Designing a waiting room tool everyone loved, and learning why that wasn't enough

The challenge

German healthcare practices were drowning in chaos. With multiple doctors, rooms, and simultaneous patients, medical assistants (MFAs) and doctors had no clear view of where patients were, who needed what, or what tasks were pending. The result? Long wait times, miscommunication, and stressed staff running between rooms asking "Where's my patient?" or "Why is this patient waiting here?"

60% of German practices confirmed they relied on their EHR's "waiting room" functionality as a critical tool. Yet our platform had nothing. Practices were forced to use third-party solutions, fragmenting their workflow and creating friction at every step.

My mission was about designing a real-time coordination system that could:

• Handle practices of vastly different sizes (2 doctors vs. 25+ doctors)
• Serve two distinct user groups with different needs (MFAs managing flow vs. doctors prioritizing patients)
• Replace deeply entrenched third-party tools users had relied on for years
• Integrate seamlessly with our existing workflows and ecosystem without adding complexity

The landscape was fragmented. Competitors like Medatixx offered highly customizable solutions but suffered from poor NPS (-4.8). Tomedo had strong satisfaction (NPS 76.5) but limited functionality. We needed to find the sweet spot: powerful enough for complex practices, intuitive enough for immediate adoption.

The design question: How do you create a waiting room management tool that handles the complexity of multi-room, multi-doctor practices while remaining instantly usable for first-time users?

My role and approach

As Staff designer, I partnered with the lead design and drove this initiative from discovery through validation. The approach was simple: listen, prototype, test, refine, repeat.

Understanding the reality

I partnered with medical experts and conducted extensive user research across German practices. The critical insight? Patient flow isn't one problem, it's many:

• Small practices (2-5 doctors) needed simple visibility
• Large practices (10-15 doctors) required sophisticated task coordination
• MFAs orchestrated patient movement and tasks
• Doctors needed quick queue visibility and one-click consultation starts

In parallel, an extensive benchmark of existing solutions with their strengths and weaknesses made me realize the competitive landscape was split between powerful-but-painful and simple-but-insufficient solutions.

"The waiting room is a key feature of our current EHR (Electronic Health Record) software and the view I interact with most in my daily work." - German Pediatrist and Medical Expert

 

Testing before building

Rather than build and hope, two rounds of user testing were done:

• Round 1: On-site testing with MFAs and doctors in Berlin revealed what worked (drag-and-drop, task management) and what didn't (confusing columns, unclear icons).
• Round 2: Remote testing with a bunch of users validated our iterations and uncovered final refinements needed.

Each round informed the next, allowing us to fail fast and refine before development.

The solution: visibility, flexibility, and flow

The Patient Flow Manager became three things simultaneously: a dashboard showing status at a glance, a coordination tool enabling movement and task assignment, and a consultation launchpad allowing doctors to start appointments directly.

Unplanned Challenges

User research revealed complexities we hadn't anticipated. The care step concept, seemingly straightforward, proved surprisingly nuanced in German practice reality. Unlike the linear "waiting → consultation → checkout" model we'd assumed, German medical structures are fluid: a single doctor might see patients across multiple rooms throughout the day, creating ambiguity about whether care steps represented physical spaces, doctor assignments, or workflow stages. Moreover, the notion of ownership and assignment of care step was an additional need.

On top of this, walk-in patients exposed a fundamental workflow mismatch. Our initial design assumed all patients started from our calendar feature before being assigned to doctors—matching scheduled appointment logic. But walk-in patients don't follow scheduled appointment logic and they represent about 30% of appointements which is a non-neglactable part of them. Users expected them to appear directly in the relevant doctor's queue, not in a generic holding area. This single insight forced us to rethink our information architecture, separating "today's scheduled visits" from "active patient queues" and changing walk-in patient behavior to match real-world expectations rather than system constraints.

These discoveries reinforced a critical lesson: what seems simple in a wireframe becomes complex in reality. The only way to uncover these nuances was to test with real users in real workflows.

Key features released

Drag-and-drop patient movement

Grab any patient card, drop it where they need to go. No forms, no menus, no friction.

Patient cards with everything at a glance

Name, insurance type (critical in German healthcare), waiting time, colleague notes, visit reason, all visible without clicking.

Customizable care steps

Each practice defines their own workflow (Reception → Lab → Doctor A → X-Ray → Checked-out). Each user customizes which steps they see, hiding irrelevant ones.

Integrated task management

Tasks appear alongside patients in the same view. No more "Did someone handle that prescription?" questions, everyone sees what's pending.

One-click consultation start

Doctors launch consultations directly from the waiting room without navigating through the agenda.

Impact and results

Early adoption signals strong product-market fit

Despite being in the early stages of rollout, the Patient Flow Manager showed promising traction:

• Classic organizations (Germany): 21.17% adoption rate among organizations, 9.6% among users
• Premium (with our EHR features) organizations (Germany): 38.1% adoption rate among organizations, 30.5% among users
• French organizations: 66.67% adoption rate among organizations, 18.2% among users
• CSAT: 78.26% (goal: >70%)
• CSAT with a remarkable consistency, maintaining 60-100% satisfaction throughout the monitoring period (last 90 days)
• 195 organisations adopted the solution on 348 enabled

What the numbers revealed

The adoption-satisfaction paradox:

High satisfaction (78.26%) but low user adoption (9.6% in Classic orgs) proved we built the right product but underestimated change management needs. Users who tried it loved it—but getting them to try it was harder than expected.

Team adoption matters:

The gap between organization adoption (21.17%) and user adoption (9.6%) in Classic orgs showed practices had champions but not team-wide usage. For a coordination tool, partial adoption limits value.

Newer customers adopt faster:

Premium organizations (38.1%) adopted nearly twice as fast as Classic organizations (21.17%). Less entrenched third-party tools and more receptiveness to new workflows made adoption easier.

Setup remains a barrier:

Only 56% of enabled organizations created care steps, revealing onboarding friction. Even with simplified design, initial configuration was a hurdle.

Business impact

Market access

Successfully launched in a segment (German practices) we previously couldn't serve, creating competitive differentiation against incumbents.

Revenue protection

Prevented churn among practices considering switching to competitors with better waiting room tools.

Foundation for scale

78.26% CSAT indicated strong retention potential once adopted. The challenge wasn't product quality—it was activation velocity.

Lessons learned and what's next

This project taught us that building the right product and driving adoption are two distinct challenges. 78.26% CSAT proved we solved the right problem—users who tried the Patient Flow Manager loved it. But 9.6% user adoption in Classic organizations revealed the gap: getting users to start required more than intuitive design. We designed for usability within the tool but underestimated initial setup friction and the team adoption dynamics essential for a coordination tool. The next design challenge isn't adding features—it's designing the path from "this exists" to "this is configured for my workflow."

The foundation is strong: high satisfaction, proven value for adopters, and versatility across markets (66.67% adoption in France, 38.1% in C&F organizations). Now we shift focus from building to activating. Short-term priorities include guided onboarding flows, practice-type templates, and in-app contextual help to reduce setup friction. Medium-term, we'll design team activation workflows that encourage collective adoption and build case studies from satisfied users to convince hesitant practices. Strategically, we'll prioritize C&F and newer organizations where adoption velocity is naturally higher, building momentum before tackling entrenched Classic users.

We set out to replace fragmented third-party tools with an integrated solution. We succeeded in building something users love. But this project reminded us that great design extends beyond the interface into the adoption experience itself. The best products don't just work well—they're easy to start working with. We built the first part. Now we design the second.