For example, consider a dietitian preparing the record after a nutrition follow-up. The food record is in one place, the intake responses in another, and the previous agreed plan needs to be checked. Before the note can be completed, a colleague also needs to clarify which information was passed on.
It would be easy to describe the whole task as “time spent documenting.” But finding existing information, writing and reviewing the note, and coordinating with another person are different activities. A note template addresses a different part of that example from a change in how information is stored or handed over.
If you lead a nutrition team, start by identifying which part of a specific workflow needs attention. This article offers a simple way to observe that work and choose one question to investigate before evaluating a software fix.
Separate the work before measuring it
Start with one task, such as preparing a nutrition follow-up record. Use the categories below to describe what people are doing within that task. These are suggested working definitions, not a validated time-study framework.
| Activity | What belongs here | Example from the follow-up |
|---|---|---|
| Finding and checking existing information | Locating or comparing information already on file, without contacting another person or drafting the note. | Opening the food record and intake responses, then checking them against the previous plan. |
| Writing and reviewing the note | Creating, editing or checking the record itself. | Documenting the follow-up and reviewing the note for completeness. |
| Coordinating with someone | Actively requesting, discussing or communicating information with another person. | Asking a colleague which version of the plan was shared. |
Keep waiting separate. Writing the clarification request is active coordination; the gap before the reply is waiting. If you work on something else during that gap, record that activity separately. Do not count the whole gap as effort spent on the follow-up record.
When the activity changes, start a new entry rather than counting the same minutes twice. If work does not fit these definitions, describe it as “other” and review it before drawing conclusions.
These distinctions give the team more specific questions to ask. If finding the previous plan is difficult, where was it stored? If a clarification holds up completion, what information or responsibility was unclear? Time alone does not establish that an activity is unnecessary.
What research can tell us about work outside the visit
A study by Crouse and colleagues tracked dietitian work in one US pediatric academic healthcare system, using data from 2013–2016 and 2018–2019. Its outpatient results included a mean 37.8 minutes of face-to-face care and 28.6 minutes of care coordination per patient, with variation by specialty.
That is a reason to look beyond consultation time when describing workload. It is not a benchmark for your clinic’s note-writing time: care coordination is broader than charting, and these historical results come from a different setting. The study does not validate the categories or worksheet proposed here.
Your own observation needs to answer a smaller question: what work happens around the record your team is trying to complete?
Try a short observation before building a tracking system
Choose a task the team recognizes and agree where it starts and finishes. For example: start when a dietitian begins preparing a follow-up record; finish when the note is ready for the clinic’s required review. Keep the initial exercise small enough to discuss together. A few observations can reveal a question worth pursuing, but cannot establish how common a problem is across the practice.
Use an ordinary sheet or document. Record workflow information only, without names, record numbers, clinical details, screenshots or identifiers that could link rows to a person receiving care. This is an administrative exercise, not a clinical record or staff performance ranking.
At the top, describe the task, practice setting and whether it concerns new or follow-up work. State what “ready” means and how you will check the output. Then add one row each time the activity changes:
| Activity or wait | Duration and basis | What happened or remained unresolved |
|---|---|---|
| Retrieval, note work, coordination, other, or waiting | Minutes, marked timed or estimated; write “not captured” if missing | A brief non-identifying description; note a correction or interruption if relevant |
At the end, record whether the expected output was complete, needed correction or could not be assessed. Keep estimated durations separate from timed observations. A missing entry is not zero minutes.
If an interruption occurs, stop the first entry and record the new activity. Resume with a new row. Mark corrections on the relevant row rather than adding their minutes again as a separate total.
For a team task, identify roles without naming individuals. Record each person’s effort separately: two people working for five minutes use ten staff minutes, even if only five minutes pass on the clock. Keep staff effort and elapsed completion time distinct.
A completed example
The following example is hypothetical. Every duration and event is invented to show how to read the worksheet, not to suggest a target.
Task: prepare one follow-up record for review. Setting: outpatient nutrition service. One dietitian’s work is observed from preparation to completion; the colleague’s effort is not captured.
| Activity or wait | Invented duration | Observation |
|---|---|---|
| Retrieval | 4 minutes, timed | Locate the food record, intake responses and previous plan. |
| Coordination | 2 minutes, timed | Ask a colleague which plan version was shared. |
| Waiting | 15 minutes, timed | Await the reply; the dietitian works on a different task. |
| Note work | 6 minutes, timed | Prepare and check the follow-up note after receiving clarification. |
The note is ready for the required review; that review has not yet occurred. The dietitian spends 12 active minutes on this task, while 27 minutes pass from start to finish. The unrelated work during the wait is excluded. The colleague’s unrecorded work means 12 minutes is not the team’s total effort.
The longest interval is the wait, but the example does not show that clarification was unnecessary. Nor does it establish that a faster note template would address it. A useful next question is: could the record have shown which plan was shared, or did that information require a conversation?
Turn the observation into one next question
Read the description beside the time. A long activity may be necessary; repeated work may have different causes. Use what was captured to choose an investigation, rather than treating the largest number as waste.
| What you observe | What to examine next |
|---|---|
| Existing information is repeatedly difficult to locate. | Where should that information be available, and why is the expected location insufficient? |
| Notes repeatedly need correction. | What was missing or unclear, and were the requirements understood before drafting? |
| Completion waits on clarification. | What information or responsibility needs to be explicit at that handoff? |
| Important parts of the task were not captured. | What would make the next observation interpretable before selecting a change? |
For the hypothetical example, the team might ask its workflow lead to inspect how the shared plan is recorded. The check would be whether someone preparing the next follow-up can identify what was shared without assuming a later timestamp proves it. Professional review still needs to determine whether the note meets the clinic’s requirements.
That investigation could lead to a clearer recording convention, a responsibility change, a software requirement or no change at all. The observation alone does not choose between them.
If the team later tests a change, compare complete tasks and their outputs. Our guide to evaluating a clinical AI pilot’s workload addresses that later evaluation. If time savings become part of a purchase case, keep the separate distinction between staff time and cash savings visible.
Bring a specific workflow question to a software demonstration
For nutrition teams working within longevity or functional medicine clinics, HolistiCare offers a relevant starting point for a fit discussion: its clinic demo page presents screens showing questionnaire responses alongside their questions, biomarker results and historical measurements, using demo data. Those views give the team something concrete to inspect if its question concerns finding existing information. They do not establish that HolistiCare will complete the record or remove the observed delay.
Bring the question from your observation. Ask where the required information would appear, what would still need to be transferred or clarified, and who would handle the remaining work. Have the relevant step demonstrated before assuming it is supported.
You can book a HolistiCare demonstration with a non-identifying description of that workflow. The useful starting point is specific: “We need to understand how this information reaches the person preparing the follow-up record.”
HolistiCare provides clinical decision-support infrastructure; it is not a licensed medical provider or electronic health record. All diagnostics, care protocols, and clinical decisions remain exclusively the responsibility of qualified healthcare professionals. Insights generated by HolistiCare’s AI engine are for clinical and informational use only and do not constitute medical advice, diagnosis, or treatment.
Reference
Crouse J, Feuling MB, Winter T, Goday PS, Smith A. Electronic health record time-tracking provides real-time data to measure and benchmark dietitian productivity. Journal of Human Nutrition and Dietetics. 2024;37:105–110. doi:10.1111/jhn.13236. Published online September 18, 2023. The study supplies bounded context; the worksheet and hypothetical example are proposals in this article.
