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Custom Healthcare Software Development

For more than 25 years Kanda has been working with Digital Health pioneers and established
healthcare delivery organizations to empower all phases of their software development lifecycle.

We are a full-service provider in all areas of product design, development, deployment, and support
for the highly regulated and technically complex software healthcare arena.

Client Spotlight

Digital Health Custom Application Development

Kanda has been successful in assisting many healthcare companies with rapid product delivery of exceptional products to the marketplace. We have an in-depth expertise with healthcare information technologies. We are particularly proud of our multi-year experience developing HIPAA and other regulatory enabled (or compliant) solutions.

What truly makes us unique is the company infrastructure that combines all levels of management and processes to meet explicit and implicit needs of software product development companies which cannot be met by “staff augmentation” firms. Add to that our upper management’s relentless efforts in ensuring every client’s satisfaction and you get a clear picture of Kanda’s Digital Health Practice.

Kanda’s digital health clientele ranges from large hospitals to disruptive startups. Our clients deliver solutions to empower or optimize various areas of healthcare – and Kanda enhances our client’s abilities to reduce time to market and associated risks.

What We Do

Within our Digital Health Practice clients can utilize any and all of these service offerings:

Technology assessment
Technology assessment and building a product roadmap
User Interface
User Interface and User Experience design
usiness Analysis
Business Analysis and New Product or Product-Reengineering definition
Cloud Conversion
Cloud Conversion and Cloud Engineering
Technical Architecture
Technical Architecture development for new products and product re-engineering
Scaled Agile
Scaled Agile (Scrum at Large, SAFe, Kanban), or Custom Model Development
Security Testing
Security Testing and assessments – Penetration testing, perimeter, crowdsource testing
Development and CI/CD
Development Operations and CI/CD pipelines. CI/CD training and mentoring
Quality Assurance
Quality Assurance – manual and automated
Performance Engineering
Performance Engineering and optimization
Production health monitoring
Production/sustaining health monitoring

How is Kanda Different?

Kanda brings to the table unique capabilities that help our clients overcome a variety of challenges:
  • Compliance with federal, state and foreign regulatory requirements such as HITRUST, HIPAA, FDA, CLIA, and NIST
  • Utilization of healthcare-specific interoperability protocols such as HL7 and FHIR
  • Integration with large-scale and speciality EHR platforms
  • Deployment of modern tools and technologies – AI/machine learning; Big Data; Cloud Engineering and Cloud Deployment; Intelligent Assistants and IoT rapidly and transparently.
Kanda has a trained cadre of business analysts, software architects, software engineers and quality assurance professionals to effectively work with:
  • Acute Care clinical and administrative workflows and data stack such as ADT, laboratory results, observations, medication orders, billing
  • Clinical Genomics and personalized medicine data processing
  • Common healthcare industry standards and nomenclatures: UB, ICD, CPT, DSM, SNOMED, LOINC, NCD, RxNorm, DiagnosisRx, and radiology imaging (DICOM)

Clients of our digital health practice benefit from Kanda’s core competencies of hiring, continuously training and long-term retaining of excellent technologists. Our key differentiating factors lie in domain knowledge, regulatory compliance and deep technical expertise in technologies underlying any successful health-related software development initiative.

When you work with Kanda’s Digital Health Practice you have the confidence of working with the partner that does not just talk the talk. We walk the walk – from understanding what and why you are building to managing the processes and methodologies all the way to letting you sleep well at night knowing your patient data, your intellectual property and your product’s runtime are well protected.

digital health devices

Challenges facing Digital Health vendors

The past few years in U.S. healthcare we have seen a consistent shift to value-based delivery, optimization of payment models, achieving better efficiency of care and better interoperability.

While there is a significant amount of discordance and uncertainty in the US healthcare federal legislation (reenactment of MACRA, future of ACOs, attempts to repeal the Affordable Care Act), the focus on improving patient’s experience will remain unchanged. For eHealth vendors, working in this ever-changing highly regulated environment (seeking compliance with both U.S. and European federal and state laws) requires significant investment into the compliance function, which often results in partnering with 3rd parties to bridge the compliance expertize gap. Finding a long-term partner who has a proven commercial experience building solutions for healthcare and who has trained engineering staff readily available to work with live ePHI data and continuously re-engineer the customer product is a challenging task.

