The Digital Revolution That Left Healthcare Behind: Why User Experience Still Isn’t Center Stage
Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA
The healthcare industry stands at a peculiar crossroads today. While other sectors have undergone remarkable digital transformations, healthcare seems caught in a perpetual state of technological adolescence. As someone who has spent years navigating the complexities of healthcare innovation, I’ve witnessed firsthand the frustration that comes with trying to bring meaningful digital solutions to an industry desperately in need of them, yet seemingly resistant to their adoption.
When Good Technology Meets Poor Implementation
Several years ago we developed a tool that cold predict major acute cardiac events with phenomenal accuracy. This system ran in the background and had the potential to save lives. Yet I could not get it past simple user acceptance testing. I could not figure out a way to incorporate this vital information into the providers’ workflow so that it would be actionable. Eventually, I had to abandon the project. The patent sits as a plaque on my wall to remind me of my error: a fundamental failure to center technology design around the actual users.
Banking Did It, Retail Did It — Why Can’t We?
When I look at what has happened across other traditionally high-touch industries, the contrast is stark. Banking once required physical presence for nearly every transaction; today, most Americans haven’t visited a branch in months. Retail has been transformed by seamless online shopping experiences. Even insurance, that most paperwork-heavy of industries, has largely moved to digital-first interactions.
These transformations didn’t happen by accident. They succeeded because they followed three fundamental principles: prioritizing user experience above all else, implementing rapid testing and iteration cycles based on user feedback, and responding directly to market forces.
Healthcare, by contrast, has approached technology implementation backwards. We’ve purchased systems based on administrative requirements, regulatory compliance, and financial metrics — with user experience typically an afterthought. No wonder adoption rates remain dismal for many healthcare technologies.
The Peculiar Challenge of Healthcare Users
Why has healthcare been so resistant to the user-centered approach that revolutionized other industries? The answer isn’t simple, but there are several distinct barriers that collectively create a perfect storm.
First, healthcare has a uniquely complex user ecosystem. When I try to map the users for a typical healthcare technology, the list quickly becomes unwieldy: physicians (across multiple specialties), nurses, administrative staff, registration personnel, billing departments, patients, and caregivers. Each group has different needs, workflows, priorities, and technical abilities.
Studies have found that healthcare applications typically need to satisfy 5–7 distinct user groups, compared to 1–2 user groups for most consumer applications. This complexity multiplies the design challenges exponentially.
Second, and perhaps most problematically, the actual users of healthcare technology rarely have any meaningful input in purchasing decisions. In my experience implementing dozens of healthcare technologies, I’ve observed a consistent pattern: health system executives and procurement teams select technology based on administrative metrics, promised ROI, and compliance features — often with minimal input from the clinicians who will use the system daily. When they do get clinician input, they rarely get input from the clinicians in the trenches who will actually be using the system.
A survey by the American Medical Association found that 70% of physicians reported having no meaningful input into EHR selection at their organization, despite being primary users of the system. This disconnect between purchasers and users creates a fundamental market failure — vendors are incentivized to please purchasers, not users.
The Regulatory Roadblock to Innovation
Third, the regulatory environment makes rapid iteration extraordinarily difficult. In other industries, product teams can release updates weekly based on user feedback. In healthcare, each change often triggers new security reviews, compliance assessments, and implementation cycles that can stretch for months. There is no change that warrants risking patient safety. But the idiosyncratic change process, that is different for every clinic, hospital, health system, and pop-up kiosk, wreaks havoc on operations that need to scale.
This regulatory burden, while necessary for patient safety, creates significant barriers to the rapid testing and iteration that drives user-centered design in other industries. But it does not need to be this way. Imagine if there was one uniform, strict, high-quality, third-party arbiter of safe, secure, and effective technology, a healthcare version of the Play Store. If this was indeed unbiased and high-quality, then all the different stakeholders could defer to this authority for this technical diligence. Consider how we regulate pharmaceuticals.
The FDA determines if the medication is safe and effective. Once the medication has been approved by the FDA for specific indications, the clinicians, hospitals, pharmacies and healthcare ecosystem determine if that medication meets their needs. If each new medication had to go through a different drug approval process at each hospital, health system, doctor office, and insurance company, we would still be waiting for penicillin. Yet that is our approach with health technology, and we wonder why it doesn’t scale faster.
Following the Money, Not the User
Another critical factor that often goes undiscussed is the role of venture capital in shaping healthcare technology. Having worked closely with numerous health tech startups, I’ve noticed a troubling pattern in how funding influences product development.
