HealthcareCheck

Built by a clinician who needed it.

HealthcareCheck was not designed in a board room and tested on a focus group. It was built inside a working clinical practice, by the licensed social worker running it, because the off-the-shelf options failed the people in front of him. The founder is the first user, the first auditor, and the first liability holder — every regulatory boundary, every PHI surface, every vendor BAA touches his own private practice before it touches yours.

Where the pathway breaks — and how we close it

Founder distance from clinical reality

Most patient navigation vendors are founded by MBAs, ex-bankers, or product managers who have never run a caseload, never charted a session, never sat with a patient who could not get to dialysis. The founder hires a clinical advisor, calls them a Chief Medical Officer, and ships a product designed around investor-deck metrics rather than clinical workflow reality. The result is software that looks correct in a demo and breaks under the actual pressure of a Tuesday afternoon caseload.

<10%Patient navigation vendors with a licensed clinician foundercite

Cost when unaddressed: Software that does not survive contact with the actual workflow becomes shelfware within 90 days of deploy.

Clinician founder, 14 years, 13 settings

Matthew Sexton, LCSW, has spent 14 years across 13 distinct clinical settings — substance abuse intensive outpatient, forensic ACT teams, dialysis psychosocial coordination, disaster case management, HIV program coordination, behavioral health program direction, and narcissistic abuse recovery. Every workflow assumption inside HealthcareCheck traces to a specific Tuesday afternoon caseload he was running when the gap surfaced.

14 yearsDirect LCSW practice across 13 clinical settingscite
Before<10%Vendor norm — clinician foundercite
After100%HealthcareCheck — clinician-founded, clinician-run
Impact on founder distance from clinical realityMethodology →

Founder cannot use the product themselves

Vendor founders rarely deploy their own software inside the operation that pays their bills. The product is sold to tenants, but the founder is not a tenant. There is no internal forcing function that catches the workflow break before a paying customer hits it. Bug reports come from tenants under SLA pressure, not from the founder running the same workflow on a Friday afternoon.

0%Patient navigation vendors with founder running their own product on PHIcite

Cost when unaddressed: Tenant becomes the QA team for a product the vendor will not run on their own data.

Founder pilot-zero on Matthew Sexton, LCSW, PLLC

Matthew Sexton, LCSW, PLLC is the first deployment of HealthcareCheck. The founder runs the same instrument library, the same audit retention, the same BAA-covered AI surface, and the same encrypted-at-rest storage on his own private practice clients before any external tenant sees the code. If the workflow breaks for a tenant clinician, it has already broken for the founder first.

Pilot-zeroFounder PLLC operates on production HealthcareCheck infrastructurecite
Before0%Vendor norm — founder is not a tenantcite
After1 of 1Founder PLLC = first production tenant
Impact on founder cannot use the product themselvesMethodology →

MVP velocity over clinical accuracy

Vendor velocity culture treats clinical instruments as content to ship. A PHQ-9 might be rendered with the wrong cutoff thresholds. A C-SSRS might collapse the ideation severity matrix into a single yes/no. A KDQOL-36 might omit the burden subscale entirely. The clinician using the tool has no way to know the instrument has been mis-implemented until a downstream auditor catches it — by which point months of patient data have been collected against the wrong measure.

1 in 4Digital health platforms with at least one mis-implemented validated instrumentcite

Cost when unaddressed: Clinician charts against wrong cutoff thresholds; auditor finds invalid data months in.

Validated instrument library, founder-audited

PHQ-9 (Kroenke 2001 cutoff thresholds preserved), C-SSRS (Posner 2011 severity matrix preserved), KDQOL-36 (kidney disease QoL with burden subscale intact), Zarit Burden Interview (caregiver assessment), ISEL-12 (social support), WEMWBS (Warwick-Edinburgh wellbeing). Every instrument passes weekly review against its citation source. Mis-implementation is caught before the workflow ships — not after.

6 instrumentsValidated, citation-anchored, weekly-reviewedcite
Before25%Vendor norm — at least one mis-implemented instrumentcite
After0Founder-audited instruments mis-implementedcite
Impact on mvp velocity over clinical accuracyMethodology →

Product-market fit over regulatory fit

Vendor product roadmaps optimize for sales-deck features that close enterprise contracts, not for the regulatory measures that the tenant is actually scored on. CCBHCs need SAMHSA-aligned quality measure capture. FQHCs need HRSA UDS-aligned referral completion documentation. Dialysis centers need CMS-required KDQOL-36 capture. Vendor sales pitches that ignore these regulatory anchors leave the tenant doing the regulatory work in spreadsheets after the platform fails to capture it.

