This is the most scalable way of registering patients. Patients who have provided their email addresses and identity verification are highly motivated and engaged. Clicking through to register from email is the fastest and easiest registration method. Hospitals typically start without such a list of patients, but individual departments may well have them. In England, local GP surgeries have the most verified email addresses since the 2015 Patient Online program, so cooperating with them is a great way to onboard patients for shared care between hospitals and primary care.

Verified email addresses in a spreadsheet

Clients with a set of verified email addresses can invite patients via the CSV upload form generating registration invite emails.

1. Collect list of verified Email addresses

2. Create CSV matching PKB's CSV upload format (ask your PKB success team project manager for help)

3. Upload CSV via Team Coordinator login

4. PKB sends a registration message to each email address

5. The user clicks on the link in the confirmation email address to complete registration, with a 2-factor authentication date of birth challenge question

6. The user can log into PKB with this email address and password to see their health record

Verified email addresses from the GP records system

13.5 million people (26% of England's population) have registered with NHS England's Patient Online GP portal. These people are digitally savvy - they managed to complete registration - and engaged - they took the trouble to go to their GP surgery with photographic identification.

1. Contact your local GP surgery (see below) to explain that you need the email addresses of their patients as part of a regional share portal roll-out

2. If the GP surgery has not yet registered its staff with PKB, ask your PKB success team member to set up the surgery free of charge

3. Export the Patient Online email addresses from the GP surgery's electronic health records system e.g. EMIS to SystmOne

4. Convert the spreadsheet into a CSV PKB's CSV upload format (ask your PKB success team project manager for help)

5. Upload CSV via the GP's Team Coordinator login

Here are screen-by-screen instructions for EMIS EHR users.

Communication to GPs

Here is recommended text to include in your request for email addresses from each GP surgery.

Dear XXXX

We would like your help in registering your patients to access their hospital records. Could you provide us with the email addresses of the patients who have registered with you to access their GP data?

We are asking as part of our rollout of the Patients Know Best (PKB) patient portal for all our patients. PKB stores data from all providers looking after a patient so the patients can see information from all the providers, including primary, secondary and mental health care. It is the UK's most widely

Verified email addresses from the hospital records system using HL7 API

Clients with verified emails can include these values upon record creation in HL7 ADT A28/31 messages. This requires HL7 integration.

1. To enable a patient to receive a registration email, all ADT A28/31 hl7 messages sent by a client must include an email address within the PID segment, (see A28 documentation)

2. If a patient has a PKB record that has no email address associated with it, then one can be sent via HL7 which will trigger the sending of a registration email.

3. For full details on how email addresses are managed please refer to the Email addresses section in the developer wiki. Some of the key considerations are:

   1. Should an email address be sent that is already associated with another patient record in PKB, the HL7 message will be rejected.

   2. Additional email addresses can be added to patient records within PKB using HL7.

   3. An existing email address associated with a patient record can not be updated/removed/deleted via HL7.

   4. Additional registration emails cannot be triggered by sending an HL7 message.

4. In some circumstances, patient records may be "managed" by a carer (e.g. a young child). In this situation, the email address of the carer should never be assigned to the email address of the patient.

5. The user clicks on the link in the confirmation email address to complete registration, with a 2FA DOB challenge question.

6. The user can log into PKB with this email address and password to see their health record.

Best practice

1. Give patients a reason to register. Over 95% of patients that had at least one blood test done, completed registration. If you tell patients without a blood test why they should also register (e.g. to receive clinic letters and discharge letters) they are more likely to do so.

2. Let patients know before they come to the clinic that this is something available to them in the clinic. For example, provide a leaflet with information that also outlines the benefits, in the same envelope as the letter about the clinic appointment.

3. Remind patients in the clinic about kiosk registration through posters, or a pop-up stand next to the kiosk.

4. Send your email and SMS codes after the clinic is finished. Patients register more quickly later in the same day. (Registration rates are similar during and after clinic hours.)