Enterprise EHR Platform with End-to-End HIPAA Compliance
What was at stake
The client's existing EHR was a legacy on-premise system that couldn't scale beyond regional deployments, lacked FHIR interoperability, and required manual compliance auditing that consumed entire weeks per quarter. Clinics were abandoning the platform due to slow performance and a clunky interface, and the company was at risk of losing its competitive position to cloud-native entrants. They needed a complete platform rebuild that met the strictest healthcare compliance standards while delivering the modern UX clinicians expect.
How we delivered
Compliance-First Architecture Design
Designed the entire platform on AWS GovCloud with encryption at rest (AES-256) and in transit (TLS 1.3), immutable audit logging, and infrastructure-as-code using Terraform for reproducible, auditable deployments. Implemented role-based access control with 14 distinct clinical roles and break-the-glass emergency override procedures.
FHIR-Native Data Model & Interoperability Layer
Built the core data model on HL7 FHIR R4 resources, enabling native interoperability with labs, pharmacies, imaging centers, and other EHR systems. Developed a bidirectional integration engine that supports FHIR REST APIs, SMART on FHIR app launching, and Consolidated CDA document exchange.
Clinical Workflow & Billing Integration
Engineered end-to-end clinical workflows covering patient intake, charting, ordering, prescriptions, and referrals. Built an integrated billing module with real-time insurance eligibility verification, automated ICD-10/CPT coding suggestions, and electronic claims submission with denial tracking.
SOC 2 Certification & Continuous Compliance
Partnered with the client's compliance team through a 12-week SOC 2 Type II audit preparation process, implementing continuous compliance monitoring with automated evidence collection, vulnerability scanning, and penetration testing. Achieved certification on the first audit attempt with zero critical findings.
Measurable impact, verified by the client
Technologies we used
“Rebuilding a production EHR used by 200+ clinics is one of the hardest things you can do in health IT. TPWITS delivered a platform that passed SOC 2 on the first try, integrates seamlessly with every lab and pharmacy our clinics use, and — for the first time — our clinicians actually enjoy using the software. Uptime hasn't dipped below 99.97% since launch.”
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