EHR user interface improvements and their effect on documentation time

On a quiet clinic afternoon I caught myself counting clicks instead of thinking about patients, and that was the nudge I needed. I opened the chart to confirm a medication dose and realized my cursor was traveling a miniature obstacle course across the screen. I kept asking: if the electronic health record is supposed to speed up my work, why does it sometimes feel like a maze? That question sent me down a very practical rabbit hole—what specific user interface changes actually shrink documentation time without cutting corners on quality or safety?

Why a few pixels can steal an afternoon

I used to shrug at minor layout issues: an extra confirmation dialog here, a buried order set there. Then I started watching the day in minutes instead of tasks. Small UI frictions—scrolling within nested frames, modal windows that block context, buttons that jump as panels load—compound fast. Over a half-day session, those frictions add up to dozens of micro-delays and broken trains of thought. The surprising part is how much these “tiny” moments matter once you multiply them by the number of notes, orders, and inbox messages. It finally clicked for me that UI design is clinical time management by another name.

  • Reduce aimless motion: Fitts’s Law becomes real when the “Sign” button lives far away from the patient header. Moving high-frequency actions closer to where my eyes already rest shaved seconds off every note.
  • Keep context visible: When I can see vitals, meds, and allergies in a stable sidebar while documenting, I stop hopping between tabs. Fewer context switches = fewer re-reads.
  • Preview before commit: Inline previews for orders and diagnosis codes reduce backtracking, which quietly eats time and attention.

Once I started treating the EHR like a workspace to be arranged (not a black box to tolerate), I went looking for grounded guidance. The Office of the National Coordinator’s notes on usability and clinician burden helped me translate “annoyance” into design patterns, and time-motion research gave me a baseline for what minutes were actually in play (see ONC Usability and Burden and a classic time-motion study in Annals of Internal Medicine (2016)).

What I changed first and what actually helped

I’m not an engineer, so I focused on changes a frontline clinician or clinic manager can request or configure. The goal wasn’t to make the EHR “fun”—just less interruptive and more aligned with how the work actually flows.

  • Surface the 20 percent we use 80 percent of the time: I asked our analyst to pin my top order sets and favorite phrases to the first screen in the order and note composer. Having the obvious choices in reach lowered decision friction and cut down on searches.
  • Collapse what’s rarely needed: Collapsible panels for low-frequency info (e.g., detailed insurance fields) freed vertical space for what I reference constantly. Less scrolling meant fewer misses.
  • Make the keyboard a first-class citizen: Learning and customizing hotkeys (and insisting they show in tooltips) turned many three-click actions into one keystroke. It also made the interface feel more “predictable.”
  • Template with restraint: I simplified boilerplate so templates suggest structure but don’t lock me into paragraphs I will only delete later. The test was simple: if a smart phrase saved me fewer than 5 seconds on average, I retired it.
  • Keep the patient story in view: A stable, always-visible header with demographics, allergies, and current meds curbed my tab-hopping habit. Cognitive strain dropped, and so did documentation time.

These aren’t abstract principles; they’re small decisions that trade seconds for clarity. To shape the plan, I leaned on usability and workflow resources targeted to health care (e.g., the AHRQ Workflow Toolkit and practical playbooks like AMA Steps Forward).

Small design choices that save minutes all day

When I audited my own clicks, four UI patterns delivered the most reliable returns:

  • One screen, one primary decision: If I’m choosing a diagnosis, don’t distract me with treatment templates until I pick one. Fewer options on the decision screen equals faster, more confident choices.
  • Progressive disclosure: Advanced options stay hidden until I actually need them. This trims visual noise without blocking power users.
  • Predictable placement: Save, Sign, and Cancel should live in the same position across modules. Muscle memory is a time-saver; breaking it is a tax.
  • Inline validation: If an order is missing a detail, tell me in place, not after I hit Sign. Real-time nudges beat after-the-fact error modals every time.

Underneath these choices sits a mindset shift: the EHR is not “just software,” it’s a clinical coworker. Good coworkers anticipate needs, avoid rework, and don’t make you repeat yourself. That’s what good UI does, too.

When the interface gets in the way of thinking

Documentation time is not only about speed; it’s about preserving clinical reasoning. I’ve noticed that UI interruptions—modal pop-ups, sudden focus changes, or a reset scroll position—don’t just slow me down. They disrupt how I hold a patient’s story in working memory. That extra minute rebuilding context is real time, and it’s also where mistakes can creep in. Resources on clinician well-being helped me see this link clearly; design that reduces cognitive load supports both accuracy and morale (see the National Academy of Medicine’s collection on well-being and burnout: NAM Clinician Well-Being).

