Patients Know Best Single Patient Record Platform: Strategy, International Reach, Clinical Evidence, and Potential as NHS Healthcare Technology Infrastructure

Lloyd Price
6 days ago
31 min read

Updated: 3 days ago

Patients Know Best Single Patient Record Platform: Strategy, International Reach, Clinical Evidence, and Potential as NHS Healthcare Technology Infrastructure

Executive Summary

Patients Know Best (PKB) represents a pivotal advancement in personal health record (PHR) platforms, fundamentally reshaping how individuals interact with their healthcare data. As a secure online system, PKB aggregates diverse health information from various providers, including hospitals, general practitioners (GPs) and specialists, into a unified, patient-controlled digital record. This capability positions PKB as a cornerstone for national digital health agendas, particularly aligning with the UK National Health Service's (NHS) strategic vision for a comprehensive Single Patient Record (SPR) and its broader digital transformation efforts.

The platform has demonstrated significant international reach, with deep integration across the UK and recent strategic expansion into markets such as Nigeria, underscoring its adaptability across varied healthcare ecosystems. Clinically, PKB has proven instrumental in enhancing patient engagement, promoting self-management, and substantially improving operational efficiencies and care coordination within the NHS. Its robust integration with the NHS App and nationwide GP data access further solidifies its role as a critical component of the future healthcare technology infrastructure.

Despite its considerable promise, widespread adoption and full realisation of PKB's benefits face systemic challenges. These include underlying NHS infrastructure limitations, inconsistencies in data quality across disparate systems, and the necessity for profound cultural shifts among both healthcare professionals and patients. To overcome these hurdles, strategic investments in foundational IT, comprehensive change management programs, and a concerted effort to leverage PKB for broader population health and research objectives are recommended.

1. Introduction to Patients Know Best (PKB)

Patients Know Best is a leading digital health platform designed to empower individuals by centralizing their health information. It functions as a secure online personal health record, patient portal, and engagement platform, fundamentally aiming to unify fragmented health data across the care continuum.

1.1 Core Features and Functionalities of the PKB Platform

At its core, PKB offers a robust suite of features that facilitate comprehensive health data management and patient empowerment. The platform excels in data aggregation and unified record creation, seamlessly drawing health information from various healthcare providers, such as hospitals, GPs & specialists and presenting it within a single, user-friendly online account. This capability is instrumental in creating a "single, unified copy of patient data," which is vital for minimising duplication and supporting the complex needs of multidisciplinary care teams.

A defining characteristic of PKB is its emphasis on patient access and control. Individuals can view their complete medical history, including test results, medications, and care plans. A granular consent model allows patients to precisely determine who can access their health records, extending control to doctors, nurses, carers, and family members. This level of patient-controlled access significantly fosters greater autonomy in managing one's health journey.

For self-management and engagement, the platform provides tools for patients to track their health by recording symptoms, monitoring conditions, and adding personal health data. It supports the upload of real-time data from wearable devices and other monitoring tools. Customisable questionnaires, forms, and Patient-Reported Outcome Measures (PROMs) further encourage active patient participation in their care.

Secure communication and collaboration are facilitated through multi-party messaging features, allowing patients to communicate directly with their healthcare teams. This streamlines interactions and prevents the disjointed communication often associated with traditional phone-based systems. Collaborative shared care plans and a curated library of tailored resources are also available to support comprehensive care.

Beyond direct patient interaction, PKB incorporates features designed for operational efficiency. These include tools that support Patient Initiated Follow Ups (PIFU), initiatives for "waiting well," and broader elective recovery programs. The platform also enables access to digital letters and appointments, complete with appointment management workflows, further enhancing administrative efficiency.

In terms of accessibility and integration, PKB is accessible from any internet-connected device via a web application and is highly mobile-optimised. Notably, it was the first personal health record to integrate with the NHS App, thereby extending its features by sharing GP data directly through the national NHS interface. Its integration capabilities also extend to systems like EMIS Web for demographic and clinical information. The platform's usability has been independently validated, receiving a 92% rating from ORCHA, one of the highest they have ever awarded.

The design and functionality of PKB position it as a significant enabler of patient-centric care and digital transformation within healthcare systems. The platform's core features, such as a single, unified patient record, granular consent, self-management tools, and secure messaging, directly empower patients by granting them control and fostering active participation in their healthcare journey. This empowerment represents a fundamental shift towards a model where patients are considered co-equal members of their care team, moving away from a passive recipient role. The deep integration with national NHS infrastructure, including the NHS App, NHS Login, and GP data, allows PKB to operationalise this patient-centric model at scale, making it a foundational component for the NHS's broader digital transformation agenda. Its capacity to connect information across primary, secondary, social, and mental health care providers is essential for achieving truly "joined-up thinking" and delivering comprehensive care, which is a key objective for the NHS.

Furthermore, PKB plays a crucial role in supporting the paradigm shift in healthcare from a focus on sickness to one on prevention, and from hospital-centric care to community-based care. The UK government's 10-year health plan explicitly emphasises these shifts: "hospital to community, analogue to digital, and sickness to prevention". PKB's functionalities, including remote management, monitoring, and consultation, as well as patient-initiated follow-ups and self-management tools, directly facilitate these transitions. By enabling patients to track symptoms, access care plans from their homes and communicate remotely, PKB reduces the necessity for frequent hospital visits, thereby supporting the "hospital to community" shift. The proactive health management and self-monitoring capabilities align directly with the "sickness to prevention" agenda, as early intervention and continuous monitoring can prevent health deterioration and improve long-term outcomes. PKB is therefore not merely digitising existing processes but actively enabling a fundamental re-imagining of care delivery in line with national strategic goals.

