For Clinicians

What if your EHR made you money instead of costing you money?

Every other EHR is an expense. Open_C is a revenue engine.

Built by a clinician at the bedside. The first platform designed to make your practice more money, not cost you more money.

See the Platform Show Me the Money
$158K+
in annual revenue your practice
is probably leaving on the table
From CCM alone. Before RPM, BHI, or ACCESS.
5.8 hrs
on the EHR for every 8 hours of patient time
49.2%
of the day spent on desk work, not patients
43.2%
of physicians burned out in 2024
The Problem

Your EHR was supposed to help. It made everything worse.

Documentation and charting now rank as the number one driver of physician burnout. For every hour of direct patient care, physicians spend nearly two additional hours on EHR and desk work.

86 min/day

Documentation Eats Your Day

86 minutes of after-hours EHR work per day. A third of residents chart 3+ hours every night.

7% revenue lost

You Leave Money on the Table

33-45% of visits undercoded. $564M in 99214 coding errors alone. Your chart doesn't prove what you did.

138K nurses gone

Your People Are Burning Out

138,000 nurses left since 2022. Replacing one physician costs $500K-$1M. Burnout turnover costs $4.6B/year.

Zero receipts

AI With No Accountability

Your vendor is adding AI that writes notes. Ask what data it used or why. Nobody can tell you.

Your EHR should work for you.
Not the other way around.

The Platform

Five instruments. One platform.

Scribe writes CEE thinks Echo listens Alexandria knows The Living EHR remembers
In Development
Ambient Documentation
Scribe
Talk to your patient. Not the computer.
  • Listens to the encounter and writes the clinical note automatically
  • Every sentence traces back to the exact moment in the conversation
  • If Scribe makes an error, you can find exactly where the misinterpretation occurred
  • No more typing, clicking, or pajama time
In Development
Clinical Reasoning Copilot
CEE
A great consultant sitting beside you during every encounter.
  • Pull up patient history with a specific medication instantly
  • Compare this visit's labs to last quarter
  • Walk through differential diagnoses with sourced evidence
  • Does not hand you answers. Walks through the reasoning with you.
In Development
The Listening Agent
Echo
Real-time clinical workflow monitoring and safety alerts.
  • Flags safety concerns before they become patient harm
  • Streams content to CEE so the copilot follows the conversation in context
  • All governed, all transparent, all receipted
In Development
Clinical Knowledge Library
Alexandria
Evidence-based clinical intelligence at the point of care.
  • Clinical guidelines, drug references, and protocols connected to the patient in front of you
  • Right information, right time, right source
  • Not a search engine. A governed knowledge layer.
In Development
Dynamic Patient Record
The Living EHR
A patient record that updates continuously, not a static chart frozen at the last visit.
  • Every encounter, device reading, and AI interaction feeds a living document
  • Designed for continuity of care across providers, settings, and time
  • Includes a counterfactual engine: "What if we had started the antibiotic two hours earlier?"
140+
More agents coming soon
Seven coordinated agent families covering clinical reasoning, care transitions, insurance governance, population health, and more. All governed. All receipted.

Every AI action carries a receipt.

Every recommendation shows exactly what data the AI used, which model version processed it, what rules it followed, and what it recommended. Zero black boxes.


Your Revenue

Stop paying for your EHR. Make it pay for you.

Without Open_C
$0
Most small practices never bill CCM because tracking 20+ minutes per patient per month is too hard without the right system.
With Open_C
$158K+
The platform tracks care coordination time automatically and flags patients when they qualify. CPT 99490, ~$66/month per the 2026 CMS Medicare Part B Physician Fee Schedule.

How your revenue grows

+$40
per visit
Better coding. Your notes prove what you did.
$66
per patient/mo
CCM tracked automatically. No manual timers.
RPM
device revenue
BP cuffs, glucometers, wearables. Data flows in.
$200+
per patient/mo
Stack CCM + RPM + BHI on the same patient.

The ACCESS Model (Medicare Part B)

CMS launched a 10-year outcome-based payment program on July 5, 2026. 150+ organizations already accepted. Pays for managing chronic diseases based on results, not activities. Open_C automates the outcome tracking, patient engagement, and FHIR reporting it requires. No legacy EHR can safely offer this. Open_C has over 150 patents pending that protect the governed AI infrastructure ACCESS demands.

