The requirements doc was correct. The workflow was not.
A $15M healthcare IT product portfolio serving clinical operations was mid-roadmap planning. The product team had completed a standard discovery cycle — stakeholder interviews, requirements documentation, and feature prioritization — and was preparing to commit engineering capacity to the next build cycle.
The challenge was not a lack of user input — it was the wrong kind. Stakeholder interviews capture what people say they do. In regulated clinical environments, staff are trained to describe the official process, not the actual one. Standard discovery methods were systematically blind to the gap between protocol and practice. The roadmap was confident, well-documented, and pointed in the wrong direction.
Compounding the challenge: challenging a roadmap that had stakeholder sign-off, documented requirements, and executive alignment required workflow evidence strong enough to override organizational momentum. Opinion would not be sufficient.
Conducted direct field observation and contextual inquiry sessions with clinical staff across care settings — watching actual task execution, not listening to task descriptions. Mapped the end-to-end as-is workflow using service blueprinting to capture frontstage actions, backstage processes, system touchpoints, and failure points in a single visual.
The service blueprint revealed a layered system of compensating behaviors: informal routing protocols, manual reconciliation steps between systems, and shadow workarounds that clinical staff had normalized over months. These were not complaints — they were invisible adaptations to a product that had drifted from the actual clinical workflow.
The workarounds were not edge cases or user preference. They were structural signals: the product architecture had diverged from the clinical workflow at a foundational level. Every new feature being planned would be built on top of that misalignment — adding complexity to a broken foundation rather than correcting it. The requirements document was not wrong — it accurately captured the official workflow. The official workflow was not what clinical staff were doing.
Presented the service blueprint and workflow gap analysis directly to product leadership — before sprint planning, before architecture commitment. The case was grounded in observed evidence, not inference: specific workflow steps, named failure points, and quantified frequency of workaround usage. Designed and proposed a future-state workflow model that resolved the structural misfit, redefining what the product needed to do at the architecture level.
The roadmap was halted. The portfolio architecture was realigned to the actual clinical workflow before any additional build investment was committed. This was not a scope change — it was a decision about what the product fundamentally needed to be.
Downstream rework — the re-architecture that would have been required after build — was eliminated before it could be incurred. The $15M portfolio was redirected to build on a workflow foundation that matched clinical reality. Owned the outcome through direct partnership with product leadership on roadmap redirection, not advisory handoff.
Methods Applied
- Field observation & contextual inquiry
- End-to-end service blueprinting
- As-is / future-state workflow mapping
- Failure point & workaround analysis
- Pre-build architecture challenge