A material study photographed in bright daylight. A monumental pleated turquoise glass wave sits in the lower right of a square frame, its quarter turn bend and the polished pearl silver ribbon running through that bend both clearly readable, cropped by the right and bottom edges and reflected in a pearl floor. The upper left of the frame is empty pale mint.
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One of the five sectors

Digital systems for Canadianclinics and health services.

Clinics run on appointments, intake, recalls and a front desk that is interrupted every few minutes. The constraint that shapes every build here is that health information law is provincial and it names who is responsible for the record.

A front desk that is interrupted less, intake completed before the visit, and a privacy design document your privacy officer can actually read.

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HUREAL / Material studies

In your words

Soundslike this?

  1. The phone rings all morning with appointment changes.

  2. Intake forms get filled in the waiting room, which is where the schedule starts slipping.

  3. We send reminders by hand, and the ones we forget become empty chairs.

  4. Referral letters and results arrive by fax and by email and by both.

  5. Recalls depend on somebody remembering to run the list.

  6. A patient asks for a document and we send it however seems easiest that day.

  7. We were asked where our data is stored and we had to go and find out.

If the recognisable line is the last one, the first piece of work is not a build at all: it is writing down what the systems hold and where, which is part of every portal scope here and can be done on its own.

The operational shape

A schedule,and a record with a custodian.

Three things shape almost every digital decision in a clinic, and the second one is the reason a system that works elsewhere cannot simply be pointed at health information.

01

The schedule is the business

Capacity is people and rooms, both of which are booked in advance and both of which are lost the moment a slot goes unfilled. An empty chair is not recoverable, which is why reminders, waitlists and rescheduling carry more weight here than in almost any other sector.

The front desk absorbs the difference. Every change, every question and every form that was not completed beforehand arrives as an interruption during clinic hours.

02

The record has a custodian

Health information law in Canada is provincial, and the applicable statute names who is responsible for a record: a custodian in Ontario under the Personal Health Information Protection Act, a custodian under Alberta's Health Information Act, and equivalent roles elsewhere. Quebec's Law 25 also governs personal information held by private sector organizations there.

That is not a footnote to a build. It decides where a system may store a record, which vendors may touch it, what a patient may see of their own file, and who has to be able to answer for all three. It is settled before the build rather than during it.

03

What the clinic may say about itself is regulated

Regulated health professionals in Canada answer to provincial colleges, and several of those colleges restrict what may appear in advertising. Testimonials are the most commonly restricted item, and comparative or superlative claims are frequently restricted too.

Which rules apply depends on the profession and the province. In practice it means a clinic site is written to persuade without the proof devices most marketing sites reach for first, and that constraint has to be in the brief rather than discovered at review.

A limit we publish rather than a capability. HUREAL does not yet put a voice agent in a clinic. The Canadian region infrastructure and the health information posture that would require are not settled, and we would rather say so here than after a call. Back office work that touches no health information is a different question and we will scope that one. The same limit is published on Agentic operating systems.

The jobs

Four jobs a systemdoes in a clinic.

Each one is a job rather than a feature, and each has a number your practice management system already holds. The third column names the measure rather than a value.

Healthcare and clinics, the four jobs and what each one moves
The job What it looks like here The number it moves
Book without the phone Patients book, reschedule and cancel against the real calendar, inside the rules you set for buffers, room and practitioner. Share of bookings made outside office hours.
Fill the empty chair Reminders and confirmations go out on their own, and a waitlist offers a cancelled slot to the next person automatically. Short notice cancellations that were refilled, against those that were not.
Move intake before the visit Forms and consents completed at home rather than in the waiting room, landing in the record rather than on paper. Minutes of clinic time per appointment spent on paperwork.
Run the recall list Recalls generated from the record rather than from somebody remembering, with the message written per language. Recalls issued on time as a share of recalls due.

Scroll the table sideways to read it.

Sized with your own numbers

What the empty chairis costing.

The most common first project in a clinic is booking and reminders, so here is the sum that sizes it. Every figure is yours. We do not publish a no show rate for Canadian clinics, because we would be inventing one.

