The Telehealth Machine A DigiKat method Score your clinic
The operating method for TRT and peptide clinics

Six stages. Four human touchpoints. The rest is a machine.

Most clinics lose patients to operations, not medicine. This is what to systemise, what must stay clinical, and exactly what we build to close the gap.

6Stages
4Human touchpoints
27Manual actions removed
12Question scorecard
01 · The one thing

If your clinic cannot name the day each patient runs out, nothing else you fix will hold

That single capability is the difference between a clinic that grows on repeat supply and one that refills a leaking bucket with paid acquisition. Everything else in this document, every stage, every automation, exists to make that one thing true and then keep it true.

If you already have it, the rest of this will sharpen a machine you have mostly built. If you do not, you are almost certainly losing compliant, happy patients every month without a single complaint to tell you it is happening.

02 · What it costs you

Nothing in this is a clinical problem

A patient does everything right. Correct dose, no missed injections, good results at month three. In week nine of his second cycle his vial empties, weeks before his script expires, because nobody calculated the difference. He waits for a call that never comes, tells himself he will sort it next week, and quietly stops.

He never complains. He appears in a churn report nobody can explain, alongside a clinical standard nobody can fault.

That patient was lost by arithmetic, not medicine. So is most of the attrition in this category. The six stages below are where it happens, and each one has a specific, buildable fix.

03 · Before you read on

The three reasons clinics tell us this does not apply to them

"We are too small for this."

Size is the argument for it, not against it. A clinic of two hundred patients can hold the whole picture in one person's head, right up until that person takes leave or the list doubles. The method costs least to install before you need it and most to retrofit after a year of workarounds have hardened into process.

"Our patients are happy. Retention is fine."

Almost every clinic we speak to believes this, and almost none can produce the number. The patients who leave for operational reasons do not complain and do not churn loudly. They go quiet. If your reporting cannot separate "stopped because treatment finished" from "stopped because supply ran out", retention is an assumption, not a fact.

"AI in a clinical setting is too risky."

Agreed, which is why nothing we build touches clinical judgement. No interpretation of results, no treatment recommendation, no dose adjustment, ever. The automation sits on logistics: booking, chasing, referrals, order entry, status, timing. The risk is not automating those. The risk is a clinician spending a third of every consult on retrieval while a patient somewhere runs dry.

04 · The machine

One system, first search to fourth refill

Six stages, run end to end on one patient record. The final stage feeds back into the machine rather than terminating, which is why retention compounds instead of leaking.

01Demand 02Qualify 03Assess 04Prescribe 05Dispense 06Retain RENEWAL LOOP ● HUMAN TOUCHPOINT

Brass nodes are where a human is required. Everything between them runs without one.

05 · What stays human

Four touchpoints, and the reason for each

01
Discovery callStarting treatment is a trust decision.
02
Clinical consultPrescribing is judgement and stays with the clinician.
03
Results conversationExplaining a number to the person who owns the body is care.
04
EscalationWorried, confused or unwell goes to a human immediately.

Everything else, and in most clinics that is roughly 27 manual actions per patient per cycle, is logistics. Capture, booking, chasing, referrals, preparation, order entry, status updates, renewal timing. None of it clinical. All of it currently done by someone who could be doing something better.

STAGE 01Acquire

Demand

Leak · anonymous traffic

Most clinic sites are built for the person ready to book, which is a small fraction of the people reading. Everyone else arrives, reads, leaves, and is never recorded. The clinic then pays to reach the same person again, because it never captured them the first time.

Manual
VisitLeaves ReturnsForm Someone chasesSource guessed later
Machine
VisitCaptured with source Routed by intentBooking or education path

What we build

Included

  • Patient record with source, campaign, first touch
  • One form per intent, one record behind them
  • Self-assessment tool, scoring you approve
  • Booking surface for the ready
  • UTM framework across every channel
  • Attribution to booked calls, not form fills

Measure · booked calls per channel · cost per booked call

STAGE 02Acquire

Qualify

Leak · the form-fill gap

A form is an intention, not a booking, and intentions decay fast in a category built on people finally admitting something is wrong. Between the form and the call sits a task list and a working week. Most clinics lose more in that gap than anywhere upstream of it.

