Three layers.
You buy the ones you need.
The record holds the care. The oversight layer holds supervision and sign off. The third layer does the administrative work around both and keeps the reason for every decision made. Most organizations start with the third one alone, and a good number never buy the other two.
Each layer works alone.
Together they compound.
This is not a foundation you have to lay first. The third layer runs on its own with no access to a clinical record, which is how most people start. The record makes the automations deeper, and the automations make the record worth keeping.
The automations
209 automations running revenue, growth, workforce, and compliance, plus the outcomes engine that turns what you do into evidence. Runs on our record or on the one you have.
- Complete revenue cycle, growth, workforce, and continuous compliance
- Outcomes engine that turns clinical actions into contractible evidence
- 127 automations require zero access to a clinical record
Oversight
Match with state-verified physicians, hold conforming practice agreements, enforce oversight ratios automatically, and route co-signatures. Audit-ready by construction.
The record
A certified record with charting, patient history, labs and diagnostics, e-prescribing with real-time cost checks, and native HIPAA-compliant telehealth.
The Record
A certified clinical record built for documentation velocity rather than billing screens designed twenty years ago. You only buy this if replacing what you have, and most people are not.
Patient Records
Demographics and clinical history in one place, continuous across every provider and location.
Charting
Structured notes and clinical snapshots built for documentation speed rather than screen count.
Labs & Prescribing
Order placement, result tracking, and secure prescription routing with real-time cost checks.
Telehealth
Native HIPAA-compliant virtual visits built into charting rather than bolted alongside it.
Oversight
Where a practitioner needs a collaborating physician, the platform holds the agreement, enforces statutory ratios, routes reviews, and assembles the proof as it happens. Every one of these refuses rather than warns.
Matching
assistsPractitioners matched with state-verified physicians by specialty, licensure, and ratio headroom.
Agreements
tracksPractice agreements held with statutory elements each state mandates, monitored to renewal.
Ratios
refusesCaps enforced at assignment. A breach invalidates oversight for everyone, so the assignment is blocked.
Scope
refusesChecked against the patient state on every visit. An encounter outside licensure does not open.
encounter requested practitioner: NP · licensed TX, NM patient location: NM ✓ licensure.state NM active ✓ practice_agreement renews 2027-02 ✓ scope.reduced_practice collaboration required ✓ oversight_ratio physician 4 of 7 ✓ cosignature.required 14-day window → PERMITTED evidence appended to the permanent oversight record
The automations, and what governs them
Every automation declares what data it may touch, what consent it operates under, and what human sign off it needs. Six things are built once and shared by all 209, rather than implemented separately and inconsistently.
Permission Engine
Every read and message asks whether it is permitted, given purpose, consent, and sensitivity. Deny by default.
Consent Record
Append-only, with named recipients, purposes, channels, and expiry. What was permitted on any past date is reproducible.
One Outbound Path
Quiet hours, frequency caps counted across everything combined, priority arbitration. Nothing messages directly.
Human Sign-off Floors
Anything clinical carries a signature floor no configuration can relax. Automations earn autonomy within limits.
Durable Execution
An auth renewal can run 21 days across payer touchpoints. An outage pauses runs without dropping state.
Audit Record
Append-only and queryable with structured reasons. This is what turns compliance into a query and makes claims verifiable.
Where our staff stand: Behind the same boundary
Our operations team runs a separate application on isolated infrastructure. They see telemetry: that something ran, whether it succeeded, how long it took, and what it cost. They do not see a patient name, note, message, or ID.
See any patient information
No screen in that application displays it
Log in as one of your staff
There is no such feature to grant
Hold any of your passwords
Credentials go vendor to platform directly
Look without asking you first
You can refuse, and practices do
Change the audit record
Append-only, for our team as much as yours
Relax a platform floor
Floors are code, not configuration