Tom Kashul's cash-pay specialty clinic in Park Ridge, IL runs end-to-end on Moonshot Clinic. TRT, peptides, GLP-1, DEXA imaging — all on one EHR built by the operator who runs it daily. Not a pilot. Not a sandbox. The product is what we use to see patients.
"I started Moonshot Medical because the cash-pay specialty model wasn't being served by any EHR. Then I built Moonshot Clinic because no EHR served the cash-pay specialty model. We use our own software every day. Every bug we hit, every workflow we wish was smoother, every report we want — we build it. The product is what we run our clinic on, full stop."
By the numbers
Every number below comes from real production usage at Moonshot Medical — not a sandbox, not a pilot, not a demo tenant.
Active patient panel
DEXA scans delivered
Lab panels ingested + interpreted
Quest, LabCorp, Genova, others
Providers + staff using it daily
Cash-pay
No insurance billing surface
EHR replaced
Athenahealth
Why we built Moonshot Clinic
Moonshot Medical started as a thesis bet: cash-pay specialty care — TRT, peptides, GLP-1, DEXA imaging — was being served by primary-care EHRs that fundamentally didn't understand the business model. Athenahealth was the first attempt. It billed insurance we didn't take. It demanded CPT codes that didn't map to our service line. It made quarterly bloodwork tracking — the core operational rhythm of a TRT clinic — feel like fighting the tool every single day.
By month six the cracks were structural. Quarterly bloodwork was being tracked in a Google Sheet because the EHR couldn't fire reminders on a per-protocol cadence. The Schedule III controlled-substance ledger lived in a separate inventory app that didn't talk to the chart, so every testosterone injection got double-entered. DEXA scan reports came out of the scanner's native reporting tool as PDFs and had to be manually re-typed into the patient portal, one section at a time. Stripe charges were reconciled by hand against a billing spreadsheet that lived in someone's Dropbox. The clinic was running, but the operating system was held together with duct tape.
The decision to build was simple, even if the execution wasn't. We couldn't find an EHR built for cash-pay specialty work, so we built one. The first version of Moonshot Clinic shipped to cover one workflow: the quarterly bloodwork cycle for TRT patients. Then inventory. Then DEXA report delivery. Then telehealth. Then AI lab interpretation. Each module shipped because Moonshot Medical needed it on Monday.
What it looks like now: quarterly bloodwork ingests from Quest and LabCorp and auto-flags abnormal hematocrit, estradiol, PSA — anything that matters for our protocols — with AI-drafted patient summaries the clinician edits and signs. DEXA scans flow from the Hologic scanner into the patient portal in about 90 seconds with a branded PDF the patient sees the moment we sign it off. Vial-level Schedule III inventory is enforced at the database layer, so dispensing more than what's in the lot is literally impossible. Stripe subscriptions reconcile themselves. The billing dashboard knows what every charge is for because the metadata contract is baked into the booking flow.
And we still find bugs every week. This is software in active development. We're our most-demanding customer because we're also the one who has to fix the bug when we hit it. That's not a marketing line — that's the actual feedback loop. A clinician at Moonshot Medical reports something that's awkward on Friday; by Monday it's usually a deployed fix. No support ticket queue, no PM triage, no roadmap negotiation. The operator who runs the clinic and the operator who runs the codebase are the same person.
Before / After
Every tool Moonshot Medical used to need, and what replaced it inside Moonshot Clinic.
A day in the clinic
Not slides. Not demos. Actual workflows running at Moonshot Medical right now.
Quest CSV ingests at 6am. The AI assistant flags abnormal hematocrit over 52, drafts a patient message asking them to come in for a check, and queues it for the clinician to review. Missy signs and sends in under 30 seconds. No spreadsheet check. No manual outreach.
Patient arrives at 9:00am. Scan completes at 9:01am. Branded PDF is in the patient portal by 9:02am. AI scan-comparison against the patient's prior scan ships in the same message. Follow-up visit is auto-scheduled for six months out. The patient leaves with the link before they leave the parking lot.
Week 4 of the patient's titration. The AI assistant prompts Missy with a dose-advancement review — weight delta, side-effect notes, last refill date. She approves, signs the new prescription via ScriptSure, and the inventory module deducts the next vial automatically. Patient gets the pickup notification before the chart note finishes saving.
Inside the clinic
The team, the room, the artifacts. Coming soon.
APRN-FPA. Solo author and director on all patient-facing clinical content at Moonshot Medical.
Brick-and-mortar cash-pay specialty clinic. Real patients, real schedule, real Schedule III ordering window.
De-identified scan deliverable — what every Moonshot Medical DEXA patient receives in their portal within 90 seconds of scan completion.
De-identified example of a TRT follow-up note — AI-drafted from the visit transcript, edited and signed by the clinician.
"Most SaaS founders never actually use their product in anger. We do. That's the moat. That's the product."
Book a 20-minute demo. We'll walk through the workflow live, on real (anonymized) data from our own clinic — not a sandbox tenant.
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