How I measure whether changes truly help

I used to trust vibes. Now I try to measure. A simple before–after snapshot tells me if UI tweaks are worth keeping:

  • Time-to-sign: Average minutes from opening a note to signing it, adjusted for visit type. If the median drops and stays down for two weeks, that’s a win.
  • Click count for common tasks: Orders for top medications, a referral, a problem list update. If clicks fall by 25–50% without new errors, the design is better.
  • Rework rate: How often I open a note again after signing to fix structure or missing data. Less rework often means the UI is guiding me properly the first time.
  • Inbox carryover: Messages still unresolved at end of day. Smarter layouts inside the inbox (batch actions, consistent sorting) reduce next-day carryover.

When I share results with our analysts, I link findings back to recognized guidance, because shared language speeds up change requests. ONC’s materials on burden reduction and patient safety make that collaboration smoother (ONC Usability and Burden).

Habits that paired well with better screens

Interface work is powerful, but it’s even better when paired with low-drama habits:

  • Batch similar work: I try to do inbox messages in timed sprints with the same filters and canned responses visible. The UI supports me when those tools are surfaced by default.
  • Draft now, polish later: I record the critical history and assessment in the room, then add nuance after. Templates that emphasize structure over prose help me do this without losing the thread.
  • Right-size the note: I aim for notes that a colleague can read in a minute. That means stripping auto-imports I never use and favoring succinct problem-based structure.

It’s tempting to chase every new feature—dictation, ambient tools, AI summaries—but my experience is that workflow-aware UI clean-up pays off first. Then, if speech or ambient documentation fits your context, layer it on thoughtfully and keep measuring. The core question stays the same: does this tool reduce clicks, rework, and cognitive load while preserving accuracy?

Simple frameworks I use to sort the noise

When confronted with too many options, I come back to three steps I can explain to anyone on the team (and to myself on a hectic day). They map nicely onto evidence-informed resources like the AHRQ Workflow Toolkit and practical change packages from AMA Steps Forward.

  • Step 1 Notice: Identify the top three friction points by feel (where you sigh) and by numbers (clicks, time-to-sign). Don’t fix ten things at once.
  • Step 2 Compare: For each friction point, pick two candidate UI tweaks. Prefer changes that simplify visibility and reduce switching costs over “more features.”
  • Step 3 Confirm: Re-measure after two weeks. If time or error rates don’t improve, revert quickly. Keep a tiny changelog so the team sees wins accumulate.

Signals that tell me to slow down and double-check

Some patterns are my cue to pause and reassess, not bulldoze ahead:

  • Frequent alerts I keep overriding—are they misfiring, or am I missing a real risk?
  • Copy-paste bloating notes—am I burying the actual reasoning? That can backfire clinically and legally.
  • Repeated back-and-forth between the same two screens—why isn’t the needed data visible in one place?

When these show up, I look for trustworthy primers to recalibrate. Patient-facing explainers from respected organizations are also helpful for aligning team language; even though they target the public, they often model clarity over jargon (e.g., resources assembled by NAM).

What I’m keeping and what I’m letting go

I’m keeping the idea that seconds matter. Not because we’re racing a stopwatch, but because seconds are where attention lives. UI that respects attention protects clinical thinking and restores a bit of calm. I’m letting go of the belief that a bigger feature set is always progress. Most of my time savings came from subtracting, not adding—fewer fields visible by default, fewer clicks to finish, fewer places to hide the same information.

When I hit a plateau, I revisit a short list of resources to sanity-check my next move and avoid reinventing the wheel:

FAQ

1) Do small UI tweaks really change documentation time?
Answer: Yes—when they target high-frequency actions. Moving commonly used buttons into consistent, reachable spots and reducing tab switches often trims minutes across a clinic session. I measure gains with simple click counts and time-to-sign snapshots to stay honest.

2) What’s the single easiest improvement to try?
Answer: Pin or favorite your top order sets and note phrases so they load first. It shortens searches and reduces decision fatigue. Pair that with keyboard shortcuts to convert multi-click routines into keystrokes.

3) Are longer templates better for completeness?
Answer: Not necessarily. Overstuffed templates can inflate notes without improving clarity. A concise, problem-oriented scaffold usually speeds up writing and reviewing while keeping the reasoning front and center.

4) Will speech recognition or ambient tools automatically save time?
Answer: They can, but results vary by specialty and workflow. I’ve had the best outcomes when I first cleaned up the UI and templates, then layered speech or ambient documentation on top and kept measuring time, edits, and error rates.

5) How do I make the case for UI work to leadership?
Answer: Show how seconds become hours. A short table of “clicks before vs after” for three common tasks, paired with time-motion data and recognized guidance (e.g., ONC, AHRQ, AMA), usually tells a compelling, low-drama story.

Sources & References

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).