Venture capital, by its nature, focuses on rapid growth and financial returns. In healthcare, this typically translates to demonstrating sales traction with purchasing stakeholders — health systems and payers. This creates a perverse incentive structure where startups prioritize features that will close sales rather than features that will drive actual user adoption.
The consequence is a familiar cycle: a healthcare technology company secures funding based on promises to purchasers, focuses development on sales-closing features, achieves initial sales success, implements at healthcare organizations, experiences poor adoption by actual users, and eventually sees the technology abandoned — all while consuming millions in investment and implementation costs.
I’ve been guilty of this myself. Early in my career, I celebrated when we closed a major contract, only to feel the sting months later when usage data showed that patients were not using it.
Toward a User-Centered Future
Despite these challenges, I remain optimistic about healthcare’s digital future. The path forward isn’t mysterious — we have the blueprint from other industries. What we need is the collective will to prioritize user experience even when it’s difficult.
First, we need to establish a new standard for healthcare technology evaluation: if the actual users wouldn’t voluntarily choose to use the product (or even pay for it themselves), then the organizational stakeholders shouldn’t purchase it — regardless of the promised administrative benefits. User adoption isn’t just a nice-to-have; it’s the primary predictor of success.
Second, venture capital firms investing in healthcare need to evolve their evaluation metrics beyond initial sales traction. Smart investors are already beginning to incorporate user adoption metrics, clinician satisfaction scores, and patient engagement rates into their diligence process — recognizing that these factors are better predictors of long-term success than early sales numbers.
Third, we need to create standardized regulations around health technology that allows a builder to build to a single, rigorous standard, that is then accepted by all the users and stakeholders. Some entrepreneurs may cringe at the idea of having greater regulation around what they are building — those are the ones who have not had to scale a technology yet.
Building the Bridge Between Tech and Healthcare
The most promising solution lies in creating meaningful partnerships between technology companies and healthcare organizations with strong product development expertise. These partnerships can solve the access problem (giving developers direct contact with users) while providing the healthcare knowledge needed to navigate complex workflows and regulations.
User-centered design places the user at the heart of the design process, developing solutions based on an in-depth understanding of the needs, challenges, and workflows of healthcare providers and patients. It involves iterative testing, feedback, and redesign to ensure that the final product genuinely addresses user requirements.
Some of the most successful healthcare technologies I’ve worked with emerged from exactly these types of partnerships — where developers had continuous access to clinicians throughout the design process, and where rapid testing was facilitated by healthcare organizations committed to improving the end product.
The Path Forward: Concrete Steps
Moving from understanding the problem to actually solving it requires concrete action. Here are the steps I believe we need to take collectively:
- Implement user satisfaction metrics as required criteria in healthcare technology purchasing decisions. Technology vendors should be required to demonstrate high satisfaction scores from actual users — not just promises of future benefits.
- Create dedicated user-testing environments within healthcare organizations that allow for rapid iteration outside production environments. These “sandbox” environments can help overcome the regulatory barriers to iteration while still maintaining necessary safety standards.
- Develop healthcare-specific user experience standards and certifications that can guide both developers and purchasers toward human-centered design.
- Reform venture capital investment criteria to prioritize user adoption metrics alongside traditional sales metrics when evaluating healthcare technology companies.
- Establish formal partnerships between healthcare organizations and technology developers that provide continuous access to end users throughout the development process.
Reimagining Healthcare’s Digital Future
The digital revolution in healthcare is still possible, but it won’t happen by following the same patterns that have failed us repeatedly. It requires a fundamental shift in how we approach technology development, evaluation, and implementation — with users at the center of every decision.
Dr. Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA, develops and deploys technology solutions in the healthcare ecosystem as a clinician, business leader, software engineer, statistician, and social justice researcher. As the Vice President of Innovation at Inflect Health and Vituity, his unique formula of skills has helped develop over 35 solutions and scale multiple new healthcare products, including the first AI occult sepsis tool with FDA breakthrough designation. Dr. Tamayo-Sarver oversees corporate venture, internal incubation, and advisory services for AI-driven healthcare solutions, blending consumerism and clinical quality to fit the delicate balance of patient desire, user experience and quality medical care. A Harvard graduate, he holds degrees in biochemistry, epidemiology, and biostatistics, as well as a medical degree from Case Western Reserve University. He is a Mentor in the Emergence Program at Stanford University.
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