Recall flattens the curve
A patient who improved for six weeks and then slid back reports "about the same." The pattern that would have told you the estradiol patch needed a step up never reaches the note.
Cost: a wasted 12 week titration cycle
For menopause and midlife clinics
Every symptom score captured between visits, so hormone therapy decisions rest on data instead of recall
Your patients score vasomotor, sleep, mood and genitourinary symptoms on a schedule you set, from a link that opens in one tap. You walk into the room already holding twelve weeks of trend.
- Used in 214 US practices
- BAA signed, encrypted US hosting
- First cohort live in one afternoon
The gap between visits
You titrate on a story the patient reconstructs in the waiting room
Twelve weeks pass. She arrives, you ask how the flashes have been, and she gives you an honest average of a season she cannot really remember. That answer decides a dose.
Paper diaries come back empty
The printed grid goes into a purse and returns unmarked, or it returns full and nobody has time to transcribe it. Either way the visit starts from zero.
Cost: 9 minutes of a 20 minute follow up
Your notes cannot answer a payer
When a plan questions continued coverage of a compounded or brand product, narrative charting is thin evidence. Scored, dated instruments are not.
Cost: appeals that take 3 to 5 staff hours
Patients quit therapy in silence
Discontinuation usually happens in month two, between appointments, over a side effect nobody heard about. You find out at the visit she does not book.
Cost: roughly $1,400 in annual value per lapsed patient
How a scoring round runs
Four steps, and none of them land on your evening
You configure the protocol once. After that, the round runs itself and arrives back as something you can read in under a minute.
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Pick the instruments and the cadence
Start from the Menopause Rating Scale, the Greene Climacteric Scale, a hot flash frequency and severity count, PSQI sleep items and a genitourinary short form. Add your own items. Set the rhythm per protocol: weekly for the first month on therapy, then every three weeks.
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The patient scores from a link, not an app
She gets a text or an email at the hour you chose. The link opens in her browser, no password, no download, no account. Twelve items take about ninety seconds, and she can finish on a phone in a parking lot.
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Scores chart themselves against the dose timeline
Every submission lands on a single trend view with therapy changes marked on the same axis. You can see the week the transdermal dose went to 0.075 and what happened to night sweats in the fourteen days after.
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A one page summary is waiting before the visit
The morning of the appointment, PauseNotes writes a plain language summary: what moved, what did not, which items she flagged as worse, and any free text she left. Paste it into the note or attach the PDF.
What is inside
Built around the way a midlife visit actually goes
Six things the software does that a spreadsheet, a portal message and a paper diary together still do not.
Validated instrument library
Menopause Rating Scale, Greene Climacteric Scale, PSQI sleep items, PHQ-9, GAD-7 and a genitourinary syndrome short form are scored to their published rules. You can add clinic specific items without breaking the validated subscale totals.
Dose timeline overlay
Every prescription change you log drops a marker on the same chart as the symptom curve. Comparing the eight weeks before and after a route change from oral to transdermal takes one glance, not a chart review.
Pre visit summary sheet
At 7 a.m. on appointment day the summary lands in your queue: subscale deltas, the three items that worsened, adherence gaps and her own words. Your medical assistant can print the stack for the day in one action.
Side effect and safety flags
Unscheduled bleeding, new severe headache, calf pain and breast changes are asked as explicit yes or no items and route straight to a flagged queue. Nothing important waits in an inbox for someone to notice it.
One reminder, then it stops
A single follow up goes out 48 hours after a missed round, at an hour you choose, in English or Spanish. Patients are not nagged, and your completion dashboard shows exactly who to catch at the front desk.
Panel level reporting
Filter your whole panel by instrument, therapy route and time on treatment to see which protocol is moving scores fastest. Group Practice accounts can compare sites without exposing individual patient records across locations.
What practices measure
Numbers our clinics report after two quarters
Averages across 214 practices using PauseNotes for at least six months, measured against their own baseline in the quarter before they started.
81%
Median completion rate
No app, no login and a ninety second questionnaire is why. Practices that add a single sentence about the link at the end of the visit run closer to 88 percent.
9 min
Saved per follow up visit
The history reconstruction that used to open the visit is already on the summary sheet. Clinicians spend that time on the decision instead of the recap.
34%
Fewer month two dropouts
Side effect flags surface in week five instead of at a cancelled appointment, so a route change or a dose adjustment happens while the patient is still on therapy.
2.4x
Faster prior authorization appeals
Dated, scored instruments with a therapy timeline attach directly to the appeal. Staff report the packet takes about forty minutes instead of most of a workday.
Scope, stated plainly
What PauseNotes does, and what it deliberately leaves alone
You have been sold enough software that promised the whole clinic. This one does a single job and stays out of the way of the rest.
It does the between visit record
Scheduling the rounds, collecting the scores, holding the therapy timeline, flagging the safety items and writing the summary you read before you walk into the room. That is the entire job, and it is built to do it without a single click from you after setup.
- Protocols per therapy route and per time on treatment
- Automatic scoring to published subscale rules
- Bilingual patient messaging in English and Spanish
- Exports that a payer or a colleague can read
It is not your chart, your billing or your inbox
PauseNotes writes nothing back into your electronic health record without you, holds no claims, does not message patients about anything other than the scoring round, and never becomes a second place your staff has to check for clinical messages. It hands you a document and stops.
