How a 40-provider primary care group in Florida no longer looks at their fax queue.
And their charts are ready before every visit, written the way they write their own notes.
Layrd is live across West Florida Medical Associates (WFMA), a 40-provider primary care group in Florida. The first practice to come online was Suncoast Primary Care, the largest one inside WFMA, and what follows is Dr. Alex Villacastin and Kristine Vogel describing the first month. Dr. Villacastin owns Suncoast. Kristine runs its operations.
“Compared to a previous AI we had, it is more comprehensive.”
How we took the fax queue off their hands
The fax queue at Suncoast used to be Kristine's problem. At the larger locations, someone on her back office team checked it every two hours and spent the next hour and a half clearing whatever had piled up, and when the queue ran over Kristine stepped in herself. At the smaller locations, one person sat on the queue all day.
The volume coming in was around 450 to 500 documents a day. Labs, specialist notes, hospital records, patient forms, every piece of paper the outside world sends to a primary care practice. A staff member had to open each one, figure out what it was, match it to the right patient, drop it into the right part of the chart, and pass it to the physician or nurse who needed to see it.
In the first month since Layrd went live on the fax line, it has handled 15,820 documents and processed 99.8% of them without failure. Layrd reads the document when it arrives, finds the right patient, and drops it into the right part of the chart in eClinicalWorks. If the document requires a follow-up that only a person can do, Layrd flags it for the right staff member with a clear instruction on what to do next.
This was working from the first week because Layrd did not arrive with its own opinions about how faxes should be handled. Before going live, it went through Suncoast's history of fax triage decisions and learned which kinds of documents had been routed to which staff member, which ones had needed physician review first, and which ones had closed without anyone doing anything. Kristine's team had worked those rules out over years. Layrd learned them and now runs them.
“Layrd has streamlined workflows by improving accuracy, consistency, and turnaround time.”
“Information is routed appropriately, securely, and without delay. This has reduced bottlenecks, minimized errors, and improved overall communication between departments.”
The documents still arrive. They just do not pile up anymore.
How we got every chart ready before the visit
With the fax queue no longer taking up the team's day, the information moving through it could start doing useful work for the next patient visit. Chart preparation went live at Suncoast a week after the fax work, which is why this part of the story covers a shorter window.
When a patient has an appointment coming up, Layrd reads everything in the chart that is relevant to the visit. The notes from prior visits, the labs that have come back since, the consults from specialists the patient has seen, the documents that came in through the fax line in the intervening days. From all of that, Layrd produces a short document that tells the physician what has changed since the last visit, what is still open, and what the patient needs the physician to address today. The physician opens the chart already oriented, rather than spending the first two minutes of the visit piecing together where things stand.
“It would review the salient information of previous consults and the diagnostic modalities that were done, and give us a heads up of what has been done and results to be discussed on the patient that will be seen that day.”
In the two weeks since chart preparation went live, Layrd has prepared 2,418 charts. To produce them, it read through 10,680 clinical documents, 4,511 lab results, and 7,918 encounter notes, which works out to around 16 separate pieces of information per chart. This is the kind of review a careful physician would do if they had the time. The physicians at Suncoast were doing it on their evenings and weekends, six to eight hours a week each, because there was no room for it during the clinic day. That time is now theirs again.
“You already have an idea of what to do with the patient without going to the details of different sections of the charts, which saves you some money and makes you more organized on the patient's visit.”
“Providers are able to focus more on patient care while maintaining high-quality, compliant records.”
How we made the chart sound like the physician wrote it
The prepared chart is only useful if it reads like something the physician would have written themselves. If it does not sound like them, they rewrite it, and a chart that has to be rewritten is worse than no chart at all.
Layrd handles this by learning each physician's writing before it ever goes live for them. It reads thousands of that physician's past notes from the EMR and learns how they phrase an assessment, how they put a plan together, and the specific shorthand they fall into. The physician then fills out a short questionnaire that sharpens the parts the past notes did not fully reveal, which consolidates the personalization. By the time Layrd is ready for that physician on day one, the prepared chart already reads like their own writing. It keeps getting closer from there as Layrd learns from their edits and feedback, but the heavy work of learning their voice is already done before they ever start using the product.
What the prepared chart does beyond the summary
The prepared chart is not only a description of what has happened with the patient. It is also where three specific pieces of work get done that change what comes out of the visit clinically and financially.
The first is care gap closure. Before the visit, Layrd identifies the things this patient is due for that have not been done yet, whether that is an overdue screening, a missed vaccine, or a chronic condition that has not been followed up on in too long. These are surfaced in the prepared chart so the visit becomes the chance to close them rather than another visit where they never come up.
“It gives you a reminder of the gaps, the healthcare gaps that need to be done for the patient, so that visit would be more detailed and all the patient's needs can be facilitated.”
The second is sharpening the assessment and plan, which includes increasing the specificity of the diagnoses. A chart that lists “diabetes” is clinically acceptable but it does not reflect the real state of the patient, while a chart that lists the specific type of diabetes, the complications the patient has from it, and the other conditions it is driving does. That level of specificity is what drives correct HCC capture under value-based contracts and Medicare Advantage, and Layrd pulls it forward into the current assessment when the information is already in the chart but has not carried through to this visit.
“The highest specificity of diagnosis to improve the MRA score of each patient, which helps with value-based medicine and Medicare Advantage programs.”
The third is evaluation and management coding with full medical decision-making justification. Every visit has to be coded at a level that matches the complexity of the work the physician did, and the current guidelines determine that level based on the complexity of the problems addressed, the data that had to be reviewed, and the risk involved in managing the patient. Layrd produces an E/M recommendation with justification against all three of those criteria, citing the specific evidence from the chart. This protects the practice from undercoding, which leaves revenue on the table, and from overcoding, which creates audit exposure.
What a demo cannot show
Everything up to this point is work that can be demonstrated. A prospect can sit through a walkthrough of the fax handling, the chart preparation, and the coding work, and judge for themselves whether the product does what it claims. What a demo cannot show is whether the people behind the product will be straight with you once you are a customer, and that is what decides whether a deployment lasts.
“They do not oversell capabilities or promise outcomes beyond what they can deliver. Instead, they provide realistic expectations and consistently follow through, which has built a strong level of trust and reliability in our partnership.”
Dr. Villacastin put the same idea in blunter terms from the physician's side.
“It's nothing in comparison… with what it can do, what functionality it has, and possibly could do in the near future.”
“Layrd has introduced a level of operational efficiency and dependability that directly supports better patient outcomes and stronger organizational performance.”
What comes next
Suncoast went first, and the rest of WFMA is now onboarding behind them. The chart preparation and the value-based care work continue to expand across the remaining providers as they come online, and the clinical documentation layer that captures the visit itself is the next piece of Layrd coming in.
“I would gladly recommend this to my colleagues, and the rest of the West Florida doctors are starting to adopt it after I explained the capability of this powerful AI tool for their practices.”
If the fax queue, the chart prep, and the evenings lost to catching up sound like your practice, the next step is a conversation.
The six to eight hours a week per physician reflects the time Suncoast's physicians were spending on chart preparation before Layrd went live. The staff time returned on the fax side is described qualitatively rather than as a specific figure, because the practice has not yet quantified it precisely.