This paper outlines a practical approach for enabling user-centric healthcare information systems development in large scale. The approach is especially powerful at the current stage of clinical informatics adoption by the leading countries which have already set deadlines for standardized capture and sharing of personal health records at national level. This stage is followed by more efficient usage of the data and improvements in clinical processes as topical action points towards optimizing

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... ctual clinical outcomes. So far the program for meaningful use in the US and strong orientation of the Nordic countries have led to reasonable availability of electronic health records, but challenges remain in their actual utilization for clinical use and readiness for new clinical processes. We propose an innovative and scalable approach for supporting the systems development, which empowers the users not only to solve problems of use, but to contribute excellence in clinical behaviour with the experiences and insights along the actual work. As a result, conceptual framework is presented and a couple of examples presented how user experience monitoring support to improve measurement of data accessibility, system use and clinical behaviour towards better clinical outcomes.