30%Patient navigation deployments that fail their first regulatory auditcite

Cost when unaddressed: Tenant audit failure; remediation cost; reputational damage with state regulator.

Regulatory-aligned by deployment vertical

CCBHC tenant deploys with SAMHSA quality measure scaffolding pre-configured. FQHC tenant deploys with HRSA UDS referral completion documentation. Dialysis tenant deploys with CMS-required KDQOL-36 capture. Each vertical inherits its regulatory measure set on day one — not as a configuration project the tenant runs after go-live.

3 verticalsRegulatory-aligned scaffolding (CCBHC / FQHC / Dialysis)cite
Before30%Vendor norm — regulatory audit failure rate first cyclecite
After0Founder PLLC + first 3 vertical templates audit-aligned at go-live
Impact on product-market fit over regulatory fitMethodology →

Consumer-grade UX over clinician-grade UX

Vendors hire UX teams that benchmark against Spotify, not against the EHR the clinician already runs. The result is a workflow that requires the clinician to context-switch between a beautiful navigation app and a hostile EHR — doubling the cognitive load and tripling the documentation time. The clinician quietly stops using the navigation tool within two weeks of go-live.

13.5 hours/weekClinician documentation burden when workflow tools do not integratecite

Cost when unaddressed: Clinician disengages from the navigation tool; SLA breach; tenant churn within 90 days.

Built around the workflow the clinician already runs

FHIR R4 first-class. athenahealth integration live in production. Closed-loop referral acknowledgment posts back to the EHR rather than expecting the clinician to chart twice. Crisis routing surfaces inside the same workflow the clinician runs for routine intake — no context switch, no doubled documentation.

FHIR R4First-class native — not a roadmap itemcite
Before13.5 hr/wkVendor norm — clinician documentation burdencite
AfterSingle workflowEHR-integrated; no doubled documentation
Impact on consumer-grade ux over clinician-grade uxMethodology →

Outcome theatre over outcome reality

Vendor pitch decks claim outcome lifts that cannot be reproduced from the underlying data. The denominator is suppressed, the comparison cohort is missing, the measurement instrument is unstated, and the time window is selected to flatter the chart. The tenant cannot defend the outcome claim to their own board, their state regulator, or their auditor.

CommonVendor outcome claims without methodology disclosurecite

Cost when unaddressed: Tenant cannot reproduce vendor claim under audit; tenant board loses confidence in platform.

Validated-instrument before/after with disclosed methodology

Every outcome claim cites the validated instrument used (PHQ-9 / C-SSRS / KDQOL-36 / Zarit / ISEL-12 / WEMWBS), the cohort denominator, the time window, and the measurement methodology. Every metric block on every product page links to a methodology anchor that explains inclusion and exclusion criteria. The tenant can defend the claim from primary sources.

100%Outcome metrics with disclosed methodology + citationcite
BeforeOften opaqueVendor norm — outcome claim without methodologycite
AfterAudit-defensibleMethodology + denominator + time window disclosed
Impact on outcome theatre over outcome realityMethodology →

Compliance as add-on, not as default

Vendor sales motions treat HIPAA compliance as a paid tier or a post-sale configuration project. The tenant signs the contract, then spends six weeks negotiating the BAA, twelve weeks configuring audit logging to meet 45 CFR 164.312(b), and six months negotiating sub-processor disclosure. Patients are exposed during the configuration window because the vendor sells the product before the controls are in place.

$2.6MAverage HIPAA breach settlement when controls were configured post-salecite

Cost when unaddressed: OCR settlement; tenant board notification; state attorney general involvement.

BAAs executed, controls live, gate weekly

Google Cloud BAA covers Vertex AI Gemini 2.0 / 2.5 (the only AI surface). AWS BAA covers RDS PostgreSQL, S3, CloudWatch, SSM Session Manager, KMS. Audit logging meets 45 CFR 164.312(b). Audit retention meets 45 CFR 164.316(b)(2) at 6 years. Wednesday HIPAA gate runs weekly; baseline is 43 PASS / 0 WARN / 0 FAIL.

43 PASSWednesday HIPAA gate baseline (0 WARN / 0 FAIL)cite
Before$2.6MVendor norm — average breach settlement when controls were configured post-salecite
AfterDay-zeroControls in place before tenant onboardscite
Impact on compliance as add-on, not as defaultMethodology →

Pivot risk over vertical commitment

Vendor cap tables tie the product to a venture timeline. When the next funding round looks soft, the product pivots — from patient navigation to provider-side billing, from behavioral health to telehealth, from CCBHC vertical to consumer wellness. The tenant who built workflow on the original product is left holding the migration cost.

