Healthcare founders and product leads
You have a clinical workflow that nobody builds well, and you need a team that can ship a first version, pass a security questionnaire from your first enterprise customer, and keep adding to it.
HIPAA and US healthcare engineering
Custom healthcare software, built for HIPAA from the first commit
We design and build clinical platforms for US practices, hospital groups and digital health companies: multi-tenant SaaS, telehealth, patient apps, imaging workflows and real time monitoring. Security is not a phase at the end of the project. It decides the architecture on day one.
- Database-per-tenant isolation for multi-location and franchise groups
- Encrypted audit trails, role based access and enforced multi-factor sign-in
- Business Associate Agreement signed before any engineer sees PHI
- Senior Laravel, React Native and cloud engineers, one accountable lead
Every engagement starts with an NDA and a BAA, and ends with source code, documentation and infrastructure that belong to you.
10Healthcare platform case studies
9+Countries we have delivered in
BAASigned before PHI access
8+Years building software
Specialties we have shipped
One engineering team, ten kinds of clinical workflow
Each specialty has its own vocabulary, forms and billing quirks. We have built platforms for all of these, and we start every project by learning how your clinicians actually work.
Dental and orthodontic groups Physical therapy and rehab Hospitals and ICU teams Imaging and diagnostics Pediatric therapy Behavioral health Integrative wellness Dermatology and med spa Podiatry and biomechanics Urgent care networks
Who we work with
Built for the people who answer for the software
Clinic groups and multi-location operators
You run five, fifty or two hundred locations and the software underneath them is a patchwork. You want one platform, with each location's data kept apart, and a way to onboard the next branch in a day.
CTOs and engineering managers
You already have a team, and you need a senior group that can take a module, a mobile app or a compliance rebuild without a long ramp up and without hand holding.
Practice administrators
You are the person who feels it when scheduling, billing and intake do not talk to each other. We map the real workflow first and automate the parts that cost your staff the most hours.
What we build
Custom healthcare software development, by problem
Pick the closest match and open the case study to see the architecture, the safeguards and how long it took.
Multi-tenant practice management SaaS
Scheduling, charting, billing, insurance verification and patient engagement for networks of clinics, with true data separation between locations.
See the case studyTelehealth and remote rehabilitation
Video visits, remote assessment, movement tracking and patient apps that clinicians actually use between appointments.
See the case studyReal time clinical monitoring
High concurrency streaming of device and vitals data, anomaly flags and role based alerting for acute care teams.
See the case studyImaging and diagnostic workflow software
DICOM handling, peer review, AI assisted report drafting and billing for imaging centers.
See the case studyPatient and parent mobile apps
React Native apps for intake, home programs, messaging and progress tracking, wired to a hardened Laravel API.
See the case studyMedical practice automation
Reminders, recalls, intake forms, claims preparation and follow-up campaigns that remove repeat work from front desk teams.
See the case studyInteroperability and integrations
HL7 v2 and FHIR connections to EHRs, labs, pharmacies and clearinghouses, built so one broken partner API does not take the product down.
See the case studyCompliance hardening for existing products
A technical gap review of your current app against HIPAA Security Rule safeguards, followed by the fixes, in priority order.
How we approach it
HIPAA engineering
How we build HIPAA compliant SaaS architecture
HIPAA does not publish a checklist for developers. It asks for reasonable and appropriate safeguards, and an auditor asks you to show them. These are the controls we put in place, in the order we design them.
Tenant isolation
Each clinic or franchise gets its own database, with its own credentials and encryption keys. A bug in one tenant's query cannot read another tenant's rows because the connection itself cannot reach them.
Encryption everywhere
TLS 1.2 or newer in transit, AES-256 at rest for databases, object storage and backups, with keys held in a managed key service and rotated on a schedule.
Access control and MFA
Role based permissions down to the field where needed, unique user IDs, multi-factor sign-in, short lived JWTs with refresh rotation and automatic logoff.
Immutable audit logging
Who opened which record, from where, and when. Logs are append only, stored apart from the application, and kept for the period your policy requires.
Backup and recovery
Encrypted backups per tenant, tested restores, and a written recovery plan with realistic recovery time and recovery point targets.
PHI-free development
Developers work with synthetic data. Real PHI stays in production, behind named access, and never lands in a laptop, a ticket or a crash report.
Multi-tenant Laravel systems
Why we default to database-per-tenant
Most SaaS tutorials teach a shared database with a tenant_id column on every table. It is cheap and it works until the day one missing WHERE clause shows a patient's record to the wrong clinic. In healthcare that is a reportable incident, not a bug ticket.
For multi-location groups and franchises we put each tenant in its own database. The application resolves the tenant from the request, switches the connection, and from that point it has no way to name another tenant's tables. Backups, restores, exports and deletions also become per tenant, which is exactly how clinics ask for them.
