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Field notes from healthcare engineering — written by people doing the work.
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liveMulti-state telehealth: the licensing routing problem (and what to build)
Engineering · 10 min
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- State lines are software boundaries
- The three things state licensing actually controls
- The routing problem
- License verification — manual or automated
Multi-state telehealth: the licensing routing problem (and what to build)
Every telehealth platform that grows past one state hits the same wall — every state has different licensing rules, scope-of-practice limits, and e-prescribing requirements. Here's the routing architecture that survives all 50.
Serhii Kholin · 10 min
Remote patient monitoring without burning out caregivers
Alert fatigue kills RPM programs faster than any technical issue. Here's the framework we use to design alert systems that surface the right thing at the right time — and the metrics that tell you it's working.
Denis Sheremetov · 11 min
CDS Hooks: shipping clinical decision support clinicians actually use
CDS Hooks is the standard for delivering decision support inside the EHR — but standards don't drive adoption. Here's what separates CDS that gets accepted from CDS that gets disabled in week two.
Serhii Kholin · 9 min
Why Mid-Size Healthcare Insurance Companies Overpay for Salesforce by 2–3×
Every healthcare insurance CFO has had this conversation: the Salesforce invoice lands, it's up 8% over last year, and the renewal includes an Enterprise Tier upgrade you weren't warned about. Here's how the overpay actually happens — and how to spot it in your own bill.
Denis Sheremetov · 9 min
How We Cut CRM Costs ~30% in Year Two — A Healthcare Insurer Case Study
The proof point behind the pillar TCO comparison. A real engagement: a California health-insurance company, custom CRM layer delivered in 6 months, Year 2 came in roughly 30% cheaper. Forward this to your CFO.
Denis Sheremetov · 12 min
What a HIPAA audit actually looks like — from the inside
Most teams build to a checklist and hope. We've sat across from the auditor — here's what they actually ask, and what surprises engineering teams.
Denis Sheremetov · 8 min
FHIR for non-engineers: a 10-minute primer for product managers
If you're the PM on a healthcare project, you don't need to write FHIR code — but you do need to understand what your engineers mean when they say it.
Serhii Kholin · 10 min
When to rescue and when to rebuild: a decision framework
Half of our healthcare engagements start as rescues. Here's how we decide — in the first 48 hours — whether to fix what's there or burn it down.
Denis Sheremetov · 12 min
Building a clinical validation harness for ML in healthcare
Models that work on benchmarks don't always work in your hospital. Here's the validation infrastructure we wish every team had on day one.
Serhii Kholin · 11 min
IEC 62304 in practice: what it actually requires (and what people get wrong)
62304 doesn't tell you to write tests. It tells you to write tests that trace to requirements that trace to user needs. Here's what that looks like in a real codebase.
Serhii Kholin · 14 min
Surviving an Epic App Orchard review: a survival guide
The Epic review process is famously rigorous. We've been through it nine times. Here's the prep work that shortens the cycle from 4 months to 6 weeks.
Serhii Kholin · 9 min
Ambient voice documentation: pipelines that don't leak PHI
Voice-to-note is one of the highest-leverage AI uses in clinical practice. It's also one of the easiest places to ship a HIPAA violation. Here's how to architect it.
Serhii Kholin · 13 min
Why nobody uses your patient portal (and what to measure to fix it)
Portal adoption baselines in healthcare run 30-40%. The teams hitting 60-80% measure four things their peers don't. Here they are.
Denis Sheremetov · 7 min
FDA's 2023 cybersecurity premarket guidance: what changed for SaMD teams
The new guidance pushed cybersecurity from optional to mandatory in the submission package. Here's what your DHF needs to include now.
Serhii Kholin · 10 min
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