Direct primary care
Flat-fee memberships billed on your own merchant account, no claims, a portal on the patient's phone and a check-in before every visit. This is the practice that runs on it now.
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 / Information / Who it is for
Who it is for
Every kind of clinician-owned practice, and how well it fits
Direct care first, because that is what our clinic is. Nothing in the stack assumes a physician: the clinician who holds the license owns the systems, in primary care, specialty, behavioral health or physical therapy and rehab, solo or a group.
"Fits today" means a running service in our clinic does the job. "Fits, with care" means the pieces exist and a practice of that kind would be the first to run them. "Not yet" means a piece we have not built.
We are one clinician-owned practice and one consultancy. We do not claim every vertical. A running clinic is the proof, and we would rather tell you where the gaps are than have you find them.
Fits today
Concierge and membership
Retainers, packages and hybrid revenue. The membership and ledger systems do not care what you call the plan.
Family and internal medicine
The record, the check-in and the visit journey were built inside a family medicine practice, one visit at a time.
Any licensed clinician
Every screen says clinician, not doctor. Sign-in, the chart, the note and the summary work the same for whoever holds the license.
Functional, integrative, longevity
Long visits, prevention plans with due dates, wearables matched by a private id, documents read on your own machines.
Virtual clinics
Video on your own server, joined from a web portal with no app to install and a second-factor sign-in.
Behavioral health and therapy
Private video, secure messaging threaded to the record, and a chart that never leaves the building.
Beyond medicine
Law, accounting and design practices that would rather own their systems get the same discipline: records with history, calendar, documents, mail and a private assistant.
Fits, with care
Physical therapy and rehab
Visit series and progress notes in one record, home programs and to-dos on the patient's phone, documents read on premise. A rehab practice would be the first to run it.
Pediatrics
The portal's calendar, to-dos and messaging fit a family; a guardian account is on our list and not built yet.
Urgent care and walk-in
Scheduling and the record work; point-of-sale for a walk-in visit is simple billing, but insurance claims are not built.
Groups and networks
Records are kept per business, so a second site or a venture never shares a list with the first. Employer-sponsored plans are on the list.
Not yet
Insurance-billing practices
Direct care skips claims by design. A fee-for-service practice needs insurance claims, which we have not built yet.
Questions about any of this?
We answer them ourselves, on the phone or by email.