In pilot · taking design partners
Your clinicians should be signing standards, not writing them.
A state changes a rule. Somebody has to find it, work out which clause of your standard of practice it lands on, draft the revision, and get it approved by a clinician licensed in that state. At most clinics that entire chain is one or two nurses, between patients.
Every part of the job that does not require a licence.
mcprotocol watches the sources that bind your practice, maps a change to the clauses it touches, drafts the revision with the sentence from the source it rests on, and hands a licensed clinician a two minute decision. Nothing takes effect until they sign it.
Establishing the practitioner-patient relationship
The clinician shall establish the practitioner-patient relationship through a synchronous audio-visual encounter, or through an asynchronous store-and-forward encounter where the clinician reviews a complete medical history and documents the clinical rationale in the medical record.
Effective September 1, 2026, a practitioner-patient relationship may also be established through an asynchronous store-and-forward encounter, provided the physician reviews a complete medical history and documents the clinical rationale in the medical record.Texas Medical Board — telemedicine
Reviewed against the TMB source and the cited sentence; this reflects the September 2026 rule.
An illustration, not a real clinician, patient or client.
A standard can be in three states. Everyone only tracks two.
A rule changed and the standard still says the old thing. This is the one people mean when they say compliance monitoring.
It was written for three states and you now treat patients in nine. Expansion creates this faster than anyone is staffed to absorb it.
Nobody ever wrote it. It appears in no diff, fails no check, and is found at the worst possible moment: an audit, an incident, a payer, a lawyer.
Send the standard you already have. We send back what is missing.
Not a demo and not a trial. A gap assessment on your own document, in 48 hours. Export it however it lives now: Word, PDF, a Google Doc. There is nothing to tag and nothing to retype.
What comes back: the standards a practice of your shape is generally expected to have written down and which of them you have nothing written for; clauses that do not cover every state you treat patients in, named state by state; changes already in force that the standard has not caught up to; and a section naming what the assessment could not see, so you can judge how much of it to trust.
Two queues, and only one of them needs a licence.
Today the clinician does all of it. The part that genuinely requires their licence is the judgement and the signature. Research, drafting, cross-referencing states, version control and tracking what is done do not, and all of it is currently paid for at clinician rates out of patient time.
AI drafts. A licensed human signs. There is no override. A clinician licensed only in California cannot sign a Texas change, an administrator cannot grant themselves the power to sign, and nothing reaches a published standard without a signature. Accreditation requires documented approval by qualified personnel, and in telehealth the licence on the line belongs to an individual clinician in the state where the patient is.
Every approval, edit, rejection and publication is written to a hash-chained trail, so an altered or removed entry is detectable rather than silent.
Priced against what else would fix this.
Your clinicians’ hours describe the problem, but they are not the comparison, because nobody is writing a cheque for them. These are ranges to replace with your own numbers.
| Option | Annual | What it actually means |
|---|---|---|
| Compliance or regulatory manager | ~$110,000 | Fully loaded, and months to recruit for a role you may not be able to justify at this headcount. |
| Outside regulatory counsel | ~$60,000 | Around ten hours a month. Accurate, expensive, and you still wait weeks for an answer. |
| Keep it on the clinicians | No line item | What is happening now. The cost is not the hours, it is what those hours are taken from, and who leaves. |
| mcprotocol design partner | $2–3k / mo | 60 to 90 days, one protocol area across the states you already operate in. Founder pricing afterwards, for good. |
What this does not do.
You are a clinician or you work for one, and you have been sold coverage that did not exist. Here is the list before you ask for it.
Who this is built for.
The engine is the same wherever a credentialed person is the bottleneck on mandated documentation. What changes is which rules matter, and whether cross-state protection is a question at all.
| Practice | Checklist | Shield law |
|---|---|---|
| Multi-state virtual clinic | Telehealth | Relevant |
| Single-state virtual clinic | Telehealth | Not relevant |
| In-person clinic | Facility & accreditation | Not relevant |
| Hybrid | Both | Relevant |
In-person practices bring their own standards — credentialing and privileging, supervision, infection control, emergency transfer, controlled substances on site, CLIA, records, staff safety, facility maintenance — and their binding sources are accreditors and the state health department rather than telehealth guidance.
Send one standard. See what comes back.
If the report is useful, the conversation is about a design partnership: real money, a named clinical lead with committed weekly time, one protocol area across your existing states, 60 to 90 days. If it is not useful, you keep the report anyway.
mcprotocol is clinical protocol change management software. It is not legal advice, it does not practise medicine, and it does not approve protocol changes — a clinician licensed in the affected state does.