Most telehealth software problems are not visible until a compliance review, an EHR integration deadline, or a pharmacy audit forces the issue. Perimattic builds telemedicine platforms with the compliance architecture, EHR integration, and e-prescribing workflows engineered in from the start - real-time video consultations, remote patient monitoring, and bidirectional HL7/FHIR sync, all built to hold up under real clinical and regulatory scrutiny.
Telemedicine Technology Stack - WebRTC, HL7/FHIR, AWS, Surescripts, Twilio Video, React Native, Node.js, PostgreSQL, Epic/Cerner, TypeScript, Docker, EPCS
Telemedicine app development is the design, engineering, integration, and ongoing support of software platforms that let patients and providers deliver and receive care remotely. A telehealth platform manages the full care encounter - scheduling and intake, real-time video consultation, clinical documentation, e-prescribing, and follow-up - and connects these workflows to electronic health record systems, pharmacy networks, and remote monitoring devices. Because the platform handles protected health information at every step, HIPAA compliance is not a feature added at the end of development - it is a property of the architecture, and it has to be treated that way from the first design decision.
The gap between a working telehealth demo and a platform ready for real clinical use shows up in specific places: video infrastructure without a signed Business Associate Agreement, e-prescribing that was scoped as a generic integration and does not actually meet EPCS requirements for controlled substances, an EHR integration that syncs scheduling but not clinical documentation, or remote monitoring data that arrives but has no alerting logic behind it. Each of these gaps is invisible in a demo and expensive to discover during a compliance review, a pharmacy audit, or a go-live with a health system partner.
Perimattic builds telemedicine platforms starting from the compliance and architecture work - HIPAA safeguards, state licensing logic, and integration design - before writing production code for the clinical workflows themselves. We build the video consultation experience, the e-prescribing and pharmacy integration, the remote patient monitoring pipeline, and the EHR sync as one connected platform rather than a collection of point integrations, and we test each piece against real clinical scenarios before it reaches production.
EHR integration
Limited to whatever integrations the vendor has already built - often scheduling-only sync, with clinical documentation re-entered manually
EHR integration
Bidirectional HL7/FHIR integration scoped to your actual EHR, syncing scheduling, documentation, e-prescribing, and RPM data
E-prescribing
Generic e-prescribing bundled as a feature, frequently without EPCS support for controlled substances
E-prescribing
E-prescribing built to the EPCS standard where controlled substances are part of the clinical workflow, with DEA-compliant safeguards
Compliance ownership
Compliance responsibility is unclear or shared awkwardly between vendor and practice, discovered during an audit
Compliance ownership
Compliance architecture documented and owned as part of delivery, with BAAs executed for every vendor in the stack
Remote patient monitoring
Device support limited to the vendor's partner list, with alerting logic that cannot be tailored to your care protocols
Remote patient monitoring
Device integration and alerting logic built around your specific care protocols and reimbursement documentation needs
Platform ownership and cost model
Per-provider or per-visit licensing that scales unfavorably as patient volume grows, with the vendor controlling the roadmap
Platform ownership and cost model
You own the platform outright, with a cost structure and roadmap that scale with your organization rather than a vendor's pricing tiers
The operational cost of a telehealth platform that does not match your clinical and compliance requirements becomes visible in failed EHR go-lives, pharmacy audit findings, and the amount of manual documentation work clinical staff absorb to compensate for gaps the software should have closed.
Seven telehealth capability areas covering the complete care encounter - from video consultation and e-prescribing through remote monitoring, EHR integration, and compliance architecture.
Real-time video visit infrastructure built on WebRTC or Twilio/Vonage Video, with virtual waiting rooms, multi-party sessions for family or group visits, screen-share for reviewing results together, and encrypted call recording where the workflow requires it. Every media path is designed against HIPAA safeguards from the start, with Business Associate Agreements in place for every video infrastructure vendor involved.
E-prescribing workflows integrated with pharmacy networks through Surescripts, covering prescription transmission, medication history, formulary and eligibility checks, and refill authorization. For controlled substances, we implement Electronic Prescribing of Controlled Substances (EPCS) with DEA-compliant identity proofing, two-factor authentication, and full audit logging at the point of prescribing.
Device integration pipelines for Bluetooth-connected blood pressure cuffs, pulse oximeters, glucometers, connected scales, and wearables via Apple HealthKit and Google Fit. We build the continuous vitals ingestion layer, configurable threshold and trend-based alerting so care teams see clinically meaningful signals, and the time-tracking documentation RPM billing codes require.
