What we have actually built

Proof

One practice, de-identified. If your intake looks anything like this, the map below is close to yours.

A behavioral health practice ran its entire operation on free Trello, with patient names and clinical reports inside cards and no healthcare BAA. Mapping the workflow surfaced an intake pipeline documented nowhere, the same record re-entered into four separate systems, and a long public intake form collecting diagnoses and medications through a consumer tool. Identifying details have been removed.

The asset

This is probably close to your intake pipeline

De-identified from a real behavioral health practice. Most owners have never seen their own operation drawn out, and the two things worth seeing are not the boxes. They are the layers underneath.

Eight-stage behavioral health intake pipeline A referral enters by email, moves through eight stages from intake to billing complete, with a supervisor review loop that can return a case for edits. Two annotation layers show four points where the same record is re-keyed into a separate system, and three points where protected health information passes through a tool with no Business Associate Agreement. Referral arrives 1. NewIntake 2. ClientContacted 3. Assignedto Clinician 4. ReportSubmitted 5. Supervisorreview 6. Sent toCase Mgr 7. Submittedfor Billing 8. BillingComplete Archived& closed returned for edits Admin / coordinator Clinician Supervisor Billing 1 2 3 4 The same record, typed four times 1  Re-keyed by hand from an emailed PDF referral  ·  2  Copied into a second tracking board 3  Copied into a spreadsheet that exists only so contractors can be given read access  ·  4  Counted again by hand for the year-end report Public intake form (no BAA) DOB, diagnoses, medications, legal history Reports as email attachments Clinical documents outside the boundary Every red box holds patient information in a tool with no Business Associate Agreement The board itself carries names and clinical detail in card titles and attachments. Free and standard plans of common task tools are not BAA-covered, and no staff member here can see only their own caseload.

The same eight stages, laid out for a phone. An interactive version of this map is available on a larger screen.

  1. 1. New IntakeReferral arrives by email as a PDF. Re-keyed by hand (entry 1 of 4) Outside the BAA boundary
  2. 2. Client ContactedCoordinator reaches out; some go non-responsive. Outside the BAA boundary
  3. 3. Assigned to ClinicianCase routed to a therapist. Copied to a second tracking board (entry 2 of 4)
  4. 4. Report SubmittedClinician writes and submits the report. Clinical documents sent as email attachments
  5. 5. Supervisor ReviewApproved, or returned to the clinician for edits.
  6. 6. Sent to Case ManagerReport goes back to the referring body. Copied to a contractor-readable spreadsheet (entry 3 of 4)
  7. 7. Submitted for BillingHanded to the biller.
  8. 8. Billing CompleteArchived and closed. Counted again by hand at year end (entry 4 of 4)

Where the hours go. The same record typed into four separate systems, none of which talk to each other.

Where PHI leaves the boundary. Three points where patient information sits in a tool with no Business Associate Agreement, and no staff member can be limited to their own caseload.

Nobody had drawn this

The eight stages existed in one coordinator’s head. Not in a process document, not in a manual, not anywhere a new hire could find them. That is ordinary, not a failing.

The hours were invisible

Because the duplication was spread across four systems, no single step looked wasteful. Only the map makes the total visible, and the total is what justifies fixing it.

The risk was already known

Staff generally know which tool is the sketchy one. What they do not have is a written, dated analysis saying so, which is the exact document regulators ask for.

Your version of this diagram is what the free 30-minute review produces. Book one →

Behavioral health · identifying details removed

A behavioral health practice running its whole operation on free Trello

A wall of boards. Patient names and clinical reports inside cards, on a plan with no healthcare BAA. Nobody had ever written down how any of it worked.

Scale, location, contract types and every count have been removed or generalized. What remains is the pattern, which is the part that transfers.

Said up front: we have not yet taken a practice through to full go-live, so there is no post-launch hours-saved figure on this page and we are not going to invent one. What we can show you is the working system and the method. Both are below.

What the map surfaced

  • A multi-stage intake pipeline that existed only in one coordinator’s head, from referral received through to billing complete.
  • Roughly half of referrals arriving as PDFs attached to emails, re-keyed by hand into the board, which was the single largest time sink in the practice.
  • The same record entered into four systems: the board, a tracking board, a spreadsheet kept only so contractors could be given read access, and a second spreadsheet for the year-end count.
  • A long public intake form collecting dates of birth, mental-health diagnoses, psychiatric medications and legal-case details through a consumer form tool almost certainly not covered by a BAA.
  • No per-clinician record privacy. Any staff member with board access could read any patient’s case.
  • Years of retained data with no retention policy and no archive strategy.

What we designed in response

  • Workflow boards in SharePoint with Power Apps, keeping the board-and-card layout the team already knew.
  • Record-level per-clinician permissions enforced on the record itself, so a therapist sees only their own cases, identical on desktop and mobile, not merely hidden in the interface.
  • A read-only role for contractors, designed to remove the reason the shadow spreadsheet existed at all.
  • Microsoft Forms intake landing inside the practice’s own BAA-covered tenant, replacing the consumer form tool.
  • Automated notifications: due dates, overdue escalation and daily digests, with templates the office could edit without calling us.
  • Reporting designed to produce the annual per-contract counts directly, so the year-end spreadsheet would no longer be needed.
  • Everything inside the practice’s own Microsoft 365 account, with the build performed against dummy data.
What we have built

We have built the hard part, and we will show you

This did not stop at a diagram. We have built this system in SharePoint and Power Apps and run it against real signed-in accounts, including the part most people are told is not possible: record-level per-clinician permissions enforced on the record itself. A therapist signs in and sees their own caseload and nothing else, on a desktop and on a phone, not merely hidden in the interface. We will demonstrate it live on the call rather than describe it.

What we will not claim: we have not yet taken a practice through to full go-live, so we have no post-launch hours-saved figure and we are not going to manufacture one. What we can show you is the working system, the mapping method, and every decision behind it, in as much detail as you want, on a call.

The finding that mattered most was not the compliance gap. It was that fixing the compliance gap also removed most of the duplicate data entry consuming the intake coordinator’s week. The regulator gets a practice’s attention; the coordinator’s calendar is what actually justifies the work.

Why this matters to you

What this means for your practice

The boards above were built for one practice. The method that produced them works on any practice whose operations grew one tool at a time.

What carries from an engagement like this to yours is not software. It is the pattern recognition: knowing to look for the record that gets typed four times, the spreadsheet that exists only because a permission does not, the intake form that quietly sits outside the compliance boundary. Those are not unusual findings. They are what tends to happen when a practice grows faster than the systems it started on.

It also means work is reusable. The workflow patterns and the per-clinician privacy architecture from this engagement are already built. Where that reuse applies to your practice it shows up in the price you are quoted.

What you can ask us on the call

Anything about the engagement above, how long each phase took, what we got wrong the first time, where the estimates moved and why. We will walk you through it in as much detail as you want, including the parts that were uncomfortable.

What we will not do

Name a client without written permission, describe an engagement as ongoing when it is not, or show you a number on a proposal that you have not already seen published on this website.

Want to see your own map?

The free 30-minute review produces your own version of the map at the top of this page, for your practice, at no cost and with no obligation.

Book a Free 30-Minute Workflow Review

30 minutes with Paul Tran, who runs every one of these calls. Evening slots available. We know your day is patients.  ·  paul@maxpowerlabs.ai