Background: User-centered design (UCD) processes often generate extensive lists of potential software features, necessitating prioritization methods to guide development. The MoSCoW method, categorizing features as “must have,” “should have,” “could have,” or “won’t have,” is widely used in software development for its simplicity and ease of adoption. Despite its popularity, limited evidence exists on its application within health informatics. The Decision Aid Navigator (DEAN) system, a clinical decision support tool, required prioritization of features for its administrative portal to ensure #usability and alignment with health information technology (HIT) professionals’ needs. Objective: This study aims to describe how health professionals engaged with the MoSCoW prioritization process during the design of the DEAN administrative portal and to consider how discussion and interaction influenced feature prioritization outcomes. Methods: A 74-minute web-based group session included 4 HIT professionals experienced in managing clinical decision support systems. Participants independently rated 30 proposed portal features using MoSCoW categories following brief discussions of each feature. Session transcripts, videos, and rating behaviors were analyzed using a single-case qualitative analysis to describe how the MoSCoW process supported prioritization and expert engagement. Results: Participants rated 37% (11) of 30 features as “must have,” 13% (4) as “should have,” 20% (6) as “could have,” and none as “won’t have.” The remaining 30% (9) showed distributed ratings without a clear majority. The summary percentages are derived from majority vote, not from individual-level ratings. All participants adjusted their ratings, often prompted by group discussion or clarification from the technical lead. Qualitative analysis describes four key insights: (1) interpretations of feature descriptions may vary; (2) group discussion generated suggestions for alternative design solutions; (3) group discussion identified implementation considerations; and (4) participants considered differences in real-world use vs idealized use when ranking features. Conclusions: The MoSCoW method appeared feasible, accessible, and potentially pragmatic for prioritizing features in a UCD process for a clinical decision support system. Group discussion enriched the prioritization session by surfacing implementation insights and design refinements beyond numeric rankings alone. Findings suggest, in this single case, that the use of MoSCoW is understandable to health informatics teams seeking structured yet flexible stakeholder engagement in software feature prioritization.

In the fast-paced world of project management and personal productivity, prioritizing tasks effectively is crucial. One powerful technique that has gained widespread recognition for its simplicity …