AI system for remote patient monitoring
- 150+
- patients under monitoring in 12 weeks
- 20%
- reduction in clinical decision-making time
EHR Software Development Company
Generic EHR systems cost specialty practices more than they save.
Major EHR vendors build for the median clinical workflow. Specialty practices end up paying for features they don't need while fighting a documentation system that doesn't fit the way their clinicians think. The result is longer note times, higher administrative overhead, and clinicians who work around the system instead of inside it. Custom EHR software changes that equation, matching your note structure, your intake process, and your billing workflow, or sitting on top of an existing EMR via FHIR.
Specialty-specific clinical templates, SOAP notes, and structured intake forms built for your care model
FHIR R4 and HL7 integration to read and write patient data without replacing the existing EMR
E-prescribing, formulary checking, and controlled substance tracking
CPT and ICD-10 code suggestion with clearinghouse integration for claims submission
Bring the problem, the current workflow, or the existing code. We reply with a practical next step within one business day.
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The brief
Start with what is not working.
Good software decisions begin with the constraint, not a list of features or a preferred technology.
01
Running a specialty practice where every major EHR forces your clinicians into documentation workflows built for a different specialty?
02
Paying for a full EMR platform but only using 20% of it because the rest does not match how your team operates?
Plain answer
RaftLabs builds custom EHR and EMR software for specialty practices and digital health companies that need clinical documentation built for their workflow. We develop specialty clinical templates, FHIR R4 and HL7 v2 integration with existing EMRs, e-prescribing, billing integration, and HIPAA-aware patient records. Most builds start with a documentation layer live in 12-16 weeks at a fixed cost, then grow into a full EHR.
What to remember
- Integration with an existing EMR (Epic, Cerner) via FHIR R4 is almost always faster and cheaper than building a full EHR from scratch, and preserves the investment already made.
- Custom builds make sense for digital health companies needing the EHR as their own IP, or specialty networks whose documentation workflows major vendors can't support without extensive customisation.
- Every note, edit, and export generates a tamper-evident audit log entry, required for medico-legal documentation integrity and HIPAA compliance.
- A documentation layer on an existing EMR runs $50,000-$90,000; a full ground-up EHR with e-prescribing and clearinghouse integration runs $90,000-$200,000.
The note that takes longer than the visit.
A specialty clinician finishes a patient encounter and opens the EHR. The template was built for a different specialty, so half the fields do not apply and the ones that matter are not there. So they chart around the system: free-text notes, a spreadsheet on the side, a workaround the whole team has memorised.
The EHR was supposed to save time. Instead it is the reason the clinic runs behind.
That is not a training problem. It is a fit problem.
Major EHR vendors build for the median clinical workflow. Specialty practices end up paying for a full platform, using a fraction of it, and fighting a documentation system that does not fit the way their clinicians think. The result is longer note times, higher administrative overhead, and clinicians who work around the system instead of inside it.
The documentation burden is well quantified: a widely cited Annals of Internal Medicine time-motion study (Sinsky et al., 2016) found physicians spend roughly two hours on EHR and desk work for every hour of direct patient care. We build clinical documentation tools that match your actual care model, and integrations that sit on top of an existing EMR via FHIR R4, so you do not have to rip and replace what is already working. RaftLabs has shipped production software since 2015 for clients across the US, UK, Europe, Canada, and the UAE. In healthcare, we have shipped HIPAA-aware clinical platforms, delivered at a fixed cost. The team that scopes your specialty workflow is the team that ships it, with no offshore handoff after the contract is signed.
Proof
- Since 2015
- shipping production software, including HIPAA-aware clinical platforms
- RaftLabs delivery record
- 4.9/5
- average client rating across delivered projects
- Clutch, verified reviews
- FHIR R4
- clinical tools that sit on top of your existing EMR, no rip-and-replace
- Every EHR build
This works when a generic EMR does not fit how your practice actually operates.
Everything on the left should already be true for your organization. Even one thing on the right, and an off-the-shelf platform is the smarter first step.
A fit
01
A specialty practice whose clinicians fight documentation workflows built for a different specialty.
02
You run Epic, Cerner, or another EMR and need a documentation layer or patient tool on top via FHIR R4, not a rip-and-replace.
03
A digital health company that needs the EHR as its own IP, with budget for a fixed-cost build.
Not a fit
01
A generic EMR already fits how your team documents, prescribes, and bills.
02
You want the cheapest off-the-shelf platform, not software built to your care model.
03
You have no clinical or billing workflow defined yet to build against.
What we build
What we build for specialty practices and digital health companies
- 01Custom EHR developmentSpecialty-specific data models capture what your clinicians actually need, with validated instrument scoring (PHQ-9, GAD-7) and SOAP structures matched to your documentation pattern, coded against SNOMED CT and RxNorm.
- 02EMR integration and interoperabilitySMART on FHIR reads and writes Patient, Encounter, Observation, and MedicationRequest resources against your existing EMR, on FHIR R4 with HL7 v2 messaging for legacy interfaces. USCDI data classes map cleanly, and CommonWell or Carequality connections pull outside records into the chart, so you inherit the interoperability the ONC Cures Act already mandates instead of rebuilding it.
