Hippo doesn't read every change in EMIS or SystmOne instantly.

For most clinical information, Hippo works on a daily sync. This means something you record today will usually be reflected in Hippo after the next data refresh.

There are two important exceptions:

📅 Appointment availability is checked live
✅ Appointments booked through a Hippo booking link are written directly into your appointment book

So the easiest way to think about it is:

🦛 Clinical data = usually next-day
​Slots and Hippo bookings = live

Most changes made in your clinical system appear in Hippo following the next daily sync.

This includes:

A patient has their annual review on Tuesday afternoon and the review is coded in EMIS.

Hippo may still show them as due for the rest of Tuesday.

Once the updated clinical data reaches Hippo, they should drop out if the new code completes the indicator.

These also rely on information coming across from your clinical system.

New slot types should appear in Hippo after the next sync.

If a slot type is renamed, your campaigns should continue using the updated version.

If a slot type is effectively replaced with a new one, you may need to update any campaigns still using the old option.

New clinicians appear once Hippo receives them from your clinical system and they have relevant appointment sessions available.

If you've started using a new site for online booking, get in touch with us so we can make sure it's enabled correctly.

Hippo also writes information back to the patient record.

This includes:

📨 Automated recall activity
🎬 Manual outcomes recorded through Action Patient
💬 Patient response selections
📅 Appointments booked through a Hippo booking link

You can usually find Hippo writebacks within the patient's Consultations or Care History.

By default, automated recall activity uses the Patient recall administration SNOMED code.

Booking through a Hippo link is different from the daily clinical-data sync.

When the patient confirms an appointment:

✅ The appointment is created directly in your appointment book
✅ The booking is associated with the Hippo recall
✅ Hippo can recognise the booking without waiting for the next daily clinical sync

This is why Hippo-link bookings can appear more quickly than appointments arranged by phone or at reception.

Some Hippo settings change immediately, while others affect the next recall run.

Examples include:

Once a campaign is paused, no further automated recalls should be sent while it remains paused.

Campaign edits are used when Hippo next works out who should be contacted and what they should receive.

This includes settings such as:

If something in Hippo doesn't appear to have updated, refresh the page first.

Some changes may already have been saved but aren't yet reflected in the version of the page you have open.

Different areas of Hippo use different data sources, so they don't all update at exactly the same time.

This is why two screens can occasionally look slightly out of step for a short period.

This is one of the most common timing questions.

Hippo sends recalls using the clinical information available from its latest data sync.

For example:

At that point, Hippo may not yet have received the newly recorded review, so the patient could still receive that day's recall.

The same can happen if a patient books an appointment with reception that morning. Hippo may not see that appointment until the next clinical-data refresh.

Once the new information reaches Hippo, the patient should no longer be recalled if it means they're no longer eligible.

See Keeping Hippo Accurate: Coding and Administration Guide and A Patient Was Recalled by Mistake. Why Did That Happen? for more information.

Occasionally, a data refresh may be delayed or recall sending may be temporarily paused for maintenance.

If there's a known platform-wide issue, we'll display a banner in Hippo.

If there's no banner but information still looks stale after more than a working day, get in touch and we can check what's happening.

For most clinical and patient information, once a day.

Appointment availability is checked live, and appointments booked directly through Hippo are created immediately.

The review may have been recorded after the clinical data used for that recall was collected.

Once the new code reaches Hippo, the patient's eligibility should update.

If they're still showing as due after 48 hours, check that the correct code was recorded and get in touch if needed.

Yes.

Hippo records recall activity back into EMIS or SystmOne.

If you can't see a writeback where you expect it, check both Consultations and Care History before contacting us.

Usually, no.

New slot types are picked up through the clinical-system sync and should become available in Hippo after the next refresh.

If it's still missing after one working day, send us the exact slot type name.

The code may not have reached Hippo yet.

Wait for the next daily sync first.

If they're still due after 48 hours, check:

Most changes between Hippo and your clinical system aren't completely live.

Remember:

🩺 Clinical data → usually reflected after the next daily sync
​📅 Appointment availability → checked live
​✅ Hippo bookings → created immediately

So if something you've just coded or changed isn't visible straight away, it usually just needs the next refresh.