Illustrative case: Physiotherapy group (4 practices), Gelderland — 2026

Patient portal with online booking and e-consult

A front desk that rings 38% less, because patients handle it themselves.

Web applications & platforms Security & compliance Web accessibility (WCAG) Healthcare & wellbeing

Plate 05 · PORTAL

−38% phone calls at the front desk
WCAG AA tested against 2.2 AA with NVDA and VoiceOver
NEN 7510 set up on the basis of a risk analysis
61% of appointments booked online after 3 months

01 — The challenge

4 practices, 22 therapists, 1 phone number. The front desk handled 180 calls a day, 7 out of 10 about rescheduling an appointment or a question answerable in 2 sentences. Therapists emailed exercises as PDFs; nobody knew whether they were being done.

The group had looked at the EHR vendor's portal, but it looked like 2009, did not work with a screen reader and could not bill an e-consult. The requirements: patients manage appointments themselves, therapists keep working in their EHR, everything complies with NEN 7510 and WCAG 2.2 AA, and the data stays in the Netherlands or at least in the EU.

02 — Our approach

We started with a NEN 7510 risk analysis and a data-flow diagram: which data leaves the EHR, where to, and who may see it. The architecture followed from that: the EHR remains the source, the portal is a secured layer in front of it. Login through Keycloak with two-factor authentication, 15-minute sessions, and a log of every record view.

The build in Next.js and NestJS took 12 weeks, with the EHR integration as the critical path: reading and writing the calendar, fetching treatment plans, writing e-consults back as billable procedures. Messages between therapist and patient run through the portal, not email; only notifications go out, without content.

Accessibility was part of the process from the first sketch: contrast, focus order and forms tested with NVDA and VoiceOver, and axe-core in the pipeline blocking every build with a violation. Trade-off: no native app, but an installable web app. That saved 5 weeks and 2 app stores, and older patients did not have to download anything.

03 — The solution

Patients log in, see their treatment plan and book or reschedule appointments in their own therapist's calendar, with availability live from the EHR. Exercise programs sit in the portal as video, with a simple checklist the therapist reviews before the next session.

For short questions there is an e-consult that the therapist answers within 1 working day and that lands in the EHR as a procedure. Large buttons, adjustable font size, fully operable by keyboard. The front desk now only picks up the phone for things that genuinely need a conversation.