Medical Software Development Company

Healthcare Software Is a Compliance Problem Before It Is an Engineering Problem

The 2026 HIPAA Security Rule made encryption mandatory. Not addressable. Mandatory. MFA is now required for every user who touches electronic Protected Health Information. HHS started enforcing 21st Century Cures Act information-blocking rules in September 2025, with penalties up to $1 million per violation. The Change Healthcare ransomware attack in 2024 exposed 192.7 million patient records in a single incident.

This is the operating environment for anyone building medical software in 2026. The global healthcare IT market is valued at approximately $480 billion and growing at 15% annually (MarketsandMarkets 2025). The opportunity is enormous. The compliance bar has never been higher.

EltexSoft is a medical software development company. 35-50 senior engineers. Headquartered in Lisbon, Portugal. Engineering team in Ukraine. Founded in 2015. We build HIPAA-compliant healthcare platforms, EHR integrations, healthcare marketplaces, and practice analytics systems. Our clients include RiseMD (healthcare marketing technology, 20X ROI for dental practices) and WinitClinic (a functional medicine marketplace with at-home testing and mobile apps).

We are not a 1,000-person systems integrator. We don’t bid enterprise EHR replacements or hospital-network transformations. We build focused healthcare products where senior team continuity, regulatory awareness, and long-term partnership matter more than headcount.

What We Build

Healthcare Marketing and Practice Analytics

Practice management platforms that close the attribution gap between marketing spend and clinical revenue.

RiseMD is a proprietary healthcare marketing platform serving dental practices, multi-location DSOs, and health systems across the US. The platform tracks patients from first ad click through phone call through appointment through treatment through payment. Not clicks. Not impressions. Actual production revenue per patient.

The results are documented: $3.2 million in new patient production from $160,000 in marketing spend over 12 months. That is a 20X return on investment. Average 140 new patient calls per month. $81 cost per new patient. Practices doubling their monthly production within 15 months.

The engineering includes EHR integration for revenue tracking, call recording with AI-powered grading and analysis, Google Ads optimization, multi-location dashboards for DSOs managing 5 to 300+ practices, and AI-powered positioning for visibility in ChatGPT, Google AI Overviews, and Perplexity. RiseMD has been recognized by Google, Facebook, the Association of Dental Support Organizations, and the University of Michigan School of Dentistry.

Healthcare Marketplaces

Two-sided platforms connecting patients with practitioners. A healthcare marketplace is not a consumer marketplace with a HIPAA logo. The differences are structural.

WinitClinic is a functional medicine marketplace we built on Nuxt.js with iOS and Android companion apps. The platform connects patients with independent practitioners: functional medicine doctors, naturopathic doctors, holistic medicine practitioners, health coaches, chiropractors, and dietitians.

The feature set includes practitioner discovery and booking, real-time chat, video consultations, at-home health testing (food sensitivity, gut microbiome, hormones, heavy metals, mycotoxin, micronutrient tests), symptom tracking, and condition-based content pages optimized for organic search.

What made it hard: credential verification for non-MD/DO practitioners has no unified national API. Each board (NBHWC for health coaches, CDR for dietitians, FCLB for chiropractic) maintains its own registry. At-home testing requires integration with CLIA-certified labs, specimen kit logistics, result delivery, and clinician sign-off where required. Cross-state telehealth means routing logic that enforces state-of-patient-presence rules because the practice of medicine occurs where the patient is, not where the practitioner sits.

EHR and EMR Integration

The bridge between your product and the clinical record.

We integrate via HL7 v2 (over Mirth Connect or Rhapsody) and FHIR R4 REST APIs with Epic, Oracle Health (Cerner), athenahealth, Meditech, and eClinicalWorks. SMART on FHIR handles OAuth 2.0 authorization, inheriting EHR user permissions so your app doesn’t need its own clinical access control layer.

The 21st Century Cures Act and TEFCA framework (finalized December 2024) now require qualified health information networks to support FHIR APIs. If your product touches clinical data and you are not building FHIR-first, you are building technical debt.

Remote Patient Monitoring

RPM is now reimbursable under expanded CMS CPT codes (99454, 99457, 99458). The software that makes RPM work is not a dashboard. It is a system that ingests data from FDA-cleared devices, triggers clinician alerts on threshold breaches, documents the required 20 minutes of clinical time per billing cycle, and generates compliant billing records.

HIPAA-Compliant Mobile Apps

Patient portals, secure messaging, scheduling, records access, push notifications. iOS and Android. We handle the BAA, the encryption at rest and in transit, the audit logging, the session timeouts, the role-based access control, and the penetration testing.

