Ritmo
Product Design
Problem: missed appointments cost clinics time and money, and the front desk can't see which reminders failed.
What I did: desk research, a service blueprint of the front desk, six desktop screens and a patient reminder page, and a heuristic review of my own screens.
Outcome: one screen for each point where a no-show starts. 10 issues found, 3 major, all fixed. Not yet tested with clinic staff.
Ritmo is a concept for a scheduling tool for clinic networks with several rooms, such as physiotherapy and dental clinics in Portugal. The front desk sees every room on one screen, knows which patients confirmed their reminder and fills freed slots from a waitlist.
Role:
Product Designer
Year:
2026
Explore the full story –
Challenge
In the SNS, 15.7% of first specialist appointments between 2019 and 2023 were lost to no-shows, according to figures reported in 2024. Portugal has 3,165 physiotherapy establishments registered with the ERS, and the local tools I reviewed don't handle rooms or no-shows. Reminders that never arrive are a common complaint, and filling a freed slot is still manual.
Objective
A front-desk workflow around three moments: a multi-room agenda with the status of every reminder, a freed-slot panel that offers the time to the best waitlist match with the receptionist's approval, and a view of when patients miss. No clinical details on screen or in messages (GDPR, art. 9).
Results
The service blueprint located four points where a no-show starts, and each one maps to a screen. Calls are prompted for patients who don't reply, because calls cut no-shows more than automated reminders (39% vs 29% in the review). A heuristic review of my own screens found 10 issues, 3 of them major, all fixed. Not yet tested with clinic staff.
Key insight
Most no-shows don't start on the day of the visit. They start the evening before, when a reminder fails, goes unanswered or a freed slot stays empty.
Process
Discover. SNS data, a systematic review of reminder studies, CNPD guidance and competing scheduling tools.
Map the service. A blueprint of one appointment across patient, front desk, back office and system. Four failure points: the SMS never arrives, no reply, a freed slot stays empty, the patient doesn't come.
Design. One screen per failure point, plus a reminder page the patient opens without an app. Consents kept separate, no clinical details.
Review and fix. A heuristic review found 10 issues. The 3 major ones: reminder status shown only by a small symbol and colour, no state for an undelivered SMS, and consent switched on with one click and no record.
Success metrics
These are the targets I would use to judge a pilot. They are goals, not measured results: the product has not been built or tested.
No-shows down by a third within three months, against each clinic's own baseline.
At least 70% of reminders answered, either confirmed or rescheduled.
At least half of freed slots refilled from the waitlist within 24 hours.
A receptionist books a standard appointment in under 60 seconds.
Shipped & next
Left out on purpose: clinical notes, billing and online self-booking. The question was keeping booked appointments, not taking new ones.
Next: a moderated test with 5 receptionists in their own clinics. Tasks: say which patients need a call and why, fix an undelivered SMS, fill a freed slot from the waitlist, record a consent. Measures: success, time, errors.