A health SaaS that makes it through a hospital security review is a competitive moat.
We build SaaS platforms for healthtech startups — EHR integrations, care coordination tools, population health dashboards, and the HIPAA-aligned, enterprise-ready architecture that unlocks health system deals. Fixed scope, fixed price.
You've closed your first pilot. The health system's IT security review starts next month. Your architecture wasn't built for the questions they're about to ask: BAAs, audit logging, HL7 FHIR, role-based PHI access, and MFA enforcement.
Healthtech SaaS has the hardest vendor qualification process of any vertical. Health systems, hospital networks, and large medical groups have IT security teams whose full-time job is vetting vendors before they touch patient data. The questionnaire runs 100 to 200 questions covering: BAA execution with all subprocessors touching PHI, network architecture (is PHI isolated on a separate data tier?), audit logging (can you prove who accessed which patient record at what time?), access controls (is there MFA enforcement and role-based PHI access?), incident response (do you have a documented breach notification procedure?), and data retention and deletion (can you delete all PHI for a given patient on request?).
Most healthtech startups pass the business review and the pilot clinical evaluation before anyone sends the IT security questionnaire. Then the questionnaire arrives, and the answers depend on architectural decisions made in the first quarter of building. If those decisions weren't made with HIPAA in mind, the remediation is expensive, time-consuming, and potentially deal-blocking.
On the product side, healthtech SaaS that connects to EHR systems needs to speak FHIR (Fast Healthcare Interoperability Resources) — the standard that Epic, Cerner, and Athenahealth use for third-party integrations. A product that requires manual data entry because it doesn't integrate with the EHR the hospital already uses is a product with limited adoption.
A healthtech SaaS built with HIPAA-aligned infrastructure, FHIR-ready data architecture, and the security posture that passes health system vendor reviews — before the questionnaire lands, not after.
HIPAA-aligned data architecture
PHI isolated in a separate encrypted data store, row-level access controls, and BAAs executed with every subprocessor (Convex, Clerk, AWS, notification services). Data residency in US regions only.
Immutable PHI audit trails
Every read, write, and access to patient data logged to an append-only audit table with actor ID, timestamp, and data classification. Queryable for compliance reporting and patient access requests.
FHIR R4 integration with EHR systems
Patient demographics, encounter history, clinical observations, and care plan data pulled from Epic, Cerner, or Athenahealth via SMART on FHIR. You write clinical data back into the record where your workflow supports it.
Role-based access with clinical hierarchy
Physicians, nurses, care coordinators, admin, and billing roles each with scoped PHI access. MFA enforcement for all roles, with hardware token support for privileged access.
Patient-facing portal with HIPAA-compliant messaging
Secure message threading between patient and care team, with the BAA and encryption architecture that satisfies CMS's messaging requirements. Built on Next.js, Postgres with row-level security, AWS (HIPAA-eligible services only), Clerk with MFA, WorkOS for health system SSO (Epic and Cerner support IdP federation), and HL7 FHIR clients for EHR integrations.
One honest number to start.
Fixed-scope, fixed-price. The number below is the starting point — final scope is built from your brief.
A healthtech SaaS built with HIPAA-aligned infrastructure, FHIR-ready data architecture, and the security posture that passes health system vendor reviews — before the questionnaire lands, not after.
Three steps, every time.
The same repeatable engagement on every project. No surprises, no mystery, no billable ambiguity.
Brief & discovery.
We send you questions, then get on a call. Output: a written scope with every step, feature, and integration listed.
Build & ship.
Fixed schedule, weekly reviews. No scope creep unless you change the scope — and if you do, we reprice it transparently.
Warranty & retainer.
30-day warranty on every launch. Most clients stay on a monthly retainer for ongoing features and maintenance.
Why Fixed-Price Matters Here
Healthtech founders are managing clinical partnership timelines, regulatory review, and runway simultaneously. The development budget is a defined line item with a close date. Fixed scope and fixed price means the engineering spend is a capital purchase, not a variable — and the security controls are scoped into the contract, not added as change orders after the IT questionnaire arrives.
Related engagements.
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Read moreQuestions, answered.
It means: BAAs with all subprocessors that touch PHI, access controls that limit PHI access to minimum necessary, audit trails on all PHI access, encryption at rest and in transit, MFA enforcement, and a documented incident response plan. We build to these requirements by default.
Yes — Epic App Orchard integration uses SMART on FHIR OAuth and the Epic FHIR R4 API. We build the integration to Epic's specifications and can support the App Orchard submission process. Note that Epic App Orchard certification is a separate review process that Epic controls; we prepare all the technical requirements.
We implement a documented data deletion workflow that identifies all PHI associated with a given patient across all tables, archives it to a deletion log (for regulatory retention periods), and scrubs it from the live system. The deletion capability is documented in your HIPAA compliance manual.
A care coordination or population health SaaS with HIPAA infrastructure, audit trail, role-based access, EHR FHIR integration, and patient portal typically runs $60k–$140k. EHR integrations and clinical complexity are the main scope drivers. Fixed-price.
14 to 20 weeks, including EHR integration testing and security controls documentation.
Tell Ryel about your project.
Describe what you’re building and what outcome you need. You’ll have a written, fixed-price scope within the week.