They Built Their Own EMR.
Then They Came Back
to Canvas.
Value-Based Dementia Care - a $4M-funded virtual dementia care company - used Canvas in 2022, left to build their own EMR on an open-source EMR framework, and returned in late 2025. They migrated their own data in weeks using Canvas's self-service tools. Today they're scaling with CMS GUIDE, a a top academic medical center ACO partnership, and 18 custom plugins.
Value-Based Dementia Care - Virtual Dementia Care for the Patient-Caregiver Dyad
Founded in 2018 in Jackson, Wyoming, Value-Based Dementia Care is a virtual dementia care company treating the patient-caregiver "dyad" - the caregiver is the primary point of contact, like pediatrics where a parent manages the child's care. Their model is especially valuable for rural families who may drive hours for in-person appointments.
The Care Model
The clinical team includes neurologists and geriatricians managing all types of dementia, supported by social workers, nurses, and care navigators. Peer support through a nationwide network of 20,000+ families. Their care model relies heavily on standardized cognitive assessments - CDR, NPI-Q, Zarit Burden, UCLA Loneliness Scale - averaging 24 assessments per patient, creating longitudinal cognitive baselines that track disease progression.
Funding & Growth
$4M raised from a regional VC, an accelerator fund, Social Innovation Ventures, Wyoming Venture Capital, and gBETA. Led by CEO Will Poe, MD, MPH with CTO Jason Decastro and ~62 employees. Selected for CMS GUIDE Model (April 2024). HITRUST certified. a top academic medical center Medicare ACO partnership serving 75,000 members (July 2025). Hilarity for Charity nationwide partnership (February 2026). Led SXSW 2025 panel on "Economics of a Dementia Diagnosis."
Build vs. Buy - The an open-source EMR framework Detour
Remo originally onboarded Canvas in mid-2022 and used it actively for 8 months. Then they left to build their own EMR on an open-source EMR framework - an open-source FHIR platform. After going through what the team described as "the gauntlet of building our own," they returned to Canvas in December 2025 with a $108K upsell deal (total contract ~$140K).
The an open-source EMR framework Experiment
Building a clinical EMR on an open-source FHIR data layer meant owning every feature: note templates, questionnaire engines, care plans, billing, e-prescribing, and compliance. For a specialty like dementia care - requiring standardized cognitive scoring (CDR, NPI-Q, Zarit), caregiver-linked charting, and value-based billing - the maintenance burden outpaced the team's capacity.
The Return to Canvas
The re-implementation went from kickoff to go-live in weeks. Canvas handled scheduling, encounters, billing, e-prescribing, and care plans natively. Remo's engineering team focused on what made their care model unique: 18 custom plugins for dementia-specific assessments, caregiver workflows, and analytics.
Self-Service Migration in Weeks, Not Months
Remo's engineering team ran the entire an open-source EMR framework-to-Canvas data migration themselves - using Canvas's self-service tools, not a months-long professional services engagement. The migration was on the critical path, and they hit their 3.5-week timeline.
What Was Migrated
Patient records, conditions, medications, and historical notes from an open-source EMR framework - all migrated via Canvas API, CSV imports, and FHIR API endpoints. Remo used Canvas's self-service GitHub migration repository to map and transfer data. Historical patients were inactivated rather than deleted, preserving the full clinical record while keeping active workflows clean.
Migration Timeline
3.5 weeks from migration kickoff to go-live target. Vendor dependencies were mapped and transitioned in parallel: Candid for RCM, a health data network for labs, SureScripts for e-prescribing (included at no additional cost, replacing Photon), and DocuSign for consent workflows. Remo's engineering team - 9 administrative developers - ran the migration themselves, proving Canvas's API-first architecture enables customer-owned migrations at clinical-grade quality.
18 Plugins - A Dementia-Specific Clinical Toolkit
Canvas provided the clinical infrastructure natively. Remo's engineering team built 11 fully custom plugins and customized 7 standard plugins - creating a comprehensive dementia care toolkit covering cognitive scoring, caregiver workflows, care plan automation, and third-party integrations.
