Built on the real staging-v3 app system (app/assets/tailwind/application.css): self-hosted Newsreader/Geist webfonts, the cool teal-tinted stone ramp (ground #edf6f9), accent #006d77, exception #be123c, caution #b45309, exact PILL_VARIANT_CLASSES + btn-primary. Desktop is the primary target (Roadmap Reconciliation 2026-07-09 — launch doctors are desktop power users); the 390px phone is the companion. Reconciled: attestation dropped (edit-before-sign guard retained + passive review telemetry), keyboard-first nav added. Encodes the locked Design Review Decisions [D-1..D-25].
accent · actionable / confirmedpositive · verified NKDAcaution · stale / unverifiedmissing · not recorded (never a check)critical · named severe allergy
This is the static spec — every surface on one page.
Buttons here are illustrative. To click through the real interactions, open the live prototypes →
The launch doctors are desktop keyboard/dictation power users, so desktop is the primary acceptance target and the 390px phone layout is the companion spec (below). Desktop uses the space structurally (not fluid type): a persistent queue rail, one calm surface with Sources hidden by default (a keystroke or the header toggle opens the evidence panel beside the note), an inline sign rail, and a full keyboard-first, mouse-free path (J/K section nav, T20).
AI draft readyfrom transcript + intake · 2 min ago · Saved
HPI
47F on compounded semaglutide for weight management, week 14. Good adherence, once-weekly, no missed doses. Down 18 lb since start; appetite suppression sustained, no nausea this interval. No injection-site reactions. Goal remains 15% total body weight.
MDM
Tolerating current dose well with continued response. No contraindications; reviewed vitals and interval labs. Discussed risks/benefits of continued titration vs. hold. Plan: continue current dose, reassess in 4 weeks. Return precautions given.
Edit the draft to record your review — an unedited AI draft can’t be signed. Time-on-note + scroll coverage captured passively (evidence, never a gate).
Desktop visit workspace — 2-pane, one calm surfacePersistent queue rail · Sources hidden by default (toggle or S opens the evidence panel beside the note) · borderless sections, only the Rx earns a card · inline sign rail with the identity anchor [D-8/9/12]
ronanrx.com/ehr/queue — Review queue
Today · 12 visits
3 waiting on youWed Jul 9
Patient
Visit
Call time
State
Waiting on you · 3
Maria Chen · 47
GLP-1 follow-up
9:10a
Ready to sign
Sign visit ›
David Okonkwo · 39
NAD follow-up · weight 94 days old
9:40a
Provider review
Continue ›
Priya Anand · 41
Peptide follow-up
10:05a
Ready to sign
Sign visit ›
System working · 2
James Rivera
GLP-1 follow-up
10:30a
Draft ready
Review visit ›
Lena Hoffmann
GLP-1 intake
11:00a
Transcript processing
Open ›
Needs attention · 2
Tomás Vega
NAD follow-up
8:45a
Manual documentation
Document ›
Desktop queue — dense table, same groupingDensity is a desktop virtue [product register] · one state per row, per-state action, grouped by who it's waiting on
Phone — companion layout (390px contract)
Same system, same decisions, reflowed for one hand. The 390px contract ([D-11] keyboard-open, 44px targets) is unchanged — it is just no longer the primary acceptance target.
Review queue · Dr. Okafor
Today · 12 visitsWed Jul 9
Waiting on you3
Maria ChenReady to sign
GLP-1 follow-up · 9:10aSign visit ›
David OkonkwoProvider review
NAD follow-up · 9:40aContinue review ›
▲ Weight 94 days old — confirm
Priya AnandReady to sign
Peptide follow-up · 10:05aSign visit ›
System working2
James RiveraDraft ready
GLP-1 follow-up · 10:30aReview visit ›
Lena HoffmannTranscript processing
GLP-1 intake · 11:00aOpen visit ›
Needs attention2
Tomás VegaManual documentation
NAD follow-up · 8:45aDocument manually ›
Aisha BelloNeeds addendum
Peptide follow-up · Jul 8Review addendum ›
Signed5
Robert KimSigned
GLP-1 follow-up · 8:15aView receipt ›
1 · Review queue — grouped by who it's waiting on[D-3] one state + per-state action · [D-4] three-tier grouping, actionable pinned top · [D-5] full 64px row is the target
Visit · Maria Chen
Maria Chen · 47
212 lb · 6 days agoSulfa severe
AI draft readyfrom transcript + intake · 2 min ago
Saved just now · 1 source uncertainty ›
HPI
47F on compounded semaglutide for weight management, week 14. Reports good adherence, once-weekly dosing, no missed doses. Down 18 lb since start; appetite suppression sustained, no nausea this interval. No injection-site reactions. Goal remains 15% total body weight.
MDM
Tolerating current dose well with continued response. No contraindications; reviewed vitals and interval labs. Discussed risks/benefits of continued titration vs. hold. Plan: continue current dose, reassess in 4 weeks. Return precautions given.
Edit the draft to record your review — an unedited AI draft can’t be signed. Time on note + scroll coverage are captured passively for the audit trail (evidence, never a gate).
Existing therapy: semaglutide 2.5 mg, since Apr 2 · Visit: transcript 9:12a (“continue same dose”) · Weight 212 lb, 6 days ago · Formula v4 (approved)
Telehealth facts1 item to verify
Patient state
TX · prefilled — verify
Identity
Photo ID ✓
Visit time
9:08–9:19a
Provider loc.