The trade is operational: more databases to migrate and monitor. We handle that with automated, versioned migrations that run per tenant, health checks, and a control plane that onboards a new branch in minutes. Smaller products with a single customer type can use a shared schema with row level safeguards, and we say so when that is the better fit.
Read the comparison
Healthcare case studies
Ten clinical platforms, from dental networks to the ICU
Representative engagements. Client names are withheld under NDA, and each page describes the architecture, safeguards and outcomes in plain terms.
Multi-tenant SaaS
Dental practice SaaS
A cloud platform for dental and orthodontic groups that run many locations and need one system for the full patient lifecycle, from first booking to recall, without letting any location see another's data.
Read the case study Telehealth and mobileRehab telehealth
A cross platform system that lets physical therapists and sports medicine specialists assess movement and pain remotely, prescribe exercise and track recovery between visits.
Read the case study Real time platformICU monitoring
A hospital platform that gathers vitals and medical device telemetry in one live view and warns attending staff early when a patient's trend moves the wrong way.
Read the case study AI and imagingImaging workflow
A SaaS platform that moves imaging studies from upload through review and reporting, helps radiologists draft structured summaries faster and handles the billing that follows.
Read the case study Care management and mobilePediatric therapy
A care management platform for occupational, speech and behavioral therapists who track developmental milestones in children and keep parents involved.
Read the case study Teletherapy practice suiteMental health suite
A virtual practice platform for counselors, therapists and psychiatric clinics that handles the session, the paperwork and the business side in one place.
Read the case study Integrative medicine hubWellness practice hub
A platform for multidisciplinary clinics that combine functional medicine, nutrition and alternative therapies, and need one view of the patient across all of them.
Read the case study Clinic management suiteDermatology and aesthetics
A specialized platform for practices that sell visible results and need to document, plan and schedule them precisely.
Read the case study Clinical workflow and 3D dataPodiatry biomechanics
A platform for podiatrists and gait labs that brings biomechanical measurements, orthotic manufacturing and billing into one workflow.
Read the case study Enterprise operations platformUrgent care operations
An enterprise platform that manages patient flow, rooms and triage queues across a network of high volume urgent care clinics.
Read the case study
Our BAA offer
We sign a Business Associate Agreement before we see PHI
Ask for it on the first call. We can sign yours or send ours, name the engineers who will have access, and keep real patient data out of development entirely. Your counsel has the last word on every clause.
- Signed before access. No engineer on our side opens a production system, a data export or a real record until the BAA is in place.
- Yours or ours. Send your standard BAA and we will review it, or ask for ours as a starting point. Either way your counsel has the final word.
- Named people only. Access is limited to the named engineers on your project, under written confidentiality terms, and removed the day they leave the work.
- Synthetic data by default. Development and staging use synthetic data. Real PHI is kept in production and only touched through approved, logged access.
Pricing ranges
Healthcare software development cost: honest price ranges
Nobody can quote a real number before they understand your workflows, your integrations and your compliance load. These ranges show where most projects land, so you can decide whether to talk to us. You get a fixed estimate after the discovery sprint.
Discovery and compliance sprint
$6,000 to $18,000
2 to 4 weeks
Teams that need a plan, an architecture and a number they can trust before committing.
- Data flow and PHI mapping
- Architecture and tenancy decision
- Security baseline and risk register inputs
- Prioritized backlog and fixed estimate for release one
- Clickable prototype of the key workflows
Clinical MVP
$45,000 to $120,000
10 to 16 weeks
A single practice type or one specialty, a web app, and a patient portal or companion app.
- Role based web application
- Patient portal or React Native app
- Scheduling, intake and messaging
- Audit logging, MFA and encryption
- One integration (EHR, payments or email and SMS)
Multi-tenant platform
$120,000 to $320,000
5 to 9 months
Clinic groups, franchises and SaaS products that serve many organizations from one codebase.
- Database-per-tenant architecture and onboarding automation
- Super admin, clinic, practitioner and patient roles
- Billing, subscriptions and insurance workflows
- Mobile apps for patients and staff
- Two to three integrations and per tenant analytics
Enterprise clinical platform
$250,000 to $600,000+
8 to 14 months
Real time monitoring, imaging, AI assisted workflows and hospital scale integrations.
- High concurrency streaming and alerting
- DICOM and large file pipelines
- Advanced audit, reporting and retention controls
- Independent penetration test coordination
- Load testing and disaster recovery drills
Ranges are indicative, in US dollars, and exclude third party costs such as cloud hosting, SMS and email providers, and the fee of an independent penetration testing firm. Final fixed estimates follow discovery.
Process
How an engagement runs
01
Discovery and data flow mapping
Two to four weeks. We map every place PHI is created, stored, moved and deleted, list the integrations, and agree the compliance boundary with your counsel or compliance lead.