Table 1: Key Features and Benefits of Patients Know Best

Feature Category	Specific Feature	Benefit Category	Specific Benefit
Data Management	Single Patient Record	Patient-Centric	Enhanced Patient Empowerment/Autonomy
	Access to Medical History, Test Results, Medications, Care Plans	Patient-Centric	Increased Patient Engagement
	Granular Consent for Sharing	Patient-Centric	Improved Care Coordination
Patient Engagement	Health Tracking (Symptoms, Wearables)	Clinical Efficiency	Remote Management, Monitoring, Consultation
	Customizable Questionnaires/PROMs	Clinical Efficiency	Reduced Data Duplication
Communication	Secure Messaging	Systemic Impact	Increased Capacity
Operational Support	NHS App/Login Integration	Systemic Impact	Financial/Environmental Savings (Digital Letters)
	Patient Initiated Follow Ups (PIFU)	Systemic Impact	Reduced Did Not Attend (DNA) Rates
	Digital Correspondence	Systemic Impact	Waiting List Validation
Technical	FHIR/HL7 Interoperability	Systemic Impact	Optimized Perioperative Pathways
	Mobile Accessibility	Systemic Impact	Decreased Hospital Attendances/Readmissions
		Systemic Impact	Administrative Time Savings
		Systemic Impact	Better Health Outcomes

1.2 PKB's Vision and Strategic Direction (2023-2027 Roadmap)

PKB's strategic roadmap for 2023-2027 articulates an ambitious vision to establish itself as a global leader in digital health infrastructure. The core vision is to create a "single record for each person that is complete, real-time and accurate," a record that is available "from cradle to grave, everywhere they go and anytime they receive care". This comprehensive approach is informed by over 12 years of extensive experience collaborating with the health and care sector.

The roadmap is structured around several critical product strategy pillars. Firstly, there is a commitment to a comprehensive data model, aiming to expand datasets to encompass the full spectrum of a person's health information, including procedures, vaccinations, safeguarding records, and family history.

Secondly, interoperability is a central tenet, with a strong commitment to Fast Healthcare Interoperability Resources (FHIR) APIs, the international standard for healthcare interoperability. This ensures that all data within PKB is available bidirectionally for access and editing by third-party systems, provided the correct patient consent is obtained. PKB's proprietary APIs are also Creative Commons licensed, further promoting data exchange.

Thirdly, PKB prioritises industry-leading security. This involves continuous encryption of data both at rest and in transit, alongside the ongoing rollout of multi-factor authentication methods, such as Time-based One-Time Passwords (TOTP).

Fourthly, usability and convenience are paramount, particularly given that over 60% of PKB's usage occurs via mobile devices. The platform plans to enhance mobile user experience by adding biometric authentication, calendar integration for appointments, browser and mobile notifications, and direct links to Apple HealthKit and Google Fit. Furthermore, dedicated native applications for Android and iOS platforms are planned for use cases where native apps offer a superior user experience.

Finally, scalable onboarding and identity verification are being addressed. Recognising the inherent complexity of patient registration and identity verification, PKB is integrating with national services like NHS Login in England and MedMij in the Netherlands, with plans for similar international integrations. The company is also exploring the possibility of federating records, which would allow a single login to access multiple records belonging to the same patient, even if those records were initially created with temporary identifiers.

A notable aspect of PKB's strategy is its focus on patient activation. The platform intends to expose behavioral data, such as the frequency of patient logins and the data viewed, through its API as metrics. This is based on the understanding that these behaviors serve as proxies for patient activation, a concept measured by the Patient Activation Measure (PAM) Score, which is a leading indicator for improved health outcomes.

The execution of this ambitious roadmap is supported by substantial funding and scale. In January 2025, PKB secured £6 Million in funding specifically to expand its personal health record platform both within the UK and internationally. The platform is already recognised as the largest of its kind globally, integrating data feeds from all GP practices in England and 25% of UK hospitals. It serves over 4.7 million registered patients and processes more than 20 million test results monthly. This scaling effort aligns directly with the UK government's strategic objective to digitize all NHS patient records over the next decade.

PKB's strategic positioning for national and international prominence is significantly bolstered by its commitment to interoperability and patient activation. The vision of a "cradle to grave" single record, coupled with a strong adherence to open standards like FHIR and extensive third-party integrations, suggests that PKB aims to be more than just a software vendor; it seeks to become a central, ubiquitous health data hub. The emphasis on open APIs indicates a desire to foster a collaborative ecosystem rather than a closed system. The focus on patient activation measures through behavioral data is a sophisticated strategic move. It acknowledges that technological adoption alone is insufficient; true impact on health outcomes requires active patient engagement. By tracking these proxies, PKB can demonstrate its value beyond mere data access, directly linking its platform to improved health. The recent £6 Million funding and existing scale provide the necessary capital and market presence to execute this ambitious, ecosystem-driven strategy, positioning PKB for significant national and international growth.

Furthermore, PKB is emerging as a prototype for future health data infrastructure. The company's active work on integrating with national identity services, such as NHS Login and MedMij, and its exploration of federated records for single login access across multiple patient records, address fundamental and complex challenges in health data management. These challenges, including identity verification and record unification across disparate systems, are critical for any national digital health infrastructure. By tackling these systemic issues, PKB is not just developing its product but is implicitly contributing to and potentially shaping the future architecture of digital health. It is demonstrating how patient identity and record access can be seamlessly unified, regardless of the originating system or care setting, thereby influencing national policy and standards for the broader healthcare technology landscape. This forward-thinking approach positions PKB as a significant innovator in the field.

