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Tidewell Booking Roadmap: Q4 2026, Q1 2027 and beyond

For: Dana Okafor, squad leads. Shared with Sales and Design.

Goals and what the data says

1. Cut no-shows. The average is 11%. The 40 clinics that text their own patients a reminder average 6%. That group is small and self-selected, so this suggests reminders help but doesn't prove it. We'll measure with a holdout group.
2. Cut multi-site churn. Multi-site clinics are 16% of clinics but 38% of ARR (about $1.5M). Their monthly churn is 2.9%, against 1.3% for single-site. Of the 31 that left last year, 23 cited "can't see all our locations in one place."

Capacity

There are 10 squad-weeks per squad per quarter, so 20 a quarter. Calendar sync ships in Q1, so its freed support time (about 3 squad-weeks) only adds capacity from Q2, bringing Q2 to about 23.

The plan

Q4: build both foundations. - Multi-site dashboard (10). This directly targets the top churn reason, and it is FitPhysio's stated must-have. Target: live mid-December. It fills Squad B's quarter with no buffer, so if it slips, we roll out to FitPhysio's sites in phases rather than wait. - Messaging service (8). SMS provider, consent records and templates. Nothing patient-facing ships from it alone, but every no-show feature depends on it.

Q1: ship reminders and pay down support load. - SMS reminders with confirm or cancel (6). This is our main no-show feature. It should ship in January. Success is measured against a holdout group, with the target being movement toward the 6% the self-reminding clinics achieve. - Calendar sync fix (5). Sync failures cause 38% of support tickets. The fix pays for itself in under two quarters. It goes after reminders because reminders serve the CEO's goals directly. - Physitrack integration (8). See the FitPhysio section below.

Q2 and after. - Deposits (14). Deposits should cut no-shows, but Legal can't sign the payments partner contract before mid-February, and 14 weeks of work doesn't fit in what remains of Q1. Action: start the contract process now so the build begins the day it's signed. - Waitlist auto-fill (7). Only build it if reminders prove the case. It fills slots cancelled with notice, and today patients mostly just don't show up. Confirm or cancel reminders should turn some no-shows into early cancellations. Trigger: the share of appointments cancelled with notice rises meaningfully in the first 6–8 weeks after reminders launch.

FitPhysio and Physitrack

FitPhysio (30 sites, $64,800 ARR) is our biggest deal this year. Sales promised Physitrack by Christmas. FitPhysio's own evaluation notes say the dashboard is a must-have and Physitrack is nice-to-have.

• The dashboard is on track for Christmas, and it is the thing that closes the deal.
• Physitrack by Christmas would cost us. Squad B is full with the dashboard, so the 8 weeks would have to come from messaging. That delays reminders, our main no-show feature, by a full quarter, for a nice-to-have for one account.
• Recommendation: Jordan goes back to FitPhysio now. The message is that the dashboard, their must-have, is live before Christmas, and Physitrack follows in Q1. I'd like Jordan and me to have that conversation this week, before the expectation hardens.
• Physitrack is conditional. We build it in Q1 if FitPhysio signs, or if a second account asks for it. Otherwise that capacity goes to the dashboard follow-up and to buffer.

What we're not doing, and why

• Booking page redesign (9 weeks, not scheduled). 64% of booking page visits already end in a booking, and none of our 18 customer interviews mentioned the page. It serves neither goal. I'd revisit it if we see evidence of drop-off or patient complaints. Design isn't sidelined, though: the dashboard and the reminder and confirm flows need heavy design input in Q4 and Q1, and I'd like Design embedded with both squads.
• Waitlist auto-fill now. It would fill few slots today (see the trigger above).
• Deposits before Q2. Blocked by the contract and too large to fit anyway.
• Physitrack before Christmas. It would push back our main no-show feature for a nice-to-have.

Risks

• Dashboard timing. Squad B has no slack in Q4. The mitigation is a phased FitPhysio rollout.
• Reminder effect. The 11% vs 6% gap may partly reflect which clinics choose to send reminders. The holdout group will give us the real number.
• Support load. Support and bugs are planned at 25% of time. If they run higher, Q1 calendar sync and Physitrack slip first, before reminders.
• Legal. If the payments contract slips past mid-February, deposits slip with it one-for-one.

Decisions needed

1. Dana: approve the Q4 plan and the no-go on the booking page redesign.
2. Jordan: take the revised Physitrack timing to FitPhysio.
3. Legal: start the payments partner contract now.

Tidewell booking roadmap: Q4 2026–Q1 2027

For Dana Okafor, CPO; both squad leads; Sales and Design

Strategy and trade-offs

Prioritise fewer missed appointments and better multi-site retention, not a broader feature set.

• No-shows average 11%. Clinics sending their own reminders average 6%—a promising signal, not proof that reminders alone cause the difference.
• Multi-site clinics represent 38% of ARR and churn at 2.9% monthly, versus 1.3% for single-site clinics. Of 31 multi-site departures, 23 cited the lack of a consolidated view.
• Fix calendar sync early: it causes 38% of support tickets, undermines booking reliability, and could release capacity for subsequent work.

Q4 2026: retain multi-site clinics and establish the reminder foundation

Sequencing: Squad B tackles calendar sync first, then messaging. Messaging remains unfinished at quarter-end; we are not promising patient-facing SMS in Q4.

