01
Post-discharge follow-up
Symptom check-ins and escalation rules for one condition cohort after discharge.
Healthcare / Clinical Innovation
Clinical innovation software development for health systems
Innovation teams are asked to prove a new care model quickly, inside a hospital that cannot bend its privacy and safety rules for a pilot. Agnotic Technologies builds the pilot software: rapid prototypes that still meet HIPAA, sandbox EHR integration through SMART on FHIR, evaluation built in, and a clear path to production when the pilot works.
SMART on FHIR
Sandbox launch from the EHR
FHIR R4
Standard API to certified EHRs
BAA
Signed before any PHI is shared
Trusted by global innovators
Industry Overview
What is clinical innovation software development?
Clinical innovation software development is building the apps, integrations and data tools that hospital and health-system innovation teams use to pilot new care models. Agnotic Technologies builds these pilots for innovation teams: rapid prototypes that still meet HIPAA, sandbox EHR integration through SMART on FHIR, evaluation and measurement design, and the engineering needed to move a successful pilot into production.
Industry Challenges
Why do so many clinical pilots stall?
Pilots rarely fail on the idea. They fail on the path around it. These are the failure points we see most often in health-system innovation work.
The prototype was built with real patient data on an unapproved tool, so security review stops it before the first user.
EHR access was assumed; production FHIR access and a SMART app registration take months the plan did not include.
No measures were agreed before launch, so at the end nobody can say whether the care model worked.
The pilot depended on one champion nurse or physician, and the workflow did not survive their rota change.
It worked, but nobody owned the move to production: no support runbook, no budget line, no interface approval.
Decision table
What changes between prototype, pilot and production?
The same care model needs different engineering at each stage. Knowing the stage you are in, and the next one, keeps the work proportionate.
| Criteria | Prototype | Pilot | Production |
|---|---|---|---|
| Purpose | Test the workflow with clinicians | Test the care model with real patients | Run the care model as a service |
| Data | Synthetic or de-identified data | Minimum necessary PHI, named data owner | Full PHI under the organisation's policies |
| EHR access | SMART on FHIR sandbox | Non-production or limited production API access | Production interfaces approved by IT |
| Users | Innovation team and a few clinicians | One unit or one cohort | Every eligible unit, with training |
| Security review | Architecture review, no PHI | Risk analysis and BAA before launch | Full security and change control |
| Support | Best effort by the build team | Named on-call during pilot hours | Service desk, runbook, monitoring |
| Measurement | Usability feedback | Pre-agreed outcome and process measures | Ongoing dashboards and audits |
Our Approach
How do we keep a rapid prototype HIPAA-ready?
Speed comes from scoping the data, not from skipping the controls. These three practices let a prototype become a pilot without a rebuild.
Start without PHI
Prototypes run on synthetic data and the SMART on FHIR sandbox, so clinicians can test the workflow while the privacy review runs in parallel.
Controls from the first sprint
Role-based access, encryption, audit logging and no PHI in application logs are built in before the first real patient, not added before launch.
Minimum necessary by design
Each pilot has a data map that lists every field, why the pilot needs it and who owns it, which is also what the security review asks for.
Capabilities
What do we build for clinical innovation teams?
The pieces most pilots need, built so they carry into production rather than being thrown away.
Patient-facing pilot apps
Check-ins, education, reminders and messaging on web and mobile, with consent and privacy screens that pass review.
Clinician tools inside the EHR
SMART on FHIR apps that launch from Epic or Oracle Health (Cerner) with patient context, and CDS Hooks where a prompt belongs in the workflow.
Care team dashboards
Worklists, alerts and escalation rules for the nurses and coordinators running the pilot.
Evaluation data pipeline
Event capture, outcome and process measures, and reports your clinical and research leads defined before launch.
AI features with human review
Summaries, triage suggestions or drafting, always reviewed by a clinician before anything reaches a patient or a chart.
Production hardening
Monitoring, runbooks, interface approvals and training material so a successful pilot becomes a supported service.
