Beam Health makes EHR-adjacent tooling for outpatient clinics. I led the redesign of the charting flow, the screen clinicians live in, and cut 42% off the average chart-completion time while passing every HIPAA and audit review.
Charting is the most-used screen in any EHR-adjacent product. A clinician sees twenty to thirty patients a day. Each visit ends with charting. Save thirty seconds per chart and you give a clinician back an hour.
Beam's charting flow had grown by accretion. A dropdown here, a modal there. By the time I joined it was a fourteen-field form clinicians had to navigate while talking to a patient, or in the twelve-second handoff between rooms.
A bad chart is not a bad form fill. It is a missing diagnosis or a billing error. Mistakes here carry clinical and financial weight.
HIPAA, audit logging and clinical-content rules constrain every interaction. Design without legal in the room is design that gets rolled back.
Clinicians do not have minutes to chart. They have seconds, often standing, often interrupted. The interaction model has to assume hostile conditions.
Chart-completion time was the company's most-watched non-clinical metric, and it had been creeping up for three releases. Diagnosis was hard. Clinicians completed charts late at night, in batches, off the floor. The screen was failing them, quietly, and asynchronously.
Shadowing fourteen clinicians across four specialties gave a sharper picture. The charting screen was demanding full attention at the moment clinicians had the least to give.
Required-field errors fired as modals mid-charting and broke train of thought. Clinicians described mentally starting over after each one.
Smart defaults existed but were buried two levels deep. Most clinicians did not know they existed. They typed everything from scratch.
The form was structured for the auditor, not the clinician. Field order matched the chart's legal structure, not the encounter's natural flow.
"I chart at 9pm at home. The screen is the last thing I see before I close the laptop and the first thing I dread in the morning."
I led the charting redesign as the senior designer, paired with one junior designer and a clinical informaticist who was embedded in the team. The compliance officer reviewed every flow.
My remit covered discovery, shadowing and diary studies, interaction design, accessibility, and the validation plan that satisfied both clinical and audit stakeholders.
Three structural changes drove the result. Each one took a piece of the form's cognitive load off the clinician.
The single highest-impact change was reordering the form. The original chart was structured for the auditor reading it three months later. Diagnosis codes first, history last. Clinicians filled it in a different order. History, then observations, then assessment, then plan. The encounter itself.
Every clinician we shadowed scrolled up and down to fill the form, because the form's structure did not match how they thought. Reordering looked trivial in Figma. It took four months of compliance review.
Sections were reordered to mirror SOAP, subjective then objective then assessment then plan. Clinicians stopped scrolling. Time to first field dropped from twenty-two seconds to six.
Modal errors were replaced with gentle inline cues. The form never blocks the clinician mid-thought. Errors surface at submit, with a clear path to fix.
When a field had a likely value, based on patient history, specialty or previous chart, the value surfaced inline as a one-tap accept. No settings menu required.
| Before | → | After |
|---|---|---|
| Audit-ordered form, codes first | → | Encounter-ordered, SOAP |
| Modal validation interrupts thought | → | Non-blocking inline cues |
| Smart defaults buried in settings | → | Inline, one-tap accept |
| 8.2 min average chart time | → | 4.7 min average chart time |
| No clinical-flow research | → | Shadowing, diary, field trial |
| Single rollout, fingers crossed | → | Phased rollout with rollback gates |
The audit-versus-encounter ordering insight was visible in five minutes of shadowing and invisible in six weeks of survey data. Be in the room.
Bringing the compliance officer into design reviews, not just sign-off, surfaced constraints early and produced better designs faster.
The three-clinic trial caught two regressions and validated the metric movement. Worth every week.
Some integration constraints surfaced late. Earlier vendor conversations could have widened the design space.
The 8.2 minute baseline came from log analysis, not a clean experiment. Cleaner instrumentation would have made the result harder to dispute.
A non-trivial fraction of charting happens at home, late at night. I designed for the floor and treated home charting as out of scope. It should not have been.
The clinician finishes their day at six, not nine. That is the metric. Everything else is downstream.