This Master’s Thesis aimed to assess and propose improvements for initial learnability in Sectra AB’s Picture Archiving Communication System (PACS) by integrating usability engineering and agile software development. Assessing initial learnability and re-designing complex systems is difficult as they have a high skill cap and take longer time to learn in comparison to simpler ones. Further, companies that use agile methodologies often focus on completing small items which might hide the overarching vision of a product that can lead to usability problems. While there are several methods for assessing usability, no research has specifically focused on assessing initial learnability in complex systems. This study however investigates how this may be achieved by combining current methodologies for measuring learnability with usability engineering and agile software development. Initial learnability issues and needs were assessed after evaluating Sectra PACS using 5 participants and analysed using impact mapping as well as conducting a focus group within the organisation that owns the product.