TX
Not ready to sign · 2 items
Required to sign
Confirm prescriptionFix ›
Verify patient stateFix ›
Safety context to review
Severe allergy: sulfa — review before signingAcknowledge ›
Will sign & issue for Maria Chen · DOB 1978-04-12
2 · Visit workspace — one continuous confirm flow[D-8] Rx provisional (dashed/caution) until confirmed · [D-9] dose ≠ concentration · [D-12] named readiness + identity anchor · [D-16] attest at end of note
Sticky header — safety states
Maria Chen · 47
212 lb · 6 days agoSulfa severe
Robert Kim · 52
198 lb · 6 days agoNKDA ✓ verified Jun 2026
David Okonkwo · 39
231 lb 94 days agoPenicillin verification required
Lena Hoffmann · 44
— no weight on fileAllergies not recorded · add
Four allergy treatments — never conflatable
severe named severe allergy — strongest weight
✓ verified NKDA asserted & verified (with date)
verify recorded but unverified
not rec. no record — empty list, never NKDA
3 · Safety-signal grammar (critical #1)[D-1] locked strings + [D-2] empty ≠ NKDA at the model · text label on every state, color never the sole signal · stale/unverified = caution “confirm this”, not alarm-red
Prescription changed — confirm the current prescription. Readiness ticked back to 1 item left.
Manual documentation
No AI draft is available for this visit. Document HPI and MDM manually — the visit is fully signable.
HPI
Reason for visit; treatment & adherence; interval response; weight change; pertinent history and goals…
MDM
Assessment; data reviewed; risks/benefits/alternatives; dose decision + rationale; counseling; follow-up…
No attestation required for a manual note · dictation available (mic not auto-started)
4 · Rx invalidation + the calm manual path[D-10] change visibly reverts confirm + ticks readiness · [D-17] “Manual documentation” leads with the action — no red, no retry, no spinner
Editor focused · keyboard up
Maria Chen · 47 · ⚑ sulfa (severe)
MDM
Tolerating current dose well with continued response. No contraindications; reviewed vitals and interval labs. Plan: continue current dose, reassess in 4 weeks.
🎙 Dictate
↺ Undo
Done
— iOS keyboard (visualViewport inset) —
5 · Keyboard-open contract (critical #3)[D-11] on focus: sign bar suppressed (no signing mid-edit), header collapses to one identity line + allergy flag, accessory row = Dictate / Undo / Done
Signed receipt
✓
Signed & prescription issued
Maria Chen · signed by Dr. Okafor 9:22a · sent to RonanRx Pharmacy
Issued prescription
Semaglutide 2.5 mg · 0.5 mL SubQ weekly
Handoff: accepted by pharmacy ✓
6 · Signed receipt (happy path)[D-23] handoff state shown (pending / accepted / rejected)
Partial · signed, not issued
✓
Note signed · prescription not yet sent
Your signature is recorded. The prescription didn’t reach the pharmacy yet — tap Retry to send it. This won’t create a duplicate.
For security, confirm your password to send this prescription
Your re-authentication expired — expected, not an error.
••••••••••
6b · Partial issue + delayed retry[D-21] calm, never error-red · [D-22] forewarns the re-auth · [D-14b] inline, no modal
Review queue — all clear
Today · 12 visits
You’re all caught up
12 signed today · next visit 1:30p
Signed12
Maria ChenSigned
GLP-1 · 9:22aView receipt ›
Robert KimSigned
GLP-1 · 8:15aView receipt ›
7 · Empty state is a feature[D-6] reuses ehr_empty_state — warmth + context, not “No items found”
Completion & delight — the moment the board clears
Design stance: reward care and completion, never speed. Clinician gamification is dangerous if it rewards velocity — a doctor chasing a “fastest sign” streak is a doctor rushing past the safety checks this whole system exists to protect. So nothing here times you or ranks you against peers. ✓ Celebrated: clearing the board (no patient left waiting), catching safety issues, correcting drafts that needed it, consistency of same-day care. ✗ Never shown: seconds-per-visit, a speed leaderboard, or a streak that breaks because you took time on a hard case.
All caught up
Queue clear
You’re all caught up
12 visits reviewed and signed. No one left waiting today.
This session · your care
12visits reviewed and signed — every note carries your judgment, not the model’s
4safety catches: 3 stale weights re-checked · 1 allergy verified before signing
2drafts corrected where the AI was off — exactly the reviews that matter
1late transcript caught for addendum — nothing signed silently changed
Same-day care · 8 clinic days running
✓✓✓✓✓✓✓8
Every patient you saw was documented and prescribed the same day. That’s the streak that matters — not how fast, but that no one waited.
8 · Board cleared (phone)Once per session, earned. Ring draws + check (reduced-motion → instant). Recap counts care, not speed · streak = consistency of same-day care
Inline reinforcement
The micro-moment that trains the right instinct
David Okonkwo · 39
231 lb re-checked todayPenicillin ✓ verified
✓ Good catch — you confirmed a 94-day-old weight before dosing
When a doctor acts on a safety flag (re-checks a stale weight, verifies an allergy, corrects a draft), a quiet acknowledgment appears inline — never a popup, never blocking. It reinforces thoroughness, which is the behavior gamification should build. There is no equivalent reward for signing quickly.
8b · “Good catch” reinforcementRewards the safety behavior [D-24], not the speed · inline, dismissible, accessible
ronanrx.com/ehr/queue — cleared
Queue clear · 4:12p
Board cleared, Dr. Okafor
12 patients seen, documented, and prescribed today — every one the same day, every note yours.
This session · your care
12visits reviewed & signed
4safety catches — stale weights re-checked, allergy verified
2AI drafts corrected where they were off
1late-transcript addendum caught
Same-day care · 8 clinic days running
✓✓✓✓✓✓✓8
9 · Board cleared (desktop end-of-day)The reward is the recap of care given, framed for a physician: patients seen same-day, safety caught, judgment applied — a calm close, not a scoreboard