Manual
FormTask created Call attemptMissed Call attemptBooked, days later
Machine
Live calendar at point of intent Instant confirmReminders Call held

What we build

Included

  • Scheduler on real clinician availability
  • Booking writes to the record, source intact
  • Confirmation and reminders
  • Finite no-book path that terminates
  • No-show recovery, one tap to rebook
  • Suppression on every sequence

Measure · form-to-booking rate · median time to contact · no-show rate

STAGE 03Clinical

Assess

Leak · the silent stall

The longest stage and the least visible. Bloods not booked. Results returned but unread. No named owner on the handover into clinical. Patients rarely complain here, they go quiet, and quiet is indistinguishable from patient until they are gone.

Manual
Referral emailedPatient books, or doesn't Results to inboxNoticed eventually Handover by memory
Machine
Referral issued and chased Results on the recordStall flagged same day Clinician reads

What we build

Included

  • Lab result record, per-marker values and ranges
  • Intake-to-cleared pipeline with owned stages
  • Referral issue and chase
  • Stall detection and an internal work queue
  • Nurse-to-clinician handover rule
  • Patient-facing progress, so silence never means fear

Measure · median days intake to cleared · stall rate by step · results unread beyond 48h

STAGE 04Clinical

Prescribe

Leak · the cold consult

Clinician time is the most expensive and most limited input in the business. Spending the first third of every consult reconstructing context the clinic already holds is a data problem, not a scheduling one.

Manual
Consult requestedBooked by hand File opened coldFree-text note
Machine
Auto-booked on clearanceBrief prepared Clinician decidesStructured protocol out

What we build

Included

  • Auto-scheduling on stage change
  • One-screen consult view: history, protocol, results
  • Structured prescribing: drug, strength, dose, route, repeats
  • Protocol write-back to the record

Measure · consults held per available hour · days from cleared to consult

STAGE 05Supply

Dispense

Leak · the re-keyed script

The clinical decision lives in one system and the order in another, joined by a person typing. Nobody designed it that way. It accumulated one workaround at a time, and every hop is a delay and an error surface.

Manual
DecisionRe-typed Order raisedPayment chased Status by phone
Machine
Prescription becomes an order Paid at the point of orderState visible to both sides

What we build

Included

  • Prescription record as structured data
  • Order record with line items and state
  • Prescribe-to-order flow, zero re-keying
  • Pharmacy connection
  • Payment at the point of order
  • Patient-facing order status

Measure · hours from prescription to dispatch · manual touches per order

STAGE 06Supply

Retain

Leak · renewal driven off the expiry date

This is the most valuable correction in the method, and almost every clinic has it wrong. Two dates exist and they are not the same one.

WHAT MOST CLINICS TRACK Script valid EXPIRY WHAT ACTUALLY RUNS OUT Medication on hand NO MEDICATION THE GAP NOBODY CALCULATED

Script expiry is administrative. It is set by regulation and repeats. True run-out is derived from the dose actually prescribed and the supply actually dispensed. Work backwards from run-out through compounding, dispensing, delivery and the lead time on a review appointment, and the renewal conversation has to start weeks earlier than most systems start it.

Which means a fully compliant patient runs dry while his script is still valid and his renewal reminder is still in the future. That is not a service failure anyone can see. It is arithmetic nobody did.

Manual
Reminder on expiry Too late to rebook bloods Patient already dry
Machine
Run-out calculated per patient Lead times subtractedPrompt with room to act Self-serve reorder

What we build

Included

  • Dose-derived run-out calculation
  • Lead-time model: compounding, dispensing, delivery, consult
  • Renewal trigger with escalation
  • Self-serve reorder and repeat supply
  • Lapsed-patient recovery
  • Run-dry reporting, so it stops being invisible

Measure · patients who ran dry before renewal · renewal rate · reorder rate

06 · Foundations

Four records, or none of the above works

A clinic split across a spreadsheet, a dispensing system and an inbox cannot answer "when does this patient run out". Every capability in this method depends on these four existing properly, on one record, in one place.

PatientIdentity, source, protocol, cycle dates, consent, address.
PrescriptionDrug, strength, dose, route, repeats, issue and expiry, prescriber.
Lab resultPanel date, per-marker values, reference ranges, reviewed flag, clinician note.
OrderLine items, payment, compounding, dispatch, tracking.
06 · Foundations

What we will not automate

Any claim about AI in healthcare is worth exactly as much as the list of things it refuses to do. Nothing we build interprets a blood result, recommends a treatment, adjusts a dose, or tells a patient what their numbers mean.

