A unified practice management platform for counsellors

Counsellors were spending too much time navigating unreliable software to prepare for sessions and document care. When TELUS Health moved its counselling tools to Microsoft Dynamics 365, I led the design of a workspace organised around their daily work.

The immediate mandate was to preserve the legacy tools’ capabilities. Research showed an opportunity to go further: keep related client information together and make preparation and documentation easier. That shaped three connected changes: a client-folder navigation model, a pre-session summary, and a chronological clinical-note history.

The workspace rolled out to approximately 250 counsellors. Internal reliability complaints fell by over 80%, and counsellors reported saving around five minutes of preparation per session. But the early improvement in satisfaction did not last. We migrated users before key workflows were ready, and delayed improvements damaged their trust.

The migration set a clear baseline: counsellors needed to keep doing their existing work on a more reliable and extensible technical foundation. Recreating the old tools would preserve their capabilities, but it would also carry forward the workflows that made daily work difficult.

The performance and usability study I had led a few months earlier gave our small design team a starting point. Reliability problems interrupted work, and confusing workflows added friction to an already demanding job. We carried those findings into discovery to decide where to focus our design effort.

Our goal was to make the workspace more intuitive, efficient, and reliable while keeping the client’s information close at hand. Counsellors needed to move between preparation, care, and documentation without repeatedly piecing the client’s story back together.

Organising the platform around the counsellor's day

Research helped us identify the activities that occupied most of a counsellor’s day. We used those activities to organise workshops across design, engineering, product, and clinical teams, keeping discussions grounded in the work the platform needed to support.

This gave us a practical way to evaluate design decisions: could counsellors get ready for a session, find the information they needed during it, and document care afterwards? Those needs shaped the navigation, client summary, and clinical notes explored below.

Defining the target experience

I brought those activities together into an aspirational journey, showing how a counsellor could move through a day with the client’s information available throughout. It gave design, product, engineering, and clinical leadership a shared view of the experience we wanted to build.

We used this journey to evaluate features in the context of the whole day, avoiding improvements to one task at the expense of another. It established a direction, rather than a delivery plan. The challenge was to turn that vision into a viable first release and keep expectations aligned with what we could deliver.

Our early concepts used a traditional hierarchical navigation structure. The screens looked clean and organised, but moving between them repeatedly pulled counsellors away from the client record. Counsellors couldn’t easily move from an assessment to a clinical note, for example, and it was harder to keep track of their location in the interface.

That exposed a mismatch between how we had organised the software and how counsellors worked. They needed related information within reach, with a clear sense that they were still working with the same client.

I worked with our engineering team to replace that structure with layered sections modelled on a physical client folder (AKA a manila folder). We used the file-cabinet-and-folder metaphor to guide and structure the platform. The metaphor also proved useful when communicating with and educating our users during the change management process. It made the new platform feel less techy, helping with adoption among our less tech-savvy counsellors. Practically, it was designed to reduce the need to hunt through the interface, keep common workflows anchored to the client, and provide a real-world mental framework for users.

Keeping related work within the client record gave us a foundation for the next design decisions. Initial feedback was promising, and the new structure made a client summary viable—something that had not been part of the initial build.

Bringing session preparation into one view

The previous client record focused primarily on personal and demographic information. Assessments, care-plan activity, episodes of care, and benefit entitlements lived in separate tabs, adding friction to an already complex workspace. The underlying platform also re-queried the database on every route change, adding loading delays to the navigation overhead. While our counsellors needed this information, it wasn't presented in a useful way. What they needed was a view that helped them quickly get up to speed before a session.

Working with counsellors, we explored and workshopped a client summary dashboard, bringing the most decision-relevant and care-relevant information into one pre-session summary: assessment trends, care progress, service eligibility, platform activity, clinical history, and risk alerts. Deeper records remained available when needed.

Designing clinical notes for ongoing care

The old counsellor tools treated every clinical note as a separate record tied to an individual appointment. Initially, Dynamics 365 worked the same way. To review a client's history, counsellors had to open appointments one at a time and find the attached notes.

Working within the Dynamics 365 record structure, I proposed elevating appointment notes to the episode of care level. Working with engineering, we added direct links between the episode of care and its notes, bringing them into one chronological history. Counsellors could review previous sessions from the same workspace while preparing for or conducting an appointment.

Moving in this direction wasn't just good for our counsellors; it was good for the business. The client-facing product being worked on in parallel was prioritising longer-term mental health support as a market differentiator. The notes improvement helped our counsellors deliver that type of service better.

The early improvement in counsellor satisfaction did not last.

We launched an MVP knowing that some workflows had not yet reached the usability bar set by the legacy tools. The plan was to close those gaps through iteration. I had also shown clinical leadership a more complete vision that included a care-plan portal and simplified booking. The target experience had helped align the team, but we had not managed the expectations around how quickly we could deliver it.

When resources shifted to accommodate the needs of a large B2B client, those improvements were delayed. We did not properly reset user expectations or reconsider the platform's rollout plan. The difference between the experience we had shown and what we could deliver damaged trust with counsellors and clinical leadership.

Losing their trust really hurt. When counsellors felt heard and could see that we cared about their needs and were making progress, they were willing to work through the smaller issues that come with a new platform. Once they felt we were no longer listening, they stopped giving us the benefit of the doubt. Every issue carried more weight and change management became much harder.

That experience changed how I approach platform transitions.

In summary, we succeeded in creating a more connected and reliable clinical workspace, but the rollout changed how I define product success. The interface, migration strategy, and delivery plan all shape the user's experience.

As this was a multi-year project, there was a lot more to it than what's been highlighted here. If you'd like to know more about any particular area, please feel free to reach out. Our team also tackled administrative UI/UX for handling client contracts and worked on streamlining UI/UX for our trauma counsellors.

Over this multi-year project, the design team’s working practices evolved alongside our collaboration with the wider team.

We balanced customer requests, technical opportunities and constraints, clinical reporting needs, and user feedback. That could be frustrating, but it taught me how to advocate for UX when product teams were under pressure. Good UX meant making the strongest choices possible with the time and resources available.

I wrote more about that experience in a brief article on advocating for UX in a large product team.