Patient Appointment & Telehealth Scheduling App

The situation

Clinic networks often have a patient portal that came with the EHR, but it is hard to use on a phone and patients rarely log in. Most people still call to book, which ties up front-desk staff and makes it hard to fill last-minute cancellations. Telehealth adds another layer: patients need the right link, a working device and a reminder at the right time. A separate booking tool that keeps its own calendar quickly drifts out of sync with the EHR, which leads to double bookings and a lot of manual cleanup.

Our approach

1. Design around the patient’s real journey

We start with short interviews and usability sessions with patients and front-desk staff. We map the paths that matter most: finding a provider, picking a slot, choosing in-person or telehealth, completing intake forms and joining the visit. Our designers prototype these flows in Figma and test them with older patients and with screen readers before any code is written. Large tap targets, clear language and dynamic type support are defaults, not extras.

2. Keep the EHR as the source of truth

The app never owns the schedule. A FHIR adapter reads Slot and Schedule resources and creates or updates Appointment resources directly in the EHR, using the vendor’s certified FHIR R4 API and SMART on FHIR authorization where available. Clinic-specific booking rules, such as visit types, buffer times and new-patient restrictions, are stored as configuration that staff can change from a console. When the EHR is slow or down, the API returns a clear message instead of confirming a booking it cannot guarantee.

3. Build a HIPAA-ready backend

Every request passes through identity checks with multi-factor sign-in for patients and role-based access for staff. Data is encrypted in transit with TLS and at rest with AWS KMS-managed keys. Each read or write of patient information produces an audit record showing who, what and when, stored in a tamper-evident log. We only use cloud, messaging and video services that offer a Business Associate Agreement, and we keep push notification text free of clinical details. We document these controls so the client’s compliance team can complete its HIPAA risk assessment.

4. Make reminders do real work

The reminder service sends messages at configurable intervals before each visit, through push, SMS or email based on patient preference. Reminders carry one-tap actions: confirm, reschedule or open pre-visit forms. For telehealth, the message includes a device check and the join link shortly before the appointment. Cancellations release the slot back to the EHR right away so another patient can take it.

5. Work offline, safely

Patients open the app in parking lots and waiting rooms with weak signal. We store upcoming appointments, clinic addresses and visit instructions in an encrypted local database built with Drift and SQLCipher. Changes made offline are queued and synced when the connection returns, and conflicts are resolved against the EHR rather than overwriting it. Signing out or remote deactivation wipes the local cache.

How we deliver it

We ship in phases. The first release covers booking, reminders and cancellations at a pilot clinic, with telehealth scheduling and intake forms following once the integration is proven. Automated tests run against an EHR sandbox, and each build goes through TestFlight and Google Play internal testing before release. Infrastructure is defined in Terraform on AWS; see our cloud services for how we run regulated workloads.

Is this relevant to you?

If your patients still book by phone, or your current app keeps its own calendar that fights with the EHR, this architecture is a good fit. Explore our web and mobile app development service or talk to us about your clinics and EHR.