2. PKB's International Footprint and Global Expansion Strategy

Patients Know Best has cultivated a substantial international presence, indicative of a deliberate and well-executed strategy for global scaling and market penetration.

2.1 Current International Deployments and Partnerships

PKB is currently being deployed in numerous countries globally, showcasing its versatility as a platform adaptable for diverse healthcare organisations worldwide.

Within its European presence, PKB is deeply embedded within the United Kingdom's NHS ecosystem, particularly in England and Wales. It has achieved "true national coverage" across England by integrating with all GP surgeries, enabling every adult patient to store a copy of their GP data within their PKB personal health record, accessible via NHS login.This significant achievement builds upon existing hospital partnerships, which already facilitate the release of over 20 million test results monthly. PKB also has experience with the NHS Wales App. Beyond the UK, PKB is actively working towards integrations with national services like MedMij in the Netherlands , signalling a strategic focus on aligning with national digital health initiatives in other developed healthcare markets.

A notable development in PKB's African expansion is its recent selection to provide a single patient record system for the Government of Lagos State in Nigeria. This partnership with Interswitch Group is set to introduce the Lagos Smart Health Information Platform, which will host health records for over 20 million citizens. This deployment is designed to leverage PKB's patient-centric architecture to address healthcare infrastructure limitations in Nigeria, mirroring its successful implementation approach in the UK. The contract specifically emphasises the secure, central and local hosting of patient data, ensuring compliance with Nigeria's sovereign data requirements.

To support its global reach, the platform offers multilingual support, with capabilities for 22 languages and automatic interface translation. This feature is crucial for breaking down barriers to care for international users or individuals seeking medical advice across borders.

The successful integration and deployment of PKB in the complex and highly regulated NHS ecosystem in England, alongside its planned integration with MedMij in the Netherlands and a significant contract in Lagos, Nigeria, highlight PKB's adaptability to diverse healthcare infrastructures and regulatory environments. These represent vastly different national healthcare systems, levels of digital maturity, and regulatory landscapes, including Nigeria's specific sovereign data requirements. This diverse portfolio of deployments demonstrates PKB's inherent flexibility and robust architecture, indicating its capacity to adapt its core platform and business model to meet specific national requirements, including data governance and interoperability standards, across various global markets. This adaptability is a significant competitive advantage for international scaling.

Furthermore, PKB's position as a global leader in patient-controlled PHRs is evident in its efforts to drive international standards. PKB asserts itself as the "largest of its kind in the world" and its CEO acknowledges a "clear global shift towards investing in Single Patient Record systems". By actively engaging with and successfully integrating into diverse national health systems, such as the NHS App, NHS Wales App and PGOs in the Netherlands, as well as the Lagos State initiative, PKB is not merely expanding its market share. Its commitment to open standards like FHIR and its multi-language support position it as a key player in the global movement towards standardised, interoperable digital health records. This leadership role extends beyond its commercial interests to actively shaping the future of global digital health policies and standards.

Table 2: PKB's International Deployments and Strategic Partnerships

Country/Region	Key Integrations/ Partnerships	Scale/Impact	Strategic Notes
UK (England)	NHS App, NHS Login, GP data integration, EMIS Web	Largest PHR globally, 4.7M+ registered patients, 20M+ test results monthly	Experience with government partnerships, commitment to international standards (FHIR)
UK (Wales)	NHS Wales App (experience)	N/A	Experience with government partnerships
Netherlands	MedMij (planned integration)	N/A	Strategic focus on national digital health initiatives
Nigeria (Lagos State)	Interswitch Group	Contract for 20M+ citizens	Compliance with sovereign data requirements, addressing infrastructure limitations
Global	FHIR, 22-language support	N/A	Adaptability to diverse healthcare systems, breaking down barriers to care

2.2 Strategic Approach to Global Scaling and Market Penetration

PKB's global expansion strategy is meticulously crafted, combining the leverage of existing successes, the cultivation of government partnerships, and an unwavering commitment to interoperability and user experience.

The strategy begins by leveraging UK success as a blueprint. PKB's deep integration and "true national coverage" within the NHS serve as a powerful proof-of-concept for international markets. The extensive experience gained from partnering with the UK government on initiatives like the NHS App is directly transferable to other national digital health programs globally. This provides a credible foundation for demonstrating large-scale digital health implementation within a public healthcare system.

A core component of this approach is targeted government partnerships. The CEO explicitly highlights experience in "partnering with government on innovations" , indicating a deliberate strategy to engage with national and regional health authorities. The recent Lagos State contract, a significant partnership with a government entity, exemplifies this approach.Such alignment with national digital agendas effectively de-risks market entry and facilitates large-scale adoption by ensuring the platform meets national strategic objectives.

The pursuit of aggressive market penetration is financially supported by the £6 Million funding secured in January 2025, which is specifically earmarked to "scale its personal health record platform in the UK and expand internationally". This capital provides the necessary resources to pursue ambitious growth targets.

PKB also places a strong emphasis on scalable onboarding and identity verification. The company acknowledges the inherent complexity of identity verification and patient registration across different national contexts. Its strategy involves integrating with national identity services, such as NHS Login and MedMij, and exploring federated records to enable convenient and scalable onboarding globally. This proactive approach addresses a fundamental barrier to widespread digital health adoption.

Interoperability remains a core tenet of PKB's global strategy. The commitment to FHIR APIs and expanding datasets using international standards, ensuring data is available bidirectionally, is central to this. This capability guarantees seamless integration with diverse existing healthcare systems, a critical factor for successful adoption in often fragmented international markets.

