Andrew Cannestra, MD PhD Urges Healthcare Innovators to Rethink Design Through a Systems Lens

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Andrew Cannestra MD PhD

From San Francisco, Dr. Andrew Cannestra calls for a major shift in how medical tools are built and adopted in real-world clinical settings.
San Francisco, CA - February 20, 2026 - Dr. Andrew Cannestra, MD PhD, a physician, scientist, and product strategist, is raising awareness around one of the biggest failures in modern healthcare innovation: good tools that don't get used.

Despite increasing investments in clinical technology, over 70% of medical software features go unused, according to a 2023 Health Affairs study. Dr. Cannestra says this isn't just a design issue - it's a systems problem.

"Most tools don't fail because they're inaccurate," said Dr. Cannestra. "They fail because they don't match how people actually work."

Drawing from his experience across academic medicine, healthcare startups, and biotech product teams, Cannestra is advocating for a new standard in how tools are evaluated - not just by what they do, but by whether they fit the workflow.

A Widespread Problem with High Stakes

Today's clinical teams are overloaded. The average hospital physician manages hundreds of tasks per day, many in environments where seconds matter. Even well-designed tools can fail when they interrupt thought flow or require extra clicks.

"If a tool adds friction, it gets ignored," Dr. Cannestra explained. "That's not a user problem. That's a systems failure."

He points to a key example: alert fatigue. More than 80% of physicians report ignoring safety alerts due to poor timing or overload, according to the American Medical Association. As a result, critical tools go unused - or worse, get disabled.

Building for Real Life, Not Just Launch Day

Cannestra emphasizes that many tools are built in isolation. They're tested in ideal conditions but fail in messy, high-pressure care environments.

"A feature that works in a quiet room might break down during a code blue," he said. "If it doesn't help in the hard moments, it's not helping at all."

Instead, he recommends testing tools in real settings, with real users, during real shifts. That's where hidden friction shows up - and where small adjustments make the biggest impact.

A Call to Action: Build Tools That Respect the System

Cannestra urges healthcare builders - from engineers to clinical leaders - to rethink how they measure success. Accuracy and innovation are important. But usability, timing, and fit are what determine real-world adoption.

His recommendations for innovators:

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Spend a full day shadowing the people you're building for

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Replace dashboards with decision support

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Reduce steps, don't add them

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Test tools during chaos, not calm

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Measure outcomes like adoption rate during peak hours or voluntary reuse

"If a tool can't be used in the hardest moment of the day, it shouldn't ship," he added.

Why It Matters Now

As health systems continue to face staffing shortages, budget constraints, and rising burnout, the need for practical, usable tools has never been more urgent. Poor adoption not only wastes money - it can lead to patient risk.

The CDC reports that clinical workloads have increased by 25% since 2020, while physician satisfaction has dropped by 30%. Building tools that work in real life isn't just nice - it's critical.

"The system always wins," said Dr. Cannestra. "If you build against the system, the system will reject your tool. If you build with it, your tool becomes invisible - and that's the real goal."

What You Can Do Today

Dr. Cannestra offers a simple path forward for professionals working in product, healthcare, or design:

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Watch a full clinical shift - not a demo, but the real thing

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Interview people after high-stress moments, not just during onboarding

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Ask, 'What can this tool replace?' If the answer is nothing, reconsider it

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Audit your own workflow - where does attention break down?

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Design exit ramps - allow users to opt out instead of forcing behavior

"The best tools I've seen didn't require training. They just worked," he said. "If it takes more than 10 seconds to understand, it's already too complicated."

About Andrew Cannestra, MD PhD

Dr. Andrew Cannestra is a San Francisco-based physician-scientist and healthcare innovator with deep experience across academic medicine, product strategy, and clinical tool development. Known for his calm leadership and clear thinking, he works with teams to build tools that support real-world care - not just theoretical improvement. His work focuses on reducing friction, improving adoption, and connecting the gap between intention and execution.

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