The challenge
A regional health network had a patient portal with a 23% activation rate. Of those who activated, most used it once. The call centre continued to handle appointment scheduling and results enquiries at volumes the portal was supposed to have reduced, and the network was paying for a system that had not changed the operational load at all.
Research made the reason plain quickly. The portal had been designed for a hypothetical patient who does not exist — comfortable with medical terminology, on a modern device, with good vision and no anxiety about the result they were about to read.
What we did
- 01
Research with the patients who were failing
We recruited specifically among older patients, patients with low digital confidence and patients using assistive technology — the groups the previous design had effectively excluded.
- 02
Designed for the actual population
Larger default type, plain-language labelling, an explicitly simple primary path for the three things people actually came to do, and full keyboard and screen reader support verified on real assistive technology.
- 03
Results in language patients understand
Lab results presented with plain-language context and reference range explanation, reviewed and approved by the clinical team — with the clinician's note always primary and the explanation clearly secondary.
- 04
FHIR integration done properly
Integration with the network's EHR via FHIR R4 with SMART on FHIR authorisation, scoped so the portal can only access what the patient is entitled to see.
- 05
Measured against call volume
Success was defined before build as activation rate and reduction in routine call volume, instrumented from launch rather than assessed by survey afterwards.
The outcome
Activation rose from 23% to 67% within two quarters, with the largest gains in the demographic segments the previous portal had served worst. Repeat usage rose alongside it, which was the measure that mattered more.
Routine call volume for scheduling and results enquiries fell 41%, freeing call centre capacity for the complex conversations that genuinely need a person. All patient-facing flows were independently verified as WCAG 2.1 AA conformant.