Bidirectional integration with existing electronic health record systems using HL7 v2 messaging and FHIR R4 APIs. We have built integrations against Epic, Cerner/Oracle Health, Athenahealth, and other major EHR platforms - syncing patient demographics and scheduling, writing visit documentation and encounter data back to the chart, and passing e-prescribing and RPM data into the patient's record.
Patient-facing scheduling, intake, and reminder systems that reduce no-shows and administrative overhead - automated intake forms, insurance and eligibility capture ahead of the visit, appointment reminders via SMS and push notification, and asynchronous secure messaging for follow-up questions and refill requests between scheduled visits.
Reporting and dashboards covering visit volume, no-show rates, provider utilization, RPM program adherence, and reimbursement-relevant documentation completeness - built from platform event data in real time rather than assembled manually from exports, giving clinical operations leaders visibility without additional administrative work.
The security and compliance layer underlying the entire platform: encryption in transit and at rest, role-based access control, comprehensive audit logging on every system touching protected health information, and infrastructure deployed on HIPAA-eligible cloud services with the required Business Associate Agreements executed and documented.
A structured five-stage process from free clinical workflow discovery through launch and ongoing platform support.
We map your clinical workflows, patient population, provider structure, existing systems, and regulatory environment. This free session establishes the care model the platform needs to support before any architecture decisions are made.
We design the HIPAA safeguards, state licensing logic, and integration architecture - EHR, e-prescribing, and RPM device connectivity - up front, so compliance is built into the platform structurally rather than retrofitted before launch.
We build the platform incrementally, delivering working video consultation, scheduling, and documentation workflows at each phase so you can test with pilot providers and patients well before the full feature set is complete.
We integrate with your EHR via HL7/FHIR, connect e-prescribing through Surescripts with EPCS support where required, and build the device ingestion pipeline and alerting logic for remote patient monitoring programs.
We deploy to HIPAA-eligible production infrastructure with audit logging, monitoring, and alerting validated against compliance requirements, and offer engineering retainers for ongoing platform evolution and feature development.
We map your clinical workflows, patient population, provider structure, existing systems, and regulatory environment. This free session establishes the care model the platform needs to support before any architecture decisions are made.
We design the HIPAA safeguards, state licensing logic, and integration architecture - EHR, e-prescribing, and RPM device connectivity - up front, so compliance is built into the platform structurally rather than retrofitted before launch.
We build the platform incrementally, delivering working video consultation, scheduling, and documentation workflows at each phase so you can test with pilot providers and patients well before the full feature set is complete.
We integrate with your EHR via HL7/FHIR, connect e-prescribing through Surescripts with EPCS support where required, and build the device ingestion pipeline and alerting logic for remote patient monitoring programs.
We deploy to HIPAA-eligible production infrastructure with audit logging, monitoring, and alerting validated against compliance requirements, and offer engineering retainers for ongoing platform evolution and feature development.
Select a care setting to see how we design, build, and integrate telemedicine platforms for the workflows that setting actually runs on.
Primary care groups need telehealth platforms that fit into an existing scheduling and documentation workflow - patients should be able to book, check in, and be seen without the visit feeling like a separate system bolted onto the practice.
Primary care groups need telehealth platforms that fit into an existing scheduling and documentation workflow - patients should be able to book, check in, and be seen without the visit feeling like a separate system bolted onto the practice.
Behavioral health telehealth has different requirements than physical-visit care: longer session lengths, recurring appointment cadences, heightened privacy expectations, and often a need for text-based check-ins between sessions.
Specialist telehealth - dermatology, cardiology, endocrinology, and similar - depends on high-fidelity media capture and clean referral workflows connecting the specialist back to the referring primary care provider.
RPM programs succeed or fail on the reliability of the device-to-platform data pipeline and the quality of the alerting logic - clinical teams need signal, not noise, from continuous vitals streams.
On-demand urgent care telehealth needs to route patients to the right level of care quickly - software has to handle unscheduled demand, symptom-based triage, and a hard handoff to in-person care when video visits aren't appropriate.
Four safeguards we treat as non-negotiable on every telemedicine engagement, because a platform that fails a compliance review after launch is far more expensive than one architected correctly from the start.