31%Healthcare SaaS vendors with a major pivot inside 24 months of Series Bcite

Cost when unaddressed: Tenant migration project; data export risk; lost configuration; regulatory re-certification.

Founder-funded by clinical fees; no venture timeline

Mental Wealth Solutions Inc. is funded by Matthew Sexton's PLLC clinical practice fees. There is no venture cap table. There is no Series B clock. The product cannot pivot away from CCBHC / FQHC / dialysis / VA-affiliated patient navigation because the founder's own clinical caseload runs on the same vertical. The tenant inherits the same vertical commitment the founder has.

ZeroVenture funding rounds; product is funded by clinical feescite
Before31%Vendor norm — major pivot inside 24mo of Series Bcite
After0Pivot risk; vertical commitment matches founder's own caseload
Impact on pivot risk over vertical commitmentMethodology →

Methodology

How we measure

Founder credentialing, clinical setting count, instrument validation status, regulatory alignment per vertical, BAA chain coverage, and pivot-risk posture are reviewed weekly inside the Wednesday HIPAA gate ritual. Every claim on this page resolves to a primary source — LCSW licensure record, instrument validation paper, vendor BAA execution date, or regulatory citation. Claims that cannot be primary-sourced are removed from the page within the same review window.

What counts

  • LCSW licensure verified across NY / FL / ME / DE — current, in good standing, no public discipline.
  • Clinical setting count counts only direct LCSW practice with caseload responsibility — not internships, not shadowing, not advisory.
  • Validated instruments are scoped to those with peer-reviewed validation studies, ICD-10 / DSM-5 alignment where relevant, and citation traceability.
  • Regulatory alignment per vertical is scoped to SAMHSA CCBHC quality measures, HRSA UDS referral completion, CMS-required KDQOL-36 capture, and 45 CFR 164.312 / 164.316 audit controls.
  • BAA chain coverage means an executed Business Associate Agreement on file for every PHI-touching vendor before the vendor is integrated into the workflow.
  • Pivot-risk posture is anchored to the funding source — clinical fees from PLLC private practice, not venture capital, not customer ARR commitments tied to a funding round.
  • Wednesday HIPAA gate baseline means the gate script returned 43 PASS / 0 WARN / 0 FAIL on the most recent run.

What doesn't count

  • Marketing language that cannot be sourced to a clinical citation, regulatory citation, or vendor BAA execution record.
  • Outcome claims that are not anchored to a validated instrument with a disclosed cohort denominator.
  • Vendor benchmark claims (e.g., percentage of vendors with X) that are not sourced to KLAS / HIMSS / OCR / NASW or peer-reviewed industry research.

How we compare

Sourced from primary citations — not vendor marketing claims.

UsHealthcareCheckvsMBA-founded vendorvsBig EHR modulevsGeneric patient nav vendor
Founder is a licensed clinicianciteYes — LCSW, 14 years, 13 settingsNo — typically MBA / ex-bankerIndirect — clinical advisor on payrollMixed — sometimes a clinician co-founder
Founder runs the product on their own PHIciteYes — PLLC pilot-zeroNo — founder is not a tenantNo — vendor is not a clinical entityNo — disclosed during sales cycle
Funding source is clinical fees, not venture capitalciteYes — PLLC fees fund Inc.No — Series A / B / CNo — public-company P&L pressureNo — typically venture-backed
Validated clinical instrument libraryciteYes — PHQ-9 / C-SSRS / KDQOL-36 / Zarit / ISEL-12 / WEMWBSPartial — depends on tenant configurationPartial — instrument list inherited from EHRInconsistent — sometimes mis-implemented
Regulatory alignment per vertical at deployciteYes — CCBHC / FQHC / Dialysis scaffoldedNo — generic template, tenant configuresNo — EHR module, not vertical-alignedNo — tenant configures post-deploy
BAA chain enumerated pre-engagementciteYes — Google Cloud + AWS, list publishedPartial — sales cycle disclosureYes — but inherited from EHR vendorPartial — high-level statement only
Audit retention meets 45 CFR 164.316(b)(2)citeYes — 6-year retention floorVaries by vendor and tenant tierYes — inherited from EHROften configured post-sale
Wednesday HIPAA gate ritual run weeklyciteYes — 43 PASS / 0 WARN / 0 FAIL baselineNo — annual or ad-hoc audit onlyQuarterly internal audit typicalTypically annual internal audit
Vertical commitment matches founder's own caseloadciteYes — CCBHC / FQHC / Dialysis / VA-affiliatedNo — pivot risk per funding roundNo — broad EHR moduleOften pivot-prone
FHIR R4 first-class nativeciteYes — athenahealth integration live in productionRoadmap or partialYes — but inside EHR wallsPartial — REST shim, not FHIR-native

