Current paper-based processes for performing billing documentation and test ordering at the end of a clinic visit are fraught with problems resulting in numerous workflow inefficiencies and significant revenue losses for a healthcare organization. Paper forms are often filled out inaccurately or insufficiently for billing purposes. Computerizing these processes can alleviate many of these problems. We are building a new module for our ambulatory electronic medical record system to automate these "end of visit" (EOV) activities, which includes completing encounter forms, ordering lab and diagnostic tests, and printing patient visit summaries. An EOV module must be carefully designed to incorporate the needs of clinicians, front office staff, ancillary labs, medical records, and finance departments. To optimize provider efficiency, the EOV module will be customizable to allow clinics to define screens containing their most commonly ordered tests and diagnoses. The new EOV module should reduce financial losses for the provider, the clinic, and the healthcare institution by providing real-time decision support to assist users in placing orders with appropriate medical necessity clinical documentation. A well-designed EOV system should be customizable to fit into the clinician's workflow, and should help reduce financial losses, improve clinical documentation, and reduce workflow inefficiencies.