We are writing a series on the challenges of building healthcare software. We feel that there is a need to reconnect to the principles of making good software while keeping in mind the unique needs of healthcare. The first principle is to take all stakeholders into account. The best software is developed with all stakeholders in mind. We can see where this is missing in the current EHR landscape. It is apparent that EHR systems are optimized for administrators and payers, rather than clinicians and patients. Most are highly lacking in functionality for the care team member who has to input and retrieve information. For any type of software, there are direct ("hands on the keyboard") and indirect (impacted in some way) stakeholders. Each has a unique need that ideally will be addressed from planning through implementation. Who are they, and how will they be affected?

In most cases, medical software is used directly by clinicians. It must be designed with ease of use and functionality at top of mind. What are they trying to accomplish with this software and how can they achieve the end goal with as little friction as possible? Is there a secondary purpose of the software that can benefit the care team member without adding unnecessary burden? The software needs to enhance the clinician's workflow, not impede it.

Healthcare is centered around the patient and providing care. The patient is the main benefactor whether or not they have access to the data. Is the software helping all of the other stakeholders achieve the goal of providing the best care possible? If the software is slowing down clinicians unnecessarily, then it is ultimately reducing the benefit to the patient and not serving its purpose well.

Administrators are tasked with optimizing for efficiency, coordinating reimbursement, and maintaining compliance. If the software touches on the areas of regulation or reimbursement, the needs of administrators must be considered. In these cases, needs of efficiency, reimbursement, and/or regulatory compliance must be identified and supported with data collection and reporting - while not detracting from any primary or clinical function.

Whether or not IT team members use the system, they have a stake. IT needs to make sure any software will integrate easily and securely into their network and any associated systems. Their concern is the security of the data and the maintainability of the system. Any medical software needs to be fully aware of security concerns and maximally implement current best practices.

Healthcare software will have an impact on all of the stakeholders in different ways and needs to be designed, tested, and implemented with this in mind. The best practice when developing is to contact all of them and understand all stakeholder needs and integrate them into the functionality in a well-prioritized and balanced way. This will produce a final product that works optimally and beneficially for all of the parties affected. What do you expect out of the software? What makes healthcare software "great"?