Platform

A complete EHR platform.

One multi-tenant platform spanning charting, prescribing, scheduling, billing, ambient documentation, a patient portal, and an analytics warehouse - composed at runtime to fit any care setting from a five-physician clinic to a multi-site hospital system.

Architecture

A compositional care-area hierarchy, not a fixed catalog.

Organization → Site Type → Care Area Family → Specialty → Subspecialty. Dashboards are composed by walking the hierarchy and merging family-level base templates with specialty overlays at runtime. A new specialty for an existing family lights up by adding a single overlay file - measured in hours, not weeks.

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Site types: 13
Family base templates: 87
Specialties: 28
Specialty overlays: 66
Active area instances

Clinical workspace

A modern clinical workspace.

Tabbed patient charts, a customizable overview, and a state-machine encounter lifecycle.

Patient chart

Tabbed chart with area-specific configurations, customizable widget overview, and patient-reported outcomes capture.

Vitals, problems, allergies

Recording, trending, and reference ranges. ICD-10 problem coding. Allergy terminology with severity classification and audit-tracked soft delete.

Medications and prescriptions

Active and historical lists, interaction checking, formulary alternatives, reconciliation, eRx with EPCS scaffolding, refill queue, and PDMP integration.

Orders and results

Order set builder, multi-select lab ordering, specimen tracking, delta-check engine, reference-range overlays, and trend graphs with PNG and CSV export.

Notes and encounters

SOAP notes, specialty templates, quick phrases, collaborative drafting, co-sign workflow, and a state machine for encounter lifecycle with handoff checklists.

Outside records (InterView)

Clinical document exchange, patient identity matching, per-record preview, duplicate detection, import profiles, and a reconciliation worklist.

Live dashboard surfaces

Twenty-two live, role-tuned dashboards composed from the hierarchy.

Each surface is the rendered output of a family base template plus an optional specialty overlay. Sixty-plus additional area instances inherit family-level templates without further overlay work.

Outpatient (primary care)

ambulatory base

Charting, scheduling, prescribing, billing, and chronic disease management for primary and specialty offices.

Emergency Department

emergency base

Real-time tracking board over WebSocket, ESI triage, sepsis screening, critical notifications, ADT automation.

Inpatient med/surg

inpatient_acute base

Admission, transfer, and discharge with longitudinal encounters, daily rounds, nursing handoff, and discharge planning.

ICU

critical_care + ICU overlay

Flowsheets, bundle compliance, vent management, vasopressor drips, sedation, SOFA trending, RRT tracker, early warning scores.

NICU

critical_care + NICU overlay

Census board, neonatal assessment, feeding, vent monitor, growth chart, gestational-age tracker, TPN calculator, NAS Finnegan, ROP screening.

Step-down Unit

inpatient_acute + SDU overlay

SDU board, telemetry status, line tracking, and discharge readiness scoring.

Urgent Care

emergency_ambulatory base

Tracking board, door-to-provider metrics, rapid result flags, and discharge readiness.

Hospice

post_acute base

Hospice-specific encounters, care plans, IDT meetings, and symptom management.

Surgery / OR

surgical base

OR scheduling, WHO safety checklists, preference cards, specimen tracking, instrument trays, timeout documentation, consent.

PACU

procedural base

Aldrete and White scoring, pain and PONV tracking, structured handoff, and discharge criteria.

Anesthesia

procedural base

Pre-op evaluation, cardiac risk, airway, anesthesia records, difficult airway registry, regional blocks, ASA-unit billing.

Radiology

diagnostic-radiology overlay

RIS worklist, radiation dose tracking, peer review, and critical finding communication.

Laboratory

diagnostic-laboratory overlay

Lab worklist, specimen tracking, quality control, serial draws, reflex rule engine, point-of-care testing.

Pathology

diagnostic-pathology overlay

Case accessioning, gross examination, frozen section, IHC tracking, CAP synoptic reports.

Skilled Nursing

post_acute-skilled_nursing overlay

MDS assessments, fall risk, pressure injury, restorative nursing, and payer tracking.

PT / OT

post_acute-therapy overlay

Therapy episodes, evaluation, daily and discharge notes, outcome measures, and goal tracking.