Population Health Management (PHM) is going to be playing a more and more visible role in the digital landscape of healthcare. Powered by the emergence of new developments in Big Data, Artificial Intelligence (AI), deep machine learning, applied statistical modeling, healthcare analytics will have much greater predictive and informative power and will lead to better clinical and financial outcomes. When AI is paired with IoT, use of home-based devices and bots, this allows for even broader home healthcare opportunities. Most notable is Amazon with its interest in prescription medicine. Alexa by Amazon has already become as a subject area of focus for several digital health companies, trying to capitalize on its functionality. Powered by AI, mobile health (mHealth) will continue to be one of the key drivers. Another emerging technology with its apparent applicability is blockchain, allowing for a secure and immutable store of medical records. Kanda’s Digital Practice has already been actively engaged in these advanced functional areas and technologies.

AI and Machine Learning in Healthcare

Machine learning has been around for decades, but fueled by emergence of big data, it has started gaining significant traction in digital health. Healthcare providers and payers have seen enormous volumes of both structured and unstructured data, generated through various manual and automated sources: electronic health record systems (EHRs), medical devices, claims and billing systems, and pharma research, to name a few. With that data organized and stored in databases, data warehouses and data lakes, a need has emerged to build algorithms, processes, software and models to turn this raw data into actionable knowledge, consumable

by healthcare providers so they could better drive clinical and financial outcomes.

Recognizing specific patterns and building predictive models is now widely used in risk adjustment for prospective payments, image processing, personalized medicine, clinical decision support and surveillance/alerting extending to mobile devices. Our digital health practice employs trained biostatisticians, software engineers with majors in Artificial Intelligence and ML (Machine Learning) / DL (Deep Learning).

digital health devices

Regulatory Compliance

Working in the field of Digital Health presents software vendors with a number of regulatory compliance challenges. Numerous government regulations require focused efforts from all internal functions that need to be managed on an ongoing basis. A company seeking compliance status is expected to thoroughly understand and align with applicable regulations, including federal, regional, or even international. The resulting set of policies and procedures deeply affect the software development practices, and an outsourcing partner that you choose has to adhere well to your regulatory practices to avoid the risk of project’s failure or worse.

In order to work on Healthcare IT projects, Kanda technical and professional personnel have received HIPAA compliance training. Our Business Analysts and engineers have gained strong experience in securely transmitting and housing ePHI while adhering to all applicable laws and regulations by developing modules and solutions as required by the HIPAA Technical Safeguards, especially as it pertains to secure housing and transmitting e-PHI. We are also actively exploring and working with HITRUST Federal framework to better understand its controls and applicability to our client base.

Deploying customer-facing solutions hosted in the cloud environment, such as AWS, adds another layer of complexity to the regulatory-compliant engineering processes. In our engagements Kanda engineers have mastered working with AWS provisions, security APIs and administrative controls, while making sure that the security and privacy of e-PHI is fully protected.

Our expertise in building secure Digital Health in the cloud environment – private, commercial and hybrid – helps Kanda’s customers rapidly deliver high quality, compliant solutions to numerous healthcare constituencies – acute care hospitals, rehabilitation centers, payers, medical practices, pharmacies, laboratories, doctors, and patients.

Clinical Data – Integration and Interoperability

The issue of interoperability in private and government healthcare has become one of the chief concerns with the lawmakers, healthcare policy administrators and clinical community. It is one of the gaps in healthcare which was not adequately addressed by the Affordable Care Act (ACA). Physicians continue to be frustrated by their inability to gain access clinical documents in a timely fashion in order to make critical decisions at the bedside and in an ambulatory setting. The recent version of FHIR

data interoperability platform

3.0 is an important milestone for this emerging technology, which quickly gains support and adoption by major EHR vendors, such as Epic and Cerner, who are now playing a much more active role in shaping the future interoperability landscape. Payers also have a strong interest in collaboration with providers to gain access to the clinical data feeds (ADT, Results, Observations, and Orders). Having access to that data allows them to better optimize their workflows.

