Scribe
Listening on premise
When the clinician turns listening on, audio is transcribed on the practice's own machines and the patient's screen shows that listening is on.
Excelsior Framework · a physician-owned MSO
Your whole practice, on a platform you own.
Records, visits, memberships, billing, messages, mail, the website and a private AI, on computers in your own office. Built by a family physician, inside a working practice, for any clinician who holds protected health information.
☰Excelsior EHRSearch patients, codes, pages… ⌘KClinical workspace◈ CopilotRADr. AlluriFAMILY MEDICINE
Wednesday, September 9
Good morning, Dr. Alluri.
Your day, your patients, and the work waiting for you.
Today's visits6View today's schedule →
Active members412412 on panel · 3 onboarding
Open orders1Across 1 chart · Review →
Inbox3Unread messages →
Today's visits 6 scheduled
September 9 · Your practice agenda
09:00TMT. Marshin person · Annual visitbooked
09:30NWNora WhitfieldVideo visit · Blood pressure follow-upbookedStart VisitOpen chart →
10:15DKD. KimVideo visit · New member · first visitbookedStart Visit
11:00PLP. Lindqvistin person · Medication reviewbooked
13:30open slot
15:00TMT. Marshphone · Result callbooked
Video visits use your private visit service. The existing join window and clinical access checks still apply.
✓ 1 encounter signed today 1 linked item signed with it.
Your patients All patients →
412 active · 3 onboarding
TMT. MarshMRN 000031 · 58y · malemember · active
NWNora WhitfieldMRN 000042 · 46y · femalemember · active
DKD. KimMRN 000057 · 34y · femaleonboarding
PLP. LindqvistMRN 000012 · 71y · malemember · active
Identifiers and membership only. Clinical history stays inside the chart; chart access is audit-logged.
The scheduleThe video visitThe visit notePatient CopilotThe chart
The record our clinic uses
A made-up patient, the real software. Click anything; what it does appears here.
The health record →The platform
Twelve systems, one record
Every piece works on its own. Together they write to one chart, one ledger and one calendar, on computers you own.
Health recordChart, medications, results, prevention plan
Scheduling and check-inBooking and a pre-visit check-in
TelehealthVideo visits on your own server
MessagesPatient messaging, filed to the chart
AIScribe, chart review, summaries, on a computer you own
Patient portalThe whole practice, on a phone
Documents and wearablesRead on your own machines, matched by a private id
MembershipsFlat fees on your own accounts
BillingA ledger of every charge
MailCovered mailboxes and a private mail server
WebsiteThe practice site, built to be found
Business officeCRM, calendar, documents, per business
1 clinicExcelsior Medicine in Reston runs on it every day.
0 requestsThis page loads nothing from anyone else's server.
0% shareNo revenue share, no per-patient fee. What renting costs →
Who it is for
Any clinician-owned practice that holds patient data
Direct care first, because that is what our clinic is. The clinician who holds the license owns the systems, solo or a group. Every practice type, and how well it fits →
Direct primary careFlat-fee memberships, no claims. The model fits exactly; it is what runs today.fits today
Family and internal medicineThe record, the check-in and the visit were built inside a family practice.fits today
Behavioral health and therapyPrivate video, secure messaging and a record that never leaves the building.fits today
Physical therapy and rehabVisit series and progress notes in one record; home programs and to-dos on the patient's phone.fits, with care
Concierge and membershipRetainers, packages and hybrid revenue on your own merchant account.fits today
Functional, integrative, longevityLong visits, prevention plans, wearables and documents read on premise.fits today
Virtual clinicsVideo on your own server, a portal on the patient's phone, no app to install.fits today
Insurance-billing practicesNeeds a claims lane we have not built yet.not yet
Questions clinicians ask
Straight answers
Answered the way we would answer them on the phone.
Is Excelsior Framework an EHR?
Yes, and more. A self-hosted record at the center, and around it the memberships, billing, scheduling, video, messaging, mail, website, portal and AI a practice needs. We do not sell a subscription. We build it on computers you own and run it with you.
Is AI included?
Yes, on every build, on a computer in your own office. No AI tier, no per-note bill. A person approves anything that matters.
What do we need to run it?
Hardware you own, in the office, or a cloud you already use. The system is vendor-agnostic: it runs the same on Google Cloud or AWS, with the business agreements a practice needs in place.
