The OS for concierge medicine — for the doctor whose members have the direct line
iksa is the harness for n‑of‑1 medicine. What you decide at a member’s assessment keeps working all year, on their nurse’s list and in your words when they ask about the nodule.
The annual assessment repeats a test only as often as the test and its last result call for
Your members stay for the doctor who remembers the last MRI and why the plan changed on a call last spring, and a decade of reading one person against their own past is a trial of one. With a scan or a blood screen in someone who feels well, the harder call is often what not to chase.
- A coronary CT every three to five yearsHeart: The scan carries a dose, and no trial has shown repeats help someone who feels well, so each must settle whether the lipid plan holds, by calcium for their age, sex and race and by the plaque calcium can’t show. Calcium can climb on a statin as plaque stabilizes, so the scan returns sooner only for non-calcified plaque.
- A multi-cancer blood screen every year and a whole-body MRI every twoCancer: Both sit beside the mammogram and colon screening, never in their place. In the first randomized trial of such a screen, the screened arm showed no fewer stage III or IV cancers (rate ratio 1.03), with a borderline drop in stage IV alone (0.86) that its authors say needs longer follow-up (New England Journal of Medicine, 2026). In descriptive results, about half of positive tests proved to be cancer (Nature Medicine, 2026). A false signal can mean months of work-up. Whole-body MRI found cancer in 1.2% of 2,064 people without symptoms (Cancer Imaging), with no mortality trial behind it. No guideline sets either interval, so what you chase stays your call.
- DEXA every year, on the same scannerMetabolism: Visceral fat against the cut-offs by age and sex in the International Journal of Obesity (2021), lean mass and bone, with ApoB, HbA1c and fasting insulin. Two scanners won’t agree on one body, so only a change on last year’s machine says whether the next block is aerobic or strength.
- A cognitive screen every year from 60Brain: The USPSTF reviews screening from 65 and calls the evidence insufficient, so with no complaints a screen from 60 gives you a baseline, on alternate forms so practice can’t flatter the score. A true decline gets a look for what’s reversible and a full neuropsychological work-up.
- Month by month, over the direct lineTherapy: The assessment sets the year’s plan, and its medicine keeps a faster clock: an incretin stepping up every four weeks as an injection or every 30 days as a pill, hematocrit re-tested within six months of starting testosterone, and the menopause labels asking periodically whether a woman still needs it.
Before the ultrasound, the doctor wrote down how far the nodule on the member’s MRI would be chased
A whole-body MRI finds something in almost everyone who feels well: 95% across 12 studies, 30% sent for more tests, 1.1% confirmed cancer (Cancer Imaging, 2020). This member’s work-up has its end point before it starts.
Tell us what your assessment does with a member who walks in holding a whole-body scan you didn’t order.
Request a walkthroughRequest a walkthrough for concierge medicineWith no study team around this member, the follow‑through comes back to the doctor holding the direct line
Your members have your number and expect you to remember. A sponsor would pay people to track what was found, what was promised and who needs telling, and no practice can afford that for one member.
Long-term follow-up
You told a member you’d look at that nodule again, and you held off on lipid lowering in Year 3 for a reason. Ten years in, memory and old notes keep both.
Outside records
The imaging center’s PDF, the cardiologist’s letter, an out-of-state discharge summary and a scan a member bought themselves reach you by fax, portal and email. After a decade, nobody could say where it all is.
Safety reporting
A member texts at nine at night that the new incretin step has them vomiting, and you slow their titration. A study logs that dose change for its whole team, and yours learns it from your next note.
Central reading
Across years of scanners and radiologists, 1,040 g of visceral fat may be a real change and a nodule only newly visible. A trial’s central reader would settle both, and here your read of the old reports does.
Between the MRI and the ultrasound, the member has a question, their nurse has a list and the doctor has the whole record
The harness knows the member’s years of labs, notes and letters, with imaging reports on file, and works inside the plan in the doctor’s note, so whoever picks up the question has those years behind them.
The Year 1 note behind a member’s lipid plan, and any cardiologist’s letter behind that, are one question away for the doctor
Clinical Intelligence looks across the member’s notes, charts, lab reports and consultation letters, and quotes and cites the one that holds the answer. A value from a lab you’ve never used, drawn while they’re traveling, reaches the doctor only after it’s checked against its source page, and one that fails is held back, labeled with what it failed.
Clinical Intelligence: clinical AI and lab trackingYour nurse has the watched labs on one list, and your team has a draft waiting when a friend the member referred writes in
Your nurse clears what’s flagged from the list the doctor is following and asks Clinical Intelligence where a marker stands against its target. Agentic CRM drafts the reply to that friend from your approved answers and names where they run out, and your team reviews it before it leaves.
Agentic CRM: scheduling and follow-upFor the question the member wouldn’t use the direct line for, what a 16 mm nodule means, they get the note explained
Patient AI is turned on for them individually, puts its safety checks ahead of any model and explains their record and what the doctor wrote. If the member writes that their voice has gone hoarse and that needs a person, their nurse or doctor opens a card with what’s known so far and a suggested action.
Patient AI: the treatment companion
The long follow-up that whole-body MRI still lacks is what a concierge panel builds by staying with you
When a colleague covers your panel or takes it over, a member’s years arrive as evidence, each reading dated and sourced, each plan item with its note. De-identified and with each member’s consent, what those scans found, what you chased and what came of it is where a research group would begin a first study. What a first study from your panel would take →
What you’d want to know before this touches a member
Who decides how far an incidental finding gets chased?
You, in your note.The MRI report goes on file, and iksa captures the next step you wrote, an ultrasound or a repeat scan, as a plan item that shows its note. The reading stays with your radiologist and the decision with you.
I order whole-body MRI and multi-cancer screens for some members and not for others. Does iksa assume I order them?
No. Order what you trust.iksa has no stake in what you order, so a member on a plain yearly panel and a member on every scan you offer sit on the same kind of record. What you left out, and why, stays in your note for Year 10.
Members pay for my cell number. Will this get between us?
No, it stays yours.Nothing about how a member reaches you changes. Patient AI is there for the questions they wouldn’t call you about, and one about changing therapy is answered as your call and, with their yes, flagged to your nurse.
Can we bring a member’s years of records with us, specialists’ letters included?
With the date each one prints.A decade of reports, imaging and letters comes in by connection or by upload, and each uploaded file shows the date of service printed on it or says it found none. A cardiologist’s letter that reads as a consultation note enters the member’s clinical record for Clinical Intelligence to cite, and a file iksa can’t place stays stored with the reason on its row.
Some of my members are well known. Who can open their records?
Whoever your roles allow.Access is set by role, so your nurse sees what a nurse’s work needs, and if anyone opens a well-known member’s chart, that’s on an audit trail your clinic can read. The BAA is signed with you before any member’s data moves, and that data is never sold and never used for marketing or advertising.
Does this replace the EHR I’ve kept my members’ charts in for years?
No, it works beside yours.Yours keeps documenting each visit and your booking system keeps the schedule. iksa reads your charts by connection or by upload and holds what your EHR was never built for, a member’s decade: the plan, the reports and the decisions.
Is this concierge medicine software, or an OS for concierge medicine?
Harness is our word.We call it the harness for n‑of‑1 medicine, because you’re reading one person across decades, and a member’s earlier years are the only control they will ever have.
What is n‑of‑1 medicine?All practicesiksa beside your EHRProtocol management softwareWhat iksa adds
Your annual assessment, pillar by pillar, is what we’d most like to see
Bring a protocol you run. We’ll walk one patient through it.