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The patient portal

The Patient portal fold on the patient record, and the portal link the practice sends the patient.

A patient booked for surgery sees the deposit terms of the hospital doing it on their Quotes and invoices page, with earlier versions beneath under Earlier versions.

A message from a patient becomes a task for their lead contact, or for the organisation's portal team when they have none. App users says so when no portal team is set, because a message from a patient with no lead contact would then reach nobody.

Before an invitation goes, the email is shown with anything the patient will see first: the sum outstanding on their invoices and the pathway steps still open. Check them, then Send, or Cancel and put them right first. Where money is outstanding, or the check itself could not be read, the button says Send anyway; the pathway steps alone are for information and leave it as Send.

Under Patient portal, the line says when the patient was invited and by whom, and whether they have signed in. App users, under Patients in the Start menu wherever the organisation has the portal or Memberships, is the list of everyone at the organisation who uses the app: invited to the portal, signed in to it, or, where the organisation has Memberships, holding points or cash, with their points and cash beside when they were invited, by whom and when they last signed in. All, Signed in, Invited and Never narrow it, with how many in each, and Search finds a name. The name opens the record.

Where you sign in at more than one organisation that has the portal or Memberships, App users lists the app users of every one of them together, each marked with its organisation, with a tick for each organisation to hide its patients. A patient is listed only where you could open them had you switched to that organisation, and the name opens the record as it would there. A patient invited at two organisations is listed once for each. Not matched and the portal team warning are about the organisation you are signed in at. If one organisation's list cannot be read, the page says which.

A patient can reserve an appointment, pay, correct the contact details the practice holds (including their house name or number), read what has been shared with them, and send a message. Everything they do waits for you in the Patient portal fold: reservations to confirm, details changes to approve, messages to answer. A reservation, a details change or a GP change can also be decided from its own task: open the task and the request is at the top of it: for a details or GP change, each detail with what the record holds now and what the patient asked for, then a box for a reason to give the patient if you decline, and Approve (Confirm, for a reservation) or Decline, which emails the patient and finishes the task. A message from the patient can be answered from its task in the same way: Reply to the patient sits under the message, sends the reply to the patient's portal exactly as the Messages card does, and ticks the task done unless Tick the task done is unticked. Any replies already sent since the message arrived are shown above the box, with who sent them.

Patients are also invited a few at a time without anybody pressing Invite. Every morning at eight, up to twenty are chosen: first those with an operation in the last fortnight or the next four weeks, then those with a clinic appointment in the same weeks, nearest today first. Besides those twenty, every patient holding points carried over from the old membership app is invited the same morning, member or not, since the portal is where their points now are; the same checks below apply to them. Nobody is chosen who is already invited or signed in, has no email address, is under eighteen or has no date of birth recorded, has an invoice past its due date, whether or not it was ever sent, or has two unpaid invoices not yet due. A patient who may have been invoiced twice is held back: two invoices for the same operation within six weeks of each other, paid or not; two invoices entered the same day for the same items, the same fees and the same total, paid or not, even from two organisations; or an unpaid invoice beside a paid one of much the same size for at least one of the same items. In every case the same organisation issued both and both charge the same fee. Where an invoice has no date, invoices are close only if their numbers are, so an old undated invoice is not set beside one years later. Invoices from two organisations are never counted as invoicing twice: a hospital that invoices the patient for every fee, and a surgeon's practice that invoices the hospital for the procedure fee, have each invoiced once. A task then names the invoices to check, once for each patient, for the people the organisation chose, with a button on the task for each invoice that opens it; Double invoicing, at the top of the to-do list, shows them all together. Void the duplicate or mark it Not for payment, and the patient is considered again the next morning. A patient near an appointment who cannot be invited only because their record has no email address or no date of birth is listed in a to-do for the people each organisation chose, nearest appointment first, so it can be asked for at the visit or by phone; each patient is listed once, and once the detail is added they are invited automatically. Where the organisation has ticked Patients of practitioners who work for themselves add missing details themselves, under Patient onboarding, those patients are sent a link to add it instead and are left off the to-do unless they cannot be reached. The email is the same one Invite sends, from the patient's own practice, and nobody is ever sent it twice. While automatic invitations are switched off, nothing is sent.

