Journal

Field notes from the clinical back office.

Practical guides on building, running, and moving compliant telehealth businesses. Case studies join this page as our customers go live.

Latest · Running a telehealth program at scale · Part 2 · Sep 2026

Running a telehealth program at scale, Part 2: eight signs you’ve outgrown your platform

Turnaround drifting with volume, state expansion blocked, data you can’t export, lapses you can’t see. The symptoms operators report, what each costs, and how to tell a platform problem from a process problem.

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API & AgentsSeries · Part 1Sep 2026

Building on Lithos, Part 1: the four integration patterns

Which integration pattern fits which team — from a fully custom patient app on the API to a forked portal template to an AI assistant ordering care — and what every pattern includes.

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OperationsSeries · Part 1Sep 2026

Running a telehealth program at scale, Part 1: unit economics at 1,000 encounters a month

Cost per encounter is the unit that matters once you have volume. The fixed and variable lines, how they move from 300 to 1,000 encounters a month, and the five levers that change margin.

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API & AgentsSep 2026

What is agentic healthcare? How AI agents deliver care in 2026

The shift from AI that answers to AI that acts — what agents can do in a care program, where clinicians must decide, and the infrastructure that makes it lawful.

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API & AgentsSep 2026

Can AI prescribe medication? How AI prescriptions actually work

AI cannot legally prescribe in any US state — but it can do almost everything around the decision. The rules, the workflow, and how to build “prescribe using AI” the right way.

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API & AgentsSep 2026

Refill medication with AI: how an agentic refill runs from request to doorstep

Why refills are the first job for a healthcare agent, the eligibility and follow-up checks it runs, the clinician authorization step, and what the patient sees.

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VerticalsAug 2026

How to start a peptide business in 2026: the compliant playbook

The clinical model that makes a peptide program lawful, the pharmacy bench that supplies it, what you can market today, and how to build for the bulks list.

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ComplianceAug 2026

HIPAA and your marketing stack: pixels, analytics, and ads for telehealth brands

Where the Meta pixel and GA4 collide with health privacy law, which pages they can never run on, and how to build a funnel you can defend.

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ComplianceAug 2026

Telehealth informed consent: what states actually require

The disclosures states enumerate, the four axes they differ on, and how to build consent as a versioned, state-aware flow rather than a checkbox.

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Build vs BuyAug 2026

Do DTC telehealth brands need an EHR? EHR vs. clinical infrastructure

What an EHR is actually for, what a DTC program actually runs, and the four questions that decide which system of record you need.

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OperationsAug 2026

Labs for telehealth programs: at-home kits vs. draw networks

How kits and draw sites compare on completion, panels, and cost — and how to build the lab loop so results actually gate care.

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VerticalsAug 2026

The GLP-1 maintenance phase: what programs do when patients reach goal

The four clinician-directed maintenance patterns, how to price the tier, and why programs without one hand their best patients to competitors.

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OperationsAug 2026

Refunds, cancellations, and chargebacks for telehealth subscriptions

A refund matrix that fits clinical products, the dispute-rate math that threatens merchant accounts, and the moves that keep you under the thresholds.

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