Practice growth
Where does the money leak? Automating the practice revenue cycle
A striking share of health spending is administrative. The biggest margin gains hide in the back office.
6 min read
A record that lives in several places is a record you cannot rely on at the moment you need it. Fragmentation is not paid for in storage. It is paid in re-collection: the history taken twice, the investigation repeated because last year's result cannot be found while the patient is still in the room.
What a DMI actually is
A dossier médical informatisé (DMI) is one patient file held in software instead of on paper, so history, consultations and treatment sit in one place rather than several. The rest is a question of what the file carries and who may open it.
In Doctopass the file carries an eleven-section medical history on all three plans — Essential, Pro and Premium — as does the consultation workspace holding symptoms, notes, diagnosis and treatment. Patients are free and unlimited on every plan, including Essential: billing is per doctor, never per patient, per note or per minute.
The regulatory frame around the file is treated separately, in the computerised patient record and the INPDP.
Where the record splinters
A record splinters wherever the same fact is entered a second time: the paper ledger, the appointment book, a photograph on a phone, a colleague's system. The file stops having one version, and no one can say which version is current.
The consequence is clinical before it is administrative: a safety check is only as good as the record it reads. The allergy safety block, and the drug-drug and drug-allergy interaction checker built on RxNorm and the Tunisian formulary, start on Pro — and they read the one record, not four. A checker blind to an allergy written on paper last spring will clear a prescription it should have stopped.
The observation is not only a local one. The OECD ties weak care coordination and fragmented records to duplicated services and low-value care in Tackling Wasteful Spending on Health, 2017.
Count the investigations you repeated last month only because the earlier result could not be found, multiply by what that investigation is worth, and multiply by the months you work. That arithmetic is yours; we will not put a percentage in its place.
One record, twenty modules
The answer to fragmentation is not a better folder. It is one canonical record that every role and every specialty writes into, with the specialty tooling above it as a lens rather than beside it as a second database.
Doctopass carries twenty specialty modules, each with four AI tools, four note templates and three or more clinical calculators tuned to that specialty. Each physician opens their own module over one shared record, one calendar and one billing engine — one system, not twenty applications.
Every AI output in that stack is a draft. The doctor reviews it and signs it explicitly before anything enters the record: no automatic finalization, no silent write. How the modules sit over the shared file is set out in one record across twenty specialties.
Getting paper in, getting data out
A record is worth consolidating into only if data can leave it again. Ask about both directions before you sign, in that order.
Coming in, data migration is included on every plan, with no setup fees. Paper has its own path: the "Zero-Effort" Paper Digitization Service is a separate add-on that works with any plan. The archive is collected and tracked box by box, digitized into structured patient data rather than flat scans, and matched to the right patient file; the originals are returned. In-product handwriting OCR — a photograph of a paper record turned into structured data — is a different product, and it is Premium only.
We will not publish what your current software will hand over, nor how long a record must be kept. The first answer belongs to whoever holds your data today, the second to the binding authority.
Going out, a patient's full record exports as structured JSON plus generated PDFs, on request — the Article 20 portability route, and the only export route we have written down. Patient data is never hard-deleted: a deletion is a soft delete, which keeps the clinical and legal record recoverable, accountable and auditable.
One limit belongs here rather than in a sales call. Device and imaging connection — PACS and DICOM for radiology, and any DICOM- or HL7-capable instrument as a custom option — ships only as a one-time specialty pack, priced on quote, fitting any plan, with on-site setup and staff training included in that fee. It is not a plan feature, and we would rather write that limit down than let it be discovered after signature — the same rule we apply to the commercial detail in practice management software in Tunisia.
Who may open it
Every access passes two authorisation layers: a role-based guard, then a per-record ownership and permission check.
The most sensitive categories are encrypted at the field level with separate keys, isolated from the rest of the record. Audit logging records every access to patient data — who viewed it, who changed it, and when — but the full audit trail starts on Pro, and searching that trail needs Premium. Every consent is versioned and time-stamped. A doctor other than the record's creator can view a patient's records only on explicit, revocable consent granted per doctor, and every such access is written to the audit trail.
For the Tunisian service, physical hosting is within Tunisia. All AI processing runs on a model self-hosted within the applicable jurisdiction, with no personal data transmitted to any external AI provider. Doctopass's INPDP declaration is submitted and the product is GDPR-ready; the key handling underneath is described in field-level encryption.
| Capability | Essential | Pro | Premium |
|---|---|---|---|
| Patient record, eleven-section history | Included | Included | Included |
| Full audit trail | No | Included | Included |
| Audit log search and investigation UI | No | No | Included |
| Handwriting OCR inside the product | No | No | Included |
Encryption, soft delete and record export carry no column because they are architecture rather than plan lines. The last three rows are gates, and they are the rows to check before signature: the record is on every plan; the account of who opened it is not.
Worth remembering
A record fragments wherever a fact is entered a second time, so enter it once and let every specialty module read the same file. A patient's full record exports as structured JSON plus generated PDFs on request, and a deletion is a soft delete rather than a destruction. Doctopass holds one record inside one practice; every view of it by a doctor other than its creator is consent-gated per doctor, revocable, and written to the audit trail.
Frequently asked
Can I bring my paper archive in without typing it myself?
Yes — the "Zero-Effort" Paper Digitization Service, an add-on that works with any plan and is scoped after a free assessment of your archive. Handwriting OCR inside the product is a separate thing, and it is Premium only.
Can my patient take their record with them?
A patient's full record exports as structured JSON plus generated PDFs, on request: that is the Article 20 portability route. Patient data is never hard-deleted either: a deletion is a soft delete, so the clinical and legal record stays recoverable and auditable.
Can another doctor see my patient's record?
Only on the patient's explicit consent, granted per doctor and revocable, with every such access written to the audit trail. That trail starts on Pro, and searching it needs Premium — we would rather write that down than let it be discovered after signature.
What does a shared record cost per doctor?
69 DT, 159 DT and 269 DT per doctor per month, billed annually, each opening with a 14-day free trial. Patients are free and unlimited, there is no setup fee and migration is included; the split sits on per-doctor pricing.
A record is not fragmented by its volume. It is fragmented by the second place someone writes into. To watch one file carry a history, a consultation and an export end to end, request a 30-minute demo — and bring one patient whose history you have had to reassemble by hand, because that reconstruction is the only honest test.