Greenfield healthcare IT — HIPAA-compliant platforms, Power BI and Tableau dashboards, FHIR APIs, clinician-facing internal tools. Senior bench, TypeScript-first, Austin-based, on the ground in week one.
The difficulty in new healthcare IT systems rarely comes from the technology itself. It comes from unclear ownership of PHI, undefined data movement processes, and the operational realities that surface when critical systems fail in clinical environments.
Build is our practice for new healthcare IT systems — the kind that don’t have a codebase yet. HIPAA-compliant platforms, BI dashboards, FHIR services, clinician-facing internal tools. Distinct from Modernize (Epic / Cerner cutovers, migrations) and Sustain (HL7 / FHIR interface troubleshooting, on-call). Senior pair on every meaningful PR. Handoff baked in from week one.
Most healthcare IT products end up needing two or three of these. We build them on the same bench, in the same repo language, so you’re not stitching together vendors when the first FHIR integration breaks.
New healthcare web platforms in TypeScript and Next.js — BAA-aware infrastructure, least-privilege access, audit logging wired in from the first commit. The compliance posture clinical buyers expect, designed in rather than bolted on.
Admin consoles, ops dashboards, and chart-adjacent workflows for the staff who use the system every shift. Built with the same care as the patient-facing surface — because the people leaning on it are the ones running the floor.
Power BI and Tableau wired into clinical and operational data — gold-layer warehouses, governed semantic models, dashboards a department head will actually open Monday morning. Not a screenshot in a deck.
FHIR R4 services, HL7 v2 listeners, and the connective work between EHRs, registries, and the systems around them. The boring plumbing that decides whether the product feels solid in week eight or starts shedding edges.
Three phases, no theater between them. Each one ends with a named artifact and a decision someone can push against.
We sit with your team, read the existing tickets, and write down what the thing actually has to do. Scope, architecture, risk surface — named on paper before anyone opens an editor.
Senior pair on every meaningful PR. Weekly demos against working software, no separate QA throw-over, no design sign-off theater. The team that drew it ships it.
Documented, tested, and walked through with whoever owns it next. An operational runbook, on-call notes, and a deploy story your in-house engineer can run without a Slack channel.
We default to TypeScript end-to-end — Next.js on the front, Node on the back, Postgres underneath. Drizzle or Prisma depending on the team. Tailwind for the surface, Vercel for the deploy. AWS or GCP when compliance or scale pulls us there. The list isn’t a religion; it’s what we’ve operated long enough to know where the edges are.
Healthcare-specific layers — FHIR R4, HL7 v2, BAA-aware infrastructure, Power BI / Tableau on the warehouse — sit on top of the same bench. The compliance posture is designed in, not bolted on the week before audit.
A clean-slate healthcare IT build attracts a lot of asks that aren't actually clean-slate builds. The list below saves us both a kickoff call.
We don’t build with stacks the senior bench can’t operate.
If nobody on staff has shipped on it before, your roadmap isn’t the place we learn. We pick boring on purpose — particularly when PHI is in the path.
We don’t take projects that need twenty people.
Six is the ceiling. Past that, the coordination tax exceeds the senior premium and you’d be better served by a larger shop.
We don’t ship clinical surfaces without tests for the parts that matter.
Not a coverage number. The pieces that touch a patient record, an HL7 feed, or an audit log get tested. Marketing copy doesn’t.
We don’t disappear after launch.
Eighteen months of operating cost is part of the build conversation, not a retainer pitched the week before go-live.
We don’t sub the work to a partner network.
The names on the kickoff call are the names writing the code. No nearshore handoff, no body-shop padding.
We don’t write a 47-page proposal.
The smallest document that gets us to a decision. If the SOW is longer than the first sprint, something has gone wrong on our end.
If you are building greenfield healthcare infrastructure, protecting sensitive patient data, and planning to own and operate the systems long after deployment, we are likely the right fit.
No discovery deck. No 47-page proposal. Tell us what you're building and we'll come back within 48 hours with a real technical read.
