Published in honor of National Nurses Week
There is a particular kind of knowledge that cannot be found in a requirements document, a software specification, or a product roadmap. It lives in the memory of a 2am shift when there wasn’t time to switch between screen after screen. It lives in the workaround that was created because the documentation process was simply too clunky to survive a busy night. It lives in the hard-won understanding of what it actually means to work in increasingly complex circumstances within increasingly compressed schedules.
At Juno Health, that knowledge doesn't exist outside our walls; it exists inside them. Many members of our team made the journey from clinical nursing to healthcare informatics, and the lessons they carried with them shape everything we build. This National Nurses Week, we asked three of them to share what clinical experience has taught them, and how those lessons make our EHR solutions better for the clinicians who depend on them every day.
Amber Ramos, B.S.N., R.N., Manager of Product Demonstrations at Juno Health, spent years at the bedside before bringing her clinical perspective to healthcare IT. What she observed in practice is something many nurses will immediately recognize: the Electronic Health Record is not a supplementary tool. It is central to nearly every aspect of a nurse's day.
"My experience in nursing has demonstrated that regardless of one's level of expertise, the Electronic Health Record often serves as an indispensable tool for nurses," Amber explains. "As patient complexity continues to increase and nurses are expected to accomplish more within limited timeframes, having an efficient, secure, and intuitive system to manage daily workflows has become an essential necessity."
That word—indispensable—carries real weight. When a tool that nurses cannot function without is poorly designed, the consequences extend far beyond inconvenience. Documentation suffers. Medication administration becomes more error-prone. Order review processes slow down. And the nurse, who should be focused on the patient, is instead focused on navigating a system that was not built with their reality in mind.
Amber is direct about why this happens: "Nursing has revealed that the majority of Electronic Health Records are not developed with sufficient input from frontline clinical staff, and the resulting gaps in functionality are evident."
The solution, she believes, is straightforward, though not always easy to execute. "Critical components such as documentation, medication administration, and order review processes should be thoughtfully designed and informed by experienced nurses who have worked directly in patient care settings—those who possess firsthand knowledge of what is both practical and effective in a demanding clinical environment."
That is precisely the standard Juno Health holds itself to.
Duane Mawhorter, RN, Senior Applications Analyst at Juno Health, has a perspective on EHR evolution that few can match. His nursing career began when patient charting was still primarily done entirely on paper, and he was part of the clinical team that implemented one of the first electronic medical records at the VA more than 25 years ago.
"The change was dramatic," Duane recalls. "Even though there was pushback initially, we gradually recognized that a chart that was organized and legible was going to benefit patient care."
That early experience of navigating the resistance, working through the transition, watching a skeptical clinical team come to appreciate a better system gave Duane a foundational appreciation for something that guides his work to this day: how updates and enhancements affect nursing workflow is never a secondary concern. It is the primary one.
"Anytime there are updates and enhancements to the software, I scrutinize how it would affect the nursing workflow," he says. "Are the clicks optimized? Does the flow make sense to the process? Does it prevent potentially harmful workarounds?"
That last question is particularly important. Workarounds are often treated as a training problem or a compliance issue. Duane sees them differently. "Most workarounds are not harmful, but nurses using the EHR to better fit their workflow makes their input into enhancements extremely important. We need to be flexible enough to listen and then incorporate their input into a more efficient EHR."
In other words, when workarounds have become necessary, the most effective response is not to retrain the nurse. It is to fix the system.
Perhaps no one articulates the human stakes of EHR design more pointedly than Kerry Ann Brown, MSN, RN, Product Line Manager at Juno Health. Her words reflect the kind of clarity that only comes from having lived what she is describing.
"Nursing taught me that every extra click, every redundant field, every poorly placed alert has a real cost—and that cost is time away from the patient where my presence is needed the most, providing skilled, knowledgeable, compassionate care," Kerry Ann says.
She remembers the shifts when the EHR felt adversarial and when finding a critical lab value meant navigating three screens deep while the clock kept moving. She remembers the sticky notes. The verbal handoffs born not from good communication habits but from a system so cumbersome that nurses found faster ways around it.
"Workarounds aren't laziness," she asserts. "They are a signal that the technology failed the clinician."
What Kerry Ann brings from those experiences into her work at Juno Health is not just frustration; it is a framework. "Clinical experience gave me a lens that no amount of requirements documentation can replace. I know what it feels like when the technology gets in the way, and that knowledge drives me to make sure we are building something that works for the nurse, not against them."
That lens shapes her most fundamental conviction about what a well-designed EHR can accomplish: "Nurses are the most frequent users of an EHR, and when the system is intuitive and efficient, it doesn't just make their jobs easier—it makes care safer. When information is where you expect it to be, when workflows mirror how care actually happens rather than how someone imagined it might happen, nurses can stay focused on what matters most."
The throughline connecting Amber's, Duane's, and Kerry Ann's perspectives is both simple and profound: the best EHR solutions are not built by imagining what clinical work looks like; they are built by people who have actually done it.
At Juno Health, we believe that having nurses embedded in our product, implementation, and client-facing teams is not a nice-to-have. It is a competitive and ethical imperative. Healthcare technology that ignores the lived experience of its most frequent users will always fall short of both its commercial potential, and of its responsibility to the patients at the end of every workflow.
This National Nurses Week, we are proud to celebrate the nurses on our team who never stop advocating for clinicians. And we are grateful to every bedside nurse whose feedback, whose frustration, and whose resilience continues to remind us why this work matters.
To the nurses everywhere, thank you. We see you. And we are building with you in mind.
If you'd like to learn more about Juno EHR, one of our healthcare experts would be happy to give you a personalized overview.