In 45 comprehensive assessments at Texas Center for Lifestyle Medicine, Zenara Assess identified findings that years of standard care had missed. This page shows you the evidence — from published research to real clinical outcomes.
8–10 clinically relevant conditions surfaced.
vs. 2.8 in published benchmarks for standard psychiatric evaluations.
Bipolar unmasked. Trauma surfaced. This is what we found.
Clinicians diagnose. Assess surfaces conditions, patterns, and root causes for their review.
HOW WE THINK ABOUT PROOF
Proof isn’t a slide deck. It’s what holds up when someone actually looks.
We didn’t build Zenara from theory. We built it from ten years of trying to practice good psychiatry inside systems that fight you at every turn—and from watching what actually helps patients get better versus what just generates clicks and compliance checkboxes.
So when we talk about proof, we mean three things:
Published evidence. Measurement-based care works. Team-based models work. Comprehensive assessment changes trajectories. We didn’t invent these ideas—we built infrastructure to make them practical.
Real clinical practice. What works in a study doesn’t always survive contact with a 15-minute visit, an overwhelmed care team, and a payer who doesn’t understand what you’re billing. Our workflows come from a practice that has to function every week, not from a whiteboard.
Clinical validation. We’ve applied structured evaluation rubrics to real assessments and shown that Assess surfaces what standard intake misses. We have case documentation. We have clinician and patient feedback. We’ll show you our work.
What we won’t do is claim outcomes we haven’t measured. We’re not going to tell you “Zenara improves remission by X%” until we’ve run the studies to prove it. What we will tell you—confidently—is that comprehensive assessment, routine measurement, and reliable follow-through are prerequisites for better outcomes. That’s what Zenara makes routine.
If you want to see the evidence in detail, we can share de-identified examples, case packets, and methodology after a brief conversation. We’d rather show you than tell you.
Evidence behind the care models we support
Measurement-based care
Decades of data—including APA guidance and multiple meta-analyses—show that routine symptom measurement leads to better outcomes. Practices using measurement-based care see 50–75% higher remission and response rates versus usual care (Fortney et al., 2017; Guo et al., 2015).
Patients benefit from clearer goals and visible progress. Clinicians benefit from earlier detection of non-response and a shared language for supervision.
Team-based and care-management models
Collaborative care has a strong evidence base. The IMPACT trial and subsequent meta-analyses show that team-based models—primary care provider, behavioral health care manager, psychiatric consultation—more than double depression treatment response and remission versus usual care (Archer et al., 2012; Unützer et al., 2002).
These models underpin CoCM, BHI, and APCM. Zenara Assist supports them operationally—it doesn’t replace the clinical judgment at their center.
Why the stack matters
Understand.
You can’t treat what you don’t understand.
Root cause detection is the foundation of high-quality care. In our case studies, a patient’s “cognitive decline” was actually anxiety from profound social isolation. Another patient’s “treatment-resistant depression” was actually Bipolar II with undisclosed trauma. Standard intake would have missed both.
That’s what Assess is for: going deep enough that you start with the right picture.
Observe.
You can’t improve what you don’t measure.
Measurement-based care has decades of evidence behind it. When patients and clinicians both see where things stand, the right questions get asked, treatment matches reality, and outcomes improve. But most practices can’t make it work—too many forms, no trending, no actionable insights, no time.
That’s what Monitor is for: making measurement routine, not heroic.
Execute.
Understanding and observation are worthless without follow-through.
No clinician can do everything in a single visit—especially when care is continuous and life is complex. A clinician can form a view, reach agreement with the patient, and set a direction. But the plan has to actually happen: follow-up, coordination, outreach, course-correction. Without a system, that work becomes invisible heroics. With a system, it becomes reliable.
That’s what Care is for: making sure the plan doesn’t die in the inbox.
The synthesis
Understanding without observation is a guess. Observation without execution is data on a shelf. Execution without understanding is motion without direction. Most software offers documentation OR measurement OR coordination. Rarely all three—and almost never as one coherent system.
Zenara Assist is built as a continuous loop:
Understand
Observe
Execute
The baseline you set in Assess becomes a living signal in Monitor, which informs the priorities in Care. Nothing falls through because the system is designed as one thing. The whole is greater than the sum of the parts. That’s the Zenara thesis.
Assessment quality audit
Zenara Assess vs. published standards
We validated our assessment methodology against published standards for psychiatric evaluation quality. Here’s how Assess performs:
These aren’t cherry-picked results. They reflect what comprehensive, AI-assisted assessment achieves when deployed in real clinical settings. These benchmarks compare Zenara Assess to published standards for psychiatric evaluation quality — not to competing software products. Comprehensive AI-assisted assessment represents a new approach that goes deeper than standard intake processes typically allow. The comparison is to usual care as documented in peer-reviewed literature, showing the gap between what typically happens and what’s possible with the right tools and workflows.
| Metric | Literature Benchmark | Zenara Assess | Source |
| Clinically relevant conditions surfaced (avg) | 2.8 | 8-10 | Wallin et al., 2022 |
| APA evaluation domain coverage | 65% | 96-100% | VA SAIL program data |
| Suicide risk assessment completion | 75% | 92-100% | VA/DoD Clinical Practice Guideline |
| Social determinants coverage | 40% | 73-81% | Gold et al., 2017 |
| Validated instruments administered | <1 per visit | 5-6 per assessment | Fortney et al., 2017 |
Data from clinical partnership with Texas Center for Lifestyle Medicine (N=45 completed assessments) and Intuitive Psychiatry practice. Benchmarks represent typical performance in published psychiatric evaluation studies.
