Telehealth Platform: FHIR Integration, HIPAA Compliance, 1,200 Patients in 90 Days
HIPAA-compliant telehealth platform with 3 EHR integrations enrolled 1,200 patients in 90 days and backed a $4.5M Series A.
The founder — a physician with 20 years of clinical experience — was running a chronic-care pilot on Zoom, spreadsheets, and manual phone calls. Clinical outcomes were strong: pilot patients showed a 1.8-point average A1C reduction over 6 months. But the manual workflow capped each care coordinator at 50 patients.
The product requirements were clinically specific: a patient mobile app for daily vitals logging, secure messaging, and video visits; a provider dashboard with risk stratification and configurable vitals alerts (e.g., blood glucose >300 mg/dL triggers immediate notification); bidirectional EHR integration with Epic, Cerner, and athenahealth via SMART on FHIR; and HIPAA compliance throughout — encryption, access controls, audit logging, BAA-covered infrastructure.
The budget was $130K maximum, because the seed round also had to fund 12 months of operations, clinical staff, and regulatory work. The timeline was 5 months, fixed by a health system contract that required a live platform by a specific date.
Month 1 built the foundation. Two weeks of clinical workflow mapping — watching coordinators work with pilot patients — surfaced unstated requirements like 6-month vitals trends at a glance and regimen-specific medication reminders. The HIPAA-compliant AWS infrastructure went up before application code: private-subnet VPC, encrypted RDS PostgreSQL, encrypted S3, CloudTrail audit logging, WAF, field-level PHI encryption, RBAC, 15-minute session timeouts, and MFA for all provider accounts.
Months 2–3 delivered the core platform. The React Native patient app used a large-button, high-contrast interface for an older population — 18px minimum fonts, 48px touch targets, vitals entry optimized to complete in under 60 seconds. The provider dashboard added color-coded risk panels, 30/90/180-day vitals trends, and per-patient alert thresholds with audited acknowledgment.
Month 4 was the FHIR work — the most technically complex phase. OAuth2 SMART on FHIR authorization per EHR, patient matching across systems, pulls of demographics, problem lists, medications, and labs, and pushes of coordinator notes and vitals back to the EHR. Because Epic, Cerner, and athenahealth each implement FHIR R4 differently, a normalization layer mapped every EHR's output to one internal data model. Month 5 covered testing (alert thresholds verified against 500 synthetic patient datasets, every violation alerting within 30 seconds), a third-party security assessment with two medium findings remediated pre-launch, and full compliance documentation.
The platform launched 1 week ahead of the 5-month deadline, fulfilling the health system contract on time. Within 90 days, enrollment grew from 20 migrated pilot patients to 1,200. Daily vitals adherence rose from 34% in the manual pilot to 78%, coordinator response time fell from 4.2 hours to 22 minutes, and critical vitals alerts were acknowledged in 4.2 minutes on average. Uptime: 99.96%. Security incidents: zero.
Patient capacity per coordinator increased 3.6x — from 50 to 180 — fundamentally changing the unit economics of the care model. The founder used the traction data (1,200 patients, 78% adherence, 1.8-point A1C reduction) to raise a $4.5M Series A 6 months post-launch, and two additional health systems signed contracts on the strength of the clinical outcomes.
Total build investment was $124,000 across four phases, with ongoing maintenance and support continuing at $5,500/month.
I'm a physician, not a technologist. I needed a team that could translate clinical requirements into software without me having to explain what a care plan is or why medication adherence matters. Gigabit's team spent their first two weeks watching my coordinators work with patients. They understood the clinical workflow before they wrote a line of code. That's why the product works — it was designed for how care actually happens, not how an engineer imagines it happens.
