Add telehealth to your practice without replacing your EHR

Licensure follows the patient, not the clinic

A clinician must generally be licensed in the state where the patient is physically located at the time of the visit, not where the practice sits.

• As of September 2026 the Interstate Medical Licensure Compact offers an expedited path to separate licenses in roughly 43 member states, and the Nurse Licensure Compact covers most RNs and, in a growing number of states, APRNs.
• Neither is a single national license.
• Orbit Intake captures patient location at every visit and routes to a clinician licensed there, whether that is your own team or the network.

Synchronous versus asynchronous, by state

Most states allow a clinician to establish a patient relationship and prescribe by store-and-forward questionnaire for suitable conditions, but a minority still require a real-time audio-video encounter for an initial visit or for any prescription.

Texas, Arkansas and Mississippi are commonly cited examples, and some states restrict asynchronous care to specific settings or specialties. Your practice decides which conditions are appropriate for async care; the platform enforces the state rule so a patient in a video-only state is never routed to a questionnaire-only path.

Controlled substances and the DEA telemedicine window

Prescribing a controlled substance without a prior in-person exam is currently possible under DEA and HHS telemedicine flexibilities, extended through December 31, 2026, with a permanent rule and a proposed special telemedicine registration still pending as of September 2026.

Every controlled prescription must be issued for a legitimate medical purpose by a DEA-registered clinician, and most states now mandate electronic prescribing of controlled substances. OrbitRx handles EPCS with two-factor identity proofing so your clinicians can prescribe Schedule II through V through the same channel as everything else.

Payer-billed telehealth and the practice's own contracts

Under the Consolidated Appropriations Act of 2026, most Medicare telehealth flexibilities, including audio-only visits and home as an originating site, run through December 31, 2027.

• Commercial and Medicaid coverage varies by state.
• When a practice bills a payer for a telehealth encounter, it does so under its own NPIs, tax ID and contracts; MyOrbitHealth is the technology and workflow layer and does not bill payers or set coding.
• Cash-pay programs run on the storefront with the practice as merchant of record.
• Your billing team decides which visits go where.

Compounded medications and pharmacy law

A 503A compounding pharmacy may fill a patient-specific prescription for a named patient and ship it to that patient; it cannot supply office stock, which requires an FDA-registered 503B outsourcing facility.

• Compounding of drugs on the FDA shortage list has tightened since the GLP-1 shortages were declared resolved in late 2024 and early 2025.
• As of September 2026, a practice that prescribes compounded products should expect the pharmacy to require a documented clinical rationale.
• OrbitRx routes what your clinician writes to a LegitScript-certified pharmacy and leaves the decision with the prescriber.

HIPAA, the BAA and the record in two systems

Any vendor that touches PHI on your behalf is a business associate and needs a BAA.

• Every MyOrbitHealth contract includes one, and the platform is SOC 2 Type II audited and HITRUST-aligned.
• The practical question for a practice is how two systems share a record: OrbitOS holds the telehealth encounter, and the API, webhooks and SDK push a copy into your EHR so the chart stays complete for payers, audits and continuity of care.
• Retention, release and breach obligations still sit with the covered entity, which is your practice.

Orbit Intake for asynchronous visits

Condition-specific questionnaires with history, medications, allergies, photos and identity verification, built to the protocols your clinicians approve.

• Orbit Intake screens for eligibility and red flags, applies state rules on visit modality, and delivers a structured case to the clinician queue.
• A follow-up or refill request takes the patient minutes; the clinician reviews a summary rather than a transcript.
• Video is available when the state or the case requires it.

OrbitRx: EPCS e-prescribing to compounding and retail

OrbitRx sends every prescription through Surescripts to a LegitScript-certified network of 503A compounding pharmacies and retail pharmacies, with cold chain shipping for injectables and temperature-sensitive products.

• Controlled substances go through EPCS with two-factor identity proofing.
• Compounded hormone therapy, GLP-1 support products, dermatology, hair and sexual health formulations route on the same rails as a retail antibiotic.
• Medication passes through at 0% markup, and the practice never handles product.

Orbit Labs, drawn three ways

Your clinician orders a panel.

• The patient collects it as a Quest or Labcorp walk-in with an order slip, a Tasso at-home kit shipped and returned by FedEx, or a mobile phlebotomy visit.
• Results route back to the ordering provider, who reads them into the plan, and to your EHR through the API.
• Your storefront can also carry a patient self-order lab catalog for wellness and screening panels; a licensed provider still signs each order and reviews each result.

Provider Network for overflow, after-hours and new states

2,400+ board-certified MDs, DOs, NPs and PAs across 38+ specialties, licensed in all 50 states, credentialed to NCQA standards with primary-source verification and monthly OIG and SAM screening.

Use them for evenings and weekends, for a state where you have patients but no licensed clinician, or for a new cash-pay program you want to test before hiring. They work to your protocols, respond in under six minutes on average during business hours, and coverage runs 24 hours.

API, webhooks, React SDK and MCP server beside your EHR

The REST API and webhooks push encounters, prescriptions, lab orders and results out of OrbitOS as they happen, so your integration team or EHR vendor can write them to the chart.

• The React SDK drops intake and scheduling into a patient portal you already run.
• A public MCP server lets internal tools and AI assistants query program state.
• Practices without an integration budget use OrbitOS as a side panel and reconcile to the EHR manually; the API is there when you are ready.

Branded storefront, app and OrbitOS

For cash-pay programs, a storefront under your brand with checkout and subscriptions, and a native iOS and Android app for refills, messaging and results.

OrbitOS is the operator console: encounter queues, refill approvals, lab status, pharmacy tracking and the audit trail. Managed LegitScript certification is included for practices that market prescription programs online: we prepare, file and manage your application through approval, typically days once filed, with the decision resting with LegitScript.