- No prescribing, no e-prescribing, no clinical advice
- No patient chat channel your team has to staff
- No advertising trackers on the patient facing link
- No lock in: your full history exports on request
- No second inbox for your staff to monitor
- No per patient fee, ever, at any panel size
Good fit
A menopause or midlife practice with a defined titration protocol and follow up intervals of six weeks or longer. Cash pay, insurance and hybrid panels all work the same way.
Poor fit
A single visit consult service with no follow up, or a practice that wants a full patient portal with messaging and billing. We will tell you that on the call rather than after the invoice.
Moving from paper
Bring your current diary sheet to the demo. We rebuild it as a scored instrument during the session, and your existing questions keep their wording so patients notice nothing but the format.
From the clinics
Clinicians who stopped guessing at the twelve week mark
Three practices, three different panel sizes, the same complaint about visit histories before they started.
"I used to open every follow up with five minutes of archaeology. Now I open the summary, see that her night sweats fell from 6 to 2 but her sleep score barely moved, and we spend the visit on the sleep."
"The bleeding flag caught a patient in week three who would absolutely have waited until her next appointment to mention it. That alone paid for the year. My medical assistant loves that the reminders stop after one."
"We fought a payer for six weeks over continued coverage. I exported eighteen weeks of scored instruments with the dose timeline, sent it once, and the denial was overturned in nine days. That is the whole argument for structured data."
- 214
- US practices sending rounds every week
- 1.9M
- Symptom scores recorded since 2023
- 4.8 of 5
- Average clinician rating in our annual survey
Pricing
Priced per clinician, never per patient
Your panel can double without your invoice moving. Every plan includes the full instrument library, the summary sheet, the safety flag queue and a signed business associate agreement.
Solo Clinician
$59 per month
One prescriber running her own panel, with or without a part time medical assistant.
- Unlimited patients and scoring rounds
- Full validated instrument library
- Dose timeline overlay and trend charts
- Pre visit summary sheets and PDF export
- Safety flag queue with email alerts
- Email support answered within one business day
Clinic
$129 per month
Up to five clinicians plus unlimited front desk and medical assistant seats.
- Everything in Solo Clinician
- Shared protocols across the clinical team
- Role based access for non clinical staff
- Completion dashboard by clinician and by cohort
- English and Spanish patient messaging
- CSV and document export to Elation, Athenahealth and Charm
- Onboarding session and protocol build with our team
Group Practice
$269 per month
Up to twenty clinicians across multiple locations under one administrative roof.
- Everything in Clinic
- Multi site structure with per location permissions
- Panel level protocol comparison reporting
- Quarterly outcomes report for your board or payers
- Custom instrument authoring with scoring rules
- Named account contact and priority support
Switching tiers takes effect on the next invoice, and moving up mid month is prorated in your favor.
Every plan is billed monthly in US dollars and can be cancelled at any time from your account screen. No setup fee, no annual contract, no per patient charge.
Questions clinicians ask us
The six things you will want settled first
Pricing is per clinician, not per patient, so a growing panel never changes your bill. Solo Clinician is $59 per month for one prescriber and unlimited patients. Clinic is $129 per month and covers up to five clinicians plus your front desk staff. Group Practice is $269 per month and covers up to twenty clinicians across multiple sites with pooled reporting.
Most practices send their first scoring round the same week they sign up. Setup is choosing which validated instruments you want, setting the cadence for each protocol, and pasting your clinic name and reply address into the message template. Practices moving from paper diaries usually spend an extra hour deciding which of their homegrown questions to keep. We run a sixty minute working session with your lead clinician and your medical assistant to get the first cohort live.
Patient responses are stored encrypted at rest in United States data centers and encrypted in transit. Access is scoped by role, so a front desk user can see whether a questionnaire was completed but not the answers. We sign a business associate agreement with every practice before the first patient link goes out. Audit logs record every view, export and deletion, and you can purge a patient record permanently on request.
It does neither. PauseNotes sits alongside the chart and produces a summary you paste, print or attach as a PDF into the encounter note. We support direct export to Elation, Athenahealth and Charm through their document endpoints, and every account can pull a CSV of raw scores. Practices on systems we do not connect to yet copy a formatted block into the note in about ten seconds.
Every plan is billed monthly and you can cancel from the account screen at any time without calling anyone. Cancellation takes effect at the end of the current billing period and we do not prorate or charge an exit fee. Before you go you can export the entire history as CSV and as per patient PDF summaries. We hold the account in read only mode for thirty days in case you change your mind, then delete it.
They do, at a rate that surprises most clinicians. Across our practices the median completion rate is 81 percent, because the link opens in a browser with no app to install, no password and no account to create. A round of twelve items takes about ninety seconds and the reminder goes out once, not four times. Patients who prefer paper can be scored by your medical assistant during the rooming interview and the entry lands in the same chart.
The Midlife Clinic
What we publish for clinicians running a menopause practice
Our magazine works through the operating questions behind this specialty: what an hour of your time has to earn, what the label obliges you to say, and what keeps a patient on therapy past month two.
Talk to us
Tell us how your follow up visits run today
We will show you a live account with a sample panel, then build one protocol against your actual titration schedule while you watch. Thirty minutes, no slide deck, and you will know by the end whether this fits your clinic.
- Every message about symptom scoring or a titration question is answered inside one business day, most often before the first clinic session ends.
- The business associate agreement is signed before any patient data moves.
- Bring one patient story and we will show you what the chart would have looked like.
No patient information belongs in this form. If you would rather write directly, email jimenezjulien42@gmail.com and a person answers.
PauseNotes is written, built and maintained by Jimenez Julien, who works directly with the menopause clinicians who use it. Read how the product is developed and what he is accountable for.