You Don't Just Need a Website: What Technology Does an Online Clinic Actually Need?

What is an online clinic actually selling?

An online clinic sells medicine. The patient is buying a treatment, and they cannot have it until a prescriber has read their answers and agreed they should.

The order of events is always the same. A patient reads about a treatment on your website, answers a set of medical questions, chooses a dose, enters their address and pays. Nothing has been sent to them yet. The order is held in a queue until a prescriber has read the answers and done one of four things: approved it, asked the patient for more information, asked the patient for a video call, or refused it. Only once it has been approved does the pharmacy dispense the medicine, print the label and post it.

This is why ordinary shop software is a poor fit. Shopping carts are written to finish the sale and get the parcel out of the door as quickly as possible. None of them know how to hold an order until a pharmacist has read it, so holding it becomes something your staff have to remember to do instead of something the software does on its own. If you are still working out the licensing and registration side of all this, we cover that in our guide to starting an online clinic in the UK.

What does each treatment page need to do?

Every treatment you sell needs a page of its own. Somebody searching for a particular medicine wants to read about that medicine, see what it costs, and get started. If all your treatments share one page they have to go hunting for the part that applies to them, and a lot of people give up instead, which is why every treatment needs its own page.

• The doses and the prices, written on the page. People compare clinics on strength and cost. If you make them fill in a form to find out what it costs, most of them will go to a clinic that simply tells them.
• A button that starts the right set of medical questions. It should open the questions for that treatment, not a general contact form or an email address.
• What happens after they pay, said plainly. Questions, payment, a prescriber reads it, then delivery. If you explain that before they order, the wait afterwards feels normal rather than like something has gone wrong.
• Who the treatment is not suitable for. Being honest about this means fewer orders that you were always going to refuse, which saves your prescriber the time of reading them.
• A page that loads quickly. Nearly everybody reads these on a phone, and patients leave within three seconds if a page is still loading.

Your own staff also need to be able to change these pages themselves. If adding a new treatment or changing a price means emailing a developer and waiting three days, you will put it off, and over time the website stops matching what you actually sell.

What do the medical questions need to do?

The medical questions are the most important part of the whole system. They decide who you can safely treat, they are the evidence behind every decision your prescriber makes, and they are the only thing your prescriber has to go on when they open an order.

A general form builder makes this harder than it needs to be. Everybody gets asked the same questions, the answers come back as long paragraphs of typing, and the whole lot arrives as a PDF that somebody has to read from top to bottom. That is manageable at five orders a day. At fifty, how quickly your prescriber can read becomes the limit on how many patients your clinic can take on.

Two details are worth getting right. The first is the follow-up question. When somebody answers yes to something that matters, the form should ask them why on the same screen, while they are still sitting there. A yes with nothing after it means your prescriber has to email the patient and wait, which adds a day to the decision for no good reason.

The second is photographs. Photo ID and clinical photos are better asked for after the order than during it. Asking somebody to go and find their passport before they have even seen a price is where a lot of first orders are lost. Take the order first, then email them a secure link they can upload through when they get a minute. The order is held in your queue and marked as needing photos, so nobody forgets about it.

It is also worth sending the answers through to the pharmacy the moment the patient submits them, before they have paid. Your team can see what is coming, and if somebody drops out at the payment screen you at least know they were there.

Your team need to be able to write and change these questions themselves, treatment by treatment. When clinical guidance changes, the question should change that day rather than whenever a developer is next available. There is more on this in tailoring the questions to every treatment and flagging concerns before a clinician looks.

How should payment work when the answer might be no?

The money should be held on the patient's card when they check out and only taken once a prescriber approves the order. The patient has committed, your team knows the card is good, and nobody pays for medicine they were never sent.

That one decision saves a great deal of work later. If you take the money at the checkout instead, every refusal turns into a refund somebody has to process, and a patient who has just been told no is out of pocket until it reaches their bank. Holding it means a refusal simply releases the hold, and you can tell the patient straight out that they have not been charged, which prevents a lot of angry emails.

Whoever builds this for you needs to answer two questions properly. How does the system know for certain that a payment has gone through, and what happens to the patient's money on each of the decisions a prescriber can make. Vague answers here turn up later as refunds your team process by hand, and occasionally as orders that were never actually paid for, which is one of the mistakes to avoid when launching an online clinic.

What happens between the patient paying and the prescriber deciding?

As soon as an order is placed it is held in a queue with a status attached to it, and it stays there until a named clinician has dealt with it. Those statuses are what your staff work from all day, and every one of them needs a second version written for the patient.

Your staff will have their own shorthand for these, and that shorthand should never reach the patient. A phrase like "needs review" describes the pharmacy's own to-do list and means nothing to somebody sitting at home. What they need to know is that a human being has their order and there is nothing for them to do. Writing it out properly takes a surprising number of "any update?" emails out of your inbox.

Your prescriber needs enough on one screen to make the decision without going looking for anything. That means the patient's answers, anything you have flagged as a concern, any photographs they have sent, and what was decided for this patient last time. The GPhC's guidance for pharmacy services provided at a distance says a prescriber must have enough information to make a safe decision, and this screen is where they either have it or they do not.

