Notes on building in digital health
Practical guides on launching, running and switching compliant care programs: architecture, compliance, pharmacy and unit economics. New posts every week.
Adding covered, branded GLP-1s to a cash-pay program
Some of your patients have coverage for branded GLP-1s. How a cash-pay program offers that option alongside compounded care: benefits checks, prior authorization, appeals, routing rules and the funnel math.
ReadPC/MSO structure for venture-backed telehealth: form your own or build on licensed infrastructure
Why investors can’t own a medical practice in most states, how the professional corporation and management company split the work, and how to decide whether to form your own.
ReadBuilding on Lithos, Part 4: adding one clinical service at a time
Refill renewals, insurance benefits checks, prior authorization and AI care agents, added one at a time to a program that already runs. The integration shape, a worked cost model per service and a rule for what to add first.
ReadAdding a second telehealth vertical without a second stack
Your existing patients are the cheapest acquisition channel you will ever have. The cross-sell math for a second vertical, what has to change clinically, what should not change at all, and a launch checklist.
ReadIntroducing the Lithos Startup Program: up to $2,500 to launch your care program
Up to $2,500 in clinical credits, a shared Slack channel with our team and a named point of contact, for founders building care products out of accelerator programs.
ReadWhat clinical infrastructure costs from pre-launch to 1,000 patients: a runway model
A ten-month worked model of what the clinical layer costs a seed-stage company under three approaches, and how each choice moves months of runway.
ReadHow large companies launch telehealth without building a medical practice
What building a medical practice actually takes, what a storefront partner keeps, and how licensed infrastructure lets an enterprise own the brand, the customer and the data.
ReadRunning your own telehealth vendor stack vs Lithos: the real cost per visit
Seven vendor contracts look cheap one at a time. Here is the full per-visit cost of running your own stack, next to the same program on Lithos.
ReadHow to build a telehealth platform, Part 3: e-prescribing and pharmacy routing
What happens after the clinician signs — the SCRIPT transaction, EPCS, choosing 503A vs 503B, state licensure routing, cold chain, and the status events your product needs.
ReadHow to build a telehealth platform, Part 2: designing intake
Intake is the product surface that decides how fast a clinician can decide. How to structure it, when to branch, what to validate at the API boundary, and what to leave to the visit.
ReadHow to build a telehealth platform, Part 1: the complete architecture
The seven layers every telehealth platform has — from storefront to pharmacy — what each one does, what it costs to build, and where the compliance actually lives.
ReadRunning a telehealth program at scale, Part 6: the telehealth infrastructure RFP
The questions a program with volume should put to every platform — clinical coverage and turnaround, pharmacy routing, API and exports, compliance evidence, pricing and exit terms, migration support — with scoring and red flags.
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Read it in order
Multi-part guides that build on each other. New parts publish Tuesday through Thursday.
How to build a telehealth platform
The architecture of a modern telehealth platform, one layer per post — what to build, what to buy, and where the compliance lives.
See the whole seriesRunning a telehealth program at scale
For teams already doing hundreds to thousands of encounters a month: unit economics, throughput, reliability, switching, and the risk work that comes with volume.
Building on Lithos
Putting physician-reviewed care inside your product — integration patterns, embedded care, webhooks, agents, and what to build around the API.
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