Digital Minimalism For Health Systems

The Growing Complexity of Digital Healthcare

Digital technologies have become increasingly embedded in healthcare delivery. Electronic health records (EHRs), clinical decision-support systems, electronic prescribing, digital communication platforms and other applications now support activities that were previously undertaken through paper-based or manual processes. These technologies have improved the availability of clinical information, strengthened communication and created opportunities for safer and more coordinated care. However, their adoption has also introduced additional layers of interaction, documentation and information processing into routine clinical practice.

In 2018, Sinsky and Privitera described the need to create a manageable cockpit for clinicians. Drawing on the concept of cockpit design in aviation, they argued that healthcare professionals were increasingly required to navigate multiple alerts, mandatory documentation fields, administrative messages and competing information sources. Individually, these interventions were often intended to improve quality, safety or accountability. Collectively, however, they could make clinical work more complicated (Sinsky & Privitera, 2018).

Subsequent research has made it possible to quantify how much clinical time these accumulated digital requirements now take up. Using national EHR activity data from more than 200,000 ambulatory physicians across 396 US healthcare organisations, Holmgren et al. (2024) found that physicians spent an average of 5.8 hours actively using the EHR for every eight hours of scheduled patient care. Documentation was the largest single component, accounting for 2.3 hours, and more than 40% of EHR time took place outside scheduled clinic hours. Much of this activity is essential to safe clinical practice, and time spent in the EHR is not in itself evidence of waste. It does, however, show how much clinical attention these accumulated requirements now occupy, and raises the question of how much of that attention is necessary for care.

Part of the answer may lie in how digital transformation is judged. Progress has tended to be measured by the capabilities introduced, with less attention given to the cumulative complexity those capabilities create for healthcare professionals. Digital minimalism offers a way of examining this complexity.

Understanding Digital Minimalism in Healthcare

Digital minimalism is a philosophy popularised by computer scientist Cal Newport in his 2019 book Digital Minimalism: Choosing a Focused Life in a Noisy World. Newport argues that the value of technology should be determined by how deliberately it supports important activities, rather than by the number of digital tools available or the potential benefits associated with each one.

His philosophy is built around three principles: clutter is costly, optimisation is important, and intentionality is satisfying (Newport, 2019).

Applied to healthcare, the first principle recognises that every additional digital requirement introduces some demand on clinical attention. A new documentation field, notification or software function may serve a legitimate purpose, but its value must be weighed against everything else clinicians are already required to attend to. When several individually useful functions are introduced without considering their combined effects, the result may be unnecessary complexity.

The second principle concerns optimisation. The benefits of a digital technology depend not only on its functionality but also on how it is configured and integrated into routine practice. For example, an EHR may provide access to comprehensive patient information while requiring clinicians to navigate several screens to retrieve information needed for a single decision. Improving how information is organised and presented may therefore be more valuable than introducing additional functionality.

The third principle emphasises intentionality. For health systems, this means that decisions to introduce, retain or expand digital technologies should be guided by clearly defined clinical and organisational needs. Digital adoption becomes a means of improving healthcare delivery rather than an objective in itself.

Singh et al. (2023) applied this philosophy to clinical practice in a perspective in the New England Journal of Medicine, proposing digital minimalism as a response to the growing burden associated with clinical technologies, arguing for more intentional approaches to their adoption and use.

Although digital minimalism has not yet been established as a validated health systems framework, its underlying principles offer a useful basis for reconsidering how healthcare organisations approach digital transformation.

In practice, these principles translate into three questions that health systems can ask of any requirement a digital system places on clinicians: whether it needs to be performed by the clinician, whether it needs to be performed through direct interaction with the system, and whether it needs to be performed at all.

Digital Minimalism in Practice: Lessons So Far

Clinical documentation accounts for the largest share of clinicians’ EHR time, and it is where efforts to reduce digital burden have been most closely studied. Although not framed in these terms, several of these efforts reflect the principles of digital minimalism.

Apathy et al. (2024) examined what happens when documentation is shared across the clinical team. Of 18,265 ambulatory physicians in the United States, 1,024 adopted team-based documentation, in which another team member contributes to the clinical note. Adoption was associated with a 9.1% reduction in physician documentation time, mostly among physicians receiving higher levels of support. The study suggests that simplification does not always require new technology, although reorganising tasks helps only if work is reduced across the team rather than passed to another professional group.

