The product

An intelligent assistant for the whole encounter.

Calixo augments the physician rather than replacing how they work. Voice is the primary input; the mouse, keyboard, and screen stay fully available for verification and fine-tuned control at every step.

01

Listen

Always-on, medical-tuned speech recognition captures the encounter.

02

Retrieve

Grounded, cited answers from the patient's own chart.

03

Recommend

Guideline-matched decision support with sources.

04

Draft

Notes, orders, codes, and patient instructions, generated.

05

Authorize

The physician reviews and signs off on every action.

Capabilities

Twelve objectives, one workflow.

01

Voice-first clinical interaction

Physicians drive the entire encounter — navigation, retrieval, ordering, documentation — through natural voice, with the mouse, keyboard, and screen retained as first-class inputs.

  • Always-on, low-latency speech-to-text tuned to medical vocabulary, accents, and noisy clinics.
  • Natural text-to-speech so results and confirmations are read back hands-free.
  • AI augmentation expands shorthand, normalizes terminology, and structures free speech.
  • Wake-word and intent detection separate patient conversation from physician commands.
02

Contextual retrieval from the chart

A conversational assistant over the patient's record — labs, imaging, meds, problems, and prior notes — answering in real time with citations back to the source.

  • Per-patient index of structured and unstructured data, refreshed continuously.
  • Every answer grounded in the chart with a citation, so nothing is fabricated.
  • Temporal reasoning returns the right value, not just the most recent.
  • Minimum-necessary scoping limits each query to the PHI it actually needs.
03

Guideline-driven decision support

Evidence-based recommendations matched to the specific patient — screening intervals, interactions, risk scores, and society guidelines — each with its source cited.

  • Versioned knowledge base spanning USPSTF, AHA, ADA, NCCN, IDSA, ACOG, and more.
  • Embedded risk calculators (ASCVD, CHA₂DS₂-VASc, FRAX, Wells) auto-populated from the chart.
  • Every recommendation shows source, date, and strength of evidence — FDA Non-Device CDS by design.
  • Deep links to PubMed, Cochrane, and the underlying guideline for the question at hand.
04

Notes, summaries & order management

The encounter becomes completed clinical work — progress notes, discharge summaries, and orders for labs, tests, and medications — with physician sign-off on every actionable step.

  • Structured notes generated in the physician's preferred template.
  • Prior notes condensed into a concise, chronological synopsis.
  • Orders placed by voice with CPT codes and clinical justification attached.
  • Every order requires explicit confirmation — Calixo drafts, the physician authorizes.
05

Automated coding & billing

Accurate ICD-10, CPT, HCPCS, and E&M codes generated from the signed note — modifiers, documentation, and an audit-ready trace, ready for revenue-cycle handoff.

  • LLM coding engine grounded in the final note, with explicit "why this code" links.
  • Real-time E&M leveling from MDM, time, and complexity, with transparent reasoning.
  • Payer-specific rules for coverage, modifiers, and prior-auth triggers.
  • Guardrails flag systematic upcoding before it drifts outside expected ranges.
06

Patient instructions

Clear, plain-language after-visit instructions grounded in the encounter — diagnosis, medications, follow-up, and warning signs — for review and handoff to the patient.

  • Auto-drafted from the signed note and orders in the physician's structure.
  • Configurable reading level with translation across major languages.
  • Medication timing and purpose pulled straight from the order set.
  • One-tap physician edit before instructions are finalized and shared.
07

Self-learning from corrections

Calixo improves from each physician's edits and overrides — personalizing retrieval, recommendations, coding, and note style to the individual clinician over time.

  • Every edit and re-dictation captured as a labeled training signal.
  • Per-physician preference profile applied at inference time, no retraining required.
  • Periodic fine-tuning on de-identified, consented data with rigorous evaluation.
  • Drift detection and full rollback if quality ever regresses.
08

Observability & quality monitoring

Full visibility into every decision — what Calixo heard, suggested, and what the physician accepted or changed — so quality, safety, and bias are measured continuously.

  • End-to-end traces: voice command → retrieval → recommendation → code → action.
  • Live dashboards for transcription accuracy, override rates, and latency.
  • Bias and fairness monitoring across demographic slices.
  • Tamper-evident audit logs satisfying HIPAA and ONC HTI-1 requirements.
09

Safety, privacy & compliance

Built to operate within HIPAA, HITECH, state privacy law, and applicable FDA and ONC frameworks — with human sign-off on every clinically actionable output.

  • Minimum-necessary access at the agent level for every function.
  • BAAs with every model provider and sub-processor; no-training, no-retention on PHI.
  • End-to-end encryption and ephemeral processing of voice and transcripts.
  • Designed to stay within FDA Non-Device CDS exemption criteria where possible.
10

Interoperability

Integrates with Epic, Cerner, athena, eClinicalWorks, and others via FHIR and HL7 during the transition — with the long-term goal of standing alone as a full AI-native EMR.

  • FHIR R4 / R5 client for read and write, with HL7 v2 fallback for legacy systems.
  • SMART on FHIR launch so Calixo runs inside an existing EMR session.
  • Bi-directional sync of notes, orders, problems, meds, and allergies.
  • USCDI v3 support and Cures Act-aligned patient Right of Access workflows.
11

Pluggable model architecture

The underlying model can be swapped or configured — Anthropic, OpenAI, Google, or self-hosted open models — to fit each institution's privacy, cost, and contractual needs.

  • Provider-agnostic abstraction decouples clinical logic from any single vendor.
  • Per-task routing — a fast model for retrieval, a stronger one for coding.
  • On-premise or VPC-hosted open models for strict data-residency needs.
  • Every model held to the same accuracy, safety, and bias benchmarks.
12

Ambient documentation

Optionally listen to the visit and draft a structured note — HPI, ROS, exam, A/P — for review and sign-off. An opt-in assistant for clinicians who want it, never required.

  • Per-encounter opt-in; recording starts only with physician and patient consent.
  • Speaker diarization attributes statements to physician, patient, and others.
  • Section-aware extraction lands findings in the correct part of the note.
  • Diff view and voice-driven edits, with the option to discard and write manually.

Safety & compliance

Human-in-the-loop on every clinically actionable output.

Calixo is designed to operate within HIPAA, HITECH, state privacy laws, and applicable FDA and ONC frameworks — with clear physician sign-off built into the workflow, not added after the fact.

Minimum necessary

Each agent sees only the PHI its function requires.

No train · no retain

BAAs and PHI clauses enforced across every model provider.

FDA Non-Device CDS

Recommendations show source, date, and evidence so physicians can review the basis.

Audit-ready

Tamper-evident traces satisfying HIPAA and ONC HTI-1 source attributes.

Bring Calixo into your practice.

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