The platform's universal benefits proposition is consistently highlighted, emphasizing enhanced collaboration, patient empowerment, interoperability, and improved care coordination as advantages that resonate with national and regional healthcare systems worldwide. This broad appeal facilitates market acceptance across different cultural and clinical contexts.

Finally, PKB's leadership demonstrates a keen ability to anticipate market trends, recognising a "clear global shift towards investing in Single Patient Record systems, with significant interest from many major markets". This foresight allows PKB to strategically position its offerings to capitalize on this growing demand, further solidifying its market leadership.

The strategic leverage of UK success and government partnerships is crucial for PKB's international expansion. The deep integration with the NHS App and nationwide GP data in England is a significant achievement. This provides PKB with a robust, real-world demonstration of large-scale digital health implementation within a public healthcare system. By proving its capabilities in a complex environment like the NHS, PKB gains immense credibility and a powerful reference case for other national health systems considering similar digital transformations. This allows them to mitigate risks associated with international expansion by aligning with established national priorities and leveraging existing digital infrastructure, rather than attempting to build from scratch or navigate entirely new regulatory landscapes without prior experience.

PKB's approach also positions it to anticipate and shape the global demand for unified digital health records. The company's investment in scalable onboarding, identity verification, and exploration of federated records extends beyond basic product development. These efforts address fundamental and complex challenges associated with creating truly seamless, patient-controlled access to health data across fragmented national and international systems. By proactively developing solutions for these systemic issues, PKB is not merely reacting to existing market demand but is actively influencing the future direction of digital health infrastructure. This forward-looking approach positions PKB as a key enabler for countries aiming for comprehensive digital health transformation, potentially influencing the very definition and implementation of future SPRs globally. The recent funding further solidifies its capacity to lead in this evolving market.

3. Clinical Evidence and Demonstrated Impact of PKB

The implementation of PKB across various healthcare settings has consistently yielded significant clinical and operational benefits, substantiated by a growing body of case studies and user feedback.

3.1 Enhancing Patient Engagement and Self-Management

PKB plays a demonstrable role in empowering patients, fostering greater engagement, and enabling more effective self-management of their health conditions. The platform inherently "gives patients more autonomy and increases their engagement" , encouraging them to assume a more active role in managing their own health. Patients are granted access to appointment letters, test results, secure messages, personalised care plans, and tailored educational resources.

The provision of direct information access and understanding is a key mechanism through which PKB empowers patients to manage their conditions. Evidence from NHS organizations utilizing PKB indicates that immediate access to test results improves care coordination, alleviates patient anxiety, and optimises the effectiveness of appointment times. A survey revealed that 75% of patients found the ability to view their radiology reports "extremely useful," and 71% considered checking their blood test results "extremely useful". While 45% of patients reported "definitely understanding" the information presented in PKB, 55% understood it "to some extent" , highlighting an ongoing need for clear patient education and communication strategies.

PKB also facilitates active data contribution by patients, allowing them to upload real-time data from wearables and monitoring devices , and to add their own health information. This capability contributes to a more comprehensive and personalized health record.

Real-world applications illustrate the tangible impact of PKB. For instance, a cardiology patient in Wales found weekly access to blood test results via PKB "critical" for effective self-management and for preparing pertinent questions for their appointments. Similarly, a parent managing the care of their 94-year-old father lauded PKB as "brilliant" for accessing appointment letters and test results, even enabling them to provide crucial real-time information to paramedics who otherwise lacked access. Some general practitioners (GPs) have reported that PKB reduces their workload, as many patients can review their results and self-reassure without requiring an appointment. Patients have also leveraged the platform to upload foreign medical history and track personal health metrics, such as HBA1C tests.

Academic support further reinforces these observations. Research indicates that patient-controlled personal health records facilitate coordinated chronic disease management through improved communications among and about patients across professional and organizational boundaries. A qualitative study examining families' use of PKB found that it led to patient empowerment by assisting them in understanding diagnoses, test results, and proposed treatments, drawing on established concepts of coping, self-efficacy, and self-determination.

PKB functions as a significant catalyst for informed patient participation and shared decision-making. By providing patients with direct, comprehensive access to their medical records, including test results and care plans, PKB fundamentally shifts the patient's role from a passive recipient to an active participant. The high utility patients derive from accessing their results and their ability to engage in self-management indicate a tangible increase in their self-efficacy. This aligns with the modern healthcare philosophy that places "evidence at the center with the patient as a co-equal member of the care team" , thereby fostering shared decision-making. Informed patients are better equipped to engage in meaningful discussions with clinicians, leading to more personalized and adherent care plans.

Moreover, the platform holds the potential for reduced healthcare burden through proactive patient engagement. Features such as self-management, symptom tracking, and remote monitoring are central to PKB's design. As observed by one GP, PKB can "cut down workload" as patients self-reassure based on the information they access. When patients are empowered to access information and manage aspects of their health independently, it can lead to a reduction in unnecessary face-to-face appointments and phone calls to healthcare providers. This proactive engagement, facilitated by PKB, directly contributes to the NHS's strategic shift from "sickness to prevention". By enabling earlier self-intervention and better long-term condition management, PKB can reduce the overall demand on healthcare services, potentially leading to significant operational efficiencies and cost savings for the NHS, while simultaneously improving patient outcomes.

3.2 Improving Clinical Efficiency and Care Coordination

PKB's unified record and communication functionalities significantly enhance clinical efficiency and care coordination across multidisciplinary teams within healthcare systems. The platform's ability to connect information from primary, secondary, social, and mental health care providers results in a "single, unified copy of patient data". This unification is crucial for reducing data duplication and effectively supporting multidisciplinary care needs, as healthcare professionals can access the same comprehensive data for informed clinical decision-making and more effective patient management.