Engineering Stack
Technologies behind a clinical pilot
Chosen to fit your EHR, your cloud agreements and the team that will support the service afterwards.
EHR access
SMART on FHIRFHIR R4 and US CoreCDS HooksHL7 v2 feeds
Apps
React NativeNext.jsSwiftKotlin
Backend and data
Node.jsPythonPostgreSQLEvaluation data marts
Platform
AWSAzureGoogle CloudYour on-premises environment
Measured Impact
How should a pilot be evaluated?
Measures we build the evaluation pipeline around. Your clinical and research leads choose the outcomes; we make them measurable from day one.
Adoption
Eligible patients enrolled
Patients and clinicians using the pilot, divided by those who should.
Process
Workflow steps completed
Check-ins done, alerts answered and time from alert to response.
Outcome
Measures your leads chose
The clinical or operational outcomes defined before launch, with a baseline.
Safety
Issues logged and reviewed
Near misses and incidents captured in the pilot and reviewed by governance.
My Lauren Maternal Health Platform | Built by Agnotic
A HIPAA-ready maternal health platform enabling remote patient monitoring, care coordination, and personalized engagement from pre-pregnancy through postpartum.
Case Study
LERA Health: Compliant Women’s Health App Platform
A women’s health product experience focused on guided care journeys, education, and compliance-aware workflows to support long-term engagement.
Case Study
Use Cases
Which care models are we asked to pilot?
Common pilots from health-system innovation teams and the digital health startups that partner with them.
02
Remote monitoring for one cohort
Home readings for a small group, with a nurse worklist and clear escalation.
03
Virtual nursing support
Admission, education or discharge tasks handled by a remote nurse with a shared worklist.
04
Care navigation
Patient navigators coordinating referrals, transport and follow-up from one view.
05
Clinical decision support prompts
A CDS Hooks prompt at order entry, measured by how often it changes the decision.
06
Ambient and drafting tools
AI drafting of notes or messages with clinician review, evaluated on edits and time saved.
Integrations
Which systems does a pilot connect to?
A pilot touches fewer systems than a production service, but the ones it touches must be done properly.
Clinical record
EHR sandbox and production APIs
Access
Identity provider (SSO)
Communication
Secure messaging and notifications
Patient data
Home devices and wearables
Operations
Scheduling and referrals
Evaluation
Research and quality data stores
Self-assessment
Is your pilot ready for production?
Our pilot-to-production checklist. Tick what is already true; the result shows which area needs work before the switch.
Compliance-First Development Services Backed by Global Standards
We build secure, scalable products designed for privacy, interoperability, and regulatory readiness from day one across every sector we serve.
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, and strict access controls.
Fast Healthcare Interoperability Resources
Enabling standardized health data exchange through standards-based API mappings.
Our Edge
Why Global Leaders Choose Us
We combine deep technical expertise with industry-specific knowledge to deliver solutions that aren't just functional, but transformational.
Enterprise-Grade Security
We implement rigorous security protocols and compliance standards (HIPAA, GDPR, SOC2) across all industrial solutions to protect sensitive data.
High-Performance Scaling
Our architectures are built to handle massive data loads and user bases, keeping performance steady whether you're serving ten or ten million.
Accelerated Time-to-Market
Using our suite of internal tools and proven frameworks, we reduce development cycles and get your product to market 40% faster.
Embedded AI Integration
Beyond simple wrappers, we build deep-learning integrations and predictive analytics directly into the core of your industry-specific workflows.
Engagement Model
How does a clinical innovation engagement work?
Timing depends on the care model, the EHR access path and the governance steps your organisation requires. We agree the first pilot's scope and timeline on the scoping call.
01
Scoping call
We agree the care model, the cohort, the measures and the EHR access path for the pilot.
02
Prototype without PHI
Clinicians test the workflow on synthetic data and the SMART on FHIR sandbox while privacy review runs.