Methodology: We developed a structured evaluation rubric from published psychiatric assessment standards and applied it to assessments completed during integrated primary care validation. This is an audit of assessment quality and domain coverage—not a controlled outcomes trial. Clinicians remain responsible for diagnosis; Assess surfaces clinically relevant conditions and patterns for their review.
Built inside a working practice
Before Zenara was software, it was a way of practicing. For the last decade, I’ve used validated instruments on nearly every visit in my San Francisco practice—not as a research protocol, but because it changed how I worked. Non-responders surfaced earlier. Treatment plans adjusted sooner. I could see who was stuck versus who was making progress, instead of guessing.
The workflows encoded in Zenara Assist grew out of this lived practice experience, aligned with the broader MBC evidence base.
- More timely treatment changes when symptom scores plateaued
- Better ability to distinguish ‘life is still hard’ from ‘the treatment isn’t working’
- Clinicians feeling more confident that they were actually moving the needle
Clinical partnership: Texas Center for Lifestyle Medicine
At Texas Center for Lifestyle Medicine, an integrated primary care and lifestyle medicine clinic in Houston, Assess was deployed as part of their Assessment Clinic. Over three months, patients with combined mental and physical health challenges were referred for comprehensive evaluation.
”That challenged my belief system—that the only way you can really identify mental health challenges was with a qualified mental health practitioner. But that's not what we found whatsoever.
The AI is able to give me a chart of the patient's hemoglobin and blood pressure and highlight areas I should be looking at. What does that really do for us? It elevates the quality of our decisions because innately we have the knowledge to make decisions—we just need the data.
It no longer becomes cross-sectional—it becomes a high-definition look at the patient.
— Dr. Cheng Ruan, MDFounder, Texas Center for Lifestyle Medicine
What comprehensive assessment actually catches
Case 1: David, 72
Presented as: Memory decline, possible early dementia
Assess surfaced: Normal cognitive testing. Profound social isolation—lived alone on rural property, nearest family 1,500 miles away. “Memory problems” were actually attention deficits from chronic anxiety.
What changed: Diagnosis shifted from “rule out dementia” to adjustment disorder with anxiety. Treatment: community connection resources, not dementia workup. Within weeks, he attended his first social event in years.
Want detailed, de-identified case documentation? We’re happy to share more after a brief conversation. Get a Practice Checkup
Case 2: Clara, 35
Presented as: Treatment-resistant depression (PHQ-9: 23)
Assess surfaced: Positive bipolar screen she’d dismissed as “good symptom days.” History of hypomania—decreased sleep, rapid speech, reckless spending. Undisclosed 2020 sexual assault she’d never reported.
What changed: Diagnosis changed from Major Depressive Disorder to Bipolar II. Treatment shifted from antidepressants (potentially destabilizing) to mood stabilizers plus trauma-focused therapy. Fundamentally different trajectory.
What clinicians and patients experienced
What clinicians experienced
- Less time manually reconstructing patient stories; more time focusing on what actually drives suffering and what could help
- Fewer repeated questions—patients didn’t have to retell basic facts multiple times across sessions
- Clearer picture going into the first substantive session, whether in psychiatry, therapy, or primary care
- AI-assisted organization of patient information reduced the stress of manual data collation
”The AI-assisted assessment freed me from digging through notes and let me spend more of the session on exploration and planning, not transcription.
TherapistTexas Center for Lifestyle Medicine
What patients experienced
- Feeling that the assessment “asked the right things”—not just symptom checklists, but context about sleep, relationships, substances, work, and daily life
- Greater understanding of how different factors in their lives fit together
- For some patients, addressing upstream factors led to meaningful functional improvement within weeks
”It was the first time I felt like the whole picture of my life was being considered, not just my symptoms.
Patientage 72
Outcome example:
One patient referred mainly for physical disability was found to be struggling with severe social isolation, fragmented sleep, and high caffeine use. The resulting plan focused on sleep, movement, and reconnection. Within weeks, she transitioned from wheelchair to walker and began driving locally again—changes her medical team hadn’t expected.
Serious about regulatory and professional safety
Generative AI in mental health is a fast-moving space, and the regulatory landscape is evolving. Zenara Assess is intentionally designed and documented to operate as non-device clinical decision support (CDS) under current FDA frameworks: it supports clinician judgment without replacing it.
Internal validation of this architecture on a sample of outputs showed a substantial improvement in adherence to FDA non-device CDS criteria versus earlier versions. We maintain detailed documentation suitable for review by regulatory counsel and, if needed, the FDA.
Clinical first
Keeping outputs clinician-first and non-directive
Non-Myopic
Supporting multiple options rather than single ‘answers’
Clinical alignment
Ensuring generated summaries remain aligned with clinicians’ own documented evaluations
* If you’re a compliance, legal, or regulatory lead, we’re happy to discuss our approach in more depth in a dedicated conversation.
How we think about proof
We care most about whether patients get better, clinicians feel supported, and practices can sustain excellent care at scale.
If you’re considering Zenara, we expect you to ask hard questions. This page is one way of starting that conversation.
Want to see what this could look like in your practice?
Proof in the abstract is helpful. Proof in your own clinic is decisive. In a practice assessment, we'll look at your current workflows, service lines, and constraints, and explore whether Assess makes sense for you. Or start by reviewing our detailed case documentation.
Ready to talk? Get a practice checkup. Want to stay informed as Assess launches? Join the waitlist.
