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Summary
Product Usage: Canvas is utilized across medical and therapy teams for tasks such as medical note documentation, lab result management, controlled substance prescription, and support for both individual and group therapy notes.
Strengths: Canvas provides a high degree of flexibility through its APIs and SDKs, allows customization for a user-centric experience, and provides exceptional support from their team.
Weaknesses: The platform currently lacks granularity in workflows and does not fit well with the group notes typically used in behavioral health, although the company is working on these issues.
Overall Judgment: Despite some issues, Canvas is a reliable, bug-free tool that delivers on most needs and allows in-house feature-building. It was the right choice due to its high degree of customization, exceptional support, and straightforward pricing model.
Review
Today, we’re chatting about Canvas and how it’s used at your company. Before we begin, could you give a brief overview of the company and your role there?
Our company delivers comprehensive outpatient care for individuals with substance use disorders, from initial detoxification to ongoing medication management and long-term therapy. We incorporate a model of peer support that offers lifelong engagement, acknowledging the chronic nature of substance abuse. As the COO and cofounder, I manage our daily clinical operations, product and engineering.
What drove you to look for a product like Canvas, and what were some of the core requirements you used during your search?
We were looking for an EMR product tailored to a startup like ours, and we prioritized API-first design so we could do a lot of customization. We also wanted to reduce context switching for our staff, so they could perform most tasks within a single system. Canvas stood out due to its robust API and SDK, allowing seamless integration and adaptability. Key criteria included comprehensive features such as pharmacy, labs, and payment processing, in addition to the flexibility to create our own workflows and a patient app that could ensure that data would be centrally accessible for decision-making and task completion.
Did you consider other vendors?
We first looked at tools designed for substance use–focused care, which included more traditional inpatient-based systems as well as configurable platforms requiring extensive customization or significant IT resources. We evaluated providers like Kipu in this category. As we extended our search to include broader behavioral health solutions, we encountered limitations in configuration capabilities.
When none of those tools worked for our specific use case, we moved on to general healthcare tools, including Healthie and Canvas. We ultimately chose Canvas due to the relationship developed with their team and its straightforward pricing model. Canvas offered a clear fee for each of our production and staging environments with a cap of 1,000 monthly active patients, and there were transparent costs for additional patients. Healthie’s pricing was more complex, involving various add-ons and API access fees that resulted in higher expenses and a more challenging cost management. Given the stringent documentation and regulatory requirements specific to behavioral health and substance use, we needed a system that allowed our clinical team to craft custom questionnaires and workflows, and Canvas was the better fit there too.
How was the sales, onboarding, and implementation process?
The sales and implementation process with Canvas was exceptional. The team was transparent about their limitations and assisted us in leveraging the APIs and SDK for extensibility. The sales cycle involved supportive, honest discussions, providing a realistic view of their product roadmap. Despite some features being 18-24 months out, they helped us find interim solutions, particularly for our regulatory needs in substance abuse care. Despite the lengthy regulatory process we had to navigate, Canvas offered unwavering weekly support, significantly aiding in our problem-solving efforts during implementation. Overall, it was a very positive experience, with clear communication and strong support.
What are your current use cases for Canvas?
We utilize Canvas across our medical and therapy teams. For medical purposes, we use it for typical tasks like documenting medical notes, managing lab results, and prescribing, including controlled substances. Therapy activities are more complex, especially in substance abuse intake, due to comprehensive regulatory requirements from entities like state governments and the Joint Commission. Canvas is used to support both individual and group therapy notes within our therapy workflows.
We don’t use Canvas for billing since behavioral health and substance abuse billing is highly specialized; we have a third party handle that.
We’ve also integrated an AI transcribing tool for enhanced efficiency. Additionally, our client-facing mobile app is deeply integrated with Canvas, leveraging FHIR APIs. This allows us to incorporate education completion records, questionnaire responses, and other client information directly into the structured medical record that Canvas creates.
What do you see as the strengths and weaknesses of Canvas?
