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Healthcare Patient Portal

May 20, 2024
Full Stack Developer

HIPAA-compliant patient portal with real-time appointment scheduling and secure messaging. Built with accessibility-first approach.

ReactNode.jsPostgreSQLWebSocketHIPAA
Live Demo
Healthcare Patient Portal

Project Overview

Developed a comprehensive patient portal for a healthcare network serving 50,000+ patients. The platform enables patients to manage appointments, communicate with healthcare providers, access medical records, and more—all while maintaining strict HIPAA compliance.

Challenge

The healthcare network needed a modern, secure platform to improve patient engagement and reduce administrative overhead. The existing system was outdated, lacked mobile support, and had poor accessibility.

Requirements:

  • Full HIPAA compliance
  • Real-time features (messaging, notifications)
  • Accessibility (WCAG 2.1 AA)
  • Multi-factor authentication
  • Audit logging
  • Mobile-first design

Solution

Built a secure, accessible web application with real-time capabilities and comprehensive security measures.

Security & Compliance

HIPAA Compliance:

  • End-to-end encryption for all patient data
  • Comprehensive audit logging
  • Role-based access control (RBAC)
  • Automatic session timeouts
  • PHI data encryption at rest and in transit
  • Regular security audits

Authentication:

  • Multi-factor authentication (MFA)
  • Biometric support (Touch ID/Face ID)
  • Session management
  • Password policies enforcement

Core Features

Appointment Management:

  • Real-time availability checking
  • Provider filtering and search
  • Appointment reminders (email, SMS)
  • Virtual visit support (video calls)
  • Cancellation and rescheduling

Secure Messaging:

  • Real-time chat with providers
  • File attachments (lab results, images)
  • Read receipts
  • Message encryption
  • Conversation threading

Medical Records:

  • Access to test results
  • Prescription history
  • Visit summaries
  • Document downloads (PDF)
  • Health timeline visualization

Accessibility Features:

  • Screen reader optimized
  • Keyboard navigation
  • High contrast mode
  • Adjustable font sizes
  • ARIA labels throughout

Results

  • 45% reduction in phone call volume
  • 92% patient satisfaction rating
  • 100% HIPAA compliance certification
  • 98 Accessibility score (Lighthouse)
  • 30% increase in appointment bookings

Impact Metrics

  • Average response time: < 2 hours
  • Appointment no-show rate: Reduced by 35%
  • Patient engagement: +67%
  • Administrative time saved: 15 hours/week per office

Technical Implementation

Architecture

Frontend (React)
├── Real-time updates (Socket.io)
├── State management (Redux)
├── Form validation (Zod)
└── Accessibility (React Aria)

Backend (Node.js/Express)
├── RESTful API
├── WebSocket server
├── Authentication (JWT)
└── Database (PostgreSQL)

Infrastructure (AWS)
├── EC2 (Application servers)
├── RDS (Database)
├── S3 (Document storage)
└── CloudFront (CDN)

Key Technologies

  • Frontend: React, TypeScript, Redux Toolkit, Socket.io Client
  • Backend: Node.js, Express, Socket.io, JWT
  • Database: PostgreSQL with encrypted columns
  • File Storage: AWS S3 with server-side encryption
  • Video Calls: Twilio Video
  • Email/SMS: Twilio SendGrid

Accessibility Highlights

Achieved 98/100 accessibility score through:

  1. Semantic HTML - Proper heading hierarchy, landmarks, lists
  2. ARIA Labels - All interactive elements properly labeled
  3. Keyboard Navigation - Tab order, focus indicators, shortcuts
  4. Color Contrast - WCAG AA compliance (4.5:1 minimum)
  5. Screen Reader Testing - Tested with NVDA, JAWS, VoiceOver

Security Measures

Data Protection

  • AES-256 encryption for data at rest
  • TLS 1.3 for data in transit
  • Database column-level encryption for PHI
  • Secure key management (AWS KMS)

Audit Logging

All actions are logged:

  • User authentication
  • Record access
  • Data modifications
  • File downloads
  • Message sending

Lessons Learned

  1. Accessibility from Day 1 - Building accessibility into the foundation saved significant refactoring later.

  2. Real-time is complex - WebSocket connection management, reconnection logic, and state synchronization required careful planning.

  3. Compliance is ongoing - HIPAA compliance isn't a one-time thing; it requires continuous monitoring and updates.

  4. User testing is critical - Testing with actual patients (various ages, abilities) revealed important usability issues.

Future Roadmap

  • Integration with wearable devices
  • AI-powered health insights
  • Multi-language support
  • Prescription refill automation
  • Family account management

Tech Stack

ReactNode.jsExpressPostgreSQLSocket.ioAWS