OB / GYN

ambulatory-ob_gyn + L&D

L&D tracking board, prenatal and antepartum, delivery documentation, fetal monitoring, GYN surgery, postpartum, 11 roles.

Oncology

ambulatory-oncology overlay

TNM/AJCC staging, chemo protocols, infusion center, radiation oncology, tumor board, NAACCR registry, CTCAE/RECIST.

Inpatient Pharmacy

pharmacy-inpatient overlay

Verification queue, formulary, IV compounding (USP 797/800), controlled-substance management, ADC scaffold.

Outpatient Pharmacy

pharmacy-outpatient overlay

Fill queue, insurance adjudication, will-call bins, immunization administration, MTM, controlled-substance tracking.

Hospital System

family-of-families command center

Executive view of census, transfers, quality and safety, throughput, and area status across the entire system.

Academic Research

administrative-research overlay

Study and protocol management, IRB tracking, enrollment, EDC/CRF builder, biospecimens, study finance, 14 roles.

Administrative & operations

System-wide operations, security, and compliance.

Quality reporting, IT administration, billing operations, multi-tenant provisioning, and the audit-and-consent layer that makes them safe.

IT Administration

administrative-it overlay

Fourteen widgets — six real-time. Uptime, active sessions, integration health, backups, security alerts, certificate expiry, audit compliance, migration status, pre-production readiness, and a 28-connector integration catalog.

Quality Reporting

quality_dashboard, admin-only

Eleven widgets with overlay drill-downs: MIPS performance composite, MIPS quality measures, PI attestation, improvement activities, APM, VBP, HCAHPS, HRRP readmission, SNF MDS 3.0, HEDIS, and payer Star ratings.

Billing operations

administrative-billing overlay

Eight widgets — AR aging, claims pipeline, denial-rate trending, payment posting, eligibility alerts, prior-auth deadlines, clean claim rate, and revenue KPIs — augmented by the Payer Policy Engine claim scrubber.

Analytics warehouse

Ten materialized views, a dedicated read-replica connection pool, eight standard analytics endpoints, a visual query builder, and a voice assistant for natural-language queries.

Role & permission management

121 user roles, a 52-key canonical permission registry, hierarchy-aware area-instance grants, JWT-embedded permission claims with version watcher, and per-org role overrides.

Multi-tenant org provisioning

A generic provision_new_org service with five specialty-profile templates (primary care, multi-specialty, ED, hospital_full, urgent care), an admin invite flow, and an eight-section deployment smoke test.

Audit & compliance

AuditLog across every domain, PHI access anomaly detection, audit-tracked soft delete, exportable compliance reports, and a HIPAA control matrix.

Security monitoring

Redis-backed rate limiting, JWT denylist with epoch invalidation, PHI middleware, consent enforcement, mTLS gateway, HMAC-validated FHIR webhooks, and JWKS-verified inbound JWTs.

Consent & legal

Consent directive middleware, patient amendment requests, retention and purge policies, and a managed legal-page library.

Admin review queue

AdminReviewTask model with assign, complete, and fail endpoints powering a live cross-domain task queue at /dashboard/admin/tasks.

Revenue cycle

A revenue cycle built into the workspace, not bolted on.

Coding, claim production, payer policy, eligibility, prior authorization, denials, and analytics — sharing the same models, audit log, and permission registry as the chart.

Coding & claim production

Documentation flows directly into accurate codes, with the AI inside the workspace.

— ICD-10 and CPT suggestions generated from the note (CPT-EMBED-01 pgvector retrieval)
— Visit-level coding assistant with POS, note type, patient type, and user-role context
— Real-time payer-specific claim editing rules
— Claim preflight: modifiers, diagnosis links, NPI checks
— ASA anesthesia unit billing and E/M level documentation support

Payer Policy Engine — Phase 1

CARC, RARC, NCCI, and MUE structured catalogs wired into a per-claim scrubber that returns in under 500 ms.