Where an assistant speaks to patients it works from a fixed vocabulary, never offers a clinical opinion, hands to a human the moment a conversation turns clinical or distressed, and logs every word. It runs in shadow mode first, where your team reads everything it would have said before it is permitted to say anything.

Automate the logistics. Never the medicine.

06 · Foundations

The advertising gate is an asset

Prescription medicines cannot be advertised to the public in Australia. Most clinics treat that as a handicap and write vague websites that convert badly.

Invert it. If treatment detail can only appear after a medical questionnaire, the gated side of your clinic becomes the only place a patient gets a straight answer. That makes the portal the most valuable surface you own: a reason to register, a reason to return, and the one place you can be specific.

Public pages educate and qualify without naming or pricing prescription products. Treatment detail sits behind the assessment. Outcome claims stay inside what evidence and regulation permit. Every patient-facing clinical word has a named clinician against it. Build to those constraints from day one and you never unpick it later.

07 · What changes

Three clinics, three different leaks

Anonymised, because the work is confidential. What matters is not the logo, it is which stage was leaking and what closing it changed structurally.

Established · TRT · leak at Retain

Could not name a single patient's run-out date

Renewal ran off script expiry. Patients on a standard supply were finishing their medication weeks before anyone contacted them, and the clinic read the result as ordinary churn.

We built dose-derived run-out across every active script, subtracted compounding, dispensing and consult lead time, and moved the renewal conversation to the point where there was still room to act.

What changed Renewal went from reactive to scheduled. For the first time the clinic could produce a list of who runs dry next month, and act on it before it happened.
Growing · peptides · leak at Assess

Patients disappearing between intake and the doctor

Referrals went out by email, results came back to an inbox, and the handover into clinical lived in one person's memory. Nobody could say how many patients were stuck, or where.

We gave the stage owned steps with due-by dates, put results on the patient record, and built stall detection that surfaces anyone who stops moving.

What changed An invisible stage became a work queue. Stalled patients are now found the same week rather than during a quarterly tidy-up.
New · TRT · leak at Qualify and Dispense

Enquiries decaying, scripts re-typed by hand

Every enquiry became a task for a human to chase, and every prescription was manually re-entered into a separate ordering process before anything shipped.

We put live booking at the point of intent and made the prescribing output flow straight into a payable order with no re-entry.

What changed Enquiries book themselves. The gap between a clinical decision and a dispatched order stopped depending on who was at a desk.

Outcomes described structurally rather than as performance claims. Specific figures are shared under NDA on a call, against the clinic they belong to.

08 · Diagnose

Where is your machine leaking?

Twelve questions, two per stage. You get a score, a band, and the one stage worth fixing first.

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09 · What you get

The build, itemised

One engagement, delivered in stages, starting wherever your scorecard says the leak is. You are not buying software. You are buying the machine assembled around your clinic.

The patient recordPatient, prescription, lab result and order, on one system that can answer any question about any patient.
Foundation
Capture and bookingIntent-matched capture, live scheduling, attribution to booked calls rather than form fills.
Stages 1 to 2
The clinical chainReferral issue and chase, results on the record, stall detection, prepared consults, structured prescribing.
Stages 3 to 4
Supply and renewalPrescription to payable order with no re-keying, and the run-out engine that drives renewal off the right date.
Stages 5 to 6
The patient portalThe gated surface where a patient can see their protocol, their results, their supply, and reorder in seconds.
Included
HandoverYour team trained on it, documented, and able to run it without us.
Included

We do not hold your clinic hostage. It is built on platforms you own, documented so your team can run it, and we would rather you did not need us afterwards.

10 · Start

Start with the teardown, not the contract

You do not need to decide anything today. The next step is thirty minutes where we go through your six stages and tell you where the leak is, whether or not you ever work with us.

STEP 01Read thisThe method, free, no email required.
STEP 02Score your clinicTwelve questions. Two minutes. You keep the result.
STEP 03The teardownThirty minutes on your stages. We tell you the leak and what it is worth.
STEP 04Build itWe assemble the machine, or specify it for your team.
Written for clinic owners and clinical directors. Operating method, not medical advice. No patient, clinic or client is named or identifiable.