Scaling Fast on Canvas
Within two months of re-launching on Canvas, Value-Based Dementia Care was approaching peak clinical volume - with 14+ providers, 294 patients, and a deep library of dementia-specific plugins powering every encounter.
A Billing Profile Built for CMS GUIDE
Value-Based Dementia Care's billing distribution reflects a practice operating at the frontier of dementia-focused value-based care - delivering care across cognitive assessments, care management, prolonged services, and behavioral health - the clinical activities that drive the greatest downstream cost savings in dementia care.
CMS GUIDE Billing
Principal Care Management (PCM) - PCM codes (99424-99427) account for 411 billing line items - the core GUIDE Model billing engine.
Cognitive Assessment (99483) - The specialized dementia diagnostic code for comprehensive cognitive assessment and care planning.
Prolonged Services (99358, G2212) - Reflecting complex patient encounters typical of dementia care, where extended evaluation time is the norm.
Multi-Modal Care
Behavioral Assessments (96127) - Systematic emotional and behavioral screening documenting neuropsychiatric symptoms across the patient population.
Phone E/M (98967/98968) - Phone-based encounters demonstrating the virtual-first model's reach, especially for rural and homebound families.
Psychotherapy (90834) - Integrated behavioral health for patients and caregivers dealing with the emotional impact of a dementia diagnosis.
Stop Building Infrastructure.
Start Building Care.
Canvas Medical's programmable EMR gives you everything out of the box - and the SDK to build everything that makes your care model unique. Go live in weeks, not years.
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2,200 Prescriptions a Month.
$8.5M Backed. One
Platform.
GLP-1 Weight Management - an $8.53M-funded telehealth obesity medicine practice backed by Oscar Health's co-founder - switched from a legacy EMR to Canvas, migrated 10,000+ patients, and now manages 2,200+ monthly GLP-1 prescriptions across 30 states with 34 custom plugins.
Obesity Medicine at Telehealth Scale
Founded in 2020 in Wilmington, Delaware, GLP-1 Weight Management is a telehealth-based obesity medicine practice pairing patients with obesity specialists and registered dietitians. Their model combines FDA-approved GLP-1 medications, nutrition therapy, and remote patient monitoring - all delivered via video, messaging, and connected medical devices.
The Care Model
Telehealth obesity medicine pairing patients with obesity specialists and registered dietitians. Combines FDA-approved GLP-1 medications (tirzepatide/semaglutide), nutrition therapy, and remote patient monitoring with connected medical devices. Average patient weight loss: ~27 lbs (13%) in 6 months, up to 55 lbs (21%) in 12 months. 13 clinicians including 8 prescribers managing full GLP-1 titration pathways.
Funding & Scale
$8.53M raised in a Series A led by Wormhole Capital - Vivek Garipalli, co-founder of Oscar Health, one of the biggest insurtech success stories. Additional investors include Black Jays VC, City Light Capital, Floating Point, North South Ventures, and 11+ others. In-network with Aetna, BCBS, Cigna, a major national payer, Medicare, Medicaid, and UnitedHealthcare across approximately 30 states. Strategic healthcare operator-investor backing validates the care model at scale.
From a legacy EMR to a Programmable EMR
GLP-1 Weight Management switched from a legacy EMR to Canvas to get the programmability their care model demanded. GLP-1 prescribing at scale requires deep workflow customization - prior authorization automation, pharmacy API integrations, benefit verification, and RPM device data ingestion - none of which a legacy EMR could support without workarounds.
The a legacy EMR Limitation
Legacy EMRs like a legacy EMR are built for general practice workflows. The company needed custom prior authorization protocols, real-time benefit verification, automated pharmacy integrations, and tight RPM device data flows - the kind of programmability that requires an open platform, not a walled garden.
The Canvas Advantage
Canvas gave the company a programmable EMR they could mold to their GLP-1-focused care model. Their engineering team built 34 plugins - including prior authorization automation, pharmacy API integration, benefit verification, CCM webhooks, and automated note signing - while Canvas handled scheduling, encounters, billing, and e-prescribing natively.
10,000 Patients. Millions of Data Points. One Migration.