2 to 4 weeks02
Architecture, BAA and plan
We sign the BAA, write the architecture and tenancy decision, set the security baseline, and turn the scope into a sprint plan with a fixed estimate for the first release.
1 to 2 weeks03
Build in two week sprints
Working software every sprint on a staging environment with synthetic data. You see real screens, not slide decks, and you can change direction between sprints.
10 to 40 weeks04
Security verification
Internal review, automated scanning, and an independent penetration test scoped with you. Findings are fixed before go live and the report is yours.
2 to 4 weeks05
Launch and ongoing development
Staged rollout, monitoring and a runbook. After launch most clients keep a small team on monthly development hours for new features, tuning and the next integration.
Continuous
Technology
The stack behind our healthcare platforms
Backend
- PHP 8 and Laravel
- REST APIs with JWT and refresh rotation
- Redis queues and Supervisor workers
- WebSockets for live data
Clients
- React Native for iOS and Android
- React and Vue web dashboards
- Three.js with GLB models for 3D
- SVG based anatomical maps
Data and cloud
- MySQL and PostgreSQL
- AWS EC2, S3, RDS, KMS and CloudTrail
- Per tenant encrypted backups
- DICOM storage and streaming
Quality and security
- Automated test suites and CI checks
- Dependency and secret scanning
- Third party penetration testing
- Written runbooks and incident drill
From our architects
Engineering notes on HIPAA, multi-tenancy and clinical data
Architecture
Database per tenant or shared schema for healthcare SaaS: how we decide
Isolation, backups, migrations and cost, compared the way we compare them with a client before a single table is created.
8 min read Compliance engineeringHIPAA technical safeguards in a Laravel codebase: what an auditor will ask to see
Five technical safeguard areas, what each one looks like in code, and the proof that makes an audit uneventful.
9 min read ComplianceBusiness Associate Agreement for software vendors: a checklist before you share PHI
When a developer counts as a business associate, the clauses worth reading twice and the red flags that tell you to walk away.
7 min read
Questions we hear
HIPAA and healthcare software questions, answered plainly
Is Kawach Technology HIPAA certified?
No software company is, because HHS does not offer a HIPAA certification for vendors. What we can do is build to support the HIPAA Security Rule, sign a Business Associate Agreement, document the safeguards, and help you gather the evidence your compliance lead or auditor will ask for. Anyone who sells you a "HIPAA certified" badge is selling a logo.
Will you sign a Business Associate Agreement?
Yes, and before anyone on our side touches PHI. We can sign yours or send ours. The BAA covers permitted uses, safeguards, breach reporting, subcontractor flow down and what happens to PHI when the work ends. Please have your own counsel review it.
Do your developers ever see real patient data?
Not in normal development. Engineers work on staging environments that use synthetic data. If a production issue needs access to live records, it goes through named, logged, time limited access that you approve, and the BAA covers it.
Why do you recommend database-per-tenant for clinic groups?
Because it turns a whole class of data leak bugs into something the application cannot do. Each location has its own database and keys, so a query written in a hurry cannot cross a tenant boundary. It also makes per location backups, exports and deletions straightforward. The cost is more operational work, which we automate.
Can you work with our existing EHR or practice management system?
Usually yes. We build HL7 v2 and FHIR integrations, and for older systems we use secure file exchange or a vendor API. We design the integration layer so a slow or failing partner API queues and retries instead of blocking a clinician.
How much does custom healthcare software cost?
It depends on scope and risk, and we publish indicative ranges on our healthcare pricing page. A focused clinical MVP often lands between $45,000 and $120,000, and a multi-tenant platform between $120,000 and $320,000. We give a fixed estimate after the discovery sprint, not before.
How long does it take to build a HIPAA compliant platform?
A clinical MVP typically takes 10 to 16 weeks after discovery. A multi-tenant platform with mobile apps and integrations usually takes five to nine months. Real time monitoring or imaging platforms take longer because the security and performance testing is heavier.
Do you build AI features for clinical software?
Yes, for workflow tasks such as drafting visit summaries, suggesting billing codes, and flagging anomalies in vitals. We treat AI output as a draft that a clinician reviews, we keep PHI out of third party model training, and we flag when a feature might fall under FDA software as a medical device rules so you can involve regulatory counsel early.
Who owns the code and the infrastructure?
You do. Source code, infrastructure as code, documentation and the cloud accounts are yours, set out in the project agreement. We do not keep anything that would make you dependent on us.
How do we start?
Book a consultation or ask for our BAA from the buttons on this page. A senior engineer, not a salesperson, will review what you have, ask about your data flows and tell you honestly whether we are the right team.
Planning a healthcare platform? Start with a conversation, not a quote.
A senior engineer will review what you have, ask about your data flows and tell you honestly whether we are the right team. We sign an NDA and a BAA before you share anything sensitive.