PKB fosters enhanced collaboration by enabling secure, real-time information sharing among healthcare professionals.This improves communication pathways and streamlines clinical workflows, moving away from disjointed methods.

Significant administrative time savings have been observed across various implementations. For example, University Hospitals of North Midlands NHS Trust (UHNM) implemented a fully automated, data-driven patient referral process using PKB for its patient portal as part of an NHS England Weight Management pilot. This initiative resulted in "significant administrative time" savings and eliminated the need to recruit additional staff for this duty. UHNM's automated approach led to it ranking first in the pilot for referral count, demonstrating the efficiency and effectiveness of the system. Similarly, Hull University Teaching Hospitals achieved a 75% time saving in managing repeat prescription requests by utilizing PKB questionnaires. More broadly, PKB helps services save time by reducing phone calls and streamlining administrative processes.

The platform also plays a vital role in optimising patient flow and capacity. Its questionnaire function enables trusts to perform waiting list validation, allowing them to assess patient status, prioritize appointments, and identify individuals who no longer require care. This directly supports national elective recovery programs. PKB also contributes to a reduction in Did Not Attend (DNA) rates. Furthermore, the platform facilitates remote management, monitoring, and consultation. The implementation of Patient Initiated Follow Ups (PIFU) through PKB helps avoid unnecessary outpatient appointments. Chelsea & Westminster Hospital NHS Foundation Trust's Heart Failure team, for instance, pioneered the use of PKB's digital tools for remote monitoring, which successfully reduced unplanned admissions among older heart failure patients. Additionally, financial and environmental savings are achieved through the digital delivery of letters, replacing traditional postal methods.

For improved long-term condition management, PKB supports efforts to decrease hospital attendances and readmission rates. Clinicians have reported that PKB enabled a new approach to managing stable patients, leading to more cost-effective utilisation of specialist nurses and optimal use of outpatient appointments and consultant time.

PKB functions as a powerful tool for systemic operational optimization and resource reallocation within healthcare. The platform's ability to unify fragmented data, enable real-time information sharing, and automate administrative tasks translates into direct operational benefits such as savings on postage, reduced DNA rates, and successful waiting list validation. More profoundly, by significantly freeing up clinical and administrative time, PKB allows for the strategic reallocation of scarce NHS resources. This enables healthcare staff to focus on higher-value activities and critical patient care, rather than being burdened by repetitive administrative tasks, thereby improving overall system efficiency and capacity.

The platform's contribution to elective recovery and long-term NHS sustainability is also significant. PKB is explicitly integrated into the national Wayfinder programme, which supports the NHS's elective recovery plans. Its features, including PIFU, waiting list validation, and optimized perioperative pathways, directly address key bottlenecks in the elective recovery process. Given the immense elective backlogs faced by the NHS, exacerbated by the pandemic , PKB's ability to streamline patient pathways, reduce unnecessary appointments, and validate waiting lists is critical. This contribution extends beyond mere efficiency gains; it directly impacts the NHS's capacity to clear backlogs, increase overall system capacity, and improve patient flow. This is fundamental for the long-term operational and financial sustainability of the NHS, demonstrating PKB's role as a strategic asset in national healthcare planning.

3.3 Quantifiable Outcomes and Illustrative Case Studies

The impact of PKB is robustly evidenced by a range of quantifiable outcomes and specific case studies across various NHS trusts, highlighting its tangible benefits in different clinical and operational contexts.

At the University Hospitals of North Midlands (UHNM), a Weight Management Pilot in 2023 saw the implementation of a fully automated, data-driven patient referral process utilising PKB. This initiative resulted in "significant administrative time" savings and "negated the need to recruit staff" for this specific duty. The impact was such that UHNM ranked first in the NHS England Weight Management pilot for referral count, showcasing the efficiency and effectiveness of this automated approach.

The Hull University Teaching Hospitals demonstrated efficiency gains in their Multiple Sclerosis service by implementing a digital solution for repeat prescription requests through PKB, which yielded a "75% time saving".

The Chelsea & Westminster Hospital NHS Foundation Trust's Heart Failure Team pioneered the use of PKB's digital tools for remote monitoring and self-management. This intervention successfully reduced unplanned admissions among older heart failure patients.

At Mid Yorkshire Teaching NHS Trust, PKB's questionnaire function is effectively used for Waiting List Validation. This enables the validation of patient status, prioritisation of appointments, and the identification and filtering out of patients who no longer require care.

Swansea Bay University Health Board's Urology Service became the first organization in Wales to achieve national integration for sharing test results with patients via PKB. This provided prostate cancer patients with faster access to their PSA blood test results, significantly improving patient information and education regarding their condition.

Across various implementations, PKB has demonstrated several general quantifiable benefits. These include financial and environmental savings achieved by sending letters digitally, a reduction in Did Not Attend (DNA) rates, successful waiting list validation that removes patients no longer requiring care, improved long-term condition management leading to decreased hospital attendances and readmission rates, and overall administrative time savings by reducing phone calls and streamlining administrative processes for healthcare services.

Patient feedback also provides valuable quantitative insights into the platform's utility. A survey indicated that 75% of patients found the ability to view their radiology reports "extremely useful," and 71% reported that checking their blood test results was "extremely useful". While 45% of patients reported "definitely understanding" the information seen in PKB, 55% understood it "to some extent," highlighting areas for continued patient education and clarity. The usability of the PKB platform has been independently verified by Orcha, which awarded it a 93% rating, one of their highest ever scores.