What unfilled appointment time costs, per month, with your own figures
The number Where you already have it Your figure
Appointments scheduled in a month Your practice management system. your figure
Share that do not happen, including short notice cancellations The same system, over the last twelve months. your figure
Share of those that get refilled today Ask the front desk how the waitlist actually works. your figure
Revenue per appointment Your billing, averaged over the same period. your figure
Unfilled appointments a month Appointments, times the miss rate, less the ones refilled. the result
What that is worth a month The line above, multiplied by revenue per appointment. the result

This is an arithmetic, not a claim. Every figure is yours, and the one that decides the project is the third: how many short notice gaps you already refill. A clinic with a good waitlist habit has less to gain from automating it than one without, and we will say so on the discovery call rather than after the build. The same sum runs for front desk interruptions and for intake time.

By category

What a clinicbuild connects to.

By category, with the systems clinics actually run. In this sector the practice management system is the system of record, and what it will and will not let another system read is the first question rather than the last.

  • Practice management and records

    Where appointments, charts, billing and the patient record live.

    Telus Health, QHR Accuro, OSCAR EMR, Jane, dental practice systems

  • Booking and scheduling

    Where capacity, rooms, practitioners and buffers are expressed.

    the practice management system's own scheduler, a booking platform

  • Billing and claims

    Where provincial plan billing and private insurance submission happen.

    your billing system, provincial plan submission, insurance claim networks

  • Clinical messaging and results

    Where referrals, results and letters arrive, often in more than one format.

    secure messaging services, clinical interfaces, fax replacements

  • Patient communication

    Where a reminder, a confirmation or a recall is actually sent.

    email, text messaging providers, the practice system's own messaging

  • Document storage

    Where consents, forms and correspondence are kept.

    the record itself, a document system, encrypted storage

  • Payments

    Where a deposit, a co-payment or a balance is taken.

    card, Interac, digital wallets, your acquirer

  • Identity

    Where a patient account is created, verified and recovered.

    your own account system, a verification step you define

Every connection is validated by HUREAL's engineers during scoping and confirmed in writing before signature. Where a system genuinely cannot be connected, you hear it during discovery rather than during the build, and the scope is drawn around it instead of making a platform migration the price of entry.

What a build here is designed around

What a build herehas to be designed around.

A system that holds health information touches more law than a website does, and the law is provincial. These are the requirements a build in this sector is designed around, and the line between what we build and what your privacy officer or counsel decides.

  • Health informationProvincial. PHIPA in Ontario, Alberta's Health Information Act, and the equivalent elsewhere

    What we design forThe applicable statute names who is responsible for the record and what may be done with it. A build here starts by identifying that person and that statute, then scopes the smallest data set that does the job, access limited by role, and retention set per record type rather than left at a default.

    What we document for your counselWhat the system holds, where it is stored, which processor sees it, who can reach it, and how long it is kept, written as a document your privacy officer reads rather than infers.

  • Where the record may liveResidency, and which vendors touch it

    What we design forSome provinces restrict where health information may be stored or who may host it, and some clinics carry contractual requirements of their own. The storage region and every processor are named in the scope before the build, chosen rather than inherited from whatever a vendor defaults to.

    What we document for your counselEach processor, what it sees, the region it sees it in, and what changes if you move region later.

  • Advertising and professional conductProvincial colleges, by profession

    What we design forSeveral colleges restrict what a regulated professional may publish, and testimonials are the item most commonly restricted. We write a clinic site to persuade without the devices those rules exclude, and any claim about qualification or scope is traced to the register that supports it before it is published.

    What we document for your counselEvery claim on the site, the source behind it and the date it was checked, so your college submission or your counsel is reviewing a list rather than a website.

  • Electronic messagesCASL, for anything automated

    What we design forReminders, recalls and follow up messages are automated messages. Consent and its basis recorded against the record, an unsubscribe that works in one action, and a sequence that stops rather than loops.

    What we document for your counselThe consent basis per patient and the full send log, which is the evidence the legislation asks you to be able to produce.

