Electronic patient record
Unified history with clinical progress notes, prescribing and results available in real time.
Healthcare systems · Healthcare
One patient record across reception, outpatients, wards and pharmacy, exchanged over HL7 FHIR
A single electronic patient record with scheduling, bed management and pharmacy on the same history, interoperable over HL7 FHIR with laboratories and the systems the group already had.
- Client
- Private hospital group, under NDA
- Market
- Brazil
- Duration
- 9 months
- Year
- 2024
- Delivered by
- The group's Brazilian engineering practice, in 2024, before Vigiles AI Ltd was incorporated.
- Across four departments
- One record
- Reception, outpatients, inpatients and pharmacy on the same patient history.
- Exchange standard
- HL7 FHIR
- One integration model rather than a bespoke adapter per external system.
- Pharmacy traceability
- Batch and expiry
- Dispensing tied to the prescription, with stock-out and expiry alerting.
- End to end
- 9 months
- Clinical discovery, build, controls testing and supported departmental rollout.
The group ran separate systems per department, which fragmented the patient history exactly where continuity of care depends on it. One electronic patient record was built covering scheduling, bed management and pharmacy, exchanging data over HL7 FHIR with laboratories and existing systems, with role-based access, encryption and audit trails over sensitive health data.
On arrival
On arrival
- Reception, outpatients, inpatients and pharmacy each ran their own system, so the patient history was fragmented across the points where continuity of care matters most.
- Bed management was manual and perpetually out of date, which produced overcrowding, slow discharges and difficulty placing emergency admissions.
- Scheduling for appointments and surgery suffered double bookings and idle theatres, because there was no integrated view of clinician, room and equipment availability.
- Pharmacy had no traceability by batch or expiry, carrying both stock-out risk on critical medicines and loss through expiry.
- Without HL7 FHIR interoperability there was no standard exchange with laboratories or legacy systems, which created regulatory and audit exposure on top of the clinical problem.
Approach
Approach
- Clinical discovery and care-pathway mappingPathways were mapped end to end across departments, because the fragmentation lived at the handovers and not inside any single department system.
- Interoperable architecture on HL7 FHIRFHIR resources were adopted as the exchange model from the start, so that laboratories, devices and legacy systems could be integrated without a bespoke adapter for each.
- The electronic patient recordOne unified history carrying clinical progress notes, prescribing and investigation results, available in real time at every point of care.
- Scheduling, beds and pharmacyAn integrated diary across clinicians, rooms and equipment; a live occupancy map including cleaning status; and dispensing tied to the prescription with batch and expiry traceability.
- Access control, data protection and clinical acceptanceRole-based access, encryption and audit trails over sensitive data, with the controls tested from non-privileged accounts and the system accepted clinically rather than only technically.
- Supported rollout alongside existing systemsDeployment ran department by department with FHIR integration to the systems being retained, preserving prior investment rather than demanding a single cutover.
Solution
What was built
- The problem presented as five system problems and was one. A patient history assembled from five departmental systems is not a history, and the places it breaks are the handovers: admission, transfer, discharge, dispensing. Discovery therefore mapped pathways across departments rather than requirements within them.
- HL7 FHIR was adopted as the exchange model from the start rather than added later as an integration layer. That decision is what allowed laboratories, devices and the systems the group wanted to keep to be connected through one standard rather than through a bespoke adapter per system, each of which would have become its own maintenance liability.
- The record itself unified clinical progress notes, prescribing and results in real time. Around it, scheduling covered clinicians, rooms and equipment together, which is what removes double booking; bed management became a live occupancy map including cleaning status, which is what shortens the gap between discharge and the next admission; and pharmacy dispensing was tied to the prescription with batch and expiry traceability.
- Sensitive health data was treated as the constraint it is. Access was granted by role, data encrypted, and audit trails kept over access and change. Every control was then tested from a non-privileged account, because a restriction that was configured correctly and never actually tried is an assumption rather than a safeguard.
- Rollout ran department by department with FHIR integration to retained systems, so the group was never asked to switch everything at once. After nine months the patient history followed the patient instead of staying behind in whichever department created it.
What mattered
What made the difference
Appointment and theatre scheduling
One diary across clinicians, rooms and equipment, which is what removes double booking.
Live bed management
Visual occupancy map including cleaning status, to shorten the gap between discharge and admission.
Pharmacy and stock control
Batch and expiry traceability, dispensing tied to the prescription, and stock-out alerts.
HL7 FHIR interoperability
Standard exchange with laboratories, devices and legacy systems instead of an adapter each.
Occupancy and management reporting
Clinical and operational indicators for hospital management.
Access control and audit trail
Role-based access, encryption and audit trails over sensitive data, tested from non-privileged accounts.
Integration with retained systems
FHIR connection to systems the group kept, preserving prior investment.
Questions
Common questions
Because point-to-point integrations compound. Each one is cheap to build and expensive to keep, and a hospital accumulates them until nobody can change a system without breaking three others. FHIR gives one exchange model that laboratories, devices and legacy systems already speak.
Access is granted through roles rather than to individuals, data is encrypted, and access and change are recorded in audit trails. Every control is then tested from a non-privileged account, because the most common finding in a review is a restriction that was configured correctly and never tried.
The architecture does; the compliance mapping has to be redone. FHIR, role-based access, encryption and audit trails are the same engineering. The obligations are not: UK work sits under UK GDPR and the Data Protection Act 2018, and NHS deployment adds its own information governance requirements that we would scope explicitly rather than assume.
Yes, and that was the deployment model here. Rollout ran department by department with FHIR integration to retained systems, so no single cutover was required and prior investment was preserved.
Next step
Arrange a technical review
A 45-minute working session with an engineer rather than a sales call. You describe the problem; we set out what we would build, in what order, and what it is likely to cost.
Answered within one working day, by the engineer who would do the work