// CASE STUDY — PRE-VISIT CONSULTATION MODEL

The Patient Arrives
Already Prepared.
The Doctor Saves 15–30 Minutes.

What if the history-taking was done before the appointment? InstantHPI makes that possible — at $0.003 per consultation, in 20+ languages, on any phone with Telegram.

15–30
Minutes saved per patient
$0.003
Cost per consultation
7
Clinical documents generated
4
Deployment models

The intake bottleneck is costing everyone

Every clinic visit begins the same way: a doctor asks the patient what's wrong. The patient describes symptoms. The doctor asks follow-up questions. History is taken. Notes are written. That process takes 15 to 30 minutes — and it happens before any real medicine begins.

Physicians are overwhelmed

History-taking consumes 30–50% of every consultation. Doctors spend more time documenting than diagnosing. Documentation burnout is a leading cause of physician attrition worldwide.

Clinics cannot absorb the volume

Patients wait hours in overcrowded waiting rooms. In Nigeria, the doctor-to-patient ratio is 1 per 5,500 people. In Ethiopia, 1 per 10,000. Each consultation must count.

Documentation is incomplete and inconsistent

Oral histories get truncated. Key symptoms are omitted. Family history is never asked. The resulting clinical note is a pale shadow of what a structured intake would produce.

Patients arrive unprepared

Most patients cannot name their medications, recall surgery dates, or articulate a clear chief complaint. The doctor wastes the first third of the visit extracting information the patient had but couldn't organize.

15–30

minutes spent per patient on history-taking and documentation

1:5,500

doctor-to-patient ratio in Nigeria

1:10,000

doctor-to-patient ratio in Ethiopia

$0.003

cost of one AI pre-consultation that replaces that entire intake

Pre-visit AI consultation

The patient uses @instanthpibot on Telegram before their appointment. The bot guides them through a full medical intake — 18 questions, in their language, at their own pace. By the time they walk into the clinic, every document is already generated.

BEFORE VISIT

Patient Uses Bot

Opens @instanthpibot, selects language, answers 18 intake questions

AI PROCESSING

Documents Generated

7 clinical documents created in seconds, including differential diagnosis

CLINIC ARRIVAL

Patient Arrives Prepared

Brings PDF printout or shows documents on phone to the doctor

CONSULTATION

Doctor Reviews + Confirms

Reviews pre-generated note, makes clinical decisions, signs where appropriate

OUTCOME

15–30 Min Saved

More patients seen. Better notes. Reduced burnout. Zero extra cost.

Documents already waiting when the doctor walks in

History of Present Illness

Structured HPI with onset, duration, quality, severity, and modifying factors

Review of Systems

Complete ROS across all organ systems — pre-populated from the intake

PMH / Social / Family History

Past medical, surgical, social, and family history in structured format

SOAP Note Draft

Complete Subjective-Objective-Assessment-Plan — ready for physician review

Differential Diagnosis

AI-generated differential with clinical reasoning for each possibility

Recommended Labs & Imaging

Suggested lab orders and imaging with clinical reasoning for each test

Referral Letter Draft

Pre-written referral letter for specialist or primary care handoff

Which model fits your setting?

The pre-visit consultation concept works across very different healthcare contexts. Here are four deployment models — each adapted to a different level of infrastructure, literacy, and physician involvement.

A

Patient-Initiated (Self-Service)

The patient does it on their own, unprompted

Best for: tech-savvy patients, urban settings, educated populations
  1. Patient schedules an appointment at the clinic
  2. Clinic shares the bot link: t.me/instanthpibot
  3. Patient completes the intake from home, the night before
  4. Patient arrives at the clinic with the PDF already on their phone
  5. Doctor opens the document, reviews, asks 2–3 clarifying questions, proceeds
Outcome: Doctor starts the consultation already oriented to the chief complaint, medications, allergies, and social history. The first 15 minutes of the visit are effectively skipped.

Flow Diagram — Model A

Patientschedules appt
Bot Intakeat home / in advance
PDF Readyon patient's phone
Doctor Reviews2–3 min
Consult Beginshistory already done
B

Doctor-Prescribed (Clinic Integration)

The clinic makes the bot part of its intake protocol

Best for: organized clinics, reducing waiting room congestion, high-volume practices
  1. Receptionist tells each patient at check-in: "Before you see the doctor, please message @instanthpibot on Telegram"
  2. Patient uses the bot in the waiting room while waiting
  3. By the time the patient is called in, documents are generated
  4. Patient shows phone to doctor — or clinic prints the PDF at the front desk
  5. Doctor proceeds with a pre-structured clinical picture
Outcome: Waiting room time becomes productive intake time. The queue moves faster. Doctors see more patients per day without working longer hours.