Dashboard rollout: Validate workflows with multi-site operators, including FitPhysio, before broad release. Track activation, repeated cross-location use and whether operators can answer their core bookings/utilisation questions without separate location views.

Calendar acceptance: Confirm failures and related tickets decline. Engineering’s expected three squad-weeks of quarterly savings are a forecast, not guaranteed capacity.

Q1 2027: launch reminders and validate outcomes

Squad A’s allocation is a budget ceiling, not ten weeks of pre-approved features. Dana and the leads will approve specific improvements from dashboard usage and customer evidence; unused capacity stays uncommitted rather than funding lower-priority scope.

The calendar fix could increase Q1 capacity to 23 squad-weeks across both squads. Confirm actual support savings before allocating the extra three weeks; use them first for rollout risks and demonstrated retention blockers.

Reminder sequencing: Finish messaging before reminder implementation. With nine squad-weeks on this dependency chain, plan for a late-Q1 rollout, not a January launch.

Measurement: - Pilot reminders with a comparison group where practical. Measure no-shows, advance cancellations, delivery failures and opt-outs; do not promise the observational 6% result. - Track multi-site dashboard adoption and monthly churn against the 2.9% baseline. Review churn reasons and rolling trends; the small population makes short-term attribution uncertain. - Establish baselines and experiment design before rollout. Expect fuller reminder-impact evidence in Q2.

Not doing in these two quarters

• Physitrack integration: Not committed. FitPhysio calls it nice to have; the dashboard is its must-have. Dana and Jordan should immediately correct the Christmas promise with FitPhysio, confirm whether its buying criteria have changed, and offer the dashboard delivery plan. An integration commitment requires an explicit roadmap trade-off—not hidden extra work.
• Waitlist auto-fill: Defer until reminders demonstrably create cancellations with enough notice to refill. Today, its prerequisite behaviour is rare.
• Deposits: No Q1 delivery promise. The contract cannot be signed before mid-February, and the 14-week build is a substantial commitment before testing the simpler reminder intervention.
• Booking page redesign: Defer. The 64% conversion rate alone does not establish a problem, and none of 18 interviews raised it. Design should support dashboard and reminder usability first.

What comes after

Q2 2027 onward: Scale effective reminders and address remaining multi-site retention gaps. Prioritise waitlist auto-fill if advance cancellations create sufficient refill opportunities. Reassess deposits if no-shows remain high and the partner contract is ready. Revisit Physitrack and booking redesign only with stronger customer or commercial evidence.

Tidewell Booking Roadmap | Q4 2026–Q1 2027

For: Dana Okafor, CPO; squad leads; Sales and Design North star: Reduce clinic no-shows and multi-site churn. We have 20 roadmap squad-weeks per quarter across two squads; support and bugs are planned separately.

Q4 2026 — Build the multi-site view and messaging foundation

• Multi-site dashboard — 10 squad-weeks. Show bookings and utilisation across every location in one view. This directly addresses the most-cited multi-site exit reason (23 of 31 surveyed departures) and FitPhysio’s stated must-have.
• Messaging service — 8 squad-weeks. Build the SMS provider, patient consent records and templates needed for reminders. This is foundational work, not a patient-facing launch; reminders follow in Q1.

Capacity: One squad takes the dashboard; the other builds messaging, with two squad-weeks uncommitted.

Sales: Jordan’s Christmas commitment for Physitrack is not in this roadmap. FitPhysio called it “nice to have,” while the multi-site view is a must-have. Please correct the commitment with FitPhysio now; do not sell a Christmas delivery date.

Q1 2027 — Launch reminders and fix calendar sync

• SMS reminders with confirm/cancel — 6 squad-weeks. Launch using the Q4 messaging foundation, with rollout and measurement. Forty clinics that send their own day-before texts average 6% no-shows versus 11% overall. That’s a promising signal, not proof of causation; measure results against a comparison group and track cancellations as well as no-shows.
• Calendar sync fix — 5 squad-weeks. Address a cause of 38% of support tickets. Engineering expects it to free about three squad-weeks of support time per quarter, starting Q2.

The remaining Q1 roadmap capacity is reserved for rollout learning and iteration rather than adding another large commitment.

Success measures: No-show rate for reminder-enabled appointments versus comparison; reminder delivery, confirmations and cancellations; dashboard adoption across multi-site locations; and multi-site support and churn trends.

After Q1 — Reassess before committing

• Waitlist auto-fill: Revisit once reminders give patients a way to cancel and we know whether cancellations happen with enough notice. Today, patients mostly don’t cancel, so auto-fill has few openings to act on.
• Deposits: Reassess after the payments contract can be signed (earliest mid-February) and we have evidence on reminder impact and clinic appetite. The 14-week estimate and partner dependency make it unsuitable for this committed plan.
• Physitrack: Reassess against customer evidence and capacity; it is not committed for Q4 or Q1.
• Booking page redesign: Revisit if research identifies a meaningful problem. Booking-page conversion is 64%, and nobody in 18 recent interviews raised it; it is not the best use of capacity against current goals.

Explicitly not doing now

We are not building the booking redesign, waitlist auto-fill, deposits or Physitrack in these two quarters. This is a focus decision: prioritize the evidenced churn driver and test the clearest no-show intervention before investing in lower-evidence or dependency-heavy work.