How Observational Research Shaped Silva

Successful digital product development starts with understanding, not assumptions. In this article, we share what we learned from conducting observational research and contextual inquiry inside working healthcare organizations and how that approach helped shape Silva, now in use across healthcare organizations in Iceland.

Gangverk and Helix Health recently formed a partnership to make a meaningful impact on healthcare. Drawing on Helix’s deep domain knowledge and Gangverk’s expertise in product development, we pooled complementary strengths from the start.

To find the most meaningful starting point, we began with a multidisciplinary discovery phase. People from both companies worked collaboratively to explore where we could have the greatest impact, examining different aspects of the challenge together.

Observational research and contextual inquiry were a key part of that phase. The research team, one researcher from Gangverk and another from Helix, was invited into healthcare organizations in Iceland. The goal was to understand how people with different roles operate independently, how they collaborate, and where the biggest pain points lie.

While we interacted with many professions, observing and talking to receptionists and health data specialists made it clear that this group could benefit immensely from software better suited to support and streamline their workflows. For example, they often worked across paper records, computer systems, and phone calls, putting in extra effort just to coordinate a single appointment.

That realization became the starting point for the Gangverk and Helix collaboration. It became Silva, a product now actively supporting this group in their daily work.

Observational research is about understanding what people actually do, not just what they say they do. Many important details, shortcuts, habits, and workarounds, live in the space between explanation and execution.

Instead of relying on secondhand descriptions, we placed ourselves in shared workspaces. We sat quietly. We watched. We listened. Over time, we began to understand how things really worked. Here is what that unlocked:

Contextual clarity. People rarely mention what feels obvious to them. These unspoken details, such as habitual actions, shared understandings, or physical cues in the environment, are often essential for understanding how tasks are carried out. Observation helps reveal these quiet but critical parts of the workflow that would otherwise go unnoticed.

Sharper questions. Observing something unexpected opens the door to more relevant and specific follow-up questions. These are often questions we would not have thought to ask in advance because they are rooted in what people do rather than what they say. Seeing real behavior surfaces better lines of inquiry.

Complexity in practice. Workflows are rarely linear. In interviews, the answer to many questions is often “it depends,” especially when discussing detailed processes. But it is nearly impossible for a researcher to ask about every possible variation, and just as hard for interviewees to recall them all. Observation allows these variations to unfold naturally and helps us understand how often they occur and in what context.

System-level patterns. By watching work unfold across roles, we saw how people, tools, and expectations interact in practice. Many workflows depended on informal collaboration, remembering doctors’ individual preferences or figuring out which “source of truth” was most up to date. This shared memory, though unwritten, was what kept things moving.

Emotional texture. Pressure, pace, tone, urgency, and quiet emotional labor shaped daily work, especially in high-contact roles like reception. These nonverbal cues revealed the emotional context of the environment, not just the steps in a process.

Empathy and trust. Observation did not just yield insights, it built relationships. Seeing work happen in real time helped us explain user needs more clearly to the wider team. And by listening carefully and sharing what we learned, we earned trust. People saw themselves in our findings, which made the collaboration stronger and more meaningful.

Observational research and contextual inquiry might seem straightforward, but doing it well takes care, patience, and intention. It is not just about watching. It is about building genuine understanding through presence and attention. These are some of the key principles that guided our approach in this project:

Start by letting go of solutions. The focus should be on learning, not fixing. That can be uncomfortable. But jumping to conclusions too early often leads to disconnected or shallow solutions. Be patient. Listen and learn. Observe before asking “why” and “how” instead of “what if.” Let curiosity lead, not urgency.

Be patient and respectful. This form of research takes time, and you need to build trust. In the beginning, your role is mostly to observe and listen. Keep your distance at first, and make sure people are comfortable having you there. Then, gradually, you can begin asking questions. Be respectful of their time and space. The people you are learning from are doing their job. Do not ask every question at once or interrupt their flow. Always be mindful of your presence and avoid overstaying your welcome.

Create feedback loops. One of the most valuable aspects of this project was the feedback loops we built at multiple levels. After each visit, the research team reflected together, surfacing new perspectives and sharpening our focus. We also kept the broader project team in the loop, regularly sharing observations and early insights, which often identified knowledge gaps. Most importantly, we closed the loop with the people we observed. They trusted us with their time and openness, and it was essential to return that trust. Walking them through what we were seeing, how we were interpreting it, and the journeys we were mapping not only helped validate our understanding but often revealed deeper insights.

Research takes time, but it is time well spent. When done early and with care, it brings clarity that helps avoid wasted effort, misaligned solutions, and costly rework. Most importantly, it grounds decision-making in the reality of the people you are designing for.

We are deeply grateful for the trust we received from the healthcare organizations that opened their doors to us. By opening their doors, they created the conditions for real understanding. That openness was not just generous, it was strategic. It allowed us to see the real workflows, tensions, and adaptations that shape the day-to-day experience.

That investment is paying off. The insights from the research continue to shape Silva, a solution that meets real needs because it is grounded in real experience.

If you want to build tools that truly fit, open your doors to researchers. The insights are worth it.