Rotenstein et al. (2026) examined ambient AI scribes, which draft clinical notes from the consultation itself. Across 8,581 clinicians in five US academic medical centres, adoption was associated with modest reductions of 13.4 minutes in total EHR time and 16.0 minutes in documentation time per eight hours of scheduled care, with no significant change in after-hours EHR time. The findings suggest that reducing direct interaction with the EHR can ease documentation, though only modestly, and the associated rise in visit volume indicates that time saved may not be returned to clinicians. Ambient AI also illustrates that adding a technology can support digital minimalism only if it removes more work than it creates, including the work of reviewing the notes it generates.

Hawaii Pacific Health’s Getting Rid of Stupid Stuff initiative, described by Ashton (2018), took a different route. It asked staff to nominate EHR requirements they considered unnecessary or burdensome, and used their input to decide what to change or remove. The initiative showed that frontline staff can identify requirements that have accumulated without review, often outlasting the reasons for introducing them.

Building Digital Minimalism into Digital Transformation

For digital minimalism to influence healthcare delivery, its principles need to shape how health systems design, implement and evaluate digital technologies.

First, decisions to introduce a technology should account for its cost to clinical attention as well as its expected benefits. Business cases for new systems tend to describe what a technology will add, but rarely what it will ask of clinicians in additional steps, alerts or documentation, or what existing tasks it will replace. Requiring both to be stated before implementation would make cumulative complexity visible at the point where it is easiest to prevent.

Second, healthcare professionals should have authority, not only a voice, in how systems are designed and configured. Clinical input is commonly sought on what a system should include, but less often on what it should not require. Frontline staff are often best placed to identify unnecessary steps, and their involvement is most valuable when it extends to deciding what is removed or never built.

Third, reviewing digital requirements should be a routine function rather than an occasional exercise. Documentation fields, alerts and duplicated data entry should be reviewed periodically by clinical, operational and digital teams, with clear processes for deciding what is changed or removed. Some requirements will remain essential for safety and compliance, but none should be retained by default.

Finally, evaluation should measure how much a technology asks of clinicians, not only how widely it is used. Adoption and utilisation metrics reward accumulation; measures such as documentation time, after-hours activity, alert volume and duplicated tasks show whether a system is simplifying or complicating care. Where time is saved, evaluation should also ask how that saved time is used. None of these measures should be read in isolation from clinical outcomes, safety and patient experience.

Conclusion

Digital minimalism does not argue against technological advancement. Its contribution is to make simplification an integral part of digital transformation, rather than an occasional response to poorly functioning systems. For health systems still expanding their digital infrastructure, this offers an opportunity to prevent avoidable complexity from becoming embedded in clinical practice in the first place.

References

Apathy, N. C., Holmgren, A. J., & Cross, D. A. (2024). Physician EHR time and visit volume following adoption of team-based documentation support. JAMA Internal Medicine, 184(10), 1212–1221. https://doi.org/10.1001/jamainternmed.2024.4123

Ashton, M. (2018). Getting rid of stupid stuff. New England Journal of Medicine, 379, 1789–1791. https://doi.org/10.1056/NEJMp1809698

Holmgren, A. J., Sinsky, C. A., Rotenstein, L., & Apathy, N. C. (2024). National comparison of ambulatory physician electronic health record use across specialties. Journal of General Internal Medicine, 39, 2868–2870. https://doi.org/10.1007/s11606-024-08930-4

Newport, C. (2019). Digital minimalism: Choosing a focused life in a noisy world. Portfolio.

Rotenstein, L. S., Holmgren, A. J., Thombley, R., et al. (2026). Changes in clinician time expenditure and visit quantity with adoption of artificial intelligence-powered scribes: A multisite study. JAMA, 335(16), 1408–1417. https://doi.org/10.1001/jama.2026.2253

Singh, N., Lawrence, K., Sinsky, C., & Mann, D. M. (2023). Digital minimalism: An Rx for clinician burnout. New England Journal of Medicine, 388, 1158–1159. https://doi.org/10.1056/NEJMp2215297

Sinsky, C. A., & Privitera, M. R. (2018). Creating a manageable cockpit for clinicians: A shared responsibility. JAMA Internal Medicine, 178(6), 741–742. https://doi.org/10.1001/jamainternmed.2018.0575