The evidence presented establishes a direct correlation between PKB adoption and measurable improvements in operational and clinical metrics. The examples provided, such as "75% time saving" for prescriptions, the elimination of the need to recruit staff for referrals, reduced unplanned admissions, and decreased DNA rates, are not merely anecdotal benefits but quantifiable impacts on efficiency, resource utilization, and direct patient outcomes. This robust evidence base moves beyond general claims of "improved care" to demonstrate a direct, causal link between PKB's implementation and tangible improvements in healthcare delivery. The high ORCHA usability rating further validates that the platform is user-friendly, which is critical for achieving and sustaining these benefits through high adoption rates.

PKB serves as a model for evidence-based digital health implementation. The platform's ability to provide specific, quantifiable outcomes and its high usability rating underscore its demonstrated effectiveness. In an environment like the NHS, where digital transformation initiatives often face scrutiny regarding their return on investment and real-world impact, PKB's capacity to provide concrete evidence of efficiency gains, cost savings, and improved patient outcomes positions it as a robust model. This evidence-based approach is crucial for justifying further digital health investments and for guiding future implementations across the NHS, setting a precedent for how digital health solutions should demonstrate their value. It underscores that successful digital health deployments require not just technological capability but also measurable positive changes in care delivery and patient experience.

4. Potential Across the NHS as Healthcare Technology Infrastructure

PKB's capabilities and strategic alignment position it as a significant candidate for serving as a foundational healthcare technology infrastructure across the NHS.

4.1 Alignment with NHS Digital Transformation Objectives

PKB demonstrates strong alignment with the overarching digital transformation objectives of the NHS, particularly its vision for a unified Single Patient Record (SPR). The NHS England's working vision for an SPR aims to grant patients visibility and control of their data, enabling them to read, write, and share joint care plans, offer corrections, and manage sharing preferences, alongside accessing an audit of who has viewed their record. PKB's core functionalities directly address these requirements, offering a patient-controlled personal health record that aggregates information from various providers and allows granular consent for sharing.

The NHS App is envisioned as the "digital front door to health services". PKB's integration with the NHS App is a crucial strategic step, extending its features by sharing GP data directly from the national interface. This integration enhances the app's utility and reinforces its role as the primary access point for patient health information.

PKB's development and expansion are also deeply intertwined with the UK government's broader 10-year health plan, which is expected to be published in spring 2025. This plan is underpinned by three major shifts in healthcare: from hospital to community, from analogue to digital, and from sickness to prevention. PKB's capabilities, such as remote management, patient-initiated follow-ups, and self-management tools, directly contribute to enabling these shifts by reducing the need for physical appointments and promoting proactive health management.

Furthermore, PKB is an integral part of the national Wayfinder programme, which supports the NHS's elective recovery plans. Its features for waiting list validation and optimising patient pathways are critical for addressing the significant elective backlogs within the NHS.

PKB's comprehensive integration and functional breadth position it as a foundational layer for the NHS's unified digital health ecosystem. The platform's ability to unify fragmented data across primary, secondary, social, and mental health care providers into a single, patient-controlled record directly addresses the NHS's long-standing challenge of disparate information systems. This unification provides a "single version of the truth" for patient data, which is essential for coordinated care and efficient clinical decision-making across the entire health and social care landscape. By serving as this central data hub, PKB enables the seamless flow of information that is critical for building a truly integrated digital health ecosystem, moving beyond siloed electronic patient records (EPRs) at individual trust levels.

The platform's role in accelerating the NHS's strategic shifts and future-proofing healthcare delivery is also profound. The government's 10-year plan emphasizes a move from analogue to digital, hospital to community, and sickness to prevention. PKB's digital-first approach, enabling remote monitoring, patient-initiated follow-ups, and self-management, directly facilitates these transitions by reducing physical demand on services and promoting proactive health. By empowering patients to manage their health remotely and access information digitally, PKB contributes to a more resilient and efficient healthcare system, capable of adapting to future demands and crises. This strategic alignment ensures that investments in PKB not only address current operational challenges but also contribute to the long-term sustainability and modernisation of the NHS.

4.2 Scalability, Interoperability, and Security Framework

The technical architecture of PKB is built to support the demands of a national healthcare infrastructure, emphasising scalability, robust interoperability, and stringent security. In terms of scalability, PKB has already demonstrated its capacity to handle large volumes of patient data and interactions. It is reported to be the largest personal health record platform globally, integrating data from all GP practices in England and 25% of UK hospitals. The platform serves over 4.7 million registered patients and releases more than 20 million test results monthly. PKB is designed to be accessible via a web application on any mobile-optimized device, with user interfaces that scale dynamically across all screen sizes (mobile, tablet, laptop, computer), ensuring broad accessibility and performance under high demand. The architecture is designed to handle increasing volumes of patient data, with the capability to scale up as usage increases.

Interoperability is a foundational principle of PKB's design. The platform is committed to making all its data available via FHIR-compliant REST APIs, which is the international standard for healthcare interoperability. This commitment ensures seamless, bidirectional integration with existing healthcare systems, including Electronic Health Records (EHRs) and Electronic Patient Records (EPRs). PKB's strategy includes expanding its datasets to cover a full range of health information, making this data available bidirectionally via APIs, using FHIR whenever possible. This open API approach allows third-party systems to identify patients requiring intervention and notify relevant professionals.

