Each system in NextCare's patient acquisition environment was doing its job correctly.
Building the HIPAA-safe signal architecture that connected all five into one patient acquisition view.
NextCare operates more than 170 urgent care clinics across 12 states.
Patient acquisition is digital-first: prospective patients search for urgent care, arrive on the website or mobile app, and book an appointment through Solv, the third-party booking platform NextCare uses across its network. The confirmed booking lands in Salesforce, where clinical and operational teams manage the care relationship from there.
Each system in this environment was chosen deliberately and worked correctly for its own purpose. The website drove visits. The app supported patient engagement. Solv handled booking reliably. Salesforce managed patient records. Google Ads ran campaigns at scale. The limit the architecture had reached was connection: no governed signal path ran from the original ad click through the booking confirmation and into the patient outcome record.
Campaigns were optimizing on signals that approximated the outcome rather than measuring it.
Google Ads was receiving conversion signals from the website: form submissions, page engagements, session completions. These were proxy conversions: structurally correlated with confirmed patient acquisition, but not identical to it. The Solv booking confirmation (the point in the journey closest to actual patient acquisition) was not being routed back to the ad platform. Campaigns were optimizing on signals that approximated the outcome rather than measuring it.
The mobile app journey sat outside the web attribution architecture. A patient who researched on the website and then booked through the app existed as two separate sessions in two separate systems, with no identity connection.
Salesforce held downstream patient data (repeat visits, patient value, care outcomes) with no clean line back to the originating acquisition channel. The question "which campaigns produce patients who return" had no answer, because the acquisition and outcome sides of the data had never been joined.
The Health Insurance Portability and Accountability Act (HIPAA) dimension compounded the structural problem. The Google Analytics 4 (GA4) implementation was passing URL path components that contained appointment details: fragments of patient health information flowing into the analytics layer and on to advertising platforms without a redaction layer at the collection point.
Building the HIPAA-safe signal architecture
Google Ads began bidding on confirmed Solv bookings.
— Richard Keech, Senior Digital Marketing Manager, NextCare
The optimization signal shifted from proxy web conversions to the actual booking outcome. The collection architecture now meets HIPAA requirements. Patient health information no longer reaches the analytics or advertising layer.
Web and app patient journeys became one record. The acquisition story for a patient who started on the website and booked through the app is traceable from originating ad click through confirmed booking to downstream patient outcome.
The BigQuery truth layer made the acquisition-to-outcome question answerable. Which channels produce patients who return for a second visit, and what those patients are worth over time, is now a reportable metric.
Internally, less time was spent reconciling which system's numbers were correct. The conversation shifted to what to do with a measurement system the team could trust.
If patient acquisition runs across multiple systems and the signal chain doesn't follow it, the campaign optimization is working with an incomplete picture.
The Assessment maps the gap.
The Measurement Architecture Assessment — a 30-minute call, a fixed-fee diagnostic, a clear picture of where your signal layer breaks and what to do about it.