Spend enough time in healthcare IT and the conversation starts to sound familiar. AI will change everything. Platforms will unify the ecosystem. Interoperability will finally unlock value.
All of that may be true. But spend enough time with a nurse at the bedside, and a different story emerges. There’s a quieter shift happening beneath those headlines, one that has less to do with technology itself and more to do with how decisions about that technology are made.
Health systems are starting to rethink not just what they buy, but how they design the environments those tools live in. And in that shift, design thinking is moving out of the UX layer and into the core of strategy.
The problem isn’t the tools, it’s how they come together.
Walk into a typical hospital room today and you can see that there isn’t a single, cohesive system supporting care. There’s a collection of tools: a workstation for documentation, a TV, clinician smartphones and patient devices. And then there are separate screens for telehealth, translation services, virtual monitoring, and digital whiteboards.
Each one was added with good intent. Each one solves a specific problem. But together, they often create something fragmented and difficult to navigate, for both clinicians and patients.
That fragmentation isn’t a technology failure. It’s a design issue.
Most of these tools weren’t conceived as part of a unified system. They were layered in over time, often by different stakeholders solving different problems under different constraints. The result is an environment where the burden of integration falls on the user.
Clinicians adapt and patients try to keep up. But neither group is operating within something that feels intentionally designed. That’s beginning to change slowly.
Design thinking is moving upstream
Some health systems are starting to ask different questions earlier in the process. Instead of beginning with procurement, they’re stepping back to define the problem more clearly. What does the workflow actually look like? Where does friction occur? What would a more coherent experience feel like for the people using these systems every day?
It sounds simple, but it represents a meaningful shift.
Design thinking, in this context, isn’t about making interfaces prettier or slightly easier to use. It’s about shaping the system itself by identifying how tools connect, how information flows, and how decisions get made across clinical, operational, and IT teams.
And that shift is changing how health systems work with partners. The shift isn’t from bad design to better design. It’s from design as an afterthought to design as the starting point.
Rethinking what partnership means
For years, the dominant model has been transactional. Requirements are defined. Vendors respond. A solution is selected and deployed. If it works, it stays. If it doesn’t, it gets worked around.
But increasingly, that model is showing its limits.
When systems are complex and environments vary widely, it’s difficult to anticipate everything upfront. Even well-defined requirements don’t always translate into real-world usability.
So some organizations are moving toward a more iterative approach, one that looks less like procurement and more like co-creation.
Instead of prescribing exactly how something should be built, they define what success looks like and refine the solution over time. Feedback loops become part of the process. Adjustments are expected, not treated as exceptions. This is where the idea of moving from vendor to “unvendor” starts to matter, not as a slogan, but as a real shift in responsibility.
What emerges is something closer to a shared design effort than a one-time transaction.
Standardization that evolves, not constrains
This is especially visible in how some organizations are approaching standardization.
Standardization has traditionally been associated with cost control – reducing variation, simplifying purchasing, and making systems easier to maintain. But in practice, it often introduces new challenges if it doesn’t align with how people actually work. What’s different now is the recognition that a “standard” doesn’t have to be static.
In some environments, standardization starts with a baseline and evolves through iteration. As clinicians use the system, they provide input. As workflows change, adjustments are made. Over time, the standard becomes more refined, and, importantly, more relevant.
That process can reduce training complexity and improve consistency. But just as important, it creates a sense of ownership. When people feel that systems reflect how they work, adoption tends to follow.
Why infrastructure decisions are strategic
All of this points to a broader realization: infrastructure decisions are not just operational, they are strategic. Infrastructure is often treated as background. In reality, it defines what’s possible. When infrastructure fails, clinicians don’t stop working. They work around it, and that’s where fragmentation begins.
The way systems are designed influences everything downstream. It affects how clinicians spend their time, how easily patients can navigate their care, and how efficiently organizations operate. And yet, many decisions are still made in isolation.
Take patient engagement as an example. Patient portals are widely available, but usage remains uneven. It’s not necessarily because patients aren’t interested. More often, it’s because the experience doesn’t align with what they actually need – clear information, simple navigation, and continuity across different parts of the system. When systems are difficult to navigate, patients don’t disengage because they don’t care. They disengage because the system wasn’t designed for them.
If anything, it raises a more fundamental question: what would healthcare look like if systems were designed around how patients move through care, rather than how organizations are structured?
Progress is real, but uneven
There are signs of progress. In some organizations, clinicians are being brought into decision-making earlier. Cross-functional teams are becoming more common. There’s a growing recognition that workflow, technology, and environment are tightly connected and need to be addressed together.
But the shift is uneven. In many cases, design thinking is still applied too late. Procurement processes still prioritize features over outcomes. And systems that are meant to work together are still selected and implemented independently.
These aren’t small challenges. They’re structural. And they won’t be solved by a single technology or platform.
The real opportunity ahead
If there’s a takeaway, it’s this: healthcare doesn’t have a shortage of innovation. It has a coordination problem.
Healthcare doesn’t need more tools. It needs systems that work for providers, for health plans, and most importantly, for patients. And that starts with designing not just for technology, but for the people who depend on it, people who need to trust it will work when it matters most.
That may not be as visible as the latest AI announcement. But it’s where many of the most meaningful changes are starting to happen.
Photo: PeopleImages, Getty Images
Chief Product Officer at Simplifi Medical and co-host of the Beyond the Blueprint podcast, Keith Washington is a seasoned healthcare executive with over 30 years of leadership in point-of-care technology, enterprise IT, and clinical workflow innovation. He has held senior roles, including CEO of TVR Communications and Green Cubes Technology, and co-founded Flo Healthcare, a pioneer in mobile computing for hospitals. His work spans operational strategy, product development, and system-wide technology adoption across acute and post-acute care.
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