Modernizing a Legacy EHR
Designing the system, not just the screen.
Years of feature-by-feature additions had created an inconsistent EHR. Front-desk teams needed to remember workarounds, move between disconnected screens, and adapt their process to the software. I recognized that we had a larger product problem to solve, and stepped into an informal leadership role to redirect the effort, reducing administrative task time by 20% and cutting scheduling clicks from 10 down to under 5.
- Role
- Senior Designer, end to end
UX strategy and design - Team
- Design, Engineering, Business and
Industry Stakeholders - Timeline
- 1 year (2021–2022)
- Company
- Ascendum Solutions
The Opportunity
The existing platform had been assembled feature by feature, with engineering driving implementation. The result was inconsistent navigation, visual clutter and disconnected workflows.
The original brief was to redesign appointment scheduling flow. However, during discovery, I realized that scheduling touched every stage of the patient journey: check-in at the front desk, review by nurses, treatment by physicians, documentation after the visit, and check-out by administrative staff. It intersected with demographics, insurance, patient history, billing, and follow-up appointments. Redesigning it in isolation would have fixed one screen and left the underlying usability problems untouched.
The Decision That Changed Everything
Rather than just focusing on the scheduling redesign as originally scoped, I made the case for a different approach: use scheduling as the entry point to modernize the platform's foundation.
- Reframed scheduling as the foundation for broader modernization, instead of an isolated feature redesign.
- Prioritized reusable interaction patterns and scalable components.
- Narrowed scope to scheduling and a small set of adjacent, high-leverage areas, rather than attempting a full platform redesign at once.
- Balanced the longer-term vision against engineering feasibility through phased delivery.
The trade-off: a narrower, more strategic slice of the platform, in exchange for a foundation future work could actually build on.
Design
The previous version had real, specific failure points: no clear hierarchy in a screen packed with information, no color key so status was unreadable at a glance, and minimal visibility into patient status or availability. The redesign addressed each directly: clear queue-status indicators, color coding to distinguish appointment types like telehealth, icons for recurring appointments, the ability to create an appointment by double-clicking an open slot, and toggles between day, week, and month views.
Behind the Decisions
Balancing clinician needs, stakeholder priorities, and technical constraints took iterative prototypes and close collaboration with engineering. Clinicians wanted immediate relief on the pain points they dealt with daily. Engineering and platform leadership needed a longterm solution they could implement. Every prototype round was a negotiation between those two timelines, tested directly with clinicians.
Narrowing scope was its own trade-off: it meant resisting pressure to fix everything at once, in favor of a smaller set of changes engineering could actually deliver without compromising the underlying architecture.
Outcomes
- Reduced clinician administrative task time by 20%, and cut clicks required to schedule an appointment from 10 down to under 5.
- Beta release to four mid-sized clinics also showed CSAT improve from 55% to 74%.
- The project aligned clinicians, business, and engineering leadership around a shared platform vision, and established a scalable UX foundation the team continued building on beyond the initial scheduling release.
Reflections
I had to look at the product as a whole to recognize that the original brief wouldn't solve the larger business problem. We need to build a practical strategy for moving forward, and align cross-functional stakeholders around a scalable foundation.
Next Steps
The reusable patterns and design system established here were built to scale beyond the scheduling feature. Next in scope: applying the same foundation to finance, billing, and insurance workflows, and building out a dedicated patient-facing view alongside the clinician-facing tools addressed in this phase.