Security is paramount for a platform handling sensitive health information. PKB pioneers industry-leading security measures, including continued encryption of all data at rest and in transit. The platform is rolling out multi-factor authentication methods, starting with TOTP, to further enhance security. PKB adheres to rigorous standards and certifications, including NHS Digital DSPT (Data Security and Protection Toolkit) and DTAC (Digital Technology Assessment Criteria). Its hosting partner holds GCP (Google Cloud Platform) ISO 27017, ISO 27018, and ISO 27701 certifications, demonstrating compliance with international standards for cloud security, privacy, and personal data management. PKB is hosted within the NHS network, ensuring security comparable to information held directly by hospitals. All personal and health information is encrypted, with PKB only having access to the NHS number, ensuring that only the patient and those they choose can access their health information.

PKB's technical architecture serves as a blueprint for national digital infrastructure. Its demonstrated scalability, handling millions of patients and test results, indicates its capacity to serve as a robust backbone for a nationwide health record system. The platform's strong commitment to FHIR standards and open APIs is critical for achieving true interoperability across the fragmented NHS landscape, allowing for seamless data exchange between different care settings and systems.This modular and open approach facilitates easier upgrades, the addition of new features, and adaptation to evolving healthcare technologies, ensuring long-term viability and future-proofing for the NHS's digital ambitions.

Furthermore, PKB's security and compliance framework sets a benchmark for trust in digital health. The platform's adherence to stringent certifications (NHS Digital DSPT, DTAC, ISO certifications) and its commitment to data encryption and multi-factor authentication address critical concerns regarding privacy and data protection in healthcare.By operating within the NHS network and providing granular consent controls, PKB builds confidence among patients and providers that sensitive health information is managed securely and ethically. This robust security posture is essential for fostering widespread adoption and trust in a national digital health infrastructure, laying the groundwork for secure data sharing and patient empowerment across the entire NHS.

5. Challenges and Considerations for Widespread Adoption

While Patients Know Best presents significant potential for the NHS, its widespread adoption and full realisation of benefits are contingent upon addressing several systemic challenges related to infrastructure, data quality, and user acceptance.

5.1 Infrastructure and Data Quality Challenges within the NHS

The fundamental basic infrastructure within parts of the NHS poses a significant impediment to the optimal deployment and utilization of digital health technologies, including PKB. Issues such as unreliable internet connections and outdated hardware can hinder staff enthusiasm and add to their workload, making it difficult for new technologies to integrate seamlessly and deliver their full potential.

A common frustration among healthcare providers and technology suppliers is the struggle to access and integrate data due to a lack of conformity in standards and information systems not being designed for easy data access. This leads to challenges in achieving a truly unified patient record.

Data quality and duplication are persistent issues. Data may not be validated before being uploaded into systems, raising concerns about its accuracy. There is also a risk of duplicated data when patients move between wards or hospitals, which can exaggerate the prevalence of issues and make analysis inefficient. Non-clinical information included in complaints can also dilute the relevance of data for safety learning. The problem of data quality in existing records will need to be addressed regardless of the supplier chosen for a single patient record system.

The fragmented nature of existing systems within the NHS further complicates integration. While most NHS hospitals and health providers use electronic records, these are often procured at the trust level, leading to regional and national fragmentation. Some hospitals in England were still paper-based as of 2023. This disparate landscape means that achieving a single, comprehensive view of a patient's health across all care settings remains a complex undertaking. Constraints on sharing data between organizations and departments can result in vital information being missed, preventing a full picture of patient care.

These systemic infrastructure deficiencies represent a significant barrier to the maturation of digital health within the NHS. The challenges of poor internet connectivity, outdated hardware and a lack of standardised data access impede the effective deployment of advanced digital solutions like PKB. This not only frustrates staff but also limits the ability of these technologies to deliver their full transformative potential, hindering improvements in efficiency and patient care. Addressing these foundational issues through strategic investment in robust, modern IT infrastructure is a prerequisite for any widespread digital health initiative to succeed across the NHS.

The imperative for standardised data governance and interoperability across the NHS is clear. The fragmented nature of existing electronic records, often procured at individual trust levels, leads to inconsistent data quality and significant challenges in data sharing and unification. This lack of a centralized, standardized approach results in duplicated data and missed information, compromising patient safety and care coordination. For PKB to truly function as a "single version of the truth" across the NHS, there must be a concerted effort to enforce common data standards (e.g., FHIR, SNOMED CT), establish clear data governance frameworks, and ensure seamless bidirectional data exchange across all care settings.Without this, the full benefits of a unified patient record, including improved clinical decision-making and reduced administrative burden, cannot be fully realized.

5.2 User Adoption and Cultural Resistance

Beyond technical infrastructure, widespread adoption of PKB faces challenges related to user acceptance and ingrained cultural practices within the NHS.

One significant area of concern revolves around clinician skepticism and resistance. Some clinicians express apprehension about patients having direct access to their results, fearing that it could lead to misinterpretation of data or increased workload due to patients "consulting Dr Google" and then raising unnecessary concerns. There are observations that patients may "kick up a fuss" when told blood tests are normal after viewing results on an app. Concerns also exist regarding the interpretation of normal values, particularly in specific contexts like pregnancy, where normal ranges might differ from general population norms, causing undue worry for patients. Some clinicians also exhibit a paternalistic approach, believing that patients should not choose their treatment but rather consent to clinician-determined plans. There is a perceived fear that giving patients direct access to information will create more work, despite evidence suggesting the opposite.

While PKB aims to enhance patient engagement, there are still hurdles. Some patients may struggle to find particular features or understand the layout of information within the app. There are also concerns about data security, privacy, and confidentiality among patients, heightened by high-profile cases reported in the press, which could lead to reluctance to engage fully with online health records. Patients may also not feel comfortable recording safety events locally, or may provide excessive, non-relevant information that can obscure critical learning points. A significant portion of patients (55%) only understand the information in PKB "to some extent" , suggesting a need for improved clarity or patient education.