Every decision needs the date, the time and the name of the person who made it recorded against the order. If you are ever asked to show how a decision was reached, that record is your answer, and you cannot piece it together from an email inbox afterwards.

How do video consultations fit in?

A video call is what you do when the written answers are not enough on their own. Most orders never need one, but the ones that do are usually the cases where getting it wrong would matter most.

When a prescriber decides they need to speak to somebody, they mark the order as needing a consultation. The order is held rather than approved or refused, the payment is held with it, and the patient is emailed and asked to choose a time. Anyone else who opens that order can see why it is being held, which matters on a Monday morning when the prescriber who asked for the call is not the one working.

The patient picks the time themselves, and they can only pick from the times your clinical team has released. That is the part worth getting right. Your team decides which days and which hours consultations can happen in, and anything already taken comes off the list, so a patient is only ever choosing from appointments that genuinely exist. Once they have chosen, the appointment belongs to both sides. The patient can see it and join it, and so can your clinicians.

Arranging it this way takes the back and forth out completely. Nobody on your team is emailing three possible times and waiting to hear back, and the patient is not ringing your pharmacy to sort out something they could have done in a minute on their phone.

• Times that come from your own schedule. Your clinical team decides when consultations can happen, so nobody books into an evening when there is no prescriber working.
• No double bookings. A slot that has gone should come off the list, and it should be checked again at the moment the patient confirms.
• A way into the call that does not depend on an email. Patients delete things, and you find out at the exact moment the call was meant to start.
• The order in front of the prescriber during the call. The answers, the photographs and any previous decisions, without opening anything else.
• The notes and the decision recorded on that order. Written while it is fresh, not typed up from memory at the end of the day.

That last point is the one that gets forgotten. If the call happens in one piece of software and the outcome is recorded in another, somebody has to carry it from one to the other, and orders stay held long after the conversation finished. There is more on how calls sit alongside written assessments in online consultations for weight loss clinics.

What has to happen when an order is approved?

Approval is the moment somebody stops being a customer and becomes your patient, and the software should handle that rather than a member of staff.

Once the prescriber approves, a run of work follows. The money is taken, a patient record is created, an account is opened for them, the decision is saved against their name, the prescription and the dispensing label are produced, the stock comes off the shelf against its batch number, and the patient is told their treatment is on its way. None of that involves any judgement, and none of it should involve typing.

In a clinic running on separate tools, most of that is a person at a keyboard, and it happens again on every single order. A pharmacy sending out four hundred orders a month is doing several thousand of these small jobs a year, and nobody counted them when they worked out what the setup was going to cost.

The patient record needs to be one record rather than six. Health information is special category data under UK GDPR, and the ICO's guidance on health data applies to every place you are keeping it. If one patient is spread across a form tool, an email inbox, a spreadsheet and a cloud drive, that is four places you have to secure, and answering a request from that patient for everything you hold on them becomes a day's work. Keeping it in one place, where you control who can see what and every time a record is opened is logged, is what clinical admin software is for.

What paperwork does the system have to produce?

An online clinic produces far more documents than the website ever suggests, and every one of them has to be kept somewhere sensible.

The list covers prescriptions, dispensing labels, order confirmations, approval and refusal emails, photo ID, clinical photographs, consent records, and the reports you will hand to an inspector. Each one has to be produced, stored securely, attached to the right patient, and logged whenever somebody opens it.

Two are worth singling out. The prescription should be produced from the approved order with the patient's details and the medicine already on it, because typing those out again is slow and it is the easiest place in the whole process to get a dose wrong. The label should be produced from the prescription for exactly the same reason, and you should be able to look back at every label you have printed and when. The standards for pharmacist independent prescribers leave the clinical decision with the prescriber, and the software's job is to take the copying and retyping off them, not the judgement.

How does a patient order again?

Ordering again is not the same as buying something twice. It is a second clinical decision, and the software has to treat it as one.

The money side matters here. You paid to get that patient in the first place, through advertising or search or word of mouth. If they order six more times, that cost is spread across seven orders instead of one. If they do not, you have to pay to find the next patient at full price, which is the point we put numbers to in how repeat orders become predictable monthly revenue.

The patient signs into their account, presses order again on the treatment they are already taking, and answers a short set of questions instead of the whole original questionnaire. Those questions cover the same ground a clinician would cover face to face: whether the treatment is working, whether there have been any side effects, whether anything has changed with their health or their mood, and whether they have started taking anything else.

Those answers go onto the order, and the order joins the same queue that a brand new patient's order goes into, marked as a repeat and held for a prescriber to read. Answers you have picked out in advance, such as severe side effects or a change in mood, are marked as a concern so they are the first thing the prescriber sees rather than something they have to scroll down to find.

This step is the difference between a prescribing service and a subscription box, and it is usually the first thing to disappear from a cheap build, because a button that just sends out another parcel is far easier to write. The questions asked here should be the same ones the patient's account asks at a routine check-in, so nobody ends up being asked two different sets of questions about the same medicine.

What should the patient's account do?

