Truer World LLC · Wilmington, Delaware

Who is Truer World?

We are a physician-led company that builds the systems primary care needs to give every patient the care the evidence says they should receive: prevention, chronic care and lifestyle medicine, delivered completely and sustainably.

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Health is a fundamental human need

Health is the ground a life is built on. It shapes how long we live, and how fully: our work, our families, our capacity to serve the people around us. Every community deserves care that protects it.

Much of the disease that shortens and diminishes lives is preventable or can be reversed. How people eat, move, sleep, rest and connect with others is real medicine, backed by decades of research. Primary care is where that medicine belongs. Today, too often, it cannot happen there.

Lifestyle is medicine

We treat the foundations of health as first-line care, not an afterthought. Lifestyle medicine organizes them into six pillars:

Why "Truer"

• We follow the evidence. Scientific truth comes before fashion, marketing or habit, even when the evidence is inconvenient.
• We report what actually happened. Not what a dashboard assumes. We start from the visit and follow it to the outcome and the payment.
• We tell people the truth. Patients and practices deserve honest answers about what works, what it costs and what we got wrong.
• We are independent. No sponsors, no kickbacks, no pharmaceutical partnerships. Our only incentive is better health.

No physician can do it alone

Modern medicine knows more than ever about how to prevent and manage disease. That knowledge has grown faster than any one person can apply it. Researchers have repeatedly estimated how long a primary care physician would need to follow the guidelines for a typical panel of 2,500 patients. Every estimate exceeds a working day.

The 2023 estimate breaks down as 14.1 hours of preventive care, 7.2 of chronic disease care, 2.2 of acute care and 3.2 of documentation and inbox work. Sharing work across a team cut the physician's share to 9.3 hours, which still exceeds a working day.

The result is predictable: a landmark national study found that US adults received just 54.9% of recommended care.⁴ The lesson is not that physicians should work harder. It is that complete, guideline-based care is a team effort, and the team needs information systems that carry the load: remembering what each patient is due, tracking it until it is done, and checking the work so nothing falls through.

What full support looks like

• Every patient's due care is visible, ranked and assigned before the visit, not discovered after it.
• Routine work is done by the system, so clinicians and staff spend their time on judgment and relationships.
• Everyone works at the top of their license: physicians, nurses, medical assistants and front-desk staff alike.
• Good workflows are followed because the system carries them, not because someone remembered.
• Outcomes are tracked, not just actions. An invitation sent is not care delivered.
• The practice keeps improving its own system, safely, as it learns what works for its patients.

Good care must also be good business

Primary care's finances and its patients' health are not naturally aligned. Much of the most valuable work, such as prevention, care management, lifestyle counseling and follow-up between visits, is paid only when it is captured, documented and billed precisely. A practice that cannot capture that revenue cannot afford to keep doing the work. Financial health is not a distraction from the mission; it is what keeps the doors open.

We learned this in our own practice. After a billing platform change, every vendor report looked clean. When we followed each visit to the bank, we found $482,000 payable across 4,848 claims that no dashboard had shown. A services audit in our own practice found that only 4.1% of eligible covered services had been delivered (4,821 of 116,433). Read what we found →

Three foundations we build on

1. Complete, evidence-based care. Every patient receives the prevention, chronic care and lifestyle medicine the evidence supports, with the system tracking each need until it is met.
2. Billing efficiency and fidelity. Every visit is matched to a bill, a claim and a payment. Care that was delivered is documented accurately and paid in full. Our target: under 1% of earned revenue lost between the visit and the bank.
3. Operational excellence. In most practices, the workflow on paper and the workflow on a busy Monday are different things. We build systems that make the right workflow the easy one, and show where it is not being followed.

From one practice to the world

We start in one primary care practice in Wilmington, Delaware, where every tool we build is used on real patients before anyone else sees it. The problem we are solving is universal: wherever there is primary care, there is more evidence than time. We build so that what works in one practice can serve communities anywhere, including those far from large health systems. Better population health, one well-supported practice at a time.

Health is a fundamental human need. Delivering it fully should not depend on a physician finding 27 hours in a day.

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References

1. Yarnall KSH, Pollak KI, Østbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? Am J Public Health. 2003;93(4):635–641. doi.org/10.2105/AJPH.93.4.635
2. Østbye T, Yarnall KSH, Krause KM, Pollak KI, Gradison M, Michener JL. Is there time for management of patients with chronic diseases in primary care? Ann Fam Med. 2005;3(3):209–214. doi.org/10.1370/afm.310
3. Porter J, Boyd C, Skandari MR, Laiteerapong N. Revisiting the time needed to provide adult primary care. J Gen Intern Med. 2023;38(1):147–155. doi.org/10.1007/s11606-022-07707-x
4. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635–2645. doi.org/10.1056/NEJMsa022615