Sastho — Doctor Appointment & Health Companion

The build

A Bangladeshi chamber does not need a marketplace; it needs its twenty-five minutes back. Patients queue on a corridor bench while the doctor guesses who is next, prescriptions leave as handwriting that pharmacies decode by faith, and no-shows are absorbed like weather. Sastho rebuilds that loop with software shaped to it: a token queue that makes waiting honest, an advance-payment deposit that prices the flake, a prescription writer that warns the prescriber about their own duplicates, and a records vault that lets the next doctor see what the last one knew. It runs on the studio's own health-stack experiments today; the clinic deployment is this same system wearing your letterhead.

What we handled

• Token-first booking: real-time slots, refundable bKash advance, reschedule with a tap, no-show history that means something
• Chamber console built from shadowed practice: queue truth, vitals row, problem-list chips, last visit in one glance
• Typed prescriptions in local 1-0-1 notation with generic-plus-brand search and duplicate-therapy warnings
• Reception desk that replaces the register: arrival marking, SMS to the missing, fee-per-token reconciliation
• Waiting-room board generated from the live queue — screens, SMS and the app always tell the same time
• Patient records vault with per-visit consent: the doctor sees what you showed them, the platform sees nothing

The chamber's scarce drug is twenty-five minutes

Sit in any specialist's waiting room in Dhaka and the diagnosis of the room itself is unavoidable: a corridor of forty people for a queue list on a clipboard, an assistant shouting names into a crowd, a patient at the front desk discovering they are number thirty-one when they booked “10 AM”, and a doctor losing the best minutes of every hour to logistics. The clinical part is fine — Bangladeshi doctors are brilliant under exactly these conditions. The conditions are the disease.

So Sastho's unit of value is not “digital healthcare”; it is recovered consultation minutes. The token queue exists so the patient waits eighteen minutes and knows it; the advance exists so the empty chair at 11:40 gets rarer; the Rx writer exists so the pharmacy legibility tax — paid daily by every counter in the country — disappears. Every feature answers one measured leak in the room.

Booking that is real, and paid forward

Availability is the doctor's actual calendar — session toggles, blocked emergency days, per-slot capacity for procedures — not a request form feeding hope. The confirmation step asks for a small advance through bKash, refundable instantly if the doctor cancels, non-refundable if the patient flakes without notice. That asymmetry is the whole no-show strategy: it converts flaking from free to ৳200, and it converts the doctor's cancellation from an awkward phone call into an automatic refund with an apology note attached.

Reschedule is one tap from the token card, and the queue re-solves itself — the waiting-room screen, the SMS “you are next” and the doctor's console all move together because they read the same queue state. The corridor bench stays, deliberately; software should decide who sits there now, not pretend the bench can be deleted.

A console built from the chair, not the whiteboard

The chamber console was designed during three days of shadowing: watch a doctor work, note where their attention pays rent, refuse everything else. The result is one screen per consultation — queue truth on the left (in room, waiting, no-show counted), the patient in front with the last visit's typed prescription and the doctor's own note from that day, problem chips that persist across visits, vitals that save into the same timeline the next clinician reads.

The prescription writer is the console's sharp edge: generic and brand names searched in one box (Amlodipine finds Norvasc), dose rows in the 1-0-1 notation every Bangladeshi pharmacist reads, and an amber warning when the doctor's second drug duplicates the first under another name. The Rx prints legible, stamps a pharmacy-verify code, and lands in the patient's vault — where the doctor who sees them next month can actually read what happened today.

The records belong to the patient, the trust belongs to the doctor

Every prescription, report and note a clinic writes flows into the patient's own vault — phone-first, private by default, released to a doctor only when an appointment grants that session's view. No analytics resale, no “anonymized insights” product, no third-party pixel in the record path. In a market where health-data consent is mostly a checkbox people click to survive, the consent log is a feature we will show a patient on demand: who saw what, when, and for which visit.

The design constraint cuts the other way too: the vault must work when the doctor has eleven seconds. So it is a stack of dated cards — last visit, last report, active medicines — not a file manager. A system that is correct but slow in a chamber is a system that gets abandoned by Friday, and we would rather ship less surface.

One doctor, then the clinic, then the chain

Deployments start with a single doctor in a fortnight: booking page live, console in the chamber, Rx printing, the old register still running beside it for two weeks because the corridor does not accept new rules from day one. Reception comes in step two — arrivals, SMS to the missing, fee-per-token reconciliation — and multi-doctor clinics adopt the shared queue rules that make a cardiology room's overflow visible to medicine's front desk.

Nothing here pretends to be a hospital information system: no ward management, no lab interfaces, no insurance adjudication. Sastho is the chamber layer — where three quarters of the country's actual medicine happens — and its scope discipline is the reason a deployment takes weeks instead of the fiscal year a hospital suite would demand.