Key points
- Clinical matters always reach a named person, with the full conversation attached.
- Escalation is designed in advance. The clinic writes down which messages go to a clinician, who covers each session and how fast they answer, and the software follows that map.
- WCAG 2.2, published by W3C in October 2023, added 9 success criteria, including help that stays in the same place on every page.1 Require level AA for anything a patient touches.
- WHO estimates 1.3 billion people, 16% of the world's population, live with significant disability.2
- wai drafts and a person approves or signs, with every message, draft, approval and signature written to an exportable event log.3
Summary
Every clinical matter should pass to a named clinician with the full conversation attached, and everything patients touch should meet WCAG 2.2 AA. The vendor should give a clear support route and tell the clinic first when something goes wrong.
With escalation routes written down before the first patient message arrives, every patient gets a fast reply and every clinical question lands with the right clinician. Below is what to expect on escalation, support and accessibility, and how to check each.
See it in your clinicThirty minutes on your own patients and doctors.
Request a demoSee a clinical question arrive at the front desk, pass to a clinician with the thread attached, and show up in the event log, in fifteen minutes.
| Situation | Who handles it | Response the clinic sets | What the log shows |
|---|---|---|---|
| Question about symptoms, results or medication | Covering clinician, with thread and record attached | Same session | Draft, clinician edit, signature |
| Patient describes something that may be urgent | Covering clinician at once, with the approved urgent-care wording sent by the team | Immediately | Time received, time picked up, reply approved |
| Safeguarding concern | Clinical lead | Immediately, per the clinic's safeguarding policy | Who was told, and when |
| Complaint or sensitive request | Operations lead | Within one working day | Holding reply, final reply, approver |
| Booking, price or payment | Front desk | Within minutes in clinic hours | Draft and approval |
| Patient needs another format or extra help | Front desk, with the clinician if clinical | Same day | Request and adjustment made |
| Platform issue or outage | Vendor contact, with the clinic's fallback rota | Vendor's stated first response | Incident notice and resolution |
A person approves or signs every message
A person at the clinic approves every operational message and a clinician signs every clinical one. On the wai security page this is a product boundary, with nothing clinical sent without a clinician's signature and nothing operational sent without the team's approval.3 Ask any vendor to show the same boundary holding on a live demo.
Approving front desk messages is covered in our guide to human approval before a message sends.
Escalation of clinical matters
List the triggers that move a thread to a clinician, usually symptoms, results, medication, a deterioration, a safeguarding concern or anything the front desk is unsure about. Give each trigger an owner and a response time the clinic sets for itself.
When a trigger appears, the thread passes to the clinician with the conversation and the patient's record attached, and the front desk approves a holding reply so the patient knows a clinician has it. wai Admin is built to loop in a doctor the moment anything turns clinical, with the full story attached.5
Name a clinician covering escalations for every session, including evenings when the inbox is still drafting. Have a clinician write the urgent-care wording, pointing patients to emergency services where needed, and approve it once, so the front desk never improvises it.
Support the clinic should expect
Ask each vendor for a named contact during setup, the support hours, the first response time for a live issue, and who calls the clinic when something breaks.
An availability aim of 99.9% leaves about 43 minutes of downtime in a 30-day month. wai states that aim, and adds that when something does go wrong, the clinic hears it from wai first.3 Keep a fallback for those minutes, usually the phone rota and a printed day list.
wai names every subprocessor with what it does and gives thirty days notice before anything changes.3 Ask any vendor for the same in writing.
Accessibility, with WCAG 2.2 AA as the floor
WCAG 2.2 became a W3C Recommendation on 5 October 2023 with 9 success criteria added since 2.1.1 Require level AA for anything a patient touches.
Several new criteria map directly onto clinic software. Consistent Help keeps help in the same place on every page. Accessible Authentication means people are not made to solve, recall or transcribe something to log in. Target Size makes buttons large enough, or spaced enough, for someone with a hand tremor to press the right one.1
WHO estimates 1.3 billion people, 16% of the global population, experience significant disability, and the number is growing as people live longer.2 On the wai Checkout page, the booking widget a clinic adds to its own site is stated to meet WCAG 2.2 AA.4
The event log
On wai, every message, draft, approval and signature is written to an event log, and the clinic can export it.3
Review it weekly in the first month. Check how long each clinical thread waited before a clinician picked it up, which drafts the team rejected and why, and whether any thread should have escalated and did not.
An escalation map to adapt
Use the table as a starting map and change the owners and times to fit the clinic.
Where to start
Write the escalation triggers and owners on one page, with a response time for each, and have the clinical lead approve the urgent-care wording. Then ask every shortlisted vendor in writing who answers a live issue and how fast, how planned changes are notified, what the stated availability aim is, and which WCAG level the patient-facing parts meet.
Bring the map to the demo and watch one clinical thread travel from the inbox to a clinician and into the log. The rollout steps that follow are in our 100-day implementation plan.
Bring your escalation map and watch one clinical thread run through it on your own workflows.
Frequently asked questions
Does the AI answer clinical questions from patients?
No. Clinical questions are passed to a clinician with the conversation attached, and nothing clinical sends without a clinician's signature.3
What accessibility standard should clinic software meet?
WCAG 2.2 at level AA for anything a patient uses. It is the current W3C Recommendation, published on 5 October 2023.1
Does the wai booking widget meet WCAG 2.2 AA?
Yes. The wai Checkout page states that the widget meets WCAG 2.2 AA.4
What uptime should we expect?
Ask for a stated aim and how incidents are communicated. wai aims at 99.9%, about 43 minutes in a 30-day month, and tells the clinic first when something goes wrong.3
Who covers escalations in the evening?
The clinic decides. The inbox keeps drafting after hours, so every session, including evenings and weekends, needs a named clinician or a clear holding reply approved in advance.
Can we prove later who handled a clinical message?
Yes. Every message, draft, approval and signature is written to an event log that the clinic can export.3
Sources
- 1W3C Web Accessibility Initiative, 2023What's New in WCAG 2.2Read 14 October 2026Read source
- 2World Health Organization, 2023Disability, fact sheetRead 14 October 2026Read source
- 3wai, 2026Security at waiRead 14 October 2026Read source
- 4wai, 2026wai CheckoutRead 14 October 2026Read source
- 5wai, 2026wai Admin, the front desk and back officeRead 14 October 2026Read source
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