Frequently asked questions

Why is Matthew Sexton the right founder for HealthcareCheck?
Matthew is a Licensed Clinical Social Worker with 14 years of practice across 13 distinct clinical settings — substance abuse intensive outpatient, forensic ACT teams, dialysis psychosocial coordination, disaster case management, HIV program coordination, behavioral health program direction, and narcissistic abuse recovery. He has been the clinician carrying the caseload, the supervisor running the program, and the owner-operator of his own private practice. Every workflow assumption inside HealthcareCheck traces to a specific clinical failure he witnessed firsthand — not to a market-research interview.

Cited:nasw-2021-lcsw-licensure-standards, klas-2023-care-coordination-platform-tco

What clinical settings has Matthew worked in?
Substance abuse intensive outpatient, forensic Assertive Community Treatment (ACT) teams, dialysis psychosocial coordination, disaster case management, HIV program coordination, behavioral health program direction, narcissistic abuse recovery, and several behavioral health outpatient settings across NY / FL / ME / DE. The 13-setting count is direct LCSW practice with caseload responsibility — not internships, not shadowing, not advisory roles.

Cited:nasw-2021-lcsw-licensure-standards

Does Matthew still see clients?
Yes. Matthew Sexton, LCSW, PLLC is an active out-of-network telehealth private practice licensed in NY, FL, ME, and DE. The practice is the first production tenant of HealthcareCheck — Matthew uses the same instrument library, the same audit retention, and the same BAA-covered AI surface on his own private practice clients before any external tenant is onboarded. The clinical fees from this practice fund Mental Wealth Solutions Inc.; the platform is not venture-funded.

Cited:nasw-2021-lcsw-licensure-standards

Where is HealthcareCheck first deployed?
Matthew Sexton, LCSW, PLLC — the founder's own private practice — is pilot-zero. External tenant deployments target CCBHCs (SAMHSA-aligned quality measure capture), FQHCs (HRSA UDS-aligned referral completion documentation), dialysis centers (CMS-required KDQOL-36 capture), and VA-affiliated programs (veteran-specific SDOH navigation). Every external tenant inherits the same workflow primitives the founder runs on his own caseload.

Cited:odphp-2030-sdoh-framework, kdqol-36-validation-2007

What clinical instruments does the platform default to?
PHQ-9 (Kroenke 2001), GAD-7 (Spitzer 2006), C-SSRS (Posner 2011), KDQOL-36 (kidney disease quality of life with burden subscale intact), Zarit Burden Interview (caregiver burden), ISEL-12 (interpersonal social support), and WEMWBS (Warwick-Edinburgh Mental Wellbeing). Every instrument preserves its source-paper cutoff thresholds, severity matrix, and subscale structure. Mis-implementation is caught at weekly founder review — not after months of invalid data collection.

Cited:kroenke-2001-phq9-validation, posner-2011-cssrs-validation, kdqol-36-validation-2007

How is HealthcareCheck funded?
Mental Wealth Solutions Inc. is founder-funded. The funding source is Matthew Sexton's PLLC private practice clinical fees — not venture capital, not Series A, not bridge debt. There is no funding-round clock that forces a product pivot away from CCBHC / FQHC / dialysis / VA-affiliated patient navigation. The vertical commitment matches the founder's own caseload commitment; the tenant inherits both.

Cited:klas-2023-vendor-deploy-timelines

What gives MWS Inc. authority on dialysis psychosocial workflows?
Matthew has run dialysis psychosocial coordination as part of his 14-year LCSW practice. The KDQOL-36 (CMS-required for dialysis centers), Zarit Burden Interview (caregiver burden assessment), and pre-/post-transplant SDOH framework are clinical measures he has used directly with patients — not market-research artifacts. The for-dialysis vertical scaffolding inherits from this clinical experience, audited weekly against primary citations.

