Deep Expertise Inside the US Healthcare System
Technology only works in healthcare when it respects how care is actually delivered, billed, regulated, and reimbursed in the United States. Our team brings deep, hands-on US healthcare domain experience to every engagement — spanning payer operations, provider workflows, and the regulatory frameworks that govern them.
Regulatory & Compliance Depth
We build with compliance as a first-class design constraint, not an afterthought. That means fluency in HIPAA Privacy and Security Rules, HITECH breach requirements, the 21st Century Cures Act's information-blocking provisions, ONC Health IT Certification (§170.315 criteria), and the CMS Interoperability and Patient Access Rule. Every architecture decision is evaluated against these frameworks before a line of code is written.
Payer Landscape Fluency
- Medicare & Medicaid — fee schedules, MACRA/MIPS quality reporting, and CMS rule cycles that shape product roadmaps.
- Commercial payers — network contracts, utilization management, and value-based care arrangements (ACOs, bundled payments, shared savings).
- Prior authorization & utilization review — the operational choke points most healthtech products underestimate.
Provider Workflow Expertise
We've sat inside ambulatory clinics, acute-care hospitals, post-acute and behavioral health settings, and understand how a feature that looks clean on a whiteboard collides with a 12-minute patient visit, a nursing shift handoff, or a discharge planning bottleneck. That operational realism is what separates a demo from a product clinicians will actually adopt.
Revenue Cycle & Reimbursement Nuance
Every clinical workflow has a financial shadow. We design with an understanding of CPT/HCPCS coding, ICD-10 documentation requirements, and how claims move from encounter to remittance — so the products we build don't create downstream billing or compliance headaches.
Bring deep US healthcare domain expertise to your next initiative.
Talk to our teamHL7, FHIR & the Connected US Healthcare Stack
Interoperability is the backbone of modern US healthcare technology — and also its most misunderstood discipline. We design and implement standards-based integrations across HL7 v2, FHIR R4, C-CDA, X12 EDI, and emerging frameworks like TEFCA and USCDI, so data moves securely between the systems that need it. Select a system type below to go deeper.
Not sure where your integration gap is? Let's map it together.
Get in touchEnterprise Health System Integration
Hospitals and multi-facility health systems run on a patchwork of enterprise platforms — Epic, Oracle Health (Cerner), MEDITECH, and dozens of ancillary systems — that all need to speak to each other reliably, in real time, without disrupting patient care.
What We Build
- ADT feed integration — real-time admit/discharge/transfer messaging (HL7 v2 ADT^A01, A03, A08) that keeps downstream systems synchronized with patient location and status.
- Order & results interfaces — HL7 ORM/ORU messaging between EHRs, ancillary departments, and third-party systems.
- Interface engine architecture — designing and optimizing integration engines (Mirth, Rhapsody, Cloverleaf-style patterns) for scalability and fault tolerance.
- Epic App Orchard & Oracle Health integrations — building against vendor-specific APIs and certification requirements.
- Enterprise Master Patient Index (EMPI) alignment to prevent duplicate records across facilities.
The Business Case
Poorly integrated health systems create duplicate documentation, delayed results, and clinician burnout from swivel-chair workflows. A well-architected integration layer reduces manual data entry, closes care gaps, and becomes the foundation every future digital health initiative builds on.
Have a health system integration that's stalled? We can help unblock it.
Talk to our teamEHR Interoperability & FHIR API Development
Electronic Health Records are the system of record for US clinical care — and increasingly, the platform other digital health products build on top of, through certified FHIR APIs.
What We Build
- SMART on FHIR applications — clinician- and patient-facing apps that launch inside the EHR context, using OAuth2-secured FHIR R4 APIs.
- Bulk FHIR data pipelines — extracting population-level data for analytics, quality reporting, and risk stratification.
- C-CDA generation & consumption — Continuity of Care Documents exchanged at transitions of care.
- CEHRT alignment — building to ONC Certified EHR Technology criteria so integrations remain compliant as certification requirements evolve.
- USCDI data class mapping — ensuring the right clinical data elements (problems, medications, allergies, labs) are structured and exchangeable.
Where This Creates Value
Whether you're a digital health startup needing to pull structured clinical data into your product, or a health system opening data access to affiliated providers, EHR interoperability done right means fewer manual workarounds and a foundation that holds up under ONC audit scrutiny.
Building on top of an EHR? Let's talk FHIR architecture.
