Records, visits, memberships, billing, messages, mail, the website and a private AI, on hardware in your own office. Built inside a direct primary care practice.
Every screen started as something Dr. Alluri needed in the middle of a visit. His training shaped the software, and the software stayed inside the practice.
Every piece works on its own. Together they write to one chart, one ledger and one calendar, on your hardware. Each has its own page.
One patient's week, in six of them. Tap a tab to hold it.
| touch | when | where |
|---|---|---|
| Site form · inquiry | 14 Aug | excelsiormedicine.com |
| Enrolled · adult membership | 15 Aug | self-service |
| Portal account created | 15 Aug | practice edge |
| date | entry | amount |
|---|---|---|
| 1 Sep | Membership · Nora Whitfield | 250.00 |
| 1 Sep | Card processing fee | −7.55 |
| 1 Sep | Revenue share | 0.00 |
A few questions from your Excelsior assistant so your care team walks in already knowing your story. Talk or type; tap an answer when one fits.
Monday evening: the check-in asks about blood pressure in one tap. The answers wait for the clinician, not for a model.
Not monitored for emergencies. If something is urgent, call 911.
Earlier that week: a question about a dose, answered by the clinician, filed to the chart.
The software reads and drafts. The clinician decides. Nothing is signed, sent or filed by a machine.
A clinician-written check-in gathers the history and screens for alarm symptoms first.
Video runs on your own server. Listening, when the clinician turns it on, never leaves the building.
The assistant proposes; the clinician accepts, edits or discards, line by line.
Everyday words, sent to the portal only when the clinician publishes it.
Today, records leave the building by default, and per-seat, per-patient and metered-AI fees grow with the practice. We built it the other way around.
Your records sit on hardware you own, inside a network that dials outward only. Anything leaving is allowed by name, or it does not leave.
Rent scales with patients, seats and tokens. Ownership does not. The AI runs on your own GPU for about the cost of a light bulb.
Most practices were sold and rented back through a management company someone else owns. Ours is the clinician-owned version. If you ever leave, you take everything.
from a widely used direct-care platform's published terms · sources on the Research page
Four reasons physicians call, in the order they bring them up.
Dr. Alluri trained in family medicine, then built the record he wanted to chart in, the check-in he wanted patients to fill, and the assistant he wanted to review, one visit at a time.
Walk through a visit →The chart, the video, the messages, the model that drafts the note: all of it runs on machines the practice owns. Backups are encrypted before they leave, and the keys stay with you.
How containment works →A fuller panel should not mean a bigger software bill. No subscription, no revenue share, no per-seat AI tier.
See the numbers →Excelsior Medicine, a direct primary care practice in Reston, Virginia, runs on this stack every day.
Try the example portal →Direct care first, because that is what our clinic is. Physician, nurse practitioner or physician assistant led, solo or a group. Every practice type, and how well it fits →
Beyond medicine, the same discipline fits law, accounting and design practices that would rather own their systems.
Answered the way we would answer them on the phone.
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 your hardware and run it with you.
Yes, on every build, on your own GPU. No AI tier, no per-note bill. A person approves anything that matters.
Yes, all of it, in the format the system keeps it in, with its full history. No export fee.
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.
Yes. Excelsior Medicine, a direct primary care practice in Reston, Virginia, runs on it every day.
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
Everything below runs on machines we own. Real work stays private, so each project is drawn rather than photographed, and any screen we show holds made-up data.
A direct-care practice stack: charting with a per-patient vault, a patient portal with an assistant that interviews before the visit, self-hosted video visits, membership billing and the practice's own mail. The proof behind every other page here.
A general contractor dashboard: jobs, estimates, schedules and the floor plans behind them on one board, with the same records, calendar and documents the practice uses. Different trade, same framework.
Modeling, rendering and interactive 3D: floor plans, sites and products modeled and rendered on premises, then delivered as stills or as interactive scenes for the browser. The pipeline behind the mark on the front page.
An agent conference room: software assistants with on-premise voices and text-mode portraits. One leads and hands out the work, one looks things up, the rest speak only when they add something. Speech in, speech out, nothing leaves.
The board, and everything under it: one live picture of every system, its health and what talks to what. Underneath, the pieces a client rarely sees: workspace, documents, notebook, calendar, a compliance scanner and mail.
On-premise infrastructure: self-hosted services on your hardware with certificates, private DNS and an encrypted network between sites. Private AI and data containment: open models on machines you own, with outbound traffic denied by default and allowed by name. Identity and access: single sign-on everywhere, staff, client and public logins kept apart.
Also in the fleet, each a real service with its own place on the board and none of them phoning home: Workspace, Documents, Notebook, Calendar, Launch board, Assurance, Speech, Wearables. Paused: the ambient scribe. Parked: agent labs.
Want the same pattern for your work? Clients, documents, deadlines and confidentiality already fit.
We answer them ourselves, on the phone or by email.