Invite, in the Patient portal fold, emails the patient their portal's address, from the practice, with how to sign in: the email address it was sent to, their date of birth, and a six-digit code that is emailed to them. Pressing it shows the email first, with who it is to, its subject and its words, which you can change before it goes: the subject is a box and the words are a box, with a blank line between paragraphs, and a web address is made a link. Your greeting and the team's name are added around them. The portal's address must stay in the words, or Send refuses, since the patient would have nowhere to go. Send sends it exactly as shown and Cancel puts it away with nothing sent. The fold then says the day they were invited, with Invite again if they need it once more; the log records who sent it. QR code, beside Invite, fills the screen with the portal's address as a code for the patient to scan with their phone camera, and under it the steps to sign in and keep the portal on their home screen; it needs no email address, and the log records that it was shown. Back to the record, Escape or a click outside the card closes it. Invite is there only once the portal is switched on for the organisation and the record holds an email address, and the fold says which is missing where either is.

CHECK SIGN-IN. Beside Invite, in the Patient portal fold, Check sign-in says in plain words why a patient may not be getting a code, or that nothing is in the way. It looks at the same things the portal does when the patient signs in: the portal being switched on for the organisation, an email address on the record, a date of birth on the record (without one, it says how they will sign in instead, by a text code or by surname and postcode, and says so when the record holds nothing to check them by), more than one record sharing the same address and date of birth, and too many code requests in the last quarter of an hour. It only reads; nothing is sent and nothing is changed. The portal itself still answers every patient the same way whether or not it found them, so that nobody can use it to find out who is a patient. The same warnings appear above the email when you press Invite, and the button then says Send anyway.

RESET SIGN-IN. Beside Check sign-in, Reset sign-in starts the patient again: it clears their recent code requests, any code still waiting and a password they chose and have forgotten, so they can ask for a new code straight away. Their face or fingerprint sign-in is kept. A line on the patient's record says who reset it.

ASKING FOR A CODE. The sign-in page offers Send me a code the first time. After that, on the same phone or computer, it opens at the password sign-in instead, with Email me a code underneath for a patient who has forgotten their password or never chose one, with a line above it saying so. The code takes them in and then to My details to choose a new password.

SIGNING IN. A patient signs in with the email address or mobile number on their record, their date of birth and a six-digit code emailed to them. Where that address or number and date of birth belong to more than one patient record, no code is sent, because Fedelsoft cannot tell which record is theirs; instead the organisation's portal team is given a task naming the records, so they can be merged, after which the patient signs in as usual. A patient whose record has no date of birth can still sign in: they type their email address and any date of birth they know, and the email that brings the code also asks for a second check. Where the record holds a mobile number, a second code is texted to it, and they open Add the extra details on the code page and type it there too. Where there is no mobile number, they type their surname and postcode as the record holds them. Once both are right they are in, and the date of birth they typed is kept on the record, with a line on the log saying the patient entered it and staff have not verified it; it is not kept if it would make them under eighteen. A record with none of these (no mobile number and no full postcode) cannot be found until one is added. At most three texts a day are sent for one patient. A date of birth that is already on the record is never changed this way. Once in, My details has Signing in, where they can choose a password, or press Add this device to sign in with their phone's or computer's own face or fingerprint. Next time the sign-in page offers Use face or fingerprint, or Use it beside Saved a password, where the password goes with their email or mobile and date of birth, instead of waiting for a code. The code always works too. Face or fingerprint works only on the portal address it was saved on, and the card names that address. Five wrong passwords in a quarter of an hour stop password sign-in for that patient for the rest of it. Each device is listed with Remove, and the password has Change and Remove. Seen by the patient shows how each sign-in was made.

Where the readiness check is on for the patient's surgeon, Care has Before your surgery. It lists each consent form the patient has been given, with I have read and understood this beside the ones not yet acknowledged (this is not a signature; the form is signed with them before the operation), and, for each operation to come, the nicotine policy with I understand and agree. The patient sees only their own two items there. A patient with nothing to do is told so.

A patient sees a quote only when the quote is recorded against them, whichever quote set it sits in, and only when it has lines on it. A quote recorded against another record, such as a duplicate of the same person, is not shown to them until it is moved onto their own. Each quote is shown by its own number with its total. One still awaiting a decision after its valid-until date, or after the period set in Settings from its date where it has none, shows as Expired and cannot be accepted.