The patient's account is where your relationship with them lives between orders. Without one, a patient who wants something can only email you, ring you, or start all over again from the website, and all three of those end up as a job for somebody on your team.

• Show them where their order is. In plain English, so they do not email to ask.
• Let them order again. Straight from the treatment they are already on, without answering everything again.
• Let them answer their check-in questions. The same short set they answer when they order again, with their previous answers there to look back at.
• Track their progress. Weight and measurements, plotted on a chart over time.
• Let them message the pharmacy. Questions about their treatment, their order and their delivery, saved onto their record rather than lost in somebody's inbox.
• Let them book and join video calls. Choosing a time and joining the call itself, without phoning anybody.

Progress tracking does more than it looks like it does. A patient who can see their own weight going down has a reason to open their account in a week when they are not ordering anything, and patients who open their account are the ones who order again. There is a fuller version of this argument in why the patient portal should be the place patients return to.

Which parts should run automatically?

Automate everything that happens around a decision, and leave the decision itself with a person. Whether to approve, whether to refuse, whether a dose is right and whether somebody needs a phone call all stay with your clinician. Everything that happens before and after can run on its own.

One worth adding that nobody thinks of: checking that the patient's email address is real. It never holds an order up and it is not there for the checkout at all. It is there so that a prescriber's decision does not get sent to an address with a typo in it, which is how a clinic ends up chasing a patient who believes they have been ignored.

What do you need to be able to see to run the clinic?

If you cannot tell which treatments make you money and where your patients came from, you are guessing, and this is a business that produces plenty of evidence to work from.

There are only seven numbers that change what you do. How many orders you received, what proportion were approved for each treatment, how long orders are held before a decision is made, the reasons orders were refused, the average order value, how many patients order again, and what a patient is worth to you over the time they stay with you.

Two of those are worth looking at every day. How long orders are held before a decision tells you about your patient experience and your refund rate in one number, because an order left unread for three days turns into a cancellation and often a one star review as well. How many patients order again is the business model itself, because a prescribing clinic where nobody comes back is a very expensive way to make one-off sales, and we have put figures to that in what one patient is actually worth to your clinic.

Marketing belongs in the same place rather than off to one side. Your treatment pages, where you appear in search results, your reviews and your paid adverts all feed the same queue of orders, and they work better when the software that publishes them also records what came of them. Advertising prescription medicines is also tightly controlled, so find out what you are allowed to say early on, because it affects how the website is built and not just the words on it.

What goes wrong when these parts are not connected?

Each individual piece of this is a solved problem. What decides whether the clinic runs smoothly is what happens in between them.

Every time information has to get from one part to the next, either the software does it and nobody notices, or a person does it. When everything sits in one system, the information does not really move at all, it is simply already there for the next step. When it does not, somebody performs the same small job by hand on every order, forever.

Getting a repeat order into the approval queue is the dangerous one. When somebody has to do that by hand it will eventually get skipped, because skipping it is quicker and nothing appears to go wrong the first hundred times. The rest are expensive rather than risky, and they get more expensive every month you grow.

So when somebody quotes you for a build, take one order and walk it all the way through what they are proposing, from the treatment page to that patient's second order. Count every point where a person has to move information from one place to another. That number is what the setup will actually cost you to run.

Build your online pharmacy on Clinic Pro

There is no off-the-shelf product that covers treatment pages, medical questions, an approval queue, prescriptions, labels and a patient account. That is why clinics end up paying for six separate subscriptions and employing somebody to hold them together. Clinic Pro was built to do all of it in one place.

• Treatment pages your own team controls. Add a treatment and the platform produces a finished page with the doses and prices on it, ready for you to check before it goes live. See clinic websites.
• Medical questions you write yourself. Follow-up questions that appear when they are needed, answers you can flag as a concern, and photo requests sent after the order rather than during it. See digital forms.
• An approval queue instead of an inbox. Every order with a status, and the answers, the flags, the photographs and the patient's history on one screen. See the platform.
• Video calls attached to the order. Requested by the prescriber, booked by the patient from the times your team has released, with the decision made from the order the call was about.
• Prescriptions and labels produced from the approved order. Already filled in, with stock and batch tracking behind them, and a record of who did what and when throughout. See clinical admin.
• An account patients come back to. Order progress, ordering again without repeating the questions, check-ins, progress charts, messaging and their full history. See the patient portal.
• All the admin around the decision, done for you. Confirmations, upload links, logins, taking payment on approval, and tracking numbers. See SMS campaigns.
• The seven numbers above, in one place. Orders, approval rates, how long decisions are taking, and how many patients order again.

If you are planning an online clinic and want to walk through how it would work before you commit to anything, get in touch and we will map it out with you.

The website is the easy part

Online pharmacies that end up drowning in admin nearly always got there the same way. Somebody built the part they could picture, which is the website, and then filled in everything else with people.

The part that gets missed is the gap between the patient paying and the prescriber deciding. Everything else in the clinic attaches to that gap, so if it has not been designed, your staff spend their days being the software.

Get the medical questions, the approval queue and the repeat order right first. The rest can wait until those three work properly.