Healthcare Mobile Platform
Regional Healthcare Network
Context
A regional healthcare network of 23 hospitals needed a unified patient portal. Existing solutions were web-only, slow, and required constant connectivity — problematic for rural patients with limited internet access. The goal was a mobile-first experience that worked reliably offline.
Constraints
- —HIPAA compliance required — PHI must be encrypted at rest and in transit
- —Offline functionality required for appointment viewing and medication tracking
- —Integration with 23 different EHR systems via HL7 FHIR
- —Accessibility requirements: WCAG 2.1 AA compliance
- —Support for iOS 12+ and Android 8+
Engineering Decisions
React Native with native modules for encryption
Cross-platform efficiency for small team. Native modules used for biometric authentication and encrypted storage to meet HIPAA requirements.
FHIR R4 as the canonical data model
Healthcare interoperability standard. All EHR integrations normalized to FHIR, creating a stable internal API regardless of source system variations.
SQLite with SQLCipher for local storage
Offline-first architecture required local data persistence. SQLCipher provided AES-256 encryption at rest, satisfying HIPAA requirements.
Security Considerations
- •Biometric authentication with secure enclave integration
- •All local data encrypted with SQLCipher
- •Certificate pinning for API communication
- •Session timeout: 15 minutes inactive, 8 hours maximum
- •Remote wipe capability for lost devices
- •No PHI in logs or crash reports
Performance Considerations
- •Initial sync optimized: full sync under 30 seconds on 3G
- •Incremental sync for subsequent loads: under 5 seconds
- •Image optimization: medical images lazy-loaded and cached
- •Bundle size: 12MB initial download
UX Trade-offs
- —Simplified information display over comprehensive data — surfaced most-used features (appointments, medications, messages) prominently
- —Biometric-first authentication — faster access but required fallback for devices without biometrics
- —Offline indicator always visible — clear user mental model of sync state
Failures & Corrections
Failure
Early versions caused excessive battery drain during background sync
Correction
Implemented intelligent sync scheduling based on connectivity and battery state. Reduced background battery usage by 70%.
Failure
FHIR normalization layer became a bottleneck with slow EHR responses
Correction
Added caching layer with stale-while-revalidate pattern. Users saw cached data immediately while fresh data loaded in background.
Final Architecture
React Native mobile app communicating with a Node.js API gateway. FHIR integration service handles EHR communication. PostgreSQL for user data, Redis for session management. AWS infrastructure with HIPAA-eligible services only.
Outcome
400,000 registered users within 6 months. 4.7 App Store rating. 85% of appointment bookings now happen through the app. Patient satisfaction scores increased 23% across the network.
Why It Matters
Healthcare software often prioritizes compliance over usability. This project proved that HIPAA compliance and excellent UX can coexist. The offline-first architecture was particularly impactful for underserved rural communities.
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