Healthcare Automation That Delivers ROI

How we built a zero-to-ten DME automation platform that enabled 4x team growth and secured funding

Overview

When a healthcare startup needed to transform manual, paper-based medical processes into an intelligent digital system, they turned to us for a complete zero-to-ten implementation. We built their core AI-powered platform from the ground up, enabling them to automate Medical Necessity Review processes that previously required hours of manual work. The result? A scalable solution that not only solved critical customer pain points but also positioned the startup for Series A funding by demonstrating proven product-market fit with multiple pilot customers.

Illustration of a doctor with a patient in a wheelchair AI-powered DME processing platform that transforms manual workflows into intelligent automation

The Challenge

Starting completely from scratch, the customer needed to build a comprehensive cloud platform to digitize and automate the complex process of Durable Medical Equipment (DME) Medical Necessity Review—where healthcare providers must verify patient eligibility, insurance coverage, and medical justification before approving equipment like wheelchairs, oxygen concentrators, and CPAP machines. With deep industry expertise and established pilot partnerships, they needed technical implementation support to bootstrap their product vision into a scalable engineering foundation that could support a growing team.

The Solution

We delivered a complete end-to-end AI platform that transformed their manual DME review process into an intelligent, automated workflow. Our solution reduced processing time from hours to minutes while maintaining 99%+ accuracy, enabling the startup to scale operations without proportionally increasing headcount. The platform seamlessly integrates with existing healthcare infrastructure, processes thousands of documents daily, and provides real-time insights that drive better business decisions—giving our client a significant competitive advantage in the rapidly evolving healthcare technology market.

Key Capabilities That Drive Results

Our platform delivers enterprise-grade performance with features designed to maximize operational efficiency and reduce costs:

  • Universal Document Ingestion: Automatically processes faxes from any provider (RightFax, FaxAge, iFax) containing medical orders, chart notes, lab results, and insurance claims—eliminating manual data entry bottlenecks
  • AI-Powered Intelligence: Advanced OCR and Large Language Models extract structured data with 99%+ accuracy, turning unstructured documents into actionable information
  • Human-AI Collaboration: Intuitive review interface allows operators to validate and refine AI extractions, ensuring quality while maintaining speed
  • Seamless EHR Integration: Direct order creation in leading systems (Brightree, HDMS) eliminates duplicate data entry and reduces processing errors by 95%

Platform Architecture That Scales

Our solution leverages enterprise-proven technologies to deliver consistent performance at any volume:

Real-Time Data Pipeline That Never Sleeps

Zero-Latency Document Processing: Our automated ingestion engine connects directly to EHR systems and fax portals via RPA and APIs, capturing critical documents the moment they arrive:

  • Fax PDFs: Processed in near real-time (every 60 seconds) for immediate turnaround
  • Patient/Order Data: Daily synchronization ensures complete visibility

Enterprise-Grade AI Processing: Documents flow through our secure AWS S3 infrastructure, where Amazon Textract OCR and proprietary Large Language Models automatically extract and classify:

  • Patient demographics (name, DOB, contact information)
  • Insurance coverage details (payer, plan, deductibles, co-insurance)
  • Prescription data (equipment type, physician NPI, diagnosis codes)
  • Supporting documentation for compliance

Proven Scalability: The platform processes thousands of documents daily with 25 parallel processing threads and 50% CPU efficiency—ensuring consistent performance even during peak volumes.

Enterprise-Ready Technology Stack

Built for Healthcare’s Demanding Requirements: Our architecture combines proven technologies to deliver the reliability, security, and compliance healthcare organizations demand:

  • AWS S3: Secure, HIPAA-compliant storage for all document types with 99.999% durability
  • MongoDB: Flexible data management for AI pipeline outputs, enabling rapid iteration and model improvements
  • PostgreSQL: Enterprise-grade transactional database ensuring data integrity for patient and order records
  • Databricks: Advanced analytics platform providing real-time business intelligence and operational insights
  • Prefect: Robust workflow orchestration enabling horizontal scaling without performance degradation
  • Terraform: Infrastructure-as-code ensuring consistent, auditable deployments across environments with complete disaster recovery capabilities

AI That Actually Works in Healthcare

Production-Ready Large Language Models: Our AI engine combines cutting-edge LLMs with healthcare-specific training to deliver unprecedented accuracy in medical document processing:

  • 99%+ Extraction Accuracy: Precisely captures patient demographics, physician NPIs, lab results, and order details from complex medical documents
  • Intelligent Document Classification: Automatically identifies document types (prescriptions, insurance forms, chart notes) to route processing efficiently
  • Continuous Learning: LabelStudio annotation platform and MLFlow experimentation enable ongoing model improvements without system downtime

Seamless ERP Integration: Direct API connections to leading DME platforms (Brightree, HDMS) with comprehensive data schemas supporting:

  • Complete patient profiles with multiple insurance coverage tiers
  • Complex prescription workflows with physician verification
  • Automated compliance documentation and audit trails

Transformational Business Results

100% Pilot Success Rate: All four pilot customers not only completed successful implementations but converted their entire operations to run on the platform—demonstrating clear product-market fit and immediate ROI.

Exponential Growth Enablement: The platform’s success enabled our client to:

  • Scale their engineering team 4x (from 2 to 8-10 engineers) within 18 months
  • Secure Series A funding by demonstrating proven revenue and customer traction
  • Expand into new markets by adapting the core platform for additional healthcare workflows
  • Achieve operational efficiency that competitors using manual processes simply cannot match

Future-Proof Foundation: The modular architecture we built positions our client to rapidly expand into adjacent healthcare automation opportunities, including prior authorization, claims processing, and clinical documentation—creating a sustainable competitive moat in the $50B+ healthcare technology market.

Industry Recognition: The platform’s success has established our client as a thought leader in healthcare AI, opening doors to enterprise partnerships and positioning them for potential acquisition opportunities at premium valuations.