Healthcare is the industry where the cost of a software bug can be measured in patient harm. That fact reshapes every engineering decision. I build healthcare systems with the assumption that anything I ship will eventually be reviewed by a compliance officer, an auditor, and possibly a regulator - and that's the right bar. My architecture work in healthcare starts from threat modeling and consent flow, not from feature lists.
HIPAA is the floor, not the ceiling. The Privacy Rule, Security Rule, and Breach Notification Rule together prescribe administrative, physical, and technical safeguards, but compliance is a posture, not a checkbox. I design platforms where PHI is encrypted at rest with customer-controllable keys, in transit with TLS 1.3, and in use with field-level encryption for the most sensitive elements. Every read is logged, every BAA is honored at the cloud-account boundary, and the blast radius of any single credential is minimized.
Interoperability is where most healthcare projects either succeed or get stuck for two years. HL7 v2 is still everywhere, FHIR R4 is the future, and bridging the two requires patience. I build integrations against Epic's MyChart and FHIR APIs, Cerner/Oracle Health, athenahealth, and the open-source HAPI FHIR server. The 21st Century Cures Act information-blocking rules mean payers and providers actually have to expose this data now, which has unlocked a wave of patient-facing apps.
AI in healthcare needs more rigor than AI anywhere else. Clinical decision support that crosses into the medical-device boundary triggers FDA review under the SaMD framework. Even when you stay outside that boundary, the bar for evaluation is high - you need retrieval grounded in source-of-truth clinical data, explicit citations, prompt-injection defenses, and clinician-in-the-loop review. I've shipped clinical document summarization that reduced chart-review time by 60% while keeping a board-certified physician as the final reviewer.
Telehealth, RPM, and digital therapeutics each have their own quirks - DEA Ryan Haight rules for controlled-substance prescribing, state-by-state telehealth licensure compacts, FDA 510(k) for connected devices. I help founders navigate this stack without overbuilding. The goal is always the same: better outcomes, lower friction, defensible compliance. Read about a HIPAA-compliant build or reach out to discuss your roadmap.