Custom Software × Healthcare & Life Sciences
Clinical workflow platforms, SMART-on-FHIR apps, patient portals, EHR integrations, and revenue-cycle automation, engineered against HIPAA, clinician workflow, and audit-defensibility from day one.
The reality
The pattern across clinical software engagements: a beautiful application that doesn't integrate with the EHR; a workflow tool that adds clicks to an already-overburdened clinician; a patient portal that wasn't designed against actual lease workflows; an audit log that captures access but not decisions; a deployment scoped without consideration for the multi-tenant operational reality of a 14-hospital system. Healthcare software succeeds when EHR integration, clinician workflow, and audit defensibility are all primary scope.
Prosigns ships custom healthcare software with the clinical reality as primary scope. EHR integration (Epic, Cerner, Athena, Meditech) as primary scope, not phase 2. Clinician-facing UI co-designed with the people who use it. SMART-on-FHIR launches into the EHR. Audit logging granularity defined before the first commit. CITADEL co-pilots HIPAA scope; FORGE engineers handle the build; CANVAS handles clinician-facing design.
Where it ships
Concrete applications where custom software unlocks measurable value inside healthcare & life sciences delivery constraints.
240+
clinics deployed
Custom EHR-adjacent applications surfacing the right data at the right time for clinicians, care managers, schedulers, ops. SMART-on-FHIR launches, role-aware dashboards, write-back where policy permits.
+38%
appointment compliance
Patient-facing apps and portals for scheduling, messaging, intake, results, and education. WCAG 2.2 AA, multilingual, EHR-tethered, and consent-aware.
Bidirectional EHR integrations via FHIR R4, HL7 v2, CCDA. Resource shaping, terminology mapping, and consent-aware data flows. Major EHRs (Epic, Cerner / Oracle Health, Athena, Meditech).
−47%
claims rework
Claims processing, eligibility verification, prior-authorization automation, and contract analytics. Integrated with payer connectivity, with the operational tooling RCM teams actually use.
Video visits, asynchronous messaging, care-team coordination, and the operational tooling care management actually requires. Identity-integrated, audit-logged, EHR-tethered.
Specialty workflow tools (oncology, cardiology, orthopedics, behavioral health) with explicit pathway logic, registries, and the regulatory-frame awareness specialty care requires.
How we engage
Each phase has a deliverable, an owner, and an acceptance criterion calibrated to healthcare & life sciences delivery.
Discovery on the floor with clinicians, care managers, and operations, not in the boardroom. We shadow workflows, audit existing tooling, and identify the friction the project has to solve. Architecture lands against actual clinical reality.
Audit logging granularity defined before the first commit. ePHI encryption boundaries, key management (CMK), BAA-covered subprocessor selection, and data-residency posture decided up front.
Epic App Orchard, Cerner, Athena, and Meditech integrations through documented contracts. SMART-on-FHIR launches with Hyperspace context awareness. Bidirectional flows with explicit consent semantics.
SOC 2 / HIPAA / state-level evidence collection produced as a side-effect. Quarterly access reviews, monthly audit-log reviews, IR plan rehearsed quarterly. Audits pull what they need in days.
Capabilities
Stack
Compliance overlay
Every healthcare & life sciences engagement carries the evidence collection that procurement and audit teams expect on day one.
Administrative, physical, and technical safeguards mapped to architectural components. BAA-covered subprocessors only. Documented risk analysis, incident response, workforce training, access reviews. Minimum-necessary at the data layer.
Continuous evidence collection: control activity logs, change-management artifacts, access reviews, vendor risk records. Produced as a side-effect of operating the system, not assembled at audit time.
FHIR-native data shapes for read and write-back. SMART-on-FHIR launches into Epic, Cerner, Athena. HL7 v2 and CCDA gateways for legacy interfaces. Consent-aware data flows respecting 42 CFR Part 2, state confidentiality laws, and patient consent directives.
Consent management integrated at the data layer. Region-aware processing for HIPAA / state law / GDPR / PIPEDA where international care is in scope. Right-to-erasure flows engineered.
Electronic record / signature controls, audit trails, role-based authority, and time-stamped record integrity for eClinical and life-sciences workloads. Validation aligned to GxP frame.
Selected work
Where this fits
Common questions
Yes: major EHRs are in our active engagement portfolio. Epic App Orchard listings, SMART-on-FHIR launches with Hyperspace context, Cerner / Oracle Health bidirectional integration, Athena REST. We treat EHR integration as primary scope, not phase 2.
Engineered into the architecture from day one. Audit logging granularity defined before the first commit, ePHI encryption with customer-managed keys, BAA-covered subprocessors, minimum-necessary at the data layer. CITADEL co-pilots every healthcare engagement.
Phased delivery with explicit per-cohort progression and documented rollback. Most multi-site deployments cut over hospital-by-hospital or department-by-department, with dual-running windows where the data model warrants. We don't do big-bang cutovers in clinical environments.
Yes. Patient portals, scheduling, messaging, results, education, designed against actual patient workflow, multilingual where the population requires, accessibility-first (WCAG 2.2 AA), and EHR-tethered through documented identity flows.
Oncology, cardiology, orthopedics, behavioral health: specialty workflow tools are common engagement scope. Pathway logic, registries, regulatory-frame awareness, and integration with the modality-specific systems specialty care relies on.
Discovery and risk modeling: 4–6 weeks, $50K–$150K. Production builds: 4–9 months, $400K–$1.5M depending on regulatory scope. Multi-quarter platform builds: $1.5M–$5M+. Managed Services: $40K–$200K monthly retainer. Brackets published honestly.
Talk to us
A senior engineer plus the FORGE department lead joins the first call, both with prior healthcare & life sciences delivery experience.