The varied departmental and regional adoption of digital tools within the NHS means that even if a hospital uses PKB, not every department may make detailed records available to patients and authorized users. This inconsistency can lead to a fragmented patient experience, where some departments offer extensive digital access while others provide very little.Furthermore, many staff members may not be fully aware of or trained on how to access and utilize the system effectively.

Addressing clinician skepticism and fostering a culture of digital collaboration is paramount for the successful widespread adoption of PKB. The concerns raised by clinicians, such as patients misinterpreting results or increasing workload due to "Dr. Google" diagnoses, highlight a need for proactive strategies. This includes robust patient education on interpreting health data, clear communication protocols for managing patient queries arising from app access, and demonstrating how PKB can ultimately reduce administrative burden and optimize clinician time. Overcoming the ingrained paternalistic attitudes and promoting a cultural shift towards shared decision-making, where patients are seen as informed partners in their care, is essential for maximizing the benefits of platforms like PKB. This requires sustained training, clear guidelines, and leadership endorsement to integrate PKB into routine clinical workflows as a tool for collaboration, not an additional burden.

Bridging the digital divide and enhancing patient digital literacy are also critical. While PKB aims to empower patients, the fact that a significant portion only "understand to some extent" the information presented, coupled with general concerns about data security, indicates a need for targeted interventions. This involves providing accessible educational materials that cater to diverse learning styles and digital literacy levels, ensuring that all patients, regardless of their background or technical proficiency, can confidently and effectively utilize the platform. Addressing patient concerns about privacy and security through transparent communication and robust data protection measures is also vital for building trust and encouraging full engagement. Without these efforts, there is a risk of exacerbating health inequalities, as those with lower digital literacy or access may be left behind in the digital transformation of healthcare.

6. Conclusions and Recommendations

Patients Know Best (PKB) stands as a robust and strategically important platform with demonstrated capabilities to transform healthcare delivery within the NHS and internationally. Its core functionality as a secure, patient-controlled single health record, coupled with extensive features for patient engagement, communication, and operational efficiency, aligns directly with the NHS's ambitious digital transformation agenda. The platform's proven ability to reduce administrative burden, optimise patient flow, and enhance care coordination is supported by quantifiable outcomes and real-world case studies across various NHS trusts. PKB's proactive approach to interoperability, adherence to international standards like FHIR, and strategic government partnerships underscore its potential as a foundational component of future national healthcare technology infrastructure. Its global expansion, particularly into diverse markets like Nigeria, further validates its adaptable and scalable architecture.

However, the full realization of PKB's potential within the NHS is not without significant challenges. Systemic issues such as fragmented legacy infrastructure, inconsistencies in data quality, and deeply ingrained cultural resistance among some clinicians and patients present substantial hurdles. Overcoming these requires more than just technological deployment; it demands a concerted, multi-faceted strategy focused on foundational improvements and comprehensive change management.

Based on this analysis, the following recommendations are put forth to maximise PKB's impact and solidify its role as a critical healthcare technology infrastructure within the NHS:

Prioritise Foundational IT Infrastructure Investment: The NHS must accelerate investment in modern, reliable IT infrastructure, including consistent high-speed internet access and updated hardware across all care settings. This foundational improvement is essential to ensure that digital platforms like PKB can operate optimally, reducing staff frustration and enabling seamless data flow, which is a prerequisite for any advanced digital health system.
Standardise Data Governance and Interoperability Protocols: A national mandate for standardized data governance and the universal adoption of interoperability standards, particularly FHIR, across all NHS trusts and GP practices, is crucial. This will enable PKB to truly function as a "single version of the truth" by ensuring consistent data quality, reducing duplication, and facilitating seamless, bidirectional data exchange across the entire health and social care continuum.
Implement Comprehensive Change Management and Training Programs: To address clinician skepticism and cultural resistance, the NHS should develop and roll out targeted change management programs. These programs must clearly articulate the benefits of PKB in reducing workload and improving patient outcomes, provide extensive training on effective system utilization, and foster a culture of digital collaboration and shared decision-making. Highlighting successful case studies and peer endorsement can help mitigate resistance.
Enhance Patient Digital Literacy and Support: Alongside technological deployment, the NHS must invest in initiatives to improve patient digital literacy and provide robust support mechanisms. This includes developing accessible educational materials that explain health data clearly, offering dedicated support channels for patient queries, and addressing concerns about data security through transparent communication. Such efforts will empower all patients to confidently engage with their digital health records, reducing the digital divide.
Leverage PKB for Broader Population Health and Research: Beyond individual patient care, the NHS should strategically leverage PKB's aggregated, de-identified data (with appropriate consent and governance) for population health management, research, and service planning. The platform's ability to expose behavioral data as proxies for patient activation offers valuable insights for public health interventions and understanding health outcomes at a population level. This will unlock further value from the platform, contributing to a more proactive and preventative healthcare system.
Integrate PKB Deeper into NHS Strategic Planning: PKB's proven capabilities in areas like elective recovery, remote monitoring, and patient-initiated follow-ups should be formally integrated into national and regional strategic planning for healthcare delivery. This ensures that PKB is not merely an add-on but a core component of the NHS's strategy to address key operational challenges, improve patient experience, and achieve long-term sustainability.

By systematically addressing these recommendations, the NHS can fully harness the transformative potential of Patients Know Best, accelerating its journey towards a truly integrated, patient-centric, and digitally enabled healthcare system.

Nelson Advisors > Healthcare Technology M&A

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