Talk to our teamClaims Clearinghouse & X12 EDI Integration
Behind every paid claim is an EDI transaction moving through a clearinghouse. We build and troubleshoot these connections so claims, eligibility checks, and remittances flow without manual rework.
What We Build
- 837 claims submission pipelines (professional and institutional), with front-end scrubbing to reduce rejections.
- 835 remittance processing — automated posting of payer remittance advice back into billing systems.
- 270/271 eligibility verification — real-time patient coverage checks at scheduling or check-in.
- 276/277 claim status inquiries to reduce staff time spent on payer phone calls.
- Clearinghouse vendor evaluation and migration support (Availity, Change Healthcare-class platforms, and others).
Why It Matters
Claim rejections and delayed eligibility checks are one of the largest hidden costs in a healthcare organization's revenue cycle. Clean EDI integration reduces days-in-A/R and staff overhead — a direct, measurable financial outcome.
Struggling with claim rejections or slow eligibility checks? Let's fix the pipeline.
Talk to our teamWearables & Remote Monitoring Device Integration
Remote patient monitoring has moved from pilot programs to reimbursable, mainstream care in the US. The technical challenge is ingesting continuous device data — reliably, at scale — and turning it into something clinically actionable.
What We Build
- Device data ingestion pipelines for continuous glucose monitors, blood pressure cuffs, pulse oximeters, cardiac wearables, and weight scales.
- FHIR Device & Observation resource mapping — normalizing vendor-specific data formats into standards-based clinical observations.
- Threshold-based alerting that flags clinically significant readings without burying care teams in noise.
- Bluetooth, cellular, and API-based device connectivity, integrated with EHR flowsheets for clinician visibility.
- Compliance-aware architecture for CMS RPM billing requirements (device data transmission thresholds, time-tracking).
Why It Matters
RPM programs succeed or fail based on data reliability and alert fatigue management. We design for both — so care teams trust the data enough to act on it, and patients stay engaged with their devices.
Launching or scaling an RPM program? We've built the pipes for it before.
Talk to our teamLaboratory Information System (LIS) Interoperability
Lab results are among the highest-volume, most safety-critical data types in healthcare. Getting LIS interoperability right means faster turnaround for clinicians and fewer manual transcription errors.
What We Build
- HL7 ORU result messaging from reference and hospital labs into ordering EHRs.
- LOINC code mapping to standardize lab test identifiers across disparate lab systems.
- Critical value alerting pipelines that ensure abnormal results reach the ordering clinician immediately.
- Point-of-care and reference lab integration, including support for CLIA-regulated environments.
- Order/result reconciliation to eliminate orphaned results and unmatched orders.
Why It Matters
A delayed or lost lab result isn't just an operational inconvenience — it's a patient safety issue. Reliable LIS interoperability is foundational infrastructure for any clinical technology initiative.
Need reliable lab interoperability? Let's design it right.
Talk to our teamPayer Systems & Prior Authorization Automation
Prior authorization is consistently ranked by US physicians as one of the most burdensome administrative processes in healthcare — and it's now a major regulatory focus, with the CMS Interoperability and Prior Authorization Final Rule pushing payers and providers toward automated, standards-based workflows.
What We Build
- Da Vinci Project FHIR Implementation Guides — including CRD (Coverage Requirements Discovery), DTR (Documentation Templates and Rules), and PAS (Prior Auth Support).
- X12 278 prior authorization transaction support for legacy payer connections.
- Automated documentation assembly that pulls supporting clinical data directly from the EHR at the point of order.
- Payer eligibility and benefits integration for real-time coverage determination.
- Turnaround-time tracking and denial pattern analytics to identify process bottlenecks.
Why It Matters
Automating prior authorization reduces care delays for patients and administrative burden for staff — while positioning organizations ahead of upcoming CMS compliance deadlines rather than scrambling to catch up.
Preparing for CMS prior auth compliance deadlines? Let's get ahead of it.
Talk to our teamEnterprise-Grade Digital Health Product Development
We design and build enterprise-level digital health products and platforms for the US market — combining clinical workflow understanding with modern software engineering. Every product starts with the regulatory and reimbursement reality it has to operate inside, not as a constraint bolted on later. Select a product category below to go deeper.
Have a product idea that needs healthcare-specific engineering? Let's scope it.