Cited:kdqol-36-validation-2007, zarit-burden-validation-1980

What is the relationship between Mental Wealth Solutions Inc. and Matthew Sexton, LCSW, PLLC?
Mental Wealth Solutions Inc. is the technology corporation that builds and licenses HealthcareCheck (and related portfolio products). Matthew Sexton, LCSW, PLLC is the founder's clinical practice. The PLLC is a separate clinical entity — it carries the licensure, holds the patient relationships, and bills clinical fees. Both entities are owned by Matthew Sexton. The PLLC is the first production tenant of HealthcareCheck. Funding flows from clinical fees (PLLC) into product development (Inc.).

Cited:nasw-2021-lcsw-licensure-standards

Founder thesis

Why this exists

I deploy the same infrastructure inside my own private practice before any external tenant onboards.

— Matthew Sexton, LCSW
I built HealthcareCheck because I was sitting in my own caseload watching patients fall through the cracks that the off-the-shelf tools were supposed to be catching. The dialysis patient who missed her appointment because no one coordinated transport. The CCBHC referral that nobody confirmed. The closed-loop documentation that took 45 minutes per patient because the workflow was designed by someone who had never run one. I am a Licensed Clinical Social Worker. I have spent 14 years across 13 clinical settings — substance abuse, forensic ACT, dialysis, disaster case management, HIV programs, behavioral health direction, narcissistic abuse recovery. Every workflow primitive in this platform traces to a specific Tuesday afternoon where I was the clinician carrying the bag and the existing tools failed. I deploy the same infrastructure inside Matthew Sexton, LCSW, PLLC — my own out-of-network telehealth practice — before any external tenant onboards. If the workflow does not work for me on a Friday at 5pm, it does not ship to a tenant on Monday. The funding comes from the clinical fees I bill. There is no venture timeline forcing a pivot. The vertical commitment is mine and it is the tenant's; we are running the same caseload reality together.

Matthew Sexton, LCSWFounder · Mental Wealth Solutions Inc.

Citations

  1. klas-2023-care-coordination-platform-tcoSee citations/klas-2023-care-coordination-platform-tco.mdx for primary source, DOI/PMID, and key statistics.
  2. klas-2023-vendor-deploy-timelinesSee citations/klas-2023-vendor-deploy-timelines.mdx for primary source, DOI/PMID, and key statistics.
  3. himss-2022-baa-execution-timeline-surveySee citations/himss-2022-baa-execution-timeline-survey.mdx for primary source, DOI/PMID, and key statistics.
  4. hhs-2013-omnibus-rule-baa-requirementsSee citations/hhs-2013-omnibus-rule-baa-requirements.mdx for primary source, DOI/PMID, and key statistics.
  5. hhs-45-cfr-164-312-technical-safeguardsSee citations/hhs-45-cfr-164-312-technical-safeguards.mdx for primary source, DOI/PMID, and key statistics.
  6. ocr-2024-hipaa-enforcement-statisticsSee citations/ocr-2024-hipaa-enforcement-statistics.mdx for primary source, DOI/PMID, and key statistics.
  7. nasw-2021-lcsw-licensure-standardsSee citations/nasw-2021-lcsw-licensure-standards.mdx for primary source, DOI/PMID, and key statistics.
  8. hl7-fhir-r4-2019See citations/hl7-fhir-r4-2019.mdx for primary source, DOI/PMID, and key statistics.
  9. aws-baa-2013See citations/aws-baa-2013.mdx for primary source, DOI/PMID, and key statistics.
  10. google-cloud-vertex-ai-baa-2024See citations/google-cloud-vertex-ai-baa-2024.mdx for primary source, DOI/PMID, and key statistics.
  11. kroenke-2001-phq9-validationSee citations/kroenke-2001-phq9-validation.mdx for primary source, DOI/PMID, and key statistics.
  12. posner-2011-cssrs-validationSee citations/posner-2011-cssrs-validation.mdx for primary source, DOI/PMID, and key statistics.
  13. kdqol-36-validation-2007See citations/kdqol-36-validation-2007.mdx for primary source, DOI/PMID, and key statistics.
  14. zarit-burden-validation-1980See citations/zarit-burden-validation-1980.mdx for primary source, DOI/PMID, and key statistics.
  15. isel-12-validationSee citations/isel-12-validation.mdx for primary source, DOI/PMID, and key statistics.
  16. wemwbs-validation-tennant-2007See citations/wemwbs-validation-tennant-2007.mdx for primary source, DOI/PMID, and key statistics.
  17. odphp-2030-sdoh-frameworkSee citations/odphp-2030-sdoh-framework.mdx for primary source, DOI/PMID, and key statistics.

Ready to close the gap?