Self-hosted
On your infrastructure
Dockerized on a Hetzner VPS — your data, your control. No per-seat SaaS bill that scales with you.
Physician-led · multi-tenant · self-hosted
One pane of glass for collaboration across all 50 states.
Replace the Notion trackers, Google Sheets, Zapier flows and one-off scripts with a single system that watches every state board for you — and stays running for years, not weeks.
Postgres system of record
Row-level multi-tenant
n8n + scraper monitor
Human-in-the-loop
Operations, compliance & contract data only — no PHI, no patient data.
50-State Compliance Map
Compliant
Watch — pending rule
Rule changed — clients impacted
46
States compliant
3
On watch
1
Active change
Weekly Regulatory Digest
To dr.j@collaborative-md.internal
From monitor@collaborative-md.internal
3 state rule changes this week — 4 of your clinics impacted
Texas — PA supervision ratio changedMedical board lowered the physician-to-PA ratio effective next quarter.→ impacts 3 active clinics (med spa, IV hydration)
Florida — NP collaboration filing pendingNursing board posted a proposed change to collaboration documentation.→ watch · 1 clinic to review
Arizona — GLP-1 program rule confirmed unchangedSnapshot diff clean since last sweep — no action needed.→ no clinics impacted
NP / PA Candidate Queue
MR
fit 0.92
DP
fit 0.88
AO
fit 0.85
Sourced into a Postgres review queue — the physician stays in control of every match.
Welcome Packet Generator
Coastal Glow Med Spa
Texas (TX)
Med spa · GLP-1
Welcome packetTX · 11 pages
Standing ordersstate-specific · signed-ready
Collaboration agreementmerged client + physician
LIVE
Texas board scraped — diff against last snapshot · 1 change flagged
Concept demo — sample data. The live build runs on your Hetzner VPS.
The problem you described
A 50-state, liability-sensitive practice — run on a stack that breaks
Notion trackers, Google Sheets, Zapier flows and a few one-off Node scripts. No single system of record, no reliable way to catch a scope-of-practice change in one of 50 jurisdictions, and every new clinic onboarded by hand. One missed rule is a real-money liability.
Today — the fragmented stack
Brittle, manual, single-tenant
- State rule changes caught by hand — if at all — across 50 boards
- Notion + Sheets + Zapier with no shared source of truth
- Welcome packets & standing orders assembled from Drive by hand
- Can't safely add a second physician — no multi-tenancy
The platform — one system of record
Durable, automatic, multi-tenant
- Every state board watched nightly — diffs flag exactly which clients are affected
- One Postgres schema for clinics, providers, agreements & jurisdiction status
- Welcome packets in seconds — Drive templates merged with state data
- Row-level multi-tenancy from day one — add a second physician cleanly
What it does
Five components — built as one product, not a patchwork
Exactly the system you asked for, built bespoke: a system of record, an automatic regulatory monitor, a human-in-the-loop sourcing queue, an instant document generator — and the longevity to run for years.
01
Postgres system of record
Clinics, NP/PA providers, collaboration agreements, contracts and per-state jurisdiction status — all in one schema, with row-level security and per-physician multi-tenancy from day one.
replaces every Notion tracker + Sheet
02
50-state regulatory monitor
An n8n + scraper pipeline watches every state medical & nursing board for scope-of-practice and collaboration changes, diffs against the last snapshot, and emails a digest naming the exact clinics impacted.
turns your #1 liability into an auto alert
03
Candidate sourcing — human-in-the-loop
NP/PA candidates are sourced from job boards into a Postgres review queue with a lightweight approval dashboard. No auto-outreach — the doctor approves or rejects every match.
keeps the physician in control
04
Auto welcome-packet generator
Indexes your existing Google Drive templates, merges client and state-specific data, and produces a ready-to-sign welcome packet and standing orders per new clinic in seconds.
onboarding hand-assembly → seconds
05
Built for longevity
Dockerized on a Hetzner VPS with pgvector for agent memory, OpenRouter for LLM routing, observability, backups and a clean handoff doc — designed to run for years, not weeks.
a system that outlives the patchwork
06
One pane of glass
The compliance map, the regulatory digest, the candidate queue and the packet generator in a single clinical-blue dashboard — the single view that replaces the entire fragmented stack.
covers IV · med-spa · GLP-1 · aesthetics
Built to last
Self-hosted. Multi-tenant. Yours.
Multi-tenant
Row-level security
Per-physician isolation from day one, so a second doctor can join without re-architecting anything.
Nationwide
All 50 jurisdictions
Every state board monitored for NP/PA scope-of-practice and collaboration-rule changes.
Durable
Years, not weeks
Observability, backups, pgvector memory and a clean handoff doc — built to keep running.
The build
Mapped 1:1 to your Phase 0–4 roadmap
Phase 0
Foundation
Postgres schema, RLS multi-tenancy, Dockerized on Hetzner.
Phase 1
System of record
Migrate Notion/Sheets into clinics, providers & agreements.
Phase 2
Reg monitor
n8n + scraper sweeps 50 boards; diff + email digest.
Phase 3
Sourcing queue
Candidate intake to a review dashboard — you approve.
Phase 4
Packets + handoff
Drive-merge generator, observability, backups, docs.
Build this
Replace the patchwork with one system that runs for years
This concept maps directly to the build you posted: a self-hosted, multi-tenant medical-direction operations platform — Postgres system of record, 50-state monitor, human-in-the-loop sourcing, and instant welcome packets. Reply and we'll scope it against your Phase 0–4 plan.
Reply YES — let's scope itSelf-hosted & multi-tenant — you own the data and the system
All 50 state boards monitored — missed-rule liability handled
No PHI, no patient data — operations & compliance only
Built to run for years, not weeks