A UK health technology company runs an ambient clinical documentation platform that records patient consultations, generates structured clinical summaries, and moves them into hospital electronic patient records across NHS trusts. Version 1, built on Angular and PHP, had reached its ceiling, and it stopped working the moment a clinician left hospital WiFi. We rebuilt the platform end to end on React and NestJS, shipped a React Native app with offline recording for home visits, and validated an EHR integration in a vendor sandbox.
Talk to Our Product TeamClinicians across NHS trusts, documenting consultations in hospital and on home visits.
Full V2 platform rebuild, React Native mobile app with offline recording, security and compliance hardening, EHR sandbox integration.
React, NestJS, React Native, Node.js, TypeScript, Deepgram, OpenAI, Microsoft Azure, AWS. Angular and PHP on V1.
V2 live, running in parallel with V1 through a phased, trust-by-trust migration.
The mobile app removed the hospital-only ceiling on where the documentation tool could be used, and the EHR sandbox proof of concept validated that its AI output can be structured and accepted into hospital record systems. The figures below are the published V1 baseline, measured on the prior architecture before this rebuild. Trusts are still migrating, so V2 numbers are not in yet.
Reduction in documentation time. Published V1 baseline, prior architecture.
More patients seen per session. Published V1 baseline, prior architecture.
Days to letter turnaround, down from 7. Published V1 baseline, prior architecture.
Angular and PHP had carried the product as far as they could. As the client pursued new NHS bids and national rollout funding, three constraints turned from irritations into blockers.
Adding features meant working around the constraints of the original stack rather than building on it. Security and compliance controls also needed strengthening to handle patient consultation audio across a growing number of NHS trusts.
The platform was web only. Once a clinician lost network connectivity, the ambient documentation tool stopped working entirely. Consultations during home visits went uncaptured, or clinicians fell back to manual notes and transcribed them later.
Clinical summaries had to reach hospital records across Cerner, Epic, EMIS and TPP/SystmOne. There is no single integration path that works across that mix, so full production builds needed proof-of-concept validation first.
We designed the NestJS backend as a modular monolith with an event-driven architecture, so the audio capture to transcription to AI summary pipeline can swap or extend any single step, the transcription provider or the summarization model, without restructuring the core system. The trickiest part was not the rebuild itself. It was keeping two live versions in sync during a gradual, trust-by-trust migration, so clinicians who had not moved to V2 yet never felt the difference.
The mobile app mirrors full web functionality: record consultations, review AI-generated summaries, edit them, and transfer to the patient record. Offline recording captures a full consultation during a home visit with no connectivity, and recordings sync automatically once the clinician reconnects. If your users work in the field without reliable connectivity, you already know what happens when an app assumes WiFi.
Patient consultation audio moving across a growing number of NHS trusts raised the bar on security. We addressed GDPR requirements directly, separated customer data at the infrastructure level, and added the operational visibility a national rollout needs.
We built an integration with a major EHR vendor's sandbox environment, validating that AI-generated clinical summaries could be structured and pushed into a hospital record system in a format clinicians and hospital IT teams accept. That gave the client a proven path before committing to production builds across a fragmented mix of EHR platforms.
If your product needs to survive connectivity gaps in the field, work across a fragmented mix of EHR vendors, and scale to a national rollout, we have done exactly this.
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