This is an idea I have been thinking about. It is more likely to be acceptable to those who do not want to run a full patient portal with messaging, and patient access to all their results, correspondence etc. First off, to be secure, the Deki wiki would have to be hosted behind https which means either a professional account ( I think it's $99/year ), or self hosting the wiki. Each patient could have their own page ( most patients won't take you up on this ! ), and have password protected access to their page and sub pages. One could have a "create wiki" button in Synapse which creates the structure for them. You then choose to populate it some data from the database ... eg. diagnoses, vaccinations etc. I have some patients who always ask for a copy of the letters I write back to their family practitioner. Instead of posting it to them, I can just send to the wiki and they have a continuous record of these letters. And someone asked today about an encounter summary .. well Synapse can produce those, and they could be uploaded to the wiki. And of course the patient can upload their own health data as they receive it. The wiki is fully versioned so that if they damage things, it can be rolled back.