- 03Clinical documentation and CPOEAuto-population pulls demographics, diagnoses, and medications into every note. CPOE order entry, dictation support, and configurable co-signature workflows fit supervised practice models.
- 04Patient record managementJaro-Winkler name matching prevents record duplication, with role-based access enforcing HIPAA minimum necessary and every view generating a tamper-evident audit entry.
- 05E-prescribing and medication managementNCPDP SCRIPT messaging handles new prescriptions and refills through Surescripts, with EPCS two-factor authentication for controlled substances and real-time formulary checking.
- 06Billing and coding integrationNLP-suggested CPT/ICD-10 codes feed charge capture directly from the encounter, with clearinghouse EDI 837 submission and automated ERA payment posting.
Have an EHR or EMR project?
Tell us your specialty, your current EMR environment, and the documentation problem your clinicians face every day. We will scope the build.
How it works
From scope to live EHR system
- Week 101
Specialty and EMR scoping
We map your specialty, current EMR environment, and documentation pain points. You leave week 1 with a written scope document and a fixed-price quote.
- Weeks 2-502
Data model and integration design
Clinical templates and FHIR/HL7 integration architecture designed against your actual care model.
- Weeks 6-1503
Build and integrate
Documentation tools, e-prescribing, and billing integration built in parallel, tested against real clinical scenarios.
- Final 2-3 weeks04
Launch and clinical training
Clinicians and billing staff trained on the workflow before full rollout.
Our documented healthcare work sits next door to a full EHR: remote patient monitoring and telehealth, both HIPAA-aware and live with US providers. The clinical-data modelling, compliance, and EMR-integration discipline is the same discipline an EHR build runs on.
Proof
Clinical platforms we have shipped
Where you land in that range depends on scope, not negotiation:
- Documentation layer on an existing EMR, $50,000-$90,000
- Custom specialty templates, FHIR R4 integration, and structured intake on top of Epic, Cerner, or another EMR. Delivers in 12-16 weeks.
- Full ground-up EHR, $90,000-$200,000
- A complete EHR including e-prescribing and clearinghouse integration, built as your own IP.
What it costs
Custom EHR software, starting at $50,000.
A documentation layer on your existing EMR, or a full ground-up EHR with e-prescribing and clearinghouse integration. Most builds deliver in 12-16 weeks.
Most practices start with a documentation layer on their existing EMR, not a full rebuild. We scope toward a ground-up EHR only when the existing system is the actual constraint.
Starting investment
Starts at $50,000
Delivery in 12-16 weeks. A documentation layer on your existing EMR is the fastest way to start; a full ground-up build comes later if you need it.
No hourly billing
Once we scope your build, that price is locked in writing, so there's no hourly billing and no invoice surprises. A scope change is a priced change request, agreed before work begins.
Integration over rebuild
Sitting on top of Epic or Cerner via FHIR R4 is often the right call. We tell you when integration beats a rebuild, rather than recommending a full build by default.
Useful next steps
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Read moreFrequently asked questions
Integration is almost always faster and cheaper than building from scratch. If your organization runs on Epic or Cerner, we build tools that sit on top via FHIR R4 APIs: a specialty documentation layer, a better patient portal, or a care coordination tool. Custom EHR development from the ground up makes sense for digital health companies who need the EHR as their own IP, and specialty networks whose workflows major vendors don't support well.
FHIR R4 is the current HL7 standard for healthcare API design and data exchange, defining resource types with coded terminology bindings and a REST API profile. Epic, Cerner, and most major US EMRs expose FHIR R4 APIs required by the ONC 21st Century Cures Act, making integrations faster to build and more likely to survive EMR version upgrades.
The HIPAA Security Rule (45 CFR Part 164) technical safeguards are architectural constraints from the start: AES-256 encryption at rest, TLS 1.3 in transit, role-based access control enforcing minimum necessary access, and audit logging of every PHI access event in tamper-evident storage with 6+ year retention. BAAs are executed with every infrastructure provider before any PHI enters the system.
Yes, when your product needs it. ONC certification under the 21st Century Cures Act requires standardized FHIR R4 APIs, USCDI data support, and specific clinical and security criteria tested by an ONC-Authorized Certification Body. We scope which criteria apply to your product and build to them. A documentation layer that sits on an already-certified EMR usually inherits its certification, so most specialty builds do not need their own.
A specialty documentation layer on an existing EMR, covering custom templates, FHIR R4 integration, and structured intake, typically runs $50,000-$90,000 and delivers in 12-16 weeks. A full EHR built from the ground up including e-prescribing and clearinghouse integration runs $90,000-$200,000.
Work with us
Tell us where the work is stuck.
Bring the rough workflow, half-built product, or messy brief. We will map the smallest useful first move, then send scope, timeline, and price in plain English.
- Scope and cost agreed before work starts. No surprises. No obligation.
- Working prototype within 3 weeks of kickoff.
- Pay by milestone. You see progress before each invoice.
- 60-day post-launch warranty. Bug fixes, UI tweaks, and deployment support. No retainer.
- All conversations are NDA-protected.
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