users to explain their decisions: Find out why they follow a particular sequence, which parts of the application they rely on most, and where they experience frustration.
Test proposed changes: Let users work through updated input methods or interface designs without directing every action. Their behavior may reveal problems that aren't apparent during an internal review.
Include different user roles: A reader, imager, administrator, or clinician may have a different relationship with the same application. Their tasks and expectations should inform the parts of the system they use.
Revisit the workflow after feedback: Adjust the design where necessary, then test again to see whether the changes have addressed the original difficulty.
This process can help development teams discover usability problems while there is still an opportunity to address them. It also gives users a chance to explain why certain features or sequences matter to their work. As Jeremy points out, clinical users may be working through a large number of patients and need applications that behave consistently.
For regulated medical devices, teams also need to consider the formal usability engineering and validation activities required for the product's intended use. Informal demonstrations can inform the design, but they do not replace applicable validation requirements.
The broader need to understand people's responsibilities and established processes also applies to healthcare AI projects. We discuss related challenges in our article on why people and process decide whether healthcare AI works.
Continue collecting feedback after deployment
Carefully tested software still meets changing use. Clinical teams introduce new procedures, take on different responsibilities, or start working with additional systems. Users develop habits around features that were never part of the original workflow. Post-launch feedback catches what development could not.
A task that worked well in initial testing becomes harder when users repeat it frequently or manage it alongside other responsibilities. Teams need a process for reviewing those reports, understanding the cause, and deciding whether a software change is warranted. That might mean refining an input method, adjusting navigation, reworking a confusing interaction, or helping users get comfortable with an updated process.
Our Implementation & Support services help healthcare and MedTech organizations manage deployment, maintenance, and improvements past the initial development phase. Listening after launch lets teams address difficulties as clinical needs and working practices change.
Build Clinical Software Around Real Needs With Estenda
At Estenda, we work with healthcare, MedTech, and life sciences organizations to develop software that accounts for the people, processes, and technical requirements involved in bringing a healthcare product into use.
Our Product Acceleration Framework provides a structured approach to moving healthcare products from an initial idea or existing prototype toward production. It brings together product planning, healthcare software architecture, security and compliance considerations, development, and testing to help teams identify risks and make informed decisions throughout the process.
If you're developing a new clinical application or looking to improve an existing one, understanding how people will actually use the software is a good place to start. Explore our Product Acceleration Framework or talk with our team about your healthcare software project.
Frequently Asked Questions
What is clinical workflow design in healthcare software?
Clinical workflow design involves understanding how healthcare professionals complete their tasks and developing software that supports those activities. It considers how users enter and retrieve information, navigate between tasks, handle interruptions, and work with other staff members.
Why is clinician muscle memory important in software design?
Clinicians who use the same application regularly may develop familiar sequences for entering information and navigating screens. These habits can help them complete repetitive tasks with less conscious effort. Changing those sequences without understanding how users depend on them may slow down familiar processes or introduce confusion.
How can developers better understand clinical workflows?
Developers can observe clinicians completing routine tasks, conduct user interviews, review existing processes, and organize live demonstrations. Watching users interact with software can reveal navigation habits, frustrations, and workarounds that aren't always captured in requirements documents.
How should clinical software handle interruptions and task switching?
Clinical software should be designed with the application's intended workflow and safety requirements in mind. Depending on the task, useful features may include saving unfinished work, maintaining clear patient context, showing task status, and helping users return to incomplete activities without unnecessary repetition.
How do you validate clinical software before deployment?
Development teams can test software with representative users performing realistic clinical tasks. These activities should examine whether users understand the interface, complete tasks correctly, and can manage the situations they are likely to encounter during normal work. Regulated medical device software may also require formal human factors and usability validation.
Should development teams preserve legacy clinical software workflows?
Development teams should first understand why existing workflows are used before deciding which elements to change. Familiar input sequences and navigation patterns may support efficient work, but outdated processes can also contain usability or safety problems. User observation, risk assessment, and testing can help determine which elements should be preserved or improved.
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Clinical software design
