Whatever you're using now has workarounds your staff runs every day. We build EHRs from the ground up — for specialty clinics that have stopped waiting for a vendor to fix it.
Talk to Us About Your EHR Project
Most organizations coming to us for a custom EHR are in one of three situations. It helps to name them upfront — so you can read what's most relevant to where you are.
You've been on Epic, Cerner, or Meditech long enough that the workarounds have multiplied past the point of tolerance. Contract renewal is coming and staying finally costs more than leaving. You need a path out that doesn't destroy your data.
A health-tech startup, a new specialty practice, or an organization spinning out a new service line. No legacy constraints — but you need something production-ready, compliant, and scalable without the institutional knowledge that comes from having done it before.
The core system works, but it's missing AI capabilities, the interoperability your payers now require, or a patient-facing layer that isn't fifteen years old. You need a team that can build on what exists without tearing down your clinical data history.
Nine capabilities, each built around the encounter types, clinical vocabulary, and workflows your providers actually use — not a horizontal system stretched to fit.
Because we build from the ground up, we integrate AI properly rather than grafting it onto a system that wasn't designed to accommodate it. Five places it earns its keep.
EHR migration is high-stakes — and most information about it comes from vendors with a financial interest in making it sound easy. Here's what it actually involves.
We've moved clinical history out of Epic, Cerner, Athenahealth, Meditech, and eClinicalWorks. We scope it during discovery and tell you what migrates cleanly, what needs transformation, and what belongs in a historical archive.
Hard cutover is clinically too risky for most organizations. We run both systems simultaneously with a defined timeline and clear protocols for which is the system of record.
Training runs as a structured workstream alongside late-stage development — role-specific sessions and go-live support during the weeks when adoption questions peak.
We map every integration — labs, imaging, clearinghouse, payer portals, pharmacy — during discovery and plan each cutover explicitly. Nothing gets missed.
Each number comes from a custom EHR we designed, built, and shipped — tied to a real problem: oncology spreadsheet workarounds, 18% denial rates, physicians charting three hours post-shift. Click through to see the system behind each metric.
Talk to Us About Your EHR ProjectThe gap between how software projects are presented and how they actually run is wide — wider still in healthcare. Hover or tap a stage to see what it actually involves.
We talk to every role that will use the system — physicians, nurses, MAs, front desk, billing, IT. We document the workarounds your staff has built and map workflows as they actually run.
Data structure, AI integration, external system connections, access controls — all decided before development starts. Changing architecture mid-build compounds in cost quickly.
Working software every two weeks — not status slides. Problems surface when they're cheap to fix. Clinical team reacts to what they see, not a description of what they'll eventually see.
Staff runs real scenarios before any patient data touches the system. Usability problems at this stage cost a fraction of what they cost post-launch.
We monitor under real clinical load and respond to issues in hours. The first weeks post-launch surface the most valuable feedback — we're present to act on it.
Clinical requirements evolve, regulations shift, AI improves. We stay engaged — updates, new capabilities, and responding to what only becomes visible once real clinicians use the system.
A custom EHR carries a heavier compliance burden than most software — and a higher cost of getting it wrong. Every standard below is an architectural requirement, built and reviewed in from the start, not a box ticked at the end.
PHI handling, access controls, audit logging, and breach-notification infrastructure — plus 21st Century Cures Act patient access and information-blocking compliance.
Independently audited security and risk controls across the stack.
FHIR-compliant APIs from the start, ONC certification support for Meaningful Use and MIPS, and the CMS rules payers now require for data exchange and prior authorization.
FDA SaMD guidance for clinical decision support that meets the medical-device definition, EPCS for controlled-substance e-prescribing, and the MIPS data-capture and submission infrastructure for ambulatory practices.
PDMP integration, state consent laws, behavioral-health confidentiality, and telehealth standards that vary by state.
Usable by every clinician and patient, by design.
Each specialty has documentation requirements, workflows, and a regulatory load that general platforms treat as edge cases. Here's where we've built EHRs around the specialty instead of stretching a horizontal system to fit.
Not in licensing fees — in clinician time, workarounds, and billing errors that surface because your clinical and financial layers don't communicate. If you're ready for an honest conversation about timeline, cost, and realistic outcomes — we're ready. Thirty minutes. No pitch.
Talk to Us About Your EHR Project
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A commercial EHR gives you options within the vendor's boundaries. A custom EHR is built around your actual clinical workflows — the boundaries are yours. For practices with unusual documentation, billing structures, or AI needs, configuration has a ceiling that custom doesn't.
Yes. We've migrated from Epic, Cerner, Athenahealth, Meditech, eClinicalWorks, and proprietary systems. We scope it during discovery and tell you what migrates cleanly, what needs transformation, and what belongs in a historical archive.
We map every integration — labs, imaging, pharmacy, clearinghouse, PDMP, HIE — during discovery. Each one is explicitly planned into the migration timeline.
A focused specialty EMR runs five to eight months. A full enterprise EHR with multiple modules, AI, patient portal, and migration runs twelve to twenty months. We give you a milestone-based timeline after discovery and hold to it.
It depends on your use case. ONC certification is required for MIPS participation or patient data access rights. We build to ONC criteria for organizations that need it and support the certification process.
We go live in stages where clinical risk warrants it, monitor the system through launch, and respond to issues in hours. We don't hand over the keys and disappear.
You do — full IP transfer at project close. Source code, data models, documentation. No license fees, no ongoing dependency on us.