Encryption in transit and at rest, role-based access control, and comprehensive audit logging on every system that touches protected health information - designed in during the compliance and architecture phase, before development starts. For UK engagements, the same architecture is built toward UK GDPR and NHS DTAC/DSPT alignment.
We execute and document Business Associate Agreements with every third-party vendor in the stack that touches PHI - video infrastructure, cloud hosting, messaging, and e-prescribing networks - so the compliance chain has no gaps.
Provider licensing data tied to state-specific scheduling and matching rules, with patient location capture and audit trails documenting the provider-patient state match for every encounter, built to support the licensing strategy your healthcare counsel defines.
DEA-compliant identity proofing, two-factor authentication at the point of prescribing, and full audit logging for controlled substance e-prescribing - built to the EPCS standard rather than treated as a generic e-prescribing feature.
Indicative pricing bands based on scope. Every engagement gets a firm, detailed quote after a free discovery session once we understand your specific compliance and integration requirements.
$14,000 - $30,000
10-16 weeks
A focused telehealth MVP to validate a care model with real patients and providers.
$30,000 - $80,000
20-32 weeks
A platform ready for multi-provider scale, EHR integration, and e-prescribing.
$80,000+
Scoped by engagement
A multi-tenant or health-system-scale telehealth platform with deep integration needs.
Further reading: our analysis of what drives the cost of telehealth implementation covers the compliance, integration, and staffing factors that move a project between these bands.
Perimattic's work resulted in stable production systems. The team was helpful, easily accessible, and communicative through email. Their professionalism was impressive.
Quality
4.5
Schedule
5.0
Cost
5.0
Willing to Refer
4.5
DevOps Managed Services · Oct 2023 - Aug 2024
24/7 monitoring and support for production environments plus Linux server administration for a leasing automation company.
The new architecture is scalable and highly efficient, saving a lot of money in fees. Perimattic provides high-quality IT consulting and cloud development work promptly and at great value. The team remains involved from the planning stage to providing support, showing diligence and proactiveness.
Quality
5.0
Schedule
5.0
Cost
4.5
Willing to Refer
5.0
AWS Migration (Legacy → Microservices) · Nov 2018 - Ongoing
Transitioned a travel systems company's legacy server system to an AWS-based microservices architecture with ongoing maintenance.
Four structural advantages that separate telemedicine platforms built for real clinical and regulatory environments from platforms that work in a demo but fail a compliance review.
HIPAA safeguards, audit logging, and access control are designed into the architecture during the compliance and architecture phase - before development begins - rather than added as a checklist before launch. This is the difference between a platform that passes a security review and one that requires re-architecture to pass it.
We have built HL7 and FHIR integrations against Epic, Cerner/Oracle Health, and Athenahealth, and we understand the practical constraints of each vendor's integration program - certification timelines, sandbox limitations, and data mapping quirks that are not visible until you are actually building against the API.
Controlled substance e-prescribing has specific DEA identity-proofing and authentication requirements that go beyond standard e-prescribing. We scope and build EPCS explicitly rather than assuming a generic e-prescribing integration covers it, avoiding a compliance gap that surfaces only during a pharmacy audit.
The team that maps your clinical workflows and designs the compliance architecture also builds, integrates, and deploys the platform. There is no handoff between a consulting team and a delivery team, and no loss of clinical or regulatory context between discovery and production.
“A telemedicine platform that works correctly in a demo but fails a HIPAA review, an EHR integration test, or a pharmacy audit is not a successful launch - it is a compliance problem deferred to your clinical operations team.”
Yes. Every telemedicine platform we build is architected for HIPAA compliance from the first sprint, not retrofitted before launch. That means encryption in transit and at rest for all protected health information, access controls and audit logging on every system that touches PHI, Business Associate Agreements in place with every third-party service we integrate (video infrastructure, cloud hosting, messaging providers), and infrastructure deployed on HIPAA-eligible services such as AWS or Azure Health Data Services with the corresponding BAAs executed. We also document the administrative and technical safeguards your organization needs on your side of the shared responsibility model, since HIPAA compliance is a property of the whole operation, not just the software.
Yes. EHR integration is a core part of most telemedicine engagements, because a telehealth platform that does not write back to the system of record creates duplicate documentation and workflow friction for clinical staff. We build integrations using HL7 v2 messaging and FHIR R4 APIs, and we have delivered integrations against Epic (via App Orchard), Cerner/Oracle Health, Athenahealth, and other major EHR platforms. Integration scope typically covers patient demographics and scheduling sync, visit note and encounter documentation, e-prescribing order transmission, and diagnostic or vitals data from remote monitoring flowing back into the patient chart. We scope the exact integration surface during discovery against your specific EHR and its available APIs.
