1000
For specialists and small practices

Hand it the whole record. It does the work.

An AI that works through a new patient’s packet the way a careful resident would: reads every page, checks the record against itself, searches what it needs, and writes one page before the visit. Then you ask it anything.

Start with 10 free patientsSee it answer back

Thousand · Hillcrest Rheumatology

L. P., 58/new patient · Thursday 2:40 pmready for review
New patient Thursday, referred for a second kidney stone. Packet attached, 112 pages. Work it up before the visit.
On it. Nine documents from four practices, 2021 to 2024. I will read all of it, put every result on one timeline, and tell you what was never followed up.
Read 112 pages · 9 documents · 2 handwritten fax covers, 1 lab table scanned sideways4 min
Built the timeline · 31 dated entries, each with its page1 min
Pulled every calcium and phosphorus into one table · 5 draws, 3 practices
Checked the explanations given · thiazide stopped Jul 2022, supplement stopped Jun 2021
Searched · persistent mild hypercalcemia with low phosphorus; radius-first bone loss2 min
Wrote the page · 3 sections, 12 citations
Worked for 11 minutes. One thing stands out:

Calcium has been 10.6 to 10.9 on five draws across three years, with phosphorus low every time. PTH has never been measured.

It was called hemoconcentration (ED, 2021), then the supplement, then the thiazide, then dehydration. It stayed high after each one was removed. Two stones, radius-first bone loss and thirst sit on the same line. Pattern fits primary hyperparathyroidism; your call.

ED p. 3 · PCP p. 2, 5, 7, 9 · DEXA p. 1 · Urology p. 2

The full page is in your inbox. Ask me anything about her record, or tell me what to check next.
Ask about this patient, or give it the next task
0
pages read, this case
0 min
of work, unattended
0
citations on one page
0
actions taken for you

A new patient arrives with 112 pages from four practices. You have twelve minutes. The calcium that has been high for three years is on page 61. A chatbot will not find it unless you ask. This does not wait to be asked.

What it does, on its own

The work of a careful first read, done before you walk in.

  1. Reading · 112 pages9 marked

    Every page, including the handwritten fax cover and the lab table scanned sideways. Marked pages are the ones your page will cite.

    01

    Reads every page

    The whole packet, not a summary of it. Faxes, lab tables, handwriting. Every claim points back to a page.

  2. Calcium · every drawPTH: never
    Apr 202110.8EDcalled hemoconcentration
    Jun 202110.6PCPsupplement stopped
    Jul 202210.7PCPthiazide stopped
    Aug 202310.9PCPcalled dehydration
    May 202410.8PCPno comment
    02

    Checks the record against itself

    Every value of one kind in one table, each explanation lined up against the dates. It notices when the reason went away and the number did not.

  3. Searched · 3 questionscited

    • Persistent mild hypercalcemia, low phosphorus

      Endocrine Society guideline, 2022

    • Distal radius loss in primary hyperparathyroidism

      J Bone Miner Res, review

    • Thiazide and serum calcium: time course after withdrawal

      Clinical pharmacology

    03

    Searches what it needs

    When the pattern is unusual it goes to the literature and cites what it finds. It does not guess from memory.

  4. Before the first visit

    L. P., 58 · new patient

    1What happened7 entries, each with its page
    2Tested and ruled out4 items
    3Not followed up2 flags, 2 notes
    04

    Writes it down

    One page before the visit. Short enough to read in the hallway.

Not only the workup

Any job in the practice that starts with reading.

The workup is the first job we give it. Chasing records, replying to the referrer, a standing watch on the literature, the Monday list: the same agent with a different instruction. Anything that touches a patient waits for your OK. Tell us the job.

Chase the outside records that never arrived for Thursday's new patients

3 faxes sent · 2 back

Every Monday: new papers on seronegative RA, one paragraph each

ran 6:00 am · 4 papers

Re-read K. O. when the MRI report lands

waiting on radiology

Draft the reply to the referring PCP from today's note

ready for your OK

Which of tomorrow's patients have a result nobody has looked at?

ran 7:02 am · 2 found

Chase the outside records that never arrived for Thursday's new patients

3 faxes sent · 2 back

Every Monday: new papers on seronegative RA, one paragraph each

ran 6:00 am · 4 papers

Re-read K. O. when the MRI report lands

waiting on radiology

Draft the reply to the referring PCP from today's note

ready for your OK

Which of tomorrow's patients have a result nobody has looked at?

ran 7:02 am · 2 found

Write the prior-auth letter from the record, cite the pages

ready for your OK

Summarise the week's incoming faxes by patient, flag anything urgent

ran 7:05 am · 41 pages

Book the 6-week follow-up and draft the portal message

ready for your OK

List every patient on methotrexate without a CBC in 90 days

ran Sunday · 3 patients

Before each new patient: the one-page workup

standing order

Write the prior-auth letter from the record, cite the pages

ready for your OK

Summarise the week's incoming faxes by patient, flag anything urgent

ran 7:05 am · 41 pages

Book the 6-week follow-up and draft the portal message

ready for your OK

List every patient on methotrexate without a CBC in 90 days

ran Sunday · 3 patients

Before each new patient: the one-page workup

standing order

Then ask it anything

Push back. It goes back to the record.

Disagree with a flag, ask what urology actually requested, ask for every calcium with its page. It re-reads, lines things up by date, and answers with the pages it used. The record stays open all week, and it keeps reading as new results arrive.

