Healthcare

Production engineering at the velocity healthcare needs — and the compliance bar it demands.

HIPAA-compliant data platforms, FHIR-native integrations, secure PHI pipelines, AI for clinical workflows. We've delivered to Fortune 500 health systems, regional networks, and Series-B-through-IPO digital-health vendors. Every engineer on a healthcare engagement understands the regulatory perimeter before they write a line of code.

What's at stake

Healthcare engineering is uniquely demanding. The data is sensitive, the regulators are serious, and the patient outcomes are real. Mistakes don't just cost money — they affect care.

HIPAA + HITRUST + state laws

The federal floor isn't the ceiling. California CMIA, New York SHIELD, Texas HB 300 — we ship systems that handle the strictest applicable rule, not the easiest to meet.

FHIR R4 + payer mandates

CMS interoperability mandates aren't optional. We build FHIR-native, not FHIR-bolted-on. Patient access APIs, provider directory APIs, payer-to-payer pipelines — to spec.

Real-time at clinical latencies

EHR-integrated systems can't afford 200ms hop budgets. We've shipped sub-100ms PHI lookups across multi-region deployments without compromising audit logging.

EHR vendor reality

Epic, Cerner (Oracle Health), Athena, Allscripts, Meditech. Each has its own integration personality. We've integrated with all five — including the politics.

How our six pillars serve healthcare

Healthcare engagements typically draw on four or five of our service pillars at once. The combination is where the leverage is.

Software Engineering →

FHIR-native applications, EHR integrations, clinical workflow systems. Built for the latency and audit demands of hospital production.

DevOps & SRE →

HIPAA-compliant Kubernetes platforms with PHI access auditing, BAA-cleared cloud configurations, observability that doesn't leak PHI to logs.

AI →

On-premises LLMs for clinical documentation. Predictive risk models. NLP for chart abstraction. All with the eval and explainability healthcare requires.

Cloud & CRM →

BAA-covered cloud architectures (GCP, AWS, Azure). Salesforce Health Cloud integrations. Patient-engagement CRM stacks.

Security & Compliance →

HITRUST CSF certification engineering. PHI tokenization at the boundary. Zero-trust architecture for clinical systems. SOC 2 + HIPAA dual-track audits.

Management & Strategy →

EHR migration program leadership. Health-system M&A integration. Digital-front-door product strategy.

Frameworks & standards we work to

HIPAA
HITRUST CSF
FHIR R4
HL7 v2
DICOM
SMART on FHIR
USCDI v3
CMS-9115-F
CCDA
SNOMED CT
LOINC
ICD-10
Epic
Oracle Health
Athena
Allscripts
SOC 2 Type II
CMIA

Selected healthcare work

Names anonymized; outcomes verifiable on request under NDA.

Hospital networkFHIR

FHIR-native patient record platform — regional health network

Problem
14 EHR vendors across the network. Patient record reconciliation took 30+ minutes per case. CMS payer mandates 18 months out with no clear migration plan.
Approach
Spring Boot + HAPI FHIR with Kafka event spine. CDC from legacy stores into a normalized FHIR resource graph. Bi-directional adapters per EHR vendor.
Outcome
Reconciliation 30+ min → 4 sec. CMS-9115-F compliance shipped 6 months ahead of mandate.
Digital healthHITRUST

HITRUST CSF certification — Series-C digital health

Problem
Enterprise sales blocked on HITRUST cert. Internal estimate: 14 months + 3 GRC hires.
Approach
Embedded compliance engineering, Drata for continuous evidence, code-based control implementations, Big Four pre-audit dry run.
Outcome
HITRUST CSF r2 certified in 9 months. ~$8M ARR unblocked. Renewal audits now take 2 weeks.
Hospital networkAIRAG

Clinician documentation assistant — large medical group

Problem
Physicians spending 2+ hrs/day on charts. Cloud LLM APIs ruled out by privacy review.
Approach
On-prem Llama 3.1 70B with patient-context RAG over the EHR. PHI never leaves the hospital network.
Outcome
Documentation 2hr → 35 min/day. 87% draft acceptance. Quarterly fine-tuning loop in place.

Healthcare engineering challenge?

30-minute call. Senior architect with healthcare-domain experience. We'll tell you on the first call whether we can ship this well.