Case study — Northwind Health
Scaling virtual care from pilot to 380,000 visits a year
How a regional health system turned a struggling telehealth pilot into the front door for 2,400 clinicians — without a single HIPAA finding.
Industry
Healthcare
Duration
14 months
Team
9 people
Services
Custom Software Development, Cloud Solutions, UI/UX Design
The challenge
Northwind Health's pandemic-era telehealth pilot was built in six weeks on a consumer video tool, and it showed. Clinicians juggled three windows per visit — video in one, the Epic EHR in another, e-prescribing in a third. Median setup time per visit was eleven minutes, no-show rates ran 26%, and the compliance team had flagged the video vendor's BAA limitations as an escalating risk.
Leadership faced a choice: license an enterprise telehealth suite that clinicians had already rejected in demos, or build a platform around their actual workflow. They asked us to prove the second option could work — with a hard constraint that nothing could disrupt the 1,100 visits already happening weekly.
How we approached it
We spent the first three weeks in clinics, not code. Shadowing 22 clinicians across four specialties produced a finding that shaped everything after: the problem wasn't video quality, it was context switching. Every minute hunting for the patient's chart or re-authenticating into the prescribing system was a minute of a fifteen-minute slot.
The platform we built put the visit, the chart, and prescribing in one screen. FHIR integration with Epic pulled the patient context automatically; SMART on FHIR launch meant clinicians never logged in twice. WebRTC infrastructure with regional TURN servers kept video stable on rural bandwidth, and an SMS-first patient flow removed the app download that had been killing attendance.
We migrated specialty by specialty over five months, running old and new systems in parallel with weekly clinician councils steering the rollout order. Behavioral health went first — highest volume, most bought-in champions — and its adoption numbers recruited the skeptics for us.
Outcomes
The results, as measured
380K
virtual visits in the first year on platform
92s
median time from patient click to clinician connected
-31%
no-show rate reduction driven by SMS-first entry
0
HIPAA findings across two external audits
“The old system made clinicians feel like IT support. This one disappears — you're just seeing your patient. Adoption stopped being a management push and became a waiting list.”
Dr. Alana Reyes
Chief Medical Information Officer, Northwind Health
Built with
- Next.js
- Node.js
- WebRTC
- PostgreSQL
- FHIR / SMART on FHIR
- AWS
- Terraform
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