Do we have to take all twelve systems?
No. Pick what you need and add the rest when you want it. Each piece works on its own; together they write to one chart, one ledger and one calendar.
Can I take my data if I leave?
Yes, all of it, in the format the system keeps it in, with its full history. No export fee.
Is it HIPAA compliant?
No software is a HIPAA certificate. We build the controls, keep the evidence and hand you the documentation: encryption, access control, audit trail, signed business associate agreements, and a network that only lets traffic out by name. The obligations stay yours, and you will know exactly what they are.
Does it run a real clinic?
Yes. Excelsior Medicine, a direct primary care practice in Reston, Virginia, runs on it every day.
Does it fit a practice that is not primary care?
Yes. Behavioral health, physical therapy and rehab, specialty and virtual clinics run the same record, visits, messaging and portal. Insurance claims are the one lane we have not built.
Get in touch
Tell us what you're working with
A sentence or two is plenty. We read everything and reply ourselves.
This lands in our own CRM, on our own hardware. No form service, no pixels.
Prefer email? excelsior@excelsiorframework.com
Excelsior Framework / Platform / AI
AI
Reads, drafts and summarizes on a computer you own
A scribe, chart review, summaries and an assistant, running on one machine in the practice with a GPU, the graphics chip that AI models run on. No token meter, no AI tier, and a person approves anything that matters.
☰Excelsior EHRSearch patients, codes, pages… ⌘KClinical workspaceRADr. AlluriFAMILY MEDICINE
Nora Whitfield 0000421 draft note×
NW
Nora Whitfield member
MRN 000042 · 46y · DOB 1980-03-14 · Reston, VA
⚠ Allergies: PenicillinHypertension
MessageBillingScheduleCheck-in · review neededOrders · 1Encounter · Telehealth Visit · openSignStart Visit
OverviewStoryEncountersPrevisitVitalsLabsMedicationsOrdersDocuments
Encounters
Folio
Every visit, lab review, and message-only encounter on this patient — newest first. Click in to see linked notes, orders, imaging, and documents. Open a signed encounter to amend.
open
Telehealth Visit
jitsiWed, Sep 9, 2026, 9:30 AMBlood pressure follow-up
✎ 1 note⚗ 1 order▣ 0🗎 1
Detail →
signed
Messaging Only
phoneMon, Sep 7, 2026, 8:40 AMDose question, answered in the thread
✎ 1 note⚗ 0 orders▣ 0🗎 0Signed Sep 7, 2026 by Dr. Alluri
Detail →
signed
Annual Wellness
Fri, Aug 15, 2026, 10:00 AMNew member · first visit
✎ 1 note⚗ 2 orders▣ 0🗎 1Signed Aug 15, 2026 by Dr. Alluri
Detail →
Patient CopilotThe Note WriterEncountersCodes
The record our clinic uses
A made-up patient, the real software. Click anything; what it does appears here.
The health record →What it does
AI, the way our clinic runs it
Four things worth knowing.
Chart review
Proposals, line by line
After the visit the assistant proposes history, assessment, plan and chart updates. The clinician accepts, edits or discards each one.
Summaries
Up to speed before the door opens
A short summary of what changed since last time: readings, check-in, documents, messages.
Assistant
For patients and for the team
The same assistant, in the patient portal with deterministic buttons, and in the practice workspace with the page in view.
Everything AI
The full list, including what is not built
Green means it runs in our clinic today. Grey means it is on our list and not built yet.
Clinical
- Scribe on premise
- Chart review proposals
- Patient summaries in plain language
- Terminology and code suggestions, review-only
Patient side
- Portal assistant, voice and text
- Page guide with one-tap options
- Alarm screening before any model
Cost
- Runs on the practice's own AI machine
- Power measured and published
- No per-token or per-seat fee
- Ambient scribe, paused until launch
Questions physicians ask
The short answers
Answered the way we would on the phone.
Does patient data train a model?
No. The models are open weights running locally; nothing leaves the building to be processed.
Which models?
Open models chosen for the job, on the practice's hardware. We publish what a week of it costs on the Telemetry page.
Can the AI sign or send?
No. It proposes. Every clinical and financial action has a person and an approval tier in front of it.
Tell us what you’re working with
A sentence or two is plenty. We read everything and reply ourselves.