Our Story

Rethinking Admissions


In 2019, the CEO of a not-for-profit hospice in North Carolina approached SMARTMD with a unique proposition:

If companies like Rocket Mortgage could reduce a convoluted financial application process down to a series of simple steps, couldn’t we do the same for our patients and take some of the stress out of admissions? And, could we build it so that it was affordable for every community based program, not just national agencies?

The idea seemed sound enough. We started by observing the Rocket Mortgage approach, then we turned to other sectors, including automotive where Tesla had built an online website for customers to purchase cars. They had redesigned every element of the experience from shopping, to ordering, financing, and even trading in a car. Tesla had thought through how customers wanted to engage virtually and built a solution to fit their needs.

VIP 1.0

Within a year, SMARTMD, Delta Care Rx, and Carolina Caring deployed the Virtual Intake Platform (VIP) in early 2020. VIP ensured every caregiver received the same Explanation of Service via a succinct video developed by hospice staff. Everyone could sign consents whether in person at admissions or participating remotely from their phone. Leveraging SMARTMD’s existing mobile platform, VIP also made it possible for nurses to finish forms at the bedside, even when their devices were offline and disconnected from the internet.

Unlike popular eSignature apps, VIP didn’t require a desktop computer for patients to be able to read and understand the paperwork they were signing. Nor did we charge for every signature envelope, or require annual minimum terms. VIP’s pay-as-you-go model made it accessible to the smallest agencies.


By spring of 2020, the pandemic was in full swing. Admission visits suddenly became difficult to conduct as facilities limited access to patients, not only from nurses, but from the families who were often decision makers for incapcitated patients. Loved ones stopped traveling, halted by restrictions or simply fear of infecting their loved one. Explaining services to families and getting consents became far more time consuming or simply delayed. A digital transformation of the admissions process was now a necessity, not just an option.

Some reached out to the only available technologies that were well known at the time – E-Signature apps like DocuSign. VIP was still in its infancy, but gaining a following. Through the initial months of the pandemic, VIP helped agencies cope with the new reality. In the process, we learned that VIP benefited agencies in ways we had not initially predicted. The old “paper, email and spreadsheet” intake process was linear, serial, prone to delay and errors. VIP enabled all stakeholders to operate in parallel, acting as the glue that kept everyone abreast of what was going on.

By the end of 2020, our story was shared in a spark round at NPHI. Interest ballooned overnight and VIP was seen by many as a major leap in thought leadership. The following year we converted one customer after the next off of Docusign to SMARTMD. As some would say, it was a “no-brainer.”


As the world makes its way back to ‘normalcy’, the world isn’t going back to the way it was in 2019. Meeting over video conference isn’t a novelty, it’s the way we all conduct meetings and how we often stay in touch with families (even my mom knows what Zoom is). Working remotely is here to stay, whether by choice or by necessity (if you’re sick, you can stay home, not infect others, and still do your job). Completing admissions paperwork virtually is expected, not a novelty. Patients want to go back to paper as much as they want to go back to working 5 days a week from the office!

We’ve also had 2 years of experience to evaluate what digital technologies work (Zoom, QR codes) and which ones aren’t exactly the best fit for our needs (ex: E-Signature apps). Our expectations are higher; digital technologies need to do a lot more than get simple signatures on forms. It is like amusement parks. Once you’ve experienced DisneyWorld, all other theme parks have a much higher bar to meet.

As we work on VIP 2.0, we are looking to help more than just hospice admissions. Palliative, PACE, and other settings for the seriously ill benefit from a better, less stressful, admissions process. And we’re expanding the boundaries of the people we help to include the patient’s entourage of providers.

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