Migrating an active obesity medicine practice with 10,000+ patients from a legacy EMR to Canvas wasn't a lift-and-shift. It was a full-scale data operation - millions of vital signs from RPM devices, 177,000 medication records, and years of clinical history, all mapped and validated for a new platform.
What Was Migrated
10,043 patients from a legacy EMR with full clinical history. 177,000 medication records preserving the complete prescribing timeline. 3.36 million vital sign records from connected RPM devices (scales, blood pressure monitors). Historical conditions, appointments, and insurance coverages. Canvas Solutions Engineering led the migration, processing over 462,000 records through automated migration tools.
Scale of the Challenge
This wasn't a typical EMR switch. Migrating an active practice with millions of RPM data points required careful data mapping, validation, and post-migration cleanup. Implementation kicked off September 2024 with go-live in June 2025. The scale of the data - especially 3.36M vitals averaging 335 per patient - demonstrates that Canvas can absorb enterprise-volume clinical datasets from legacy platforms without losing fidelity.
GLP-1 Prescribing Across 30 States
GLP-1 Weight Management runs one of the highest-volume GLP-1 prescribing operations on Canvas - managing full titration pathways, prior authorization, and pharmacy coordination at a scale that drives meaningful cost savings for payers managing obesity-related chronic disease.
34 Plugins Powering GLP-1 Workflows
GLP-1 Weight Management's engineering team built a comprehensive plugin suite on Canvas's SDK - automating prior authorization, pharmacy coordination, benefit verification, RPM data ingestion, and clinical documentation across every step of the GLP-1 prescribing pathway.
A Practice Built Around GLP-1 Titration
GLP-1 Weight Management's prescribing profile and patient population reflect a highly specialized obesity medicine practice - managing complex, multi-comorbidity patients through structured GLP-1 titration pathways with insurance-backed coverage.
GLP-1 Forward
Tirzepatide (Mounjaro/Zepbound) dominates the prescribing profile across all dose strengths (2.5mg through 15mg), showing full titration pathway management. Semaglutide (Ozempic/Wegovy) is secondary. Phentermine complements as traditional pharmacotherapy. The dose distribution reflects long-term patient management, not one-off prescriptions.
Complex Patient Population
Morbid obesity stratified by BMI class (40-44.9, 45-49.9, 50-59.9), alongside the comorbidities that drive the highest downstream healthcare costs - hypertension, hyperlipidemia, prediabetes, obstructive sleep apnea, and GERD. BMI stratification is critical for insurance authorization of GLP-1 medications, and treating the full comorbidity profile generates the largest long-term cost savings for payers.
Stop Fighting Your EMR.
Start Scaling Your Care Model.
Canvas Medical's programmable EMR gives you everything out of the box - and the SDK to build everything that makes your care model unique. Go live in weeks, not years.
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44x Growth in 7 Months.
AI-Powered Primary Care
That Prescribes at Scale.
AI-Assisted Primary Care - the AI-native telehealth platform backed by $65M from a leading VC firm, Abstract, and angel investor a prominent AI researcher - went from 313 notes in its first month on Canvas to nearly 14,000, with 57,000+ electronic prescriptions sent across 40,000 patients. Canvas powers every encounter, every prescription, and every claim.
On-Demand Primary Care, AI-Assisted and Physician-Led
AI-Assisted Primary Care is an AI-assisted primary care platform offering $39 on-demand video visits across all 50 states, 24/7. Licensed physicians leverage Canvas for clinical documentation and claims, supported by a proprietary multi-agent AI system for symptom assessment and clinical reasoning.
The Care Model
AI-first primary care: free anonymous symptom assessments drive patient acquisition, converting to $39 on-demand video visits with licensed physicians leveraging Canvas for clinical documentation and claims. AI-Assisted Primary Care has integrated a proprietary multi-agent AI doctor system with their clinician users, engaging multiple specialized AI agents in every encounter. The company has completed 24.2 million consultations to date. In a western US state, the first state-approved program for AI-driven prescription refills lets patients renew chronic medications in under 5 minutes for $4. A published 500-case validation study showed 81% diagnostic agreement with physicians, 99.2% treatment plan alignment, and zero hallucinations.