Get in touchClinical Decision Support Systems (CDSS)
Clinical Decision Support Systems are among the highest-value — and highest-risk-if-done-wrong — categories of healthcare software. We build CDSS platforms that improve clinical decision-making without contributing to alert fatigue.
What We Build
- Rules-engine architecture for evidence-based clinical guideline enforcement at the point of care.
- Alert fatigue reduction design — tiered alerting, context-aware suppression, and workflow-integrated notifications.
- Drug interaction and allergy checking integrated directly into ordering workflows.
- AI-assisted diagnostic support tools that augment, rather than replace, clinical judgment.
- Integration with EHR CDS Hooks for real-time, in-workflow guidance.
Why It Matters
A CDSS that clinicians ignore because of alert fatigue delivers zero clinical value regardless of how sophisticated its logic is. We design for adoption first — accuracy is necessary but not sufficient.
Building a CDSS that clinicians will actually use? Let's design it together.
Talk to our teamHospital Administrative Workflow Automation
Hospitals run on hundreds of manual administrative processes that quietly consume staff time and create bottlenecks in patient flow. We automate the ones with the highest operational impact.
What We Build
- Bed management and capacity forecasting tools that reduce ED boarding and improve throughput.
- Staff scheduling and shift optimization platforms aligned with clinical demand patterns.
- Discharge planning automation — coordinating case management, pharmacy, and transportation tasks.
- Automated patient intake and registration workflows that reduce front-desk data entry.
- Task orchestration platforms that route administrative work to the right team automatically.
Why It Matters
Administrative friction directly affects patient throughput, length of stay, and staff burnout. Automating these workflows delivers measurable operational ROI, often within a single fiscal quarter.
Have an administrative bottleneck slowing down patient flow? Let's automate it.
Talk to our teamCustom EHR Development for Specialty Care
Off-the-shelf EHRs are built for general use — and often fall short for specialty practices and niche care settings with unique documentation and workflow needs. We build purpose-built EHR platforms designed around specific clinical specialties.
What We Build
- Specialty-specific charting templates — behavioral health, physical therapy, dermatology, and other niche care settings.
- Compliance-first architecture — HIPAA-compliant data handling, audit logging, and role-based access built in from day one.
- ONC certification pathway planning for organizations pursuing Certified EHR Technology status.
- Interoperability-ready design — FHIR API support and C-CDA export built into the core architecture, not retrofitted.
- Billing and coding workflows tailored to the specialty's typical reimbursement patterns.
Why It Matters
A generic EHR forces specialty practices into workarounds that slow down documentation and hurt reimbursement accuracy. A custom-built EHR fits the actual clinical workflow, improving both clinician satisfaction and billing accuracy.
Considering a custom EHR for your specialty practice? Let's talk feasibility.
Talk to our teamRPM, CCM & TCM Platforms
Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Transitional Care Management (TCM) are among the fastest-growing reimbursable care models in the US — but the CMS billing rules governing them are unforgiving of poor platform design.
What We Build
- Time-tracking and documentation workflows aligned to CPT codes 99457, 99458 (RPM treatment management), 99490, 99487 (CCM), and 99495, 99496 (TCM).
- Care coordination dashboards that give care managers a unified view across enrolled patients.
- Automated eligibility screening to identify patients who qualify for RPM/CCM/TCM enrollment.
- Device data integration feeding directly into billing-compliant documentation.
- Patient engagement workflows that keep enrollment and adherence rates high — a key driver of program ROI.
Why It Matters
These programs generate real recurring revenue for provider organizations, but only if documentation meets CMS's exact time and data requirements. We build platforms designed around audit-readiness from the start.
Launching or scaling an RPM, CCM, or TCM program? Let's build it compliant from day one.
Talk to our teamRevenue Cycle Management (RCM) Platforms
Revenue cycle performance is one of the clearest levers for a healthcare organization's financial health. We build RCM platforms and automation layers that reduce denials, speed up collections, and cut administrative overhead.
What We Build
- Automated claims scrubbing that catches errors before submission, reducing first-pass denial rates.
- Denial management workflows with root-cause categorization and automated appeal generation.
- Real-time eligibility verification integrated at scheduling and check-in.
- Patient billing and payment portals that improve patient collection rates and satisfaction.
- Analytics dashboards tracking days-in-A/R, denial rates, and net collection ratios.
Why It Matters
Every percentage point improvement in clean claim rate or reduction in days-in-A/R has a direct, quantifiable financial impact. RCM technology is one of the fastest ways to demonstrate measurable ROI in a healthcare technology investment.
