Harrow Health

The real problem

Therapists at Harrow Health wrote three to five session notes every working day. Each note meant clicking through twelve screens, typing the same client details more than once, and hoping nothing timed out before they reached the end.

It got worse. The interface never said how far through you were, so people finished what felt like the last screen only to find three more hiding behind it. Nobody trusted the back button, which sometimes kept your work and sometimes did not. With no autosave, one stray click could wipe fifteen minutes of careful writing.

The feedback we gathered in the first week was blunt:

• I never know whether I am done or whether there are more screens hiding somewhere.
• I have lost the same note three times this week.
• Why am I entering the session date in four different places?

The deeper issue was not bad screens. Nobody had ever walked the whole journey from start to finish, so each team had tuned its own corner of the flow and made the whole thing slower.

Finding the fix

I began by mapping all twelve screens end to end: not just the interface, but how data moved between them, where it was duplicated and where people got stuck. After reading support tickets and survey replies, three problems stood out.

No sense of progress. People could not tell where they were or what was left. No safety net. One wrong click and the work vanished. A structure built around the database, not around how a therapist thinks about a session.

The clinical directors I interviewed described a session note as telling the story of what happened: context, observations, interventions, next steps. The interface chopped that story into arbitrary fragments. So I set out three fixes:

1. A progress indicator that shows completed sections, the current section and what remains, always visible.
2. Autosave with real feedback, so therapists can see exactly when their work is protected.
3. Fewer screens, grouped the way therapists actually think, going from twelve to four.

All of it had to be achievable inside the constraints we had, with no backend overhaul.

Working inside the limits

Nothing about this project was ideal. We could not shadow live sessions because of client confidentiality, so I relied on surveys, interviews with clinical directors and months of support tickets. The platform used a third party component library we could not change, so custom solutions were off the table. And leadership wanted improvements shipped in eight weeks.

Those limits shaped everything. Instead of redrawing the whole system, I focused on the changes that would have the biggest effect with the least structural upheaval.

What shipped

The new note flow has four sections instead of twelve screens. A slim progress rail sits at the top and never scrolls away. Autosave runs every few seconds and says so in plain words, with the time of the last save. Client details are entered once and carried through.

In the first month, the median time to complete a note dropped from nineteen minutes to eleven. Support tickets about lost work fell by more than half. The clinical directors stopped asking us for screenshots and started asking when the same approach would reach the treatment plans.