Many systems fall short not because the technology is inadequate, but because user experience (UX) is not meaningfully considered — or sustained — over time. In clinical environments, where time is finite and pressure is constant, this gap becomes especially visible.
Clinical systems are used by a wide range of people with very different needs. Epidemiologists often focus on outputs: trends, reports, and population-level insights. Their interaction with a system may involve minimal data entry but a strong expectation of clarity and speed. Nurses, by contrast, spend much of their day entering data. Some are content to work through a task regardless of how long it takes, while others are quick to identify inefficiencies and opportunities for improvement. Working closely with nursing teams makes these differences clear.
A system that feels fluent and intuitive can be empowering. One that does not can be quietly demoralizing. Poor UX doesn’t just slow people down — it creates a sense that time is slipping away, particularly for people who are motivated by the desire to make a difference. In fast-paced clinical environments, that feeling is amplified by stress, workload, and constant interruptions.
The impact becomes even clearer when systems are pushed to scale. Public health units vary widely in staff ratios, workload, and case complexity. A system that works adequately in a smaller or quieter unit may struggle in a busier one. Under heavier workloads, UX friction that was once tolerable becomes a daily obstacle. Tasks take longer, inefficiencies compound, and frustration grows. Siloed systems exacerbate this problem, particularly when users are required to enter the same data multiple times across different platforms.
Off-the-shelf systems are not inherently the problem. In many cases, they are the only realistic option, especially in government and large organisations where procurement, compliance, and risk management are legitimate concerns. The challenge arises when these systems are treated as static purchases — something that can be bought, deployed, and assumed to remain fit for purpose indefinitely.
In reality, systems exist within organisations, and organisations change. One commonly observed issue is that a system is sold with strong engagement and support, only for the vendor to later undergo changes in management, structure, or priorities. Support models evolve, key personnel move on, and the quality or responsiveness of engagement can shift. This is not necessarily due to poor intent; it is a natural outcome of business change. However, the impact on end users can be significant.
When this happens, systems risk stagnation. Feedback loops weaken, minor usability issues remain unresolved, and trust between users and vendors erodes. Over time, the system drifts further away from frontline needs, even if the original implementation was sound.
The solution is not to burden vendors with unrealistic expectations, nor to assume that support can remain static forever. Instead, there needs to be an intentional framework for long-term cooperation. This includes clear expectations around ongoing engagement, mechanisms for prioritising and actioning user feedback, and shared ownership of the system’s trajectory. Trust is built when users can see that feedback leads to thoughtful consideration and meaningful change, even if not every request is implemented.
Importantly, UX itself does not need to be endlessly configurable. Systems should not be cluttered with options to satisfy every edge case. Rather, fields, workflows, or modules should accommodate differing requirements only where they also fill another gap or create future versatility. This keeps systems usable while allowing them to evolve as needs change.
Several principles can help maintain a healthy system over time:
- Treat systems as living tools rather than one-off procurements
- Establish durable vendor relationships that survive organisational change
- Create structured feedback pathways with visible outcomes
- Design modular, extensible systems that can adapt without constant redesign
- Enable interoperability through APIs to reduce silos and duplication
- Quantify the value of good UX in time saved, errors reduced, and staff wellbeing
Good systems do not eliminate risk — they manage it. They recognise that clinical environments are complex, pressured, and human, and that sustainability matters as much as initial delivery. When UX, scalability, and long-term collaboration are taken seriously, systems become enablers rather than obstacles, supporting people to do their work effectively and sustainably over time.
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