I've been mulling this over some, and I think I'm going to try something like what Vyn does except stagger the elements/totems so that I get the timer benefits.

Basically, for a given setup, I'll have 4 button presses, and they'll trigger a variety of totems.

Button 1: 1-Poison Cleansing, 2-Tremor, 3-Grounding, 4-Searing
Button 2: 1-Earthbind, 2-Grounding, 3-Tremor, 4-Healing Stream
Button 3: 1-Wrath of Air, 2-Healing Stream, 3-Healing Stream, 4-Grounding
Button 4: 1-Searing, 2-Searing, 3-Searing, 4-Tremor

Instead of doing an element per key, I will just map the icons on each character to their assigned Button X responsibility. Get some of the benefits of the castsequence macro without the reset problems, perhaps?

This is a PvP loadout, obviously, and I'd have separate Fire Nova/Grounding All-at-Once type totem keys too.