How We Handle HIPAA

HIPAA compliance is not a feature. It is a set of engineering constraints that affect every architectural decision.

Encryption. AES-256 at rest. TLS 1.2+ in transit. Full-disk encryption on servers and workstations. KMS-managed keys. No exceptions.

Access control. RBAC with attribute-based extensions. MFA for every ePHI user (mandatory under the 2026 Security Rule). Unique user IDs. Session timeouts. Automated access revocation on role change.

Audit logging. Tamper-evident logs for every PHI access event. Retained for six years per HIPAA documentation requirements. Queryable for incident investigation.

BAA chain. We sign BAAs. Every cloud service touching PHI runs under a signed BAA (AWS, GCP, Azure). Every third-party service that might handle PHI (Twilio for messaging, SendGrid for email) is verified HIPAA-eligible and covered by a BAA. Stripe handles payments but does not sign a BAA, so we architect PHI out of payment flows entirely.

Infrastructure. VPC isolation. PrivateLink where available. CloudTrail and Activity Log for infrastructure audit. Automated patch SLAs documented and tracked.

Incident response. Documented breach notification procedures per HIPAA Breach Notification Rule (60-day reporting to HHS for breaches affecting 500+ individuals, individual notification without unreasonable delay).

The Regulatory Landscape in 2026

HIPAA Security Rule (2026 update). Encryption is mandatory. MFA is mandatory for ePHI access. Continuous monitoring (real-time intrusion detection, regular vulnerability scanning) supplements annual risk assessments. Patch management timelines must be documented.

21st Century Cures Act. Information-blocking enforcement began September 2025. Health IT developers face up to $1 million per violation. HHS’s December 2025 HTI-5 proposed rule signals regulatory intent to allow autonomous AI systems to retrieve and share health data via FHIR APIs.

FHIR R4 and TEFCA. CMS Interoperability Rules require FHIR R4 API support. TEFCA (finalized December 2024) obliges qualified health information networks to support FHIR by July 2025. If you’re building a healthcare product that doesn’t speak FHIR, you are building for 2020.

FDA SaMD. The FDA published draft AI/ML guidance in January 2025 (lifecycle management) and August 2025 (Predetermined Change Control Plans). Over 1,250 AI-enabled medical devices have been authorized for marketing in the US. If your software performs a medical purpose (diagnosis, treatment, prevention), it may require FDA clearance.

GDPR for EU health data. Health data is special-category under Article 9. Explicit consent or another lawful basis required. Data residency and DPO obligations apply. Our Lisbon headquarters means GDPR-native contracting by default.

What It Costs

Healthcare software costs 20-40% more than standard SaaS because of encryption, audit logging, RBAC, penetration testing, and compliance documentation.

Senior healthcare engineer (dedicated): $50-99/hr. A full-time dedicated developer costs $8,000-$16,000/month.

By project type:

Telemedicine MVP: $25K-$70K, 3-5 months.

Healthcare marketplace (two-sided, web + mobile, payments, messaging): $120K-$350K, 6-12 months.

Practice analytics platform with EHR integration: $80K-$200K, 4-8 months.

HIPAA-compliant patient portal: $60K-$150K, 4-8 months.

EHR integration project (FHIR R4 + SMART on FHIR): $30K-$80K, 2-4 months.

Remote patient monitoring platform with billing logic: $80K-$200K, 4-8 months.

Annual maintenance: 15-20% of build cost for OS updates, security patches, compliance updates, and feature work.

Compare to US healthcare agencies at $100-$250/hr or large global SIs at $100-$300/hr. Our $50-99/hr rate with senior-only engineers and a 3+ year average engagement delivers 40-60% lower total cost of ownership.

Who We Are

EltexSoft is a boutique medical software development company. 35-50 senior engineers. Headquartered in Lisbon, Portugal. Engineering team in Ukraine. Founded in 2015.

Our healthcare clients include RiseMD (practice marketing platform, 20X ROI) and WinitClinic (functional medicine marketplace). We also build with Laravel, Django, Vue.js, React, iOS, and Android.

5.0 Clutch rating across 30+ verified reviews. 200+ five-star Upwork reviews. Top Rated Plus and Expert-Vetted agency status (top 1%). Average client engagement: 3+ years.

We are not the right partner for FDA Class III device firmware or 50,000-endpoint payer transformations. We are the right partner for focused healthcare products: marketplaces, practice platforms, EHR integrations, patient-facing applications, and RPM systems where senior team continuity and regulatory awareness matter more than headcount.

30-minute technical call. Bring your compliance requirements, your EHR integration challenge, or your healthcare product idea. We’ll tell you what we’d build and what we wouldn’t.

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