Project Overview
An NHS Trust with 8,400 clinical staff and 280,000 patient episodes per year needed to supplement their existi...
Technology Stack
Compliance & Standards
The Challenge
An NHS Trust with 8,400 clinical staff and 280,000 patient episodes per year needed to supplement their existing EPR (Electronic Patient Record -- Epic) with a digital patient engagement platform -- enabling patient-initiated follow-up (PIFU), patient-facing appointment management, and clinical correspondence digitisation. NHS England PIFU (Patient-Initiated Follow-Up) national programme, Epic MyChart integration, NHS Login (patient authentication), NHS App API, NHS e-Referral Service (eRS), NHS DTAC all 5 domains, DCB0129, NHS Letters (NHS England correspondence transformation), UK GDPR Article 9, WCAG 2.1 AA. Budget GBP140,000.
Our Approach
Epic MyChart
Epic patient portal -- NHS Trusts on Epic can configure MyChart for patient-facing access.
Epic API integrations
- 1Epic SMART on FHIR (SMART on FHIR -- industry standard for Epic third-party application integration -- OAuth 2.0 PKCE, FHIR R4 resource access),
- 2Epic appointment API (FHIR R4 Appointment resource -- patient can view upcoming appointments, cancel, request reschedule),
- 3Epic clinical notes (FHIR R4 DocumentReference -- patient can access clinical correspondence),
- 4Epic patient demographics (FHIR R4 Patient -- PDS-matched demographics),
- 5Epic questionnaire response (FHIR R4 QuestionnaireResponse -- patient-completed forms stored in Epic).
SMART on FHIR launch
ClickMasters patient engagement platform launched from within Epic clinician workflow (EHR launch) and from NHS App (standalone launch).
NHS PIFU Digital Implementation
- PIFU (Patient-Initiated Follow-Up): NHS England programme to reduce unnecessary outpatient appointments.
- Patients on stable pathways can self-refer back to clinic if they have a clinical concern, rather than having routine follow-up appointments.
PIFU digital implementation
- 1PIFU eligibility (clinical team identifies PIFU-eligible patients -- Epic flag),
- 2patient notification (NHS Login notification -- patient informed of PIFU pathway, safety netting information),
- 3PIFU booking (patient books appointment directly via NHS App / patient portal -- FHIR Appointment request to Epic),
- 4clinical triage (clinical admin reviews PIFU request -- approve, add to urgent list, or contact patient for safety netting),
- 5PIFU outcome (appointment held -- outcome recorded in Epic).
NHS England PIFU target
30% reduction in routine outpatient follow-up -- ClickMasters PIFU platform contributed to 28.4% reduction in this Trust.
NHS Letters
NHS England programme to digitise clinical correspondence (discharge summaries, outpatient letters, clinic letters) from paper/post to digital.
NHS Letters standards
- 1FHIR Communication resource (clinical letters published as FHIR R4 Communication -- accessible via NHS App),
- 2NHS Mail integration (letters sent via NHS Mail secure email for clinician-to-clinician correspondence),
- 3patient digital delivery (patient-facing letters via NHS App -- patient can view, download, save),
- 4postal override (patients without NHS App access -- letters still sent by post),
- 5letter digitisation (legacy paper letters -- OCR + FHIR conversion -- historical letter access).
NHS Letters rollout
NHS England expects all NHS Trusts to implement NHS Letters by 2027 -- ClickMasters NHS Letters module is a modular addition to existing EPR platforms.
NHS App API
NHS England provides NHS App API for Trust applications to surface patient-facing features within the NHS App.
ClickMasters NHS App integration
- 1NHS Login P9 authentication (patient authenticates with NHS Login P9 within NHS App shell),
- 2NHS App Feature API (register ClickMasters features in NHS App -- appointment management, PIFU, correspondence),
- 3NHS App notification API (push notifications to NHS App -- appointment reminders, PIFU availability, letter received),
- 4deep linking (NHS App notification links directly to relevant feature in ClickMasters platform),
- 5NHS App WCAG (NHS App shell provides WCAG 2.1 AA -- ClickMasters embedded features must also pass axe-playwright).
NHS App
30M+ registered users -- the most important patient-facing channel for NHS Trusts.
The Results
NHS DTAC all 5 domains approved.
Epic SMART on FHIR integrated.
Platform live at 28 weeks, GBP132,000. 280,000 patient episodes/year.
PIFU digital: 84.2% of PIFU-eligible patients registered.
Outpatient follow-up reduction: 28.4% (NHS England target: 30%).
NHS Letters digital: 72.4% of patients receiving letters digitally (was 8% paper-only).
NHS App active users: 42,000 (15% of eligible patient population).
DCB0129 zero incidents.
WCAG zero.
DTAC all 5.
PIFU 84.2% registered.
Outpatient reduction 28.4% vs 30% target.
NHS Letters 72.4% digital vs 8% paper.
NHS App 42,000 active users.
Zero DCB0129.
The NHS Letters digitisation -- from 8% digital to 72.4% -- was achieved not by forcing patients to use digital but by making digital the default and postal the exception.
Patients who want letters by post still get them.
Patients who have the NHS App get their letters there.
When you make digital easy enough, adoption follows.
You do not need to mandate it. -- Chief Digital Officer, NHS Trust
Project Details
Related Case Studies
View AllGovTech Service — Local Council Digital Transformation
GovTech Service — Local Council Digital Transformation. A UK local council needed to digitise three resident-facing services: planning application status tracking, council tax ...
GovTech API Integration — HMRC Making Tax Digital for Accountancy SaaS
A UK accountancy software startup needed to integrate with HMRC Making Tax Digital (MTD) for VAT as a software...
Open Data Platform — UK Local Government Digital Transformation
A consortium of three UK local authorities needed to build an open data platform to publish public sector data...
Ready to Transform Your Business?
Let's discuss how our technical expertise can help you achieve remarkable results.