Why not just thiazide effect? She was on HCTZ for years.
Re-read medication lists · PCP p. 2, 5, 7, 9
Lined up each calcium against what she was taking that month
She was, until July 2022. The next two calciums, August 2023 and May 2024, were drawn fourteen and twenty-two months after it stopped and were the highest of the five (10.9, 10.8). Thiazide raises calcium while it is taken, not a year later. And phosphorus was low on every draw, which thiazide does not do.
PCP p. 5 (switch to amlodipine, Jul 2022) · PCP p. 7, 9 (later draws)
OK. What would you want before Thursday?
Nothing you have to do. If you want the answer in hand at the visit: PTH with a paired calcium, and a 25-OH vitamin D. Both are routine draws. I can write the order text for your staff to place, if you like.
Show me every calcium with its pageWhat did urology actually ask for?Has anyone checked a 24-hour urine since 2023?
The first thing it writes

One page, in your inbox the day before.

A synthetic record, written for this page. Nine documents from four practices, 112 pages, one new patient referred for a second kidney stone.

Before the first visit

L. P., 58 · new patient

Referred for a second kidney stone. Thursday 2:40 pm.

Documents
9
Pages
112
Practices
4
1

What happened

every entry points to its page
  1. Apr 2021ED, left flank stone 6 mm, passed. Calcium 10.8, written off as hemoconcentration.ED note, p. 3
  2. Jun 2021Annual visit. Calcium 10.6, phosphorus 2.4 (low). Calcium supplement stopped.PCP, p. 2
  3. Jul 2022Fatigue, constipation, low mood. Calcium 10.7, attributed to thiazide. HCTZ switched to amlodipine.PCP, p. 5
  4. Nov 2022DEXA. Distal radius T −3.1, spine −2.2. Alendronate started.DEXA report, p. 1
  5. Mar 2023Second stone, 4 mm. 24-hour urine calcium 342 mg. “Metabolic workup per PCP.”Urology, p. 2
  6. Aug 2023Calcium 10.9, now off thiazide and off supplement. “Likely dehydration.”PCP, p. 7
  7. May 2024Polyuria and thirst. Calcium 10.8, phosphorus 2.5. Omeprazole started for reflux.PCP, p. 9
2

Tested and ruled out

  • DiabetesA1c 5.5, May 2024
  • ThyroidTSH 2.0, Jun 2021
  • Thiazide as the causeCalcium still high 14 months after HCTZ stopped
  • Supplement as the causeCalcium still high after supplement stopped
3

Not followed up

for your review

  • Calcium 10.6 to 10.9 on five draws over three years, phosphorus low each time. PTH has never been measured.

    Fits primary hyperparathyroidism. Stones, bone loss, thirst and mood all sit on the same line.

  • Bone loss is worst at the distal radius (T −3.1), not the spine.

    The pattern that goes with high PTH, not with age alone.

  • Urology asked for a “metabolic workup per PCP” in March 2023. No matching order anywhere in the record.

  • Alendronate started without the cause of bone loss being named.

Suggested for the visit: PTH with a paired calcium. Your call.

Thousand Health · example, synthetic record
Built for a small practice

Nothing to set up. Nothing to unlearn.

Nothing to install
Fax, email or portal export, the way it reaches you now. No login, no integration.
We sign the BAA
Business associate agreement before it sees a page. Records are never used to train anything.
It never acts alone
It reads, checks, searches and drafts. It does not order, sign or contact a patient. Every decision stays yours.
Stop any time
No contract. The first 10 new patients are free, so you can judge the work before paying.
The offer

10 patients, free.

Your next ten new patients, worked up before they arrive, at no cost and with no commitment. Judge the pages. Then decide.

Start the pilot
After that

  • $250 a month

    per clinician, every new patient worked up

  • or per patient

    a per-record price when your volume is small

  • BAA included

    and no minimum, no term, no setup fee

Questions

What practices ask us

How is this different from the AI chat tools?

Those answer the question you type, from what you paste in. This one is given the whole record and a job, and works through it on its own: reading, cross-checking, searching, writing. The thing you did not know to ask about still comes up. Then you can ask it anything.

What does it actually do by itself?

Reads every page of the packet, builds a dated timeline, pulls repeated results into tables, checks each explanation in the chart against what happened after, searches the literature when the pattern is unusual, and writes one page with citations. It can keep going: re-read when new results arrive, or answer follow-ups.

What does it never do?

Order tests, sign anything, change the chart, or contact a patient. It flags; you decide. Every line it writes is a pointer back into the record so you can check it in seconds.

Which AI is underneath?

Frontier models from the major labs, swapped as better ones arrive. Our work is the harness around them: how the record is read, checked and cited. No model is trained on your patients.

Who sees the records?

Our systems and, on request, our clinician. We sign a business associate agreement before anything is sent, keep records only as long as the visit needs, and never use them to train models.

What does it cost after the first 10?

A flat monthly fee per clinician, or a per-patient price if your volume is small. We agree the number with you before anything is billed.

Get started

Send us your next new patient.

Tell us about your practice. We reply within one business day with the BAA and a fax number, and the first page follows the first packet.

Prefer email? tomo@thousandhealth.com

The patient, record, practice name and findings shown on this page are synthetic, written to show how it works. Thousand Health reads records and reports what is in them; every clinical decision stays with the treating clinician.