A quote that was set up with choices in the builder shows the patient one list instead of the usual table of lines and total: In your quote for what is part of it, then Yours to choose, and the list of quotes says the patient chooses what to include rather than giving the sum of every line. A line with a padlock is part of the quote. The patient ticks or unticks the others to see what the quote would come to, and the total changes at once; Fedelsoft works every total out, the same way the builder does. Nothing changes until they press Approve my choices. Approving makes a new quote with exactly the lines they chose and the discount the scheme gives for that choice, marks the quote they were shown as superseded, records the new one as accepted in the same way as Accept does, and sends the care team a task saying what was chosen. Package items they chose are ordinary lines on the new quote. Where the practitioner has set rules between lines, a line a rule holds back is greyed with the reason beside it, a line that needs another cannot be taken off while it is on, and ticking a line that cannot go with another takes the other off and says so; a line that is not in the quote shows what it adds, which goes once it is ticked, and unticking a line that has something written about it opens a box saying what they lose without it, which they confirm with Take it out or cancel with Keep it. A quote with choices has no Accept, because Accept would take the quote as first shown whatever they ticked, and the staff preview of the portal cannot approve.

Their pathway is their current course of treatment in date order: the appointments on it, their operation, and the steps still to come. A step shows as done only once its date has passed.

Seen by the patient, in the Patient portal fold, lists every time the patient signed in and everything they opened, newest first, with the date, the time and the device. Each letter on the record says when the patient first opened it, or when they were told of it and have not opened it yet. Looking through View as the patient is not in the list.

A patient who has the portal is told by email when a new letter or quote is waiting for them: one short message, with nothing about their care in it, that something new is in their portal and where to find it. They are told once for each, between seven in the morning and nine at night; a letter or quote that was itself emailed to them brings no second message.

Every letter that has been sent or approved is on the patient's portal, GP letters included, from every organisation caring for them; drafts never are, so approving a letter is enough to put it there. On the patient record each such letter has a Share tick, ticked to begin with: untick it to take that letter off their portal, tick it again to put it back. The portal names each letter by who signed it. Where a sent letter is signed by somebody other than the person who wrote it, opening it on the record shows Signed by as a choice of the two; the writer, the person named or an administrator can put it in the writer's name, provided the writer has a clinical role. Nobody without a clinical role can sign a letter, and correcting a letter's words before it is sent leaves it in its writer's name. One clinician cannot change the words of a letter another clinician signed: it opens to be read, and says so. The change is written on the log, which also says that the copy already emailed went with the earlier name.

An invoice on the portal has Pay by card wherever the organisation's own card account is connected in Settings: the patient pays what is owed on the card company's own secure page and the payment is written on to the invoice by itself. A payment page address that still has placeholders in it is not offered. Bank transfer details come from the organisation's own payment details. Where an invoice collected the surgeon's or anaesthetist's fees and passed them on, the patient sees the whole price they paid: those fees go back into the line they belong to or, where the invoice does not say which line, sit beneath the lines as the practitioner's fee, so the total always matches what was paid. The list of invoices on Quotes and invoices shows that same total, not only the hospital's share.

Everything the patient has been given in the way of consent and information is on their portal by itself, under From your care team: every consent document filed for them, which they can read and sign there with their finger and their typed name while it is unsigned; older consent forms, to read; and every information sheet given to them, each once, as it was when they were given it; if the sheet was given again after a change, the newer version is listed with the earlier one beneath it. A consent waiting to be signed is named at the top. Email and QR code still send the same documents straight to the patient's phone.

THE INVOICES A PATIENT SEES. Their portal lists every submitted invoice with anything unpaid, however old, and nothing that is still Open: an Open invoice is a placeholder that can change, such as the one a surgery or booking form holds, so it is not shown, not counted as owed and cannot be paid until it is submitted. A paid invoice is listed only while its date is within the last twelve months; the twelve can be changed under Settings, Fees and quotes, Paid invoices on the patient portal. Under the list a line, Older invoices on request, takes them to Messages. The portal never adds invoices up into one total. Staff see every invoice, as always.

Photographs and documents on an appointment or operation each carry a Share tick, and so does every photograph and video in Attachments on the patient record. Ticked, the patient sees the file under From your care team; untick it to take it back. Nothing is shared until somebody ticks it. Shared by you holds only what the patient sent through the portal.

