I’m wrapping up a doctorate in clinical nutrition, and we were required to use the Living Matrix software for the clinical portion of our program. I wanted to share my thoughts after using the platform for three months, in case it’s helpful for others who might be considering it. For context, I’ve been a licensed nutritionist for 13 years, and I’ve just returned to part-time practice after a five-year break for kid-related reasons :). I almost exclusively work with clients virtually.

I am not associated with Living Matrix other than as a user, although as a student I did get a heavily discounted rate for the semesters we were required to use the platform, negotiated through the university.

What is Living Matrix?

Living Matrix is a “technology-based, clinician-designed functional medicine platform for practitioners to effectively evaluate patients, create personalized actionable care plans, and track superior health outcomes over time.”

Essentially, it’s an electronic form delivery/storage service, similar to but not exactly like an electronic medical record platform. Here’s the basic workflow:

Clinicians add new patients/clients manually by adding name, email and date of birth. Clinician selects intake forms to send to the client.
The LM system emails the client an invitation to join and a notification of the forms to be filled out.
Client creates their own username/password, logs in, fills in forms.
Practitioners can manually send a reminder if the forms are not filled out before the visit.
After the forms are filled in, the practitioner clicks a button to generate a “report” that calculates an MSQ score (IFM’s medical symptom questionnaire) and an IFM matrix and timeline. These are only visible to the practitioner.
During or after the visit, the practitioner can enter in session notes/chart either using a template or a blank form. There is a separate area to enter anthropometric data.
Practitioners can also fill in the “Functional Medicine Prescription” area with their recommendations relating to nutrition, stress, supplements, etc. LM has a variety of template recommendations based on partnerships with supplement companies, and clinicians can also choose to include handouts from the IFM.
The practitioner can generate a report containing the MSQ, timeline, matrix, intake responses, recommendations and/or any handouts that can be shared with the client.

The Good

Image by Bela Geletneky from Pixabay

The Living Matrix system automatically generates a really pretty timeline that helps contextualize the client’s story. This can help us put together pieces that have gone unnoticed, and it saves time in the initial session since you’ve already got very detailed start/end dates for most of the key experiences (if the client fills them out… see below).
The standard Living Matrix intake form is incredibly detailed (and time-consuming for clients). Some clients enjoy the process of putting the pieces of their medical history together as they fill out the form. Multiple clients said that just going through their history in such detail was helpful, and often doing so was the first time they’d thought about everything they’d been through in order.
The auto-generated IFM matrix – while it did need to be manually tweaked – was a helpful quick visual for identifying areas needing support.
I appreciated that validated Global Health Questionnaire was included in forms, could be used to track progress over time and was presented in graph format.
The “functional medicine prescription” form was helpful in organizing recommendations by type (diet, supplements, exercise, etc) and did offer the option to save/reuse commonly-made recommendations.
The support team was responsive. It was easy to talk/email with a person when I had questions or challenges.