Early Cardio-Kidney-Metabolic
Hypertension, Dyslipidemia, Obesity, Prediabetes
$360/year
Target: Reduce systolic BP by 10-15 mmHg or achieve control below 130 mmHg. Open_C tracks blood pressure continuously through integrated remote monitoring.
Cardio-Kidney-Metabolic
Diabetes, CKD, Cardiovascular Disease
$420/year
Target: Reduce HbA1c by 1 point or achieve control. Open_C tracks labs, medications, and glucometer data across providers.
Musculoskeletal
Chronic Pain
$180/year
Target: Meaningful improvement in validated pain and function scores. Open_C automates patient-reported outcome collection between visits.
Behavioral Health
Depression, Anxiety
$180/year
Target: 5-point PHQ-9 or 4-point GAD-7 reduction. CEE provides psychiatric-level decision support for PCPs.

The math: 500 Medicare patients across multiple tracks.

A practice managing 500 qualifying Medicare patients across ACCESS tracks could generate $90,000 to $210,000 per year in new revenue on top of normal E&M billing. CMS set the Outcome Attainment Threshold at 50% for the first performance period. The platform handles all outcome tracking, patient engagement, and quarterly FHIR reporting.

For practices that do not want to participate directly: You can refer chronic disease patients to an ACCESS organization and bill a co-management code (~$30 per documented review).

14 major private insurance companies covering 165 million lives have pledged to adopt ACCESS-style outcome-based payment by 2028. This is not just Medicare. This is where the entire industry is heading.


Behavioral Health Integration

Built by someone who holds both boards.

Open_C is the only clinical AI platform designed by a board-certified family nurse practitioner (FNP-BC, FNP-C) with psychiatric mental health training (PMHNP-BE, board eligible).

Why this matters for your practice

Nearly 60% of patients who receive mental health treatment get it from their PCP, because over 150 million Americans live in mental health shortage areas. Open_C makes it clinically safe to manage behavioral health in-house.

  • PHQ-9 and GAD-7 tracking built into the Living EHR
  • Evidence-based medication algorithms through Alexandria
  • Monitors treatment response and flags patients who need specialist referral
  • ACCESS Model behavioral health track means additional revenue per patient
Clinical Safety First

CEE knows when to tell you to refer: severe psychiatric illness, active suicidal ideation, treatment-resistant depression, bipolar disorder, psychosis. The governance layer flags these cases rather than letting a PCP manage beyond their comfort zone.

Built by a clinician. Governed by design. Safe by architecture.


Instruments That Chart For You

Your stethoscope just learned how to write a note.

Intelligent clinical instruments that capture, classify, and document findings automatically into the Living EHR. Governed and receipted.

Auscultation

Intelligent Stethoscope

Captures heart, lung, and abdominal sounds, classifies them using on-device AI, and documents findings directly into the chart with a full audio trail.

  • Heart sounds (S1-S4, murmurs) down to 10 Hz
  • Lung sounds (crackles, wheezes, rhonchi, stridor)
  • Every finding replayable by any specialist
Visual Diagnostics

Otoscope, Ophthalmoscope, Dermatoscope

Look through the scope. The device captures what you see, classifies the finding, and writes it into the chart.

  • AI-assisted classification with confidence scoring
  • Change tracking over time for skin lesions
  • Every image linked with provenance metadata
Continuous Monitoring

Pulse Oximeter, Capnography, Blood Pressure

Vital signs that flow directly into the Living EHR with continuous trending, not just a single number at triage.

  • Waveform quality captured alongside SpO2
  • Trends visible across encounters, not just one visit
  • Automated concordance checking across sources
Ambient Documentation

Your Phone Becomes a Clinical Instrument

Next-generation optical microphone technology will enable clinical-grade audio capture from the device you already carry.

  • 80 dBA SNR, 10 Hz floor, 132 dB dynamic range
  • Ambient scribe dictation from your pocket
  • Powered by sensiBel optical MEMS technology

Why optical microphone technology changes everything

Conventional MEMS microphones max out at 73 dBA SNR and roll off below 50-100 Hz, missing low-frequency clinical sounds like S3 and S4 heart gallops. Optical MEMS microphones use laser interferometry to achieve 80 dBA SNR, a 10 Hz floor, and 132 dB dynamic range in a package smaller than a pencil eraser. When these arrive in consumer smartphones, every Open_C user will have a clinical-grade acoustic sensor in their pocket.

Every instrument is governed.

No finding enters the chart without provenance. Every AI classification includes confidence scoring. If the AI is not confident enough, it tells you instead of guessing.