My details shows the patient their GP and surgery. They can ask for a change by choosing their GP or surgery from the same list the practice uses; it waits in the Patient portal fold to be approved, like a change of address, and approving it sets the GP on the record.

From the day of an operation until seven days after, the portal offers the recovery diary, with the same questions as the diary link that is texted, and above them a notice that it is not an emergency or out-of-hours service. Each entry raises a task for the patient's surgeon (the admitting consultant on the operation), or for the person that surgeon has named to take their diaries on their contact card, never for the care team; where no surgeon is recorded on the operation the task goes to the care team and says so at the top, so the surgeon can be recorded. The task is always Immediate so it sits at the top of the list, shown with the same scores, table of days and earlier entries as a diary that came by the text link, writes a line on the log, and appears on the record under Recovery diary beside the diaries that came by the text link. The card counts the entries needing someone that nobody has seen yet; opening it records them as seen by you, the count goes, and each of those entries then says who saw it and on what day. Above the entries a table sets pain and swelling by day for that operation, with a word for which way each is going since the first entry, and each entry says how its scores differ from the entry before it. For a patient who has the portal, a Reply box sits above the entries: Send puts what you wrote into their portal messages, like any other reply there. Where the organisation has Ask and AI drafting, Suggest first fills the box with a draft written from the latest entries, which you can change freely; nothing is sent until you press Send.

REMINDERS TO COMPLETE IT. On each of the seven days after an operation, in the evening, the patient is reminded to complete that day's diary, with a link that opens it in the portal. They are texted where they have a mobile number and the organisation sends texts, and emailed otherwise. A day already completed, in the portal or by the old text link, is not reminded, and nobody is reminded twice for a day. No surgeon has to opt in. An organisation can change the hour or turn the texts or the reminders off in its options.

Where the organisation has an app icon, set under Settings, Portal and payments, How the portal looks, App icon, a patient on a phone is offered Save to your phone: on Android one press brings up the phone's own install, and on an iPhone the portal shows the two taps it takes, Share then Add to Home Screen. Saved, the portal opens from its own icon, full screen like an app. The invitation tells the patient to look for the button.

NOTIFICATIONS. Once the portal is saved to a phone, Home offers Turn on each time the patient signs in, until they turn notifications on; Not now puts it away until the next sign-in. My details always has it. The phone asks the patient to allow notifications; nobody can turn them on for a patient. On an iPhone this works only in the portal saved to the Home Screen and opened from its icon; in Safari, My details says so. From then the phone is told when somebody replies to a message, shares a photograph or document, files a consent for them to sign, gives them an information sheet, or when a new letter or quote is waiting, beside the email, never instead of it. The words say only that something has arrived and from which organisation, because they show on a locked phone. Pressing one opens the right page of the portal. My details has Send a test, and Turn off.

OFFERS. Where the organisation has written an invitation to hear about offers (Settings, Portal and payments, How the portal looks), a patient signing in is shown it on Home with a box to tick, never ticked for them, and Don't show again. It is shown at each sign-in until they tick it or press Don't show again, and stays on My details so they can change their mind either way. Each answer is kept with the words they were shown, and the Patient portal fold says what they answered and when. Offers are only ever for patients who have ticked it: the offers a Director sends are on their Home, under Offers, while the offer runs, and unticking takes every offer away at once.

RECEPTION CODE. On a day the patient has an appointment, an operation or a treatment session, Home opens with Arriving today: what they are coming in for, and their reception code, the same code the sign-in email carries, drawn large on white so the reception scanner reads it off the phone. Held under the scanner it signs them in exactly as the emailed code does. On any other day the code is under My details. A cancelled appointment or operation does not bring it to the top.

WHERE TO WAIT. Where the organisation has written its words under Settings, Portal and payments, Where patients wait, a patient with notifications on who signs in at reception for a clinic is told where to wait. A clinic in a room of the waiting area set there shows the area on Start, beside the clinic, as Staffed or Away; press it to switch it, and every Start showing that clinic changes within half a minute. It starts each day as Away. While it is Staffed, patients for that clinic are told to wait there; while it is Away, they are told to wait as for any clinic, and each one who has arrived has Send for patient, which tells their phone to come now. A patient without notifications on has to be fetched, and Start says so. The evening before an operation, at six, the patient's phone is told where to go when they arrive.

