Forming (FFB)

Behavioral health still runs on paper. Every paper intake is data the EHR can’t see, a clinician re-typing by hand, and an audit risk. The company initiative, Kill the Clipboard, needs forms that are structured, clinically coded, and portable across five acquired platforms that each speak a different internal format.

The insight that shaped the product: build to the standard, not to any one EHR. A form authored once exports as a standards-compliant FHIR R4 Questionnaire and receives submissions as QuestionnaireResponse, so it runs anywhere FHIR is understood.

It started as product management, not pixels. I ran the discovery myself: sourced research from every corner of the company, contacted the people living with paper intake, and compiled user-submitted requests and feedback into a real backlog. From there, every feature began as a detailed, investigation-first PRD — drafted with Claude, specifying contracts and acceptance criteria rather than prescribed implementations — written and reviewed before code.

Then the hybrid part: I built the design system first, codified its patterns as Claude skills, then used those skills to build FFB directly in code — no Figma file, because the system carried the visual and interaction rules and I designed in the medium the product ships in. The repo’s decision records list “Deciders: Luke” on the architectural calls.

Twenty-three field types, from text through Likert matrices, tables, signatures, semantic masked fields, and slider scales. Click to inspect:

{
  "linkId": "first_name",
  "text": "First name",
  "type": "string",
  "required": true
}

Conditional logic is authored visually and exported as native FHIR. Toggle the answer and watch the wire update:

"item": [{
  "linkId": "drinks_per_week",
  "text": "Drinks per week",
  "type": "integer",
  "enableWhen": [{
    "question": "drinks_alcohol",
    "operator": "=",
    "answerBoolean": false
  }]
}]

The moments where a design decision and an engineering decision are the same decision:

// Focus-based routing: while inside a TipTap editor,
// Cmd/Ctrl-Z drives its per-character history;
// outside, it drives the builder's structural history.
// A rich-text change becomes ONE builder step when the
// 150ms debounce flushes to the schema.

The whole product exists to make one thing true: clinical data that can go anywhere. A form is authored once; a patient completes it once; and because everything on the wire is FHIR, every downstream system can act on it — no re-typing, no integration project per destination. Play it:

Publishing flows into a pending draft that never touches the live version EHRs consume; publish is the only version-incrementing action; a single diff engine renders change review. The future runtime half, the EIR, is architecturally resolved, with the design system confirmed as its rendering base (100% coverage of all 23 field types).

Standards-native product thinking (FHIR/SDC, not pixel-pushing); the ability to make and document architecture decisions; design choices that are simultaneously correctness choices; and end-to-end ownership, a codified system built in code and gated in CI.

Honest flags kept on purpose: EIR is unbuilt (architecture resolved); extension namespace mid-migration; AI import needs its verification gate; repeating groups and multi-language are the known SDC gaps, all PRD’d.