What Didn’t Work Well for Me

Image by Michael Gaida from Pixabay

You’re not able to change questions on the forms. For me, this was the most pressing concern. The forms provided can’t be changed at all. You can’t add questions, you can’t edit them, and you can’t delete them. Some questions are awkwardly worded (e.g. one just says “Bone density?” with the option to check yes or no), and there aren’t questions about height and weight (see below). As someone who specializes in pregnancy and fertility, I typically gather very specific information in my intake forms (e.g. date of ovulation, signs of ovulation, days between ovulation and menses, etc.) Because I wasn’t able to add those questions to the intake form, I had to spend time during the initial visit asking about this, which gave me less time to spend on other key areas during visits.
You can’t add additional forms. Not only can you not change the questions on the forms, you can’t add supplemental forms to send to the client. The LM system doesn’t include informed consent or HIPAA forms, so if you want the client to read/sign these before their visit (or at all if you have a virtual practice) you’ll need to use a different system. As a practitioner, you can upload the signed forms into the client’s file, but you can’t have the client fill them in through LM. I found this highly inconvenient, as it meant clients had to juggle different logins and multiple platforms.
The forms were too lengthy and frustrating for clients. Depending on how much detail the client chose to include, the initial intake forms could take anywhere from 30-90 minutes to complete. Some questions are repetitive, and clients are asked to enter extremely specific dates – day, month, and year – for any health concern/diagnoses they’ve ever had. For example, one of the questions asks if you have experienced gas and the specific start and end dates. If you had your wisdom teeth out in 1992, the system insisted that you had to enter the specific month and day when it happened. Many clients found this frustrating and gave up or only entered a few conditions.
Living Matrix is not mobile-friendly. You and your client need to access it on a desktop or laptop. Also, the only browser that I could get to generate a report was Microsoft Edge (probably due to a setting on my own computer – no one else in my cohort had this problem – but tech support not able to resolve it).
The set-up is not designed for a virtual practice. There is no video communication software integration, which meant that if I wanted to work with people virtually, I had to have them create a separate account/login on a different platform for HIPAA-secure video conferencing. The intake form does not ask about height/weight at all, assuming that you’ll be taking these measurements in the office. Since you can’t add questions to the forms, you have to ask for this information in your first visit if you're seeing clients from a distance. If you recommend any supplements, you’ll need to provide info about where to get them as LM is not integrated with Fullscript or another platform for purchasing high-quality supplements. It also doesn’t include billing/invoicing or allow clients to schedule appointments directly.
There are no forms for pediatrics or other special populations. It only includes the IFM adult intake questionnaire and some supplemental forms. If you’ll be seeing a pediatric client, you’ll need to use a different software/intake form, or you can have a parent fill in the LM form even though it isn’t really appropriate for children.
The report generated for the client is very long and unwieldy. The timeline and matrix graphics are impressive, and the report looks very professional in terms of headings, font, etc. However, it can be VERY long depending on what you choose to include. Practitioners can’t re-order the sections of the report. The timeline and matrix are early in the report, while if you chose to share any of the IFM handouts those are added at the end. Some are dozens of pages long. The recommendations wound up in the middle of the report (e.g. one client’s recommendations were on pages 14/15 out of 25), meaning that they are relatively easy to overlook. I had a few clients who didn’t know I had sent recommendations because they were buried in the report.
Living Matrix is not really set up for non-physician practitioners. The default terminology centers those who can prescribe. The words “patient” and “prescription” are integral parts of the system, and there’s no option or setting to change these terms to “client” and “recommendation.” This potentially puts practitioners who are not physicians and/or who don’t have prescribing rights at legal risk.
Living Matrix compiles client data for their research initiatives. While this is interesting, I do have some concerns about exactly what data is being tracked and whether/how clients are consenting to this use of their data.

Living Matrix Review

the short version!

Pros

Creates fancy graphics and professional reports for clients
Auto-generates a medical history timeline
Support is solid
Can save recommendations for re-use later
Recommendations are organized nicely
Tracks progress over time on MSQ, Global Health Questionnaire

Cons

Can't edit forms or add new ones
Forms are long and challenging for some clients to complete
Not mobile-friendly
Uses "patient" and "prescription" (not great for non-prescribers)
Does not include forms for children or other special populations
Doesn't include features such as video conferencing, scheduling or billing

Conclusion:

This program may be useful for functional medicine practitioners who work with adults and have a largely in-person practice. The software is helpful and time-saving for those using a functional medicine approach in this context, particularly if time with the client is limited. Living Matrix fills a very specific role, and you'll need supporting platforms or programs to meet other needs in your practice such as scheduling, billing, and collecting informed consent/HIPAA forms.

For me, the cost ($129/month for a private practice or $1393 per year + $245 setup fee) and the limitations mentioned above mean that I do not plan to continue using Living Matrix in my own practice, as I need a more affordable and comprehensive software that offers secure video conferencing, customization of intake forms, and other practice management features.*

* In case you're wondering, I use Practice Better and love it. That's a referral link! You can also read my full review of Practice Better.

Thoughts? Add your comments here.

Thank you for this information! I’m starting my practice soon, and I would have greatly regretted this choice, as I plan on doing virtual coaching. Thank you also for the referral, because I was wondering what should I chose next? Looking into that now!

Camille says:
October 5, 2020 at 8:42 am
You’re very welcome! I’m glad it was helpful. I love Practice Better, but others that are popular include Healthie and Kalix. I hope you find something that’s a perfect fit.
Reply

Thank you for your review. I found the details of your review of the cons enlightening. Many times I thought to sign on with LM but for a number of reasons including the extremely lengthy and detailed patient data entry, I chose not to. It makes sense about the detail of day, month, year of past health events as it is needed to collect data for research. As well the standardization of questions. I agree that it is quite strange that there is no ht and wt question. With the other options of Nutrition Focused HIPAA compliant telehealth ready programs like HEALTHIE, KALIX, KAREO, chARM, SimplePractice and others, what led you to select Better Practice?

Thanks, this was very helpful

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Camille Freeman, LDN

Hi there! I'm a clinical herbalist and licensed nutritionist specializing in fertility and reproductive health. I mentor other practitioners who need help building and growing their practices, working with complicated clients and getting clinical hours. I'm also a professor in the Department of Nutrition at the Maryland University of Integrative Health, where I teach physiology, pathophysiology, and mindful eating. My pronouns are she/hers.

Review of Living Matrix