ConsultOS, the operating system for behavioral-health clinics. The context of care lives between sessions. Althio builds it.
Mariyam Vidhu Vijayan · Rustum Usman
Mariyam spent five years building and running an online therapy practice serving 20,000+ working professionals. The pattern she could not ignore: clients did their best work inside the session, then went quiet for a week. The therapy was sound. The space between sessions was empty.
That gap, not the quality of clinicians, is where outcomes are lost.
Coverage retrenchment pushes behavioral health out of reimbursed channels.
Clinician headcount grows while utilization per clinician falls.
Large platforms absorb supply without fixing continuity of care.
Patients increasingly open up to AI before they ever reach a clinician.
lost every year to no-shows by a typical 10-clinician practice. A cash problem a clinic can identify in its own numbers within a week, not a quarter.
Outpatient therapy no-show rates run 18–30%. Every empty hour is clinician capacity already paid for and never recovered.
One client, month 4. Node size is current weight. Thin dashed links are context that has not been reinforced.
Every client is a weighted context graph, not a case file. Client context carries weight as per current relevance. The AI does not summarize. It connects.
Client ↔ therapist sessions, transcribed. Client ↔ AI conversation, continuous. Both feed the same graph.
Watch data, phone usage, and other passive signals add a third stream no session transcript can capture.
Every conversation makes the next one better. The graph is the asset, and it cannot be replicated by an episodic competitor.
This is what recovers the $300K. The same context that compounds into a moat is what keeps a client engaged through the week — and showing up on Thursday.
The hybrid human-therapy + AI-support model is corroborated by published clinical literature (Noto et al., Journal of Technology in Behavioral Science, 2026).
Independent and group behavioral practices: big enough to feel the no-show loss, small enough to adopt without a hospital procurement cycle.
We do not enter through CoCM (a primary-care instrument) or DMHT codes (~$20 per 20 minutes, gated behind FDA device clearance). Clinics pay directly for recovered attendance and capacity, the same cash motion that works internationally.
Midpoint annual contract value about $92K.
A low single-digit share of the national sellable count. Market size is not the binding constraint.
clinics per metro across 387 US metros. No payer in any single market has to notice us.
clinics in a large metro, so $100M arrives from four or five of them, as a network a payer cannot route its members around.
Same revenue, a different company. Density is what stage 1 trades for stage 2: clinic cash buys concentration, and concentration buys payer distribution.
US psychologists in active discovery, pre-launch
chain opportunities in pipeline: a large Middle East hospital group and a 17-location clinic chain
customer live: our own clinic operates the product daily, the proof and the reference
mental health has been the top-funded digital-health indication, seven years running