Flow Diagram — Model B

Check-Inreceptionist prompts
Bot Intakein waiting room
Queue Clearswait time = intake time
Doctor Readypre-filled note waiting
C

Community Health Worker Mediated

A CHW uses the bot on the patient's behalf

Best for: rural areas, low-literacy populations, home visits, remote communities
  1. Community health worker visits patient at home or community center
  2. CHW opens the bot on their own phone and reads questions aloud
  3. Patient answers verbally; CHW inputs responses into the bot
  4. Generated documents are forwarded to the supervising physician
  5. Physician reviews remotely or at the next clinic visit
Outcome: Populations who could never reach a doctor now have a structured clinical intake on record. The physician's 45-minute home-visit equivalent becomes a 10-minute document review.

Flow Diagram — Model C

CHW Home Visitrural / remote
Bot IntakeCHW as guide
Docs Forwardedto physician
Remote Reviewor next clinic visit
D

Emergency Triage Support

Patient uses the bot when symptoms first appear

Best for: reducing ER overcrowding, guiding patients to appropriate care level, better triage on arrival
  1. Patient experiences symptoms — headache, chest tightness, abdominal pain
  2. Before going to the ER, patient opens @instanthpibot
  3. Bot generates urgency flags and differential diagnosis
  4. Patient arrives at the emergency department with documentation
  5. Triage nurse receives a pre-structured intake — vital context is already captured
Outcome: Triage becomes faster and more accurate. Patients who should be at urgent care are redirected. Patients with true emergencies are flagged immediately with supporting clinical documentation.

Flow Diagram — Model D

Symptoms Appearat home
Bot Triageurgency flags generated
ER Arrivalwith documentation
Faster Triagepre-filled clinical picture

Doctors gain time. Patients gain a voice.

Both sides of the consultation improve — at zero cost to either party.

For Physicians and Clinics
  • Save 15–30 minutes per patient on history-taking and intake documentation
  • See 2–4 more patients per day without extending clinic hours
  • Receive better-structured clinical notes, ready to review and modify
  • Use the AI-generated differential as a clinical reasoning starting point
  • Reduce documentation burnout — the hardest part is already done
  • Works with any existing workflow — no system integration required
  • No cost to the clinic unless they choose to sponsor consultations
  • Available in 20+ languages — no interpreter needed for initial history
$0.003 Cost to the doctor per patient — or $0 if patient self-initiates
For Patients
  • Arrive at appointments with complete, organized medical history already documented
  • Communicate more effectively with their doctor — less forgetting, less confusion
  • Receive a written summary of their consultation to keep and reference
  • Understand their own health better through the structured intake process
  • Available in their native language — not just English
  • Free — no cost ever, no account required, no data collected
  • Works on any phone with Telegram — no special hardware
  • Available 24 hours, 7 days a week — can complete before any appointment
$0.00 Cost to the patient — always free, no exceptions

The arithmetic of scale

At $0.003 per consultation, the numbers become almost impossible to argue with. This is not a pilot program that will cost millions to sustain — it is a service whose cost is essentially rounding error.

Scale Consultations / Year AI Cost Context
Single patient, 12 visits/year 12 $0.036 Less than a single text message
Small clinic, 100 patients/month 1,200 $3.60 Less than a coffee
Mid-size clinic, 5,000 patients/year 5,000 $15 Less than one clinic supply order
1,000 patients, monthly visits 12,000 $36 Per year, for a community of 1,000
Regional health system, 50,000 patients 600,000 $1,800 Per year — less than one employee's monthly salary
National program, 1 million patients 12,000,000 $36,000 Per year, for 1 million people with healthcare access

The annual salary of a physician in sub-Saharan Africa averages approximately $15,000 USD. At $0.003 per consultation, that same $15,000 would fund 5 million AI pre-consultations — serving a population for which no physician currently exists. The question is no longer cost. It is reach.

Which model fits your practice?

We are looking for doctors, clinics, community health programs, and health systems to pilot these four models in real settings. Every environment is different. We want to learn from yours.

Solo Physicians

You already do everything yourself. Let the bot handle intake so you can focus on what only you can do — clinical judgment. Takes 5 minutes to pilot. Costs nothing.

Community Clinics

High volume, constrained resources. Adding the bot to your check-in protocol is a zero-cost infrastructure upgrade. We can help train your reception staff.

NGOs and Health Programs

Operating in underserved areas without reliable infrastructure? This model was designed for you. We want to understand your specific context and adapt accordingly.

Health Ministries

Looking to extend primary care reach without new infrastructure investment? Let us walk you through the numbers and the deployment options. The technology is already live.

Emergency Departments

Interested in the triage model? We want data from real emergency settings — what urgency flags matter most, what the triage team would actually use, and how to reduce noise.

Medical Schools

Every bot interaction is a complete clinical case with differential diagnosis and reasoning. A built-in teaching tool — for free, at any scale, in any language.

Which model would work for you?

Tell us about your setting. We read every message personally — this is not a sales funnel. It's a conversation between people who care about the same problem.

We do not store or share your email. This opens your email client with the form prefilled.

Or email directly: cff@centremedicalfont.ca

The documentation is done
before the doctor walks in.
That's the future. It's here now.

Try the bot. Read the story. Partner with us. Help us understand how this fits your world.

cff@centremedicalfont.ca  |  Built by Dr. Carlos Font, Family Physician