Building healthcare tools is hard. Not because the ideas are bad. Not because the code is broken. But because two critical groups — engineers and clinicians — often don’t speak the same language.
Engineers want to solve problems with systems. Clinicians want to care for patients with speed and clarity. When these worlds don’t connect, even the smartest products fall short.
This gap isn’t just technical. It’s human. It’s about communication, priorities, and pressure. Bridging it is the key to healthcare tools that actually work.
One expert who sees this clearly is Andrew Cannestra, MD PhD. With a background in both medicine and product strategy, he has spent years translating between builders and users. He’s seen firsthand how this missing link breaks down even the best intentions.
“I’ve watched brilliant engineers build tools no one used,” he says. “Not because they didn’t care — but because they weren’t close enough to the room where care happens.”
Why the Gap Exists
Different Training, Different Mindsets
Engineers are trained to break down systems. They think in terms of logic, process, and scale. Clinicians are trained to manage uncertainty. They think in real time, under pressure, with lives on the line.
That creates two different worldviews.
For an engineer, a two-second delay might not matter. For a clinician, it breaks their focus.
For a developer, an extra screen might organize information. For a nurse, it adds risk of error.
“I once watched a team debate tooltip wording for weeks,” Cannestra says. “Meanwhile, the nurse using the tool just wanted to finish charting before her next patient crashed.”
Asymmetric Access to the Problem
Clinicians are busy. They rarely have time to join product meetings or beta tests. Engineers don’t always get access to clinical environments. So tools are built from fragments of feedback.
That leads to good guesses, but bad fit.
According to a 2023 Health Affairs study, over 70% of health software features go unused. Often, it’s not because they’re useless — it’s because they weren’t designed with the user’s real day in mind.
What Happens When Communication Fails
Poor Adoption
If a tool interrupts care or doesn’t feel helpful, it won’t get used. This isn’t about resistance to change. It’s about survival. Clinicians under pressure will always choose what works — even if that means ignoring new tech.
Lost Trust
When tools slow clinicians down or add to their burden, trust erodes. Even helpful tools start getting ignored. Over time, this creates tension between frontline teams and the builders meant to support them.
“If you launch something that makes things worse, you lose the right to try again,” says Cannestra. “Rebuilding that trust takes months.”
Slow Iteration
When feedback loops are broken, problems don’t get fixed fast. Engineers may not hear about friction until it’s too late. Updates lag. Bugs persist. People give up.
How to Bridge the Gap
1. Put a Translator on the Team
Hire or empower someone who speaks both languages — someone who understands product and has clinical experience. This person becomes the link.
“Some of the best outcomes I’ve seen came from having a nurse or doctor on the product team,” Cannestra says. “They don’t need to write code. They just need to help shape the right questions.”
2. Watch Real Work, Not Just Reports
Engineers should spend time shadowing users. Not just interviews — full shifts. Watch the stress, the pace, the interruptions. That’s where the real design insights come from.
Build empathy first. Then build features.
3. Co-Design in Real Time
Invite clinicians into design reviews. Use tools like Figma or live prototypes. Ask, “What part of this feels wrong?” Give them space to critique and shape the tool as it evolves.
This doesn’t just improve fit. It builds buy-in.
4. Use Feedback Loops That Actually Work
Set up tight, clear feedback cycles. Not just quarterly surveys. Weekly check-ins. Fast fixes. Clear points of contact.
Make it easy for users to report friction. Then fix it fast.
“People don’t expect perfect tools,” says Cannestra. “They expect someone to care when it breaks.”
What Leaders Can Do
Align Incentives
Leadership should reward simplicity and adoption — not just new features. Ask, “Is it being used? Is it helping people move faster?” Reward those outcomes.
Protect Time for Cross-Functional Work
Give clinicians protected time to work with product teams. Don’t make it a side job. Make it part of the mission.
Fund Translators, Not Just Builders
Invest in roles that bridge the gap. The ROI of good communication beats another dashboard.
What’s at Stake
The cost of broken communication isn’t just wasted money. It’s clinician burnout. It’s missed chances to improve care. It’s tools that could help — but never get used.
Healthcare doesn’t need more code. It needs more connection.
“You can’t build the right thing if you’re asking the wrong questions,” says Andrew Cannestra, MD PhD. “And you can’t ask the right questions if you’re not in the room.”
Final Thoughts
The best healthcare tools aren’t just well-engineered. They’re well understood.
They come from listening deeply. From asking better questions. From working side by side — not in silos.
If you want your next product to work, don’t just hire more developers.
Bring the clinician into the room. And keep them there. That’s the missing link. And that’s where the real progress starts.