Growth Trajectory
$65M raised across three rounds in under one year - $5M seed, $20M Series A (a leading VC firm), and $40M Series B (two leading VC firms, March 2026). Angel investors include a prominent AI researcher, a healthcare executive, and a tech executive. 50,000+ weekly visits, 24.2 million medical conversations, 1 million+ unique users. Nearly 50% of users return within a week. Currently handling 12,000+ monthly live doctor visits with 20% month-over-month growth. At current trajectory, AI-Assisted Primary Care is on pace to manage 100K+ chronic condition patients (hypertension, anxiety, depression) and process 150K+ annual prescriptions by year-end. a wellness platform partner partnership extends services to 100,000+ patients.
57,000 Prescriptions. 40,000 Patients. One Integrated EMR.
AI-Assisted Primary Care's AI system creates nearly half of all clinical notes programmatically through Canvas's API, creating massive efficiency and care quality gains for its partners. Human providers review, sign, and prescribe. The result: telehealth at a scale most practices can't imagine, with prescription volume tracking almost 1:1 with encounters.
Acute Care, Mental Health, and Chronic Disease Treatment, AI Assisted
AI-Assisted Primary Care's clinical profile combines high-volume urgent care and primary care. The top diagnoses reveal a platform handling the conditions that drive significant downstream savings in the key cost centers of healthcare - hypertension, anxiety, depression, UTIs. Their AI assisted model means they operate at a scale no traditional practice could match.
Top Conditions
1.6 conditions documented per patient on average. Essential hypertension leads (6.6% of patients), followed by acute sinusitis (5.2%), anxiety disorder (4.7%), urinary tract infections (4.6%), and depression (4.3%). The mix confirms broad primary care coverage - structured clinical encounters with documented diagnoses, treatment rationale, and follow-up plans.
Prescribing Depth
1.4 prescriptions per patient on average, reflecting a model where nearly every encounter results in a clinical action. Top prescribers average 3-4 Rx per unique patient, spanning both acute treatments (antibiotics for sinusitis and UTIs) and chronic medication management (antihypertensives, SSRIs, anxiolytics). Full titration pathway management for chronic conditions.
16 Plugins Powering a Customized EMR with Structured Human-AI Interaction
AI-Assisted Primary Care's AI system interacts with Canvas through a custom plugin layer that structures every encounter, prescription, and clinical action. Every workflow is purpose-built for their AI-assisted care model.
Retrieve and search medication records from Canvas
Query patient demographics and clinical summaries
Pull payer and coverage data for eligibility checks
Search and select pharmacies for prescription routing
Execute SOAP commands to build clinical notes programmatically
Retrieve claim records for billing reconciliation
Push real-time note state changes to AI-Assisted Primary Care's AI platform
Manage high-volume prescription renewals with filtering and pagination
Track patient enrollment state with auto-assignment for new patients
Comprehensive worklist view of open encounters for clinician triage
Block prescription commits until state-required questionnaires are completed
Dashboard for eRx and EPCS enrollment status across providers
Track patient adherence to prescribed medication regimens
Customized APCM and medication management workflow tracking
Display RPM data within the patient chart for clinician review
API Resources
Six custom API plugins (medications, patients, insurers, pharmacies, note commands, claims) enable AI-Assisted Primary Care's AI system to read and write clinical data in Canvas programmatically. Every AI consultation, prescription, and clinical action flows through these endpoints. Webhook notifications fire real-time payloads on every note state change, keeping systems in sync.
Compliance and Workflow
A dedicated a western US state Rx validation plugin enforces questionnaire completion before any prescription commit in the state-approved AI refill program. The refill encounter worklist powers their high-volume prescription renewal workflow with filtering, pagination, and one-click chart access. A heavily customized chronic care management tracker (31% match to reference - extensively modified for AI-Assisted Primary Care's specific APCM and medication management workflows) rounds out the clinical tooling.
Build the Future of Healthcare
On a Platform That Gets Out of the Way.
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