  • AccessibilityWCAG 2.2 AA, plus AODA or the Accessible Canada Act where they apply

    What we design forEvery surface a patient uses, which here means booking, intake, the portal and any letter generated from it. Keyboard, screen reader, contrast and reduced motion, tested rather than asserted, and intake designed for somebody filling it in on a phone.

    What we document for your counselThe test results per surface and the standard tested against, so a barrier report can be answered with a measurement.

HUREAL designs to a standard, tests against it, and documents what was built. The determination belongs to your privacy officer or your counsel, and a vendor offering to make it for them is offering something they do not have. Our own conformance target and how to report a barrier are on the accessibility page.

Where to start

Which of the eightmatter most here.

Four services, and the reason in each

  • Customer portals and booking

    Booking, rescheduling, intake and documents are the four things the front desk is interrupted by, and each of them has an answer in the practice management system already. This is almost always the first project in a clinic.

  • Corporate and marketing websites

    A clinic site has to persuade without testimonials or comparative claims, because the college rules exclude them. That is a writing and structure problem rather than a design problem, and it is the one the site has to solve.

  • Multilingual websites

    Patient communication reaches people at their least patient, and a reminder or an intake form in a language somebody does not read is the same as no reminder at all. In several markets this is the difference between a portal being used and being ignored.

  • Integrations and Data

    Whatever a clinic builds has to read from the practice management system rather than from a copy of it, because a second copy of a health record is a second place to be wrong and a second thing to secure.

Read on this

Articles about intake, booking and the privacy questions a clinic build has to answer will live under the Insights index.

The Insights index

three articles to set

Asked and answered

What clinicsask us.

  • Can you connect to our practice management system?

    Often, and we check yours by name during discovery rather than after signature. Some systems have well documented ways in and some do not, and where one genuinely cannot be connected we say so during discovery and draw the scope around it.

  • Where would our data be stored?

    In a region named in the scope before the build, chosen rather than inherited from a vendor default, along with every processor that touches it. Some provinces and some contracts restrict this, which is why it is settled in the first sessions rather than at launch.

  • Can we put a voice agent on our phones?

    Not with us yet. The Canadian region infrastructure and the health information posture that would require are not settled, and we publish that as a limit rather than work around it. Back office work that touches no health information is a different question and we will scope that one.

  • Can we use patient reviews on the site?

    That depends on your college, and several restrict testimonials outright. We write clinic sites to persuade without them, because a site built around a device your regulator excludes is a site you will have to rebuild.

  • Will patients actually use a portal?

    Some will immediately, and adoption grows when it is genuinely faster than phoning. We design for that, we measure it, and we design what happens for patients who will never use it, because they are not going away and they should not get a worse service.

  • Who owns what you build?

    You do. The code, the content and the accounts are yours with admin access from day one, and the patient record stays in the system that already holds it rather than being copied into anything of ours.

  • What does it cost?

    The build price is set after the discovery call and sent in a written proposal, because an honest number needs the scope, and here the scope is mostly which systems have to be read and how strict the rules around them are. The number is written into the signed scope and does not move once it is signed.

Close

Two ways to start.Both end with a document you own.

Book a discovery call

For when you know which part of the day the front desk is losing and want the scope before the spend. A discovery call with whoever runs the schedule and whoever answers for the record. We fill in the arithmetic above with your own figures, and afterwards you get a written proposal with a scope, a price and a timeline you can sign.

Book a discovery call

Request a performance audit

For when you want the evidence before the decision. We look at what you have against the job you want it to do, and give you a prioritised plan with the arithmetic attached. The document is yours either way.

Request a performance audit

Know what you are building? Book a discovery call. Not sure where the problem is? Request the audit. If neither is right for you, we will say so, and tell you what is.

Not ready for either? Talk to the demonstration in your browser for three minutes, or paste your own address and hear it answer as your business. No form and no booking, and the transcript arrives by email a minute later.

Hear it work
A material study photographed in bright daylight. A thin sliver of the monumental pleated turquoise glass wave enters from the right edge of a very wide frame, its fins and one polished silver ribbon catching the light at the crest, above a pearl reflective floor that runs the full width. The left of the frame is an almost empty pale mint room.

Built around a schedule and a record.

HUREAL / Material studies