A patient platform built around consent from the first line of code

Cadence operated eleven sites on three different clinical systems, none of which shared a patient identity.

Front-desk staff re-keyed patient details at every visit, and clinicians routinely worked without prior history from a sibling site.

Consent was captured on paper, stored locally, and effectively unauditable across the group.

A unified patient identity service with deterministic and probabilistic matching, reviewed by clinical staff before any records were merged.

An interoperability layer to bring the three legacy systems into one record, then retire them one site at a time over eight months.

Consent was modelled as a first-class, versioned, event-sourced entity — every grant, scope change and withdrawal is an auditable event with a timestamp and an actor.

Clinician workflows were designed on site with the people who would use them, and no site was migrated until its own staff had signed off the workflow.

Administrative time per appointment fell 71%, returning roughly nine minutes per patient to clinical staff.

All three legacy systems were retired on schedule, with every consent event across the group now queryable and audit-ready.

Patient net promoter score rose 22 points, with the reduction in repeated intake questions cited most often in verbatim feedback.