In the Patient portal fold, Messages and requests and Reply appear once the patient has signed in to the portal or written to you through it; before that there is no conversation to reply to. Under Reply, Send appears once you have written something and not before. A patient with notifications on has a line saying how many phones, and a tick, Show the words on the patient's phone. Ticked, the phone shows what you wrote, at once and on the lock screen, which is for directions on the day such as Please come up to the first floor; write nothing clinical there. Unticked, it says only that a message has arrived. The reply is in their Messages either way.

An organisation can give its portal a web address of its own, such as portal.example.com, under Settings, Portal and payments, How the portal looks, Own web address, once its domain has been pointed at Fedelsoft. A patient arriving there sees that organisation's portal, and every email that gives a patient the portal, the sign-in code included, gives them that address. The portal's usual address keeps working.

The portal's Feedback page lets a patient send a suggestion, report something not working, or ask about the portal itself, and shows them what they have sent with any reply underneath, asking under each reply whether it solved the problem (No lets them say what is still wrong, and puts the item back to be looked at again); it is found under Me, beside My details and How your information is used. It points them to Messages for anything about their care. What they send is listed with the team's own feedback, marked as from a patient with their record number, and a reply written there appears on their Feedback page.

WHERE A PATIENT CAN BOOK. Under Appointments the patient sees the free times of their organisation's practitioners wherever those practitioners hold clinics, including clinics that belong to another organisation, and can reserve any of them. Nothing else of the patient's record is shared with that organisation. NEW MESSAGES. When the team has sent a message the patient has not yet opened, a glowing button on Home says so; pressing it takes them to Messages, where the newest message is at the top. THE PORTAL'S BOTTOM BAR. Signed in, a patient finds their way by the bar along the bottom: Home, Membership, Care and Me. Membership is there only where the organisation has Memberships and plans to offer, or the patient has a membership. Care holds Appointments, Letters, Quotes and invoices, Information (the photographs and documents) and Messages as a row of buttons along the top, with Recovery diary first while it is open; a dot on Care means a message from the team or a recent letter has not been opened yet. Change and Cancel on an appointment ask the practice exactly as before. Me holds My details, Feedback and suggestions and How your information is used, with Sign out at the foot. The organisation's logo sits top right of every page.

MEMBERSHIP IN THE PORTAL. A member sees their plan, next payment and commitment, their points and rewards to come, the treatments left with Book, the discounts with what they have saved, their payments, and Card, Pause and Cancel. A patient who is not a member sees their points and cash first, then the organisation's default plan with its price, commitment, allowances and perks, and any other plan under Compare plans; Join takes a card payment where the organisation can take one, and otherwise tells the portal team, who are given a task to get in touch. A patient whose membership has ended sees the same page with their payments kept beneath it. On Home, a patient who is not a member also sees a quiet Membership card under their pathway.

HOLDING THE PORTAL UNTIL AN INVOICE IS PAID. In the Patient portal fold, Hold until an invoice is paid lists the patient's issued invoices with something left to pay; press Hold for this invoice on one. From then on the patient's portal shows them that invoice and the ways to pay it, the same Pay button, bank details and payment page as the invoice itself, and nothing else: no letters, quotes, consent forms, photographs, appointments or messages, on any page, however they reach it. A patient already signed in is held at their next press, without signing in again. The links that open a shared document, a publishing consent or a quote question without signing in show a page sending them to the portal to pay instead. The hold is for that one patient and that one invoice, never a setting for the organisation, and it lifts by itself the first time the portal sees the invoice paid, which is as soon as the payment is recorded on it. Opening the patient's record after the payment shows the hold already lifted, so nobody has to lift it by hand. Lift hold, beside the line that says the portal is held, lifts it sooner; who held it and who lifted it are kept. An invoice that is not yet submitted cannot be held for until it is submitted, so Hold until an invoice is paid also lists the patient's unsubmitted invoices, each with Submit and hold: it asks you to confirm, submits that invoice exactly as Submit on the invoice itself does (the same people may, and the payment terms start), and then holds the portal for it. If the invoice is submitted but the portal cannot be held, you are told, and the invoice stays submitted. A voided invoice, one written off or marked not for payment, and one with nothing on it cannot be held for. A hold on an invoice the patient can no longer see lets them in. If the patient's invoices cannot be read, the portal stays held and says so, with a button to try again.

View as the patient, in the Patient portal fold, shows the portal on a phone exactly as the patient sees it, read only; the fold closes so the preview is in front.