See It In Action

Built for real clinical workflows. Coming soon.

Interactive walkthroughs showing how Open_C works in the scenarios you deal with every day. Split-screen view: clinical encounter on the left, Open_C governance on the right.

Coming Soon

Chest Pain Interview with Copilot

Watch CEE work alongside a provider in real time. The copilot cues questions, builds the differential, and suggests a plan as the conversation unfolds.

Coming Soon

Paramedic to Charge Nurse to Physician Handoff

A 67-year-old male with dyspnea and altered mental status arrives by ambulance. Follow the handoff with real-time agentic updates at every transition.

Coming Soon

Nurse-to-Nurse 12-Hour Report

What changed, what is pending, what needs follow-up, and what cannot be closed until specific conditions are met.

Coming Soon

Hospital to PCP Transition

Your patient was admitted, had surgery, and is coming home with new medications. See exactly what changed and what you need to do next.

Additional demos coming soon: Autonomy Levels 1-10, Agentic ER for Low-Acuity Visits, Cost Savings Calculator, Neuromorphic Device Integration


Revenue Calculator

Run your own numbers.

Estimated Annual CCM Revenue
×
×
$158,400
estimated annual revenue from chronic care management

This does not include RPM, BHI, APCM, or ACCESS Model revenue, which can layer on top of CCM. Actual reimbursement varies by geographic location.


The Cost of Doing Nothing

Every day without the right platform costs you money, people, and patients.

$4.6B
lost every year to burnout-related physician turnover alone
Sinsky et al., Mayo Clinic Proceedings, 2022
7%
of total practice revenue lost to billing errors every year
AMA Medical Billing Error Analysis, 2018
$564M
in improper payments from 99214 coding errors alone
CMS CERT Program
33-45%
of outpatient visits are undercoded
Brinkman et al., PMC, 2023; CMS CERT data
$1M+
to replace a single physician who leaves due to burnout
AMA STEPS Forward Burnout Calculator

Open_C was built to stop every one of these losses.

Ambient documentation eliminates pajama time. Automatic coding captures full visit complexity. The Living EHR tracks every billable activity so you capture every dollar you earn.

Ready?

Your practice deserves better than a billing tool that calls itself an EHR.

Open_C is currently in development. Join the waitlist to be among the first independent practices to access the platform when it launches.

Join the Waitlist Schedule a Demo
Sources

1. Holmgren AJ, Sinsky CA, Rotenstein L, Apathy NC. "National Comparison of Ambulatory Physician Electronic Health Record Use Across Specialties." Journal of General Internal Medicine, 2024;39:2868-2870. Sample: 200,081 physicians, 396 organizations using Epic Systems EHR. Published via the AMA Electronic Health Record Use Research Grant Program.

2. Sinsky C, Colligan L, Li L, et al. "Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties." Annals of Internal Medicine, 2016;165:753-760. Funded by the American Medical Association.

3. American Medical Association. National Physician Comparison Report (Organizational Biopsy), 2024. Nearly 18,000 responses from physicians across 43 states and more than 100 health systems.

4. 2026 CMS Medicare Physician Fee Schedule. CPT 99213 national average: ~$91.85. CPT 99214 national average: ~$135.60. Conversion factor: $33.40.

5. 2026 CMS Medicare Physician Fee Schedule. CPT 99490 (base CCM, 20 minutes): ~$66.30/month national average. 10% increase finalized in 2026 Final Rule (CircleLink Health analysis, November 2025).

6. CMS Innovation Center. ACCESS Model Request for Applications, December 2025. Payment amounts: eCKM $360/year, CKM $420/year, MSK $180/year, BH $180/year. Outcome Attainment Threshold: 50% for first performance period.

7. CMS Innovation Center. "ACCESS Model Accepted Applicants," April 13, 2026. 150+ organizations accepted. Application deadline extended to May 15, 2026.

8. CMS Innovation Center. ACCESS Payer Pledge, February 12, 2026. 14 health plans representing 165 million members committed to adopting outcome-aligned payment by 2028.

9. Allzone Medical Solutions. "Navigating the Complexities of Chronic Care Management Codes," April 2025. Analysis of Medicare CCM claims data showing smaller practices less likely to adopt CCM billing.

10. Nsight Health. "Chronic Care Management CPT Codes 2026: Billing and Reimbursement Guide," April 2026. Layered billing analysis: CCM + RPM + BHI = approximately $200-$300+ per patient per month.

