For decades, healthcare has poured time and money into patient portals, health apps, and personal health records - all with the promise of “empowering patients.” These tools proudly display lab values, medication lists, and colorful symptom graphs. Yet in practice, they confuse information with understanding, and data with agency.
Clinicians know this better than anyone. Every year brings another portal, another intake form, another digital front door with its own login. Each claims to make care more connected. Each ends up underused or ignored. Patients still show up uncertain about what to say. Clinicians still start visits without meaningful context. Messages pile up. Data fragments. Trust erodes.
The problem was never access.
The problem is focus.
For better or worse, the visit remains the gravitational center of care. Everything from labs, referrals, history, and medications ultimately converges on that singular human encounter. Yet most technology ends up centered around the data instead of the moment itself.
A portal can show results, but it doesn’t help a patient consider what to ask when they see their doctor. A personal health record returns ownership of health data to the patient, but does little to inform them how to use it or how to be an active participant in their care. Even pre-visit intake tools, which offer clear value to patients and providers alike, rarely integrate into workflows and often stop helping the moment the patient walks into the room.
Studies tell the same story. A PCORI-funded trial of a digital “visit planner” found that while patients arrived better prepared, there was no measurable impact on adherence or follow-up rates. Portal usage shows similar limits: roughly 40% of adults report ever logging in, and only one in four use it more than once or twice a year. Without shared benefit, the loop collapses. Patients are told to “fill this out,” clinicians to “check another box."
But the visit is different.
Both sides care about the same moment, at the same time.
Patients want to feel heard and informed. Clinicians want to spend less time reconstructing the story. If technology were built to strengthen that shared moment, rather than layering more tasks on top of it, it could finally align incentives instead of dividing them.
In hospitals and clinics, clinicians begin their day with “pre-rounding” and rounding - reviewing charts, checking updates, gathering test results, and mentally organizing what matters before stepping into a room. This ritual exists for a reason: the visit is the moment where decisions are made, and preparation improves care.
Patients, meanwhile, have no equivalent structure. They walk into visits without the context clinicians rely on, expected to remember symptoms, timelines, medications, and questions without support.
A visit shouldn’t be treated as a 15-minute island floating in a sea of disconnected data. Instead, it can serve as the organizing event of the health journey; a moment whose value increases when prepared for, and whose insights ripple outward.
When patients prepare thoughtfully before the visit - reviewing updates, gathering documents, capturing changes - they become active participants rather than passive narrators. When those discussions are captured during the encounter, context is preserved instead of lost. And when clear summaries and action items follow after the visit, both sides stay aligned.
Extending the visit isn’t about expanding the appointment. It’s about stretching its influence into the spaces where health is actually lived: at home, at work, in day-to-day choices and follow-through. The result is not another portal or a shinier dashboard. It’s continuity. It’s coherence. It’s a shared thread of understanding that bridges the gaps between moments of care.
This is how true personal health records are born, not as static databases, but as living narratives grounded in real context.
The tension between patient empowerment and clinician efficiency is often treated like a trade-off. But when preparation is done right, these things reinforce each other.
A patient who arrives with clear priorities saves a clinician minutes of backtracking.
A concise pre-visit summary reduces inbox messages.
A shared understanding lowers the risk of missed labs or forgotten tasks.
Prepared patients lighten the workload, reduce the cognitive burden of reconstructing the story, and help clinicians stay focused on what matters most.
The next generation of health technology shouldn’t begin with data aggregation or massive interoperability projects. Those are important - but they solve the wrong problem first.
Instead, the design unit should be the visit: the moment where human connection and clinical reasoning meet.
Build outward from that anchor and everything aligns:
We don’t need smarter dashboards.
We need tools that treat each visit as a moment of collaboration—and then extend that clarity forward and backward in time.
Healthcare is, at its core, about people. Technology can bring people closer together or bury them in noise. Extending the visit before, during, after, and in the space between is how we rebuild the experience around clarity, partnership, and understanding.
This is the future of healthcare we’re building at Alcott.
And we’re excited to share that journey with you.