Looking to improve collections or reduce denials? Let's talk about your RCM stack.
Talk to our teamPatient Engagement Solutions for the US Healthcare Market
Patient engagement directly influences clinical outcomes, satisfaction scores, and revenue — from reduced no-show rates to higher HCAHPS scores. We design engagement solutions that meet patients where they already are.
What We Build
- Patient portals with secure messaging, appointment scheduling, and access to health records — designed for real-world digital literacy levels, not just technical compliance.
- Omni-channel communication — SMS, email, and app-based reminders that reduce no-show rates and close care gaps.
- Digital intake and pre-visit workflows that reduce front-desk friction and improve data accuracy.
- Social Determinants of Health (SDOH) screening tools integrated into patient-facing workflows.
- Patient education content delivery tailored to condition, literacy level, and language preference.
- Engagement analytics that identify which patients are at risk of disengaging from care.
Why It Matters
Patient engagement is directly tied to value-based care performance — readmission rates, preventive care compliance, and HCAHPS scores all move when patients stay engaged between visits. In an increasingly consumer-driven healthcare market, the organizations that make engagement effortless retain more patients.
Looking to reduce no-shows or improve patient satisfaction scores? Let's design your engagement strategy.
Talk to our teamAI & Intelligent Automation for Healthcare Workflows
AI and automation applied to clinical and operational workflows reduce friction and improve efficiency — but only when applied to the right problems, with the right guardrails. We focus on automation that measurably reduces administrative burden without compromising clinical safety.
What We Build
- Ambient clinical documentation — AI-assisted scribing that reduces clinician time spent on charting.
- Prior authorization automation using AI to assemble supporting documentation from clinical notes automatically.
- Robotic Process Automation (RPA) for repetitive back-office tasks — eligibility checks, claims status follow-up, and data entry between disconnected systems.
- Predictive analytics for readmission risk, no-show prediction, and patient deterioration early warning.
- Natural Language Processing (NLP) for extracting structured data from unstructured clinical notes.
- Workflow orchestration platforms that route tasks intelligently across care teams and systems.
Why It Matters
Clinician burnout is directly linked to administrative burden, and much of that burden is automatable without touching clinical judgment. Applied thoughtfully, intelligent automation gives time back to care teams — which is ultimately what moves outcomes and staff retention.
Curious where automation could reduce burden on your team? Let's find the highest-impact starting point.
Talk to our teamHealthcare Technology Consulting
Not every organization needs a full build — sometimes what's needed is expert guidance to make the right decision before committing resources. Our consulting practice covers every service area above, backed by deep US healthcare domain experience.
EHR Strategy & Optimization Consulting
Selecting, implementing, or optimizing an EHR is a multi-year commitment with major financial and clinical implications. We provide vendor-neutral assessments, workflow optimization reviews, and implementation oversight to help organizations avoid the common pitfalls that derail EHR projects.
Interoperability Roadmap Consulting
Many organizations have fragmented, ad-hoc integrations built up over years. We assess your current interoperability posture against HL7/FHIR standards and regulatory requirements, then build a prioritized roadmap that closes the highest-risk gaps first.
Digital Health Product Strategy
Before writing a single line of code, we help healthtech founders and enterprise innovation teams validate product-market fit against real US healthcare workflows, reimbursement models, and regulatory pathways — the factors that determine whether a great idea becomes a sustainable product.
Patient Engagement Strategy
We audit existing patient engagement touchpoints and design a strategy that improves activation, retention, and satisfaction scores — grounded in what has and hasn't worked across similar patient populations.
AI Readiness Assessment
Before investing in AI and automation, we assess data quality, workflow readiness, and regulatory risk — helping organizations avoid costly AI initiatives that stall due to poor data foundations or unclear governance.
Regulatory Compliance Advisory
From HIPAA risk assessments to ONC certification readiness to CMS interoperability rule compliance, we provide advisory support that keeps technology initiatives audit-ready rather than exposed.
Vendor Selection & Technology Due Diligence
Whether you're evaluating a new platform vendor or conducting technical due diligence ahead of an investment or acquisition, we provide independent, healthcare-informed technical assessments that go beyond a vendor's sales deck.
Every consulting engagement starts with a conversation. Tell us what you're trying to solve, and we'll tell you honestly whether — and how — we can help.
Schedule a consultation