11. sensiBel AS. "SBM100B Series Product Brief," 2025. 80 dBA SNR, 14 dBA equivalent input noise, 146 dB SPL acoustic overload point, 132 dB dynamic range, 10 Hz low-frequency roll-off. www.sensibel.com

12. sensiBel AS. "How optical technology enables a generational shift in MEMS microphone performance," White Paper, 2023. State-of-the-art capacitive MEMS microphones reaching 73 dBA SNR and 101 dB dynamic range. SBM100 optical MEMS achieves 80 dBA SNR and 132 dB dynamic range. Technology originated at SINTEF (Norwegian independent research organization), 2003.

13. Arndt BG, Beasley JW, et al. "Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations." Annals of Family Medicine, 2017;15(5):419-426. Family physicians spent 86 minutes per day (1.4 hours) on EHR work after clinic hours.

14. American Board of Family Medicine. National Resident Survey, 2023. Published in Annals of Family Medicine, 2024. One-third of upper-year US family medicine residents report spending 3+ hours per night on after-hours EHR documentation.

15. Tebra Research. "How Documentation Became the Top Cause of Physician Burnout," 2025. Documentation and charting rank as the number one driver of physician burnout, tying with difficult patients and surpassing bureaucratic red tape.

16. Association of American Medical Colleges (AAMC). "A Growing Psychiatrist Shortage and an Enormous Demand for Mental Health Services," 2022. Nearly 60% of patients who receive mental health treatment do so from their PCP. Over 150 million Americans live in federally designated mental health professional shortage areas.

17. American Academy of Family Physicians (AAFP). "Mental and Behavioral Health Care Services by Family Physicians," Position Paper, 2021. 40% of office visits for mental health concerns occur in primary care offices. 47% of prescriptions for any mental illness are written by PCPs.

18. HRSA Bureau of Health Workforce. "Behavioral Health Workforce Brief," 2023. Projected shortages across psychiatrists, psychologists, counselors, and marriage and family therapists. 45% of rural counties had no practicing psychologists in 2021.

19. Steinberg Institute. "Fact Sheet: How Primary Care Providers Can Help Solve Our Psychiatrist Shortage," 2017. 55% of US counties had zero psychiatrists. 77% of counties reported a severe shortage.

20. Sinsky CA, Shanafelt TD, Ristow AM, et al. "Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis." Mayo Clinic Proceedings, 2022. Burnout-related PCP turnover costs $260 million per year in excess health care expenditures, and combined with the $4.6 billion in organizational turnover costs, totals nearly $5 billion annually.

21. American Medical Association. Medical billing error analysis, 2018. Billing errors result in an average loss of approximately 7% of a physician's total annual revenue due to inaccurate coding, undercoding, duplicate billing, and unbundling of services.

22. NCSBN. 2024 National Nursing Workforce Study, 800,000 nurses surveyed. 138,000+ nurses left the workforce since 2022. 41.5% cited stress and burnout as the root cause. 39.9% of RNs reported intent to leave or retire within five years.

23. Brinkman JE, Roehl TD, et al. "The Fermi Problem: Estimation of Potential Billing Losses Due to Undercoding of Florida Medicare Data." Exploratory Research in Clinical and Social Pharmacy, PMC, 2023. 33-45% of outpatient visits estimated to be undercoded. 8.9% undercoding rate consistent with CMS CERT findings.

24. AMA STEPS Forward. Cost of Physician Burnout Calculator. Replacing a physician costs $500,000 to over $1 million depending on specialty. At Mayo Clinic, payroll analysis of 2,500 physicians found 30-50% greater likelihood of reduced professional output in the two years following increased burnout.

25. Cross Country Healthcare / Florida Atlantic University. "Beyond the Bedside: The State of Nursing in 2025," 2,600 respondents. 65% of nurses report stress and burnout as the top workplace challenge.

26. AMN Healthcare. 2025 Survey of Registered Nurses, 12,171 respondents. 58% of nurses report feeling burned out most days. Only 39% plan to remain in their current position in 12 months.

27. Li LZ, et al. "Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis." JAMA Network Open, 2024. 85 studies, 288,581 nurses. Nurse burnout associated with more nosocomial infections, medication errors, patient falls, adverse events, and lower patient satisfaction.

28. CMS Comprehensive Error Rate Testing (CERT) Program. 63.4% of improper payments associated with E/M code 99214 were due to incorrect coding, totaling $564 million in errors.