Canvas provides significant flexibility through its APIs and SDK, enabling customization and a user-centric experience. However, there’s a need for additional granularity in the workflows to ensure that medical and clinical teams see only the relevant aspects, which is a current weakness but I believe is being addressed in the forthcoming API updates.
Canvas was originally designed for primary care with a one-to-one patient note relationship, which doesn’t fit well with the group notes typically used in behavioral health. To resolve this, we developed an external single-page application, utilizing the API for seamless group note creation and signing, avoiding the need to revert to Canvas for these actions.
The support from the Canvas team is a significant advantage. The proactive post-implementation engagement, including regular discussions with an account manager and rapid product and engineering support, enhances the platform’s flexibility. Despite the need for better documentation of this flexibility, the Canvas team is responsive and quickly provides solutions to any issues encountered.
How reliable and bug-free is Canvas?
It has been very reliable and largely bug-free. Over the past year, we’ve encountered only a single issue related to a bug fix, which was addressed swiftly, and there have been no concerns with stability or reliability during that time.
How has the API process been for you?
Our goal was to create a patient-facing mobile app that seamlessly integrated with the EHR system, particularly for telehealth services. We find significant value in providing mobile educational content and questionnaires for behavioral health, including standard tools like PHQ-9 and GAD-7, alongside tailored content for things like monitoring cravings. Ensuring this data flows back into the EHR in real time enables immediate alerting and task creation. This establishes robust feedback loops, keeping the clinical team informed and engaging patients, who see their input is being actively utilized.
Additionally, we’ve developed single-page web applications to handle specific tasks that Canvas doesn’t cover, allowing us to document directly back into the EHR, keeping the data structured. More recently, we’ve started integrating AI-enhanced transcription for clinical notes. The FHIR capabilities, combined with Canvas’s customizable questionnaires, facilitate the structuring of patient responses, allowing us to easily structure that data.
Have you integrated Canvas with any other vendors or software?
Our integration strategy doesn’t rely on a broad suite of pre-existing integrations but on more customized connections using Canvas’ webhooks and APIs. For instance, we’ve connected to LeadSquared for CRM functionalities, particularly for handling initial patient intake. We’ve also integrated Upheal, an API-centric AI tool tailored for behavioral health, which we find highly effective.
How has the account management and support been?
We have every-other-week calls with our account manager, mainly focused on future plans and API usage. Currently, we’re also engaged in implementation and beta testing review with Canvas, which has given us greater access to account management. We seldom address immediate issues in these calls because the support team is responsive, typically replying within one to two hours. Urgent matters are usually resolved on the same day. While complex technical questions about our development roadmap may take a couple of days, the effective account management and support contribute significantly to our ability to utilize the product fully and are important factors in our decision to renew.
Do you feel you made the right decision in choosing Canvas?
Yes, choosing Canvas was the right decision for us. No solution is perfect, but at its price point, Canvas delivers on most of our needs. It has also allows us to build our own features that integrate structured data directly into our EHR system, which compensates for any features it may lack.
What do you see as areas of growth for Canvas?
Primarily at the product feature level. We’ve established strong relationships with our vendors, especially since we tend to partner with early-stage companies. Our goal is to be involved with their development roadmaps and even influence them when possible. Unlike some partners who rapidly add features without a clear plan, Canvas is strategic in their approach. They meticulously structure and rebuild their offerings, which prevents their products from becoming overly complex and unwieldy. A key example of their strategic approach is the recent overhaul of their API suite, which significantly enhances our capabilities as a customer. It opens up opportunities for us to develop specialized features that serve unique needs or particular clinical specialties.
What advice would you give to someone who is looking for a product like Canvas?
If you’d like to build an integrated stack, prioritize API-first solutions to ensure smooth integration with your existing systems. Additionally, focus on establishing a strong relationship with the provider’s team. You want a supportive dynamic, free from aggressive sales tactics or confusing pricing schemes. A good partnership with the vendor is a valuable investment.