Having the complete and comprehensive medical record from multiple sources such as provider office, ambulatory, hospital, rehabilitation and dialysis clinics available at the decision-making point is one of the critical success factors in improving the patient safety and achieving better outcomes. Enabled by IT interoperability, clinical integration is powered by clinical data, coding standards and protocols.

Kanda has been on the forefront of interoperability and integration protocols for the most of our twenty-year history. Even prior to establishing our Digital Health practice, many if not most of our clients ranging from D&B to Nuance had been operating in a highly integrated multi-vendor environment rich with technologies enabling Enterprise Data Integration, SOA and RESTful API integration. With that background, we are able to speed up our customers’ ability to develop products that utilize a full stack of rich clinical data, collected both automatically and manually including demographics, laboratory results, observations, imaging, and billing. Our interface developers have hands-on experience with HL7 v. 2.4, ANSI X12 and, most recently, FHIR® 3.0.

Personalized Medicine

For many years patients with various conditions have been treated based on industry standard clinical guidelines and protocols. With an advent of personalized medicine, the fusion of genetic, genomic and clinical data has been put in service to improve the patient outcomes. Predicting the individual’s risk for developing certain conditions, the course of a disease, and most importantly, aligning drug treatments with genetic biomarkers has been made possible as gene sequencing technologies such as next-generation sequencing have become more mature and widely available in the academic settings and molecular laboratories.

The subject of personalized medicine is of significant interest to a variety of healthcare constituencies, including but not limited to Pharma research companies, acute care centers, community physicians, and payers. Physicians of various medical specialties, but most notably oncologists, specializing in treating patients with solid tumors, have been actively using genetic and molecular testing capabilities. To illustrate this point: the recent studies suggest that more than half of patients with Non-Small Cell Lung Cancer are linked to at least 10 key biomarkers, enabling oncologists to use molecular profiling combined with evidence-based treatment information.

For software and bioinformatics solution vendors, developing workflow and analytical products presents a variety of challenges: dealing with data volumes and scientific complexity, data exchange and interoperability between different participating entities, and regulatory compliance with HIPAA and CLIA.

While helping our personalized medicine clients, Kanda engineers have gained experience working with the sequenced genomic data, as well as the evidence content coming from repositories such as PubMed.gov and ClinicalTrials.gov. Our clients are effectively utilizing the RESTful API-based functionality, which we have built for them in order to create interoperable solutions, serving the needs of clinical oncologists and molecular pathologists.

Mobility in Healthcare

Since the mid-90s with the arrival of handheld devices with extended capabilities, software developers have been looking for creative and efficient ways to use these devices in healthcare. Obvious use cases include extending the data viewing and entry capabilities of EHRs to a mobile device in the hands of a clinician. Performing a positive patient identification, checking laboratory results, ordering tests, charge capture and clinical notes – all seemed no-brainer disruptive ideas. However, as the mHealth industry gained maturity and gained traction with vendors, hospitals, and individual providers, especially with an advent of telemedicine, it had become increasingly apparent that these great benefits also impose a variety of challenges on mobile developers: technical, regulatory, workflow usability and performance. The success stories of our mHealth clients attest to our expertise in this challenging domain.

With a variety of competing devices, manufacturers, and two platforms with the largest adoption in healthcare (iOs, Android), mHealth solution vendors face a difficult support decision: building native applications for

each platform vs a platform-independent framework, such as Xamarin.

Kanda mobile engineers have done both: developing native applications for iOS and Android, as well as building its own platform-agnostic frameworks, supporting a daily clinical practice. Another important aspect is a great variability of manufacturer/carrier-specific versions of Android and associated with it Quality Assurance challenge. Our testing methodologies allow for expedient regression cycles and reduced time to market.

The successful mobile solutions used by physicians and nurses have to fit into the existing IT infrastructure of acute care hospitals, rehabilitation centers, and outpatient clinics. In addition to the application security and compliance with all applicable regulations, the UX design is the key to successful adoption by clinicians. Kanda’s UX engineers have strong industry expertise in mobile clinical workflows, designing solutions that physicians, nurses and healthcare coordinators use in their day-to-day practice.