— CARC and RARC reference catalogs — 253 + 200 codes
— NCCI procedure-to-procedure and MUE seed — 240 + 188 rows on the 2026Q1 CMS baseline
— Structured payer policy library with admin PDF upload to MinIO
— 835 remittance → denial-case auto-trigger gated on a 10-CARC frozenset
— Per-claim POST /claims/{id}/scrub/ composing structural, NCCI, MUE, and ClaimEditRule checks
— Nightly batch scrubber and a Claims-Awaiting-Correction widget on the billing dashboard

Eligibility, prior auth, and patient finance

Coverage, deadlines, and patient-side numbers surface where the work happens.

— Eligibility verification with cache and stale-data indicators
— Prior-authorization auto-builder, renewal tracker, and deadline status board
— Patient cost-estimate generator
— Underpayment appeal packet generator
— ERA posting exception worklist and denial workqueue with appeal templates

Financial analytics

Revenue and AR signals on the same warehouse the rest of the platform queries.

— AR-aging buckets, denial rate by payer, revenue KPIs — three of ten materialized views
— Financial KPI dashboard sliced by location, provider, and payer
— Charge-capture audit tracking
— Medicare CPT rate loading and payer fee schedule administration
— Hospice billing compliance engine: election periods, certifications, cap tracking

Supply

Supply chain and clinical support.

Inventory, requisition, vendor management, and sterile compounding across the operating room, pharmacy, and every clinical unit.

Inventory management

Par levels, barcode tracking, cycle counts, and real-time on-hand visibility across units and sites.

Requisitions & purchase orders

Workflow with approvals, fulfillment tracking, vendor routing, and receiving reconciliation against the PO.

Vendor management

Vendor catalog, rate cards, performance scoring, and onboarding with document and contract tracking.

Expiry & recall tracking

Lot numbers, expiration alerts, recall management, and first-expired-first-out picking rules.

Controlled substances

DEA-compliant tracking, automated dispensing cabinet integration, count reconciliation, and diversion monitoring.

Instrument trays & preference cards

Surgical kit management, assembly and sterilization tracking, and surgeon preferences linked to scheduled procedures.

Sterile compounding

USP 797 and 800 cleanroom operations, batch records, stability windows, and hazardous drug handling.

Supply analytics

Five dashboard widgets for par burn, cost per case, waste tracking, and vendor spend.

Patient portal

A full-featured patient portal.

Runs on the same backend as the clinician workspace, with dedicated portal auth and consent middleware.

Ten-step onboarding wizard with idempotent step progression
My Health: results, conditions, medications, allergies, immunizations, vitals trending
FHIR Bundle records export under US Core IG
Billing: patient statements, balances, nightly billing sync
Self-scheduling from physician templates
Secure messaging with staff in-basket integration
Telehealth Zoom launch, document upload, and consent forms
WCAG accessibility, dark mode, and Spanish-language UI

Analytics warehouse

Built-in analytics warehouse.

Dedicated read replica, scheduled materialized views, and a visual query builder.

Ten materialized views - daily census, encounter volume, AR aging, MIPS denominators, quality gaps, appointment utilization, readmissions, denial rates, revenue KPIs, population cohort base
Dedicated read-replica connection pool
Eight standard analytics endpoints - census, encounter volume, AR aging, quality gaps, appointment utilization, readmissions, denial rates, revenue
Visual query builder and scorecard views
Voice assistant that converts natural-language questions into analytics queries

Interoperability

Standards-first interoperability.

FHIR, HL7, CCDA, and DICOM, all routed through a dedicated mTLS security gateway.

FHIR - Patient, Encounter, Observation read endpoints, Problem and Allergy and MedicationStatement write validation, bulk export, subscriptions
HL7 - ADT message ingestion with routing rules, ORU results normalization with source mapping profiles
External MPI - matching workflow with confidence scoring and manual resolution
C-CDA - export and validation foundations
PACS / DICOMweb - Orthanc integration with QIDO-RS and WADO-RS proxy, launch token service, study tracking
External connectors - onboarding wizard, source reliability scoring, provenance timeline
mTLS gateway - dedicated security gateway for all external integrations

The AI layer.

Ambient documentation, an End-Visit-to-Sign workflow, and an AI integrations console with cost discipline — all running inside the same workspace as the chart.

Read about the AI layer Join early access