A focused MVP covering scheduling, video consultation, and basic documentation typically launches in 10-16 weeks. A platform that adds e-prescribing, EHR integration, and remote patient monitoring typically takes 20-32 weeks, largely driven by the compliance architecture work and the EHR integration timeline, which depends on the responsiveness of the EHR vendor's integration team. We deliver working software in phases throughout rather than a single release at the end, so you have a usable platform to test with pilot users well before the full feature set is complete.
Yes. We build e-prescribing workflows integrated with pharmacy networks through Surescripts, covering standard prescription transmission, medication history and formulary checks, and refill request handling. For controlled substances, we implement Electronic Prescribing of Controlled Substances (EPCS) in line with DEA requirements, which includes identity proofing for prescribers, two-factor authentication at the point of prescribing, and the audit logging required for regulatory inspection. EPCS certification requirements are specific and we scope this work explicitly during discovery rather than assuming it is included in a general e-prescribing build.
Telehealth licensing rules vary by state and by provider type, and they change more frequently than most other areas of healthcare regulation. We do not provide legal or licensing advice, but we build the platform to support your compliance requirements operationally: provider licensing data tied to state-specific scheduling rules so patients are only matched with providers licensed in their state, geolocation or attestation-based patient location capture at the point of visit, and audit trails documenting the provider-patient state match for every encounter. We recommend working with healthcare counsel on the underlying licensing strategy, and we build the platform logic to enforce whatever rules that strategy requires.
Yes. We build remote patient monitoring integrations covering Bluetooth-connected blood pressure cuffs, pulse oximeters, glucometers, connected scales, and wearable devices via Apple HealthKit and Google Fit. The RPM pipeline includes device pairing and patient onboarding, continuous vitals ingestion, configurable threshold and trend-based alerting so clinical teams see meaningful signals rather than raw data streams, and the time-tracking and documentation structure needed to support RPM reimbursement under current CPT billing codes.
Cost depends primarily on scope: a focused MVP with scheduling and video consultation is a different investment than a platform adding e-prescribing, deep EHR integration, and remote patient monitoring at scale. We provide indicative pricing bands on this page and a firm, detailed quote after a free discovery session once we understand your specific compliance requirements, integration targets, and patient volume.
Both, depending on the use case. Provider-facing consultation workspaces are frequently web-based for ease of deployment and updates across a care team. Patient-facing experiences are often built as native or React Native mobile apps to support push notifications, background vitals sync from wearables, and biometric login - though a responsive web app is a reasonable starting point for an MVP. We recommend the platform mix during discovery based on your patient population and how they are expected to access the service.
We follow a structured five-stage process: a free discovery session mapping your clinical workflows, patient population, and existing systems; a compliance and architecture phase that defines the HIPAA safeguards, licensing logic, and integration architecture before a line of production code is written; platform development delivered incrementally; integration with EHR, e-prescribing, and RPM device systems; and launch with monitoring, audit logging validation, and a support plan for ongoing evolution. We deliver working software at each phase so you can validate the platform against real clinical scenarios throughout the engagement.
For UK engagements, we architect the platform for UK GDPR and Data Protection Act 2018 alignment from the same compliance-first phase we use for HIPAA: lawful basis and data minimisation built into how patient data is collected and processed, encryption in transit and at rest, role-based access control, and audit logging on every system touching patient data. Where the platform is intended for use within or alongside NHS services, we build toward the NHS Digital Technology Assessment Criteria (DTAC) - covering clinical safety, data protection, technical security, and interoperability - and structure the platform's evidence and controls to support your organization's NHS Data Security and Protection Toolkit (DSPT) submission. We do not claim formal DTAC approval or DSPT certification on your behalf, since those are assessed against your specific deployment and organizational context, but we build the underlying architecture and documentation so your compliance team is not starting from zero when that assessment happens.
Tell us about your care model, your existing EHR and pharmacy systems, and the compliance requirements you are working under. In a free assessment, we will show you exactly how a custom telemedicine platform can replace point solutions and workarounds with a single, HIPAA-compliant system built around how your organization actually delivers care.