Context
Our client runs an extensive hospital management network in the United States. They had lived the problem personally: every hospital in their network ran its own processes, and none of the software on the market connected the parties that actually deliver care.
Problem
A patient’s care touches telemedicine, logistics, laboratories, physicians, pharmacy groups, hospitals and locum tenens staffing. In the client’s network each of those ran on separate systems that did not talk to one another. Scheduling happened in one place, prescribing in another, billing in a third. Nobody had a real-time view of a patient across the chain, and every new hospital that joined needed the whole thing configured differently.
Off-the-shelf hospital software solved one link at a time. What they needed was one platform that could be customised per hospital without forking the codebase — and that could carry protected health information legally while doing it.
Approach
We started from the data model rather than the feature list. Because every hospital would need different workflows on top of the same core, the architecture had to make customisation a configuration problem, not a development problem. We designed the database around that constraint first, agreed a standard interface with the client before building screens, and set up a shared communication channel so decisions did not queue behind weekly calls.
Compliance was a design input, not a final review. HIPAA obligations shaped how we handled storage, transport, access and audit from the first sprint.
What we built
A turnkey CRM covering the full clinical and administrative workflow:
- Prescribing — e-prescribing with a drug reference database, real-time prescription benefits, eligibility and real-time formulary checks, and pharmacy-initiated refills
- Patient access — a patient portal, custom intake form builder, and scheduling
- Communication — inbound and outbound click-to-dial telephony, SMS messaging, and video consultations that need no download or sign-up from the patient
- Administration — an administrator portal, invoice management, and detailed reporting
- Security — HIPAA-compliant handling with 2,048-bit encryption
- Extensibility — per-hospital customisation on request, and an API layer for third-party integration
The video and voice layers were the hardest part. Removing the patient-side download requirement mattered clinically: an elderly patient who cannot install an app is exactly the patient who most needs a remote consultation.
Results
The platform went into service across healthcare providers in the network and carried a significant patient load through the COVID-19 pandemic, when remote consultation stopped being optional. We have continued to scale and extend it since.
Metric slot — needs client approval. The strongest available numbers here are patients served, consultations delivered, or hospitals onboarded. Any one of these would replace this paragraph. See
claude/messaging.md, blocked item 4.
Related
Chronic Care Management System · Instant Virtual Primary Care · Web Application Development