03
Fixed-scope pilot
One unit or cohort, with controls, evaluation capture and named support in place from the first patient.
04
Evaluation review
Results against the pre-agreed measures, reviewed with clinical, research and operational leads.
05
Pilot to production
Hardening, interface approvals, runbooks and training, then rollout to the next units.
Facts and sources
Rules and standards behind clinical pilots
Short facts we design pilots around, each linked to its primary source.
The SMART App Launch implementation guide uses OAuth 2.0 and OpenID Connect so that apps can launch from an EHR with the user's and patient's context and only the access scopes they were granted.
Source: HL7 International (SMART App Launch)ONC certification criterion 170.315(g)(10) requires certified EHRs to offer a standardized API for patient and population services based on HL7 FHIR.
Source: 45 CFR 170.315 (eCFR)The HIPAA Privacy Rule lets covered entities use or disclose health information for research with a waiver of authorization approved by an IRB or privacy board.
Source: 45 CFR 164.512(i) (eCFR)HIPAA allows two ways to de-identify health data: expert determination, or the safe harbor method, which removes 18 categories of identifiers.
Source: 45 CFR 164.514(b) (eCFR)A HIPAA covered entity may share protected health information with a business associate, such as a software vendor, only under a business associate agreement that commits the vendor to safeguard it.
Source: 45 CFR 164.502(e) and 164.504(e) (eCFR)
Voice of success
We don't just build products; we forge lasting partnerships. See how we've helped industry leaders transform their vision into technical reality.
“I can clearly see how Agnotic has a unique way of handling end-to-end development. They are always active on quick chat and provide support quickly.”
Aaron Phelan
Founder, Benchmark
“Agnotic combines deep technical expertise with strong domain knowledge. They understand the business context, anticipate challenges, and make collaboration smooth and effective.”
John Pasmore
Founder, Latimer
“Agnotic is the best technical team we evaluated. Their engineering excellence made our work dramatically easier and allowed us to stay focused on what matters most for maternal care outcomes. They took full ownership of the technical execution, and we are always happy to continue working together.”
Kim Smith
Founder, My Lauren
Related services
Related services for innovation teams
Detailed pages for the services most clinical innovation pilots draw on.
FHIR and SMART on FHIR development
SMART apps, FHIR APIs and CDS Hooks services that launch inside the EHR.
MVP development
A fixed-scope first release to test the idea with real users before scaling.
EHR integration services
The interfaces a pilot needs when it moves from sandbox to production.
HIPAA requirements for software teams
The safeguards a pilot must meet before the first real patient.
More in Healthcare
More Healthcare Solutions
Explore other production-grade engineering platforms we deliver across healthcare.
Cross-Industry Reach
The Same Engineering Patterns, Across Other Industries
The technical patterns behind this platform translate naturally into adjacent verticals.
Frequently Asked Questions
It depends on the care model, the EHR access path and your governance steps. We agree a fixed-scope pilot on the scoping call and give you a timeline for it before work starts.
Yes. As soon as a pilot touches protected health information, Agnotic signs a business associate agreement with your organisation before any PHI is shared with our team. Prototypes run without PHI until then.
Yes. We start in the SMART on FHIR sandbox, move to a non-production environment with your interface team, and register the app in production once the pilot is approved. Timelines for production access are set by your EHR team, so we plan around them early.
Yes. Most engagements start with one care model for one unit or cohort, with the measures agreed up front, before any decision to scale.
Your clinical and research leads choose the outcome and process measures; we design the data capture, the baseline and the reports so the measures are answerable at the end. If the pilot is research, your IRB or privacy board process applies and we build to it.
We run the pilot-to-production checklist on this page with you: security review, interface approvals, runbooks, training and a product owner. The pilot code is built to carry into production, so the move is hardening rather than a rebuild.
AI tools help our engineers draft code and tests, but a person reviews every change, and it passes the same automated tests and security checks as any other code. AI features inside a pilot always keep a clinician in the loop.
Industries