Why healthcare is a different hire
Healthcare is different because a mistake exposes patient information, and the legal responsibility stays with you. A clinic, health program or digital health company that collects health information is accountable for it, even when a vendor wrote the code.
That changes what you look for. A beautiful portfolio matters less than whether the team has worked under privacy rules before, and whether they can explain their choices in plain language to your privacy officer. For background on the product side, read application development in healthcare.
Check privacy experience first
Start by asking which privacy law applies to your app and listen to how the developer answers. A team with real experience will ask where your patients are and who the health information custodian is before they answer.
- In Canada, health privacy is mostly provincial. Ontario has PHIPA, Alberta has the HIA, Quebec has Law 25, and federal PIPEDA applies in some commercial settings. Our guide to healthcare app development in Canada explains how that shapes the product.
- In the United States, HIPAA applies when you handle protected health information for a covered entity. A developer who touches that data is normally a business associate and should expect to sign a business associate agreement.
- In the United Kingdom, UK GDPR treats health data as a special category, and NHS work brings its own standards.
Good signs: they talk about consent, access logs, data minimisation, data residency and privacy impact assessments without being prompted. They should also say clearly that they are not your lawyer. This article is general information, not legal advice, and your own counsel or privacy officer should confirm what applies to you.
One claim to be careful with: there is no official government "HIPAA certification" for software vendors. A developer who leads with a badge instead of their practices is telling you something.
Ask about clinical system integration
Most healthcare apps are only useful when they connect to the system of record, so ask for specifics about integration work. The clinical record usually lives in an EMR or EHR, and the app should read from and write to it instead of creating a second copy.
Questions that separate experience from guesswork:
- Which EMR or EHR systems have you integrated with, and through what method: a vendor API, HL7 messages, or FHIR?
- How did you get access to the vendor's sandbox, and how long did approval take?
- How do you match a patient in the app to the right chart?
- What happens in the app when the clinical system is down?
- Have you integrated booking, lab results, e-prescribing, video visits or medical devices?
Integration access is often controlled by the EMR vendor, not the developer, so an honest team will warn you that this step can set the timeline. If you are scoping a portal, see how to build a patient portal app.
Ask for security evidence
Ask the developer to show how they work, not to describe how secure they are. Evidence beats adjectives.
- A sample architecture diagram showing where health data is stored, in which country, and how it is encrypted.
- How access is logged: who viewed which record and when.
- Their release process: code review, automated tests, separate staging and production, no real patient data in test environments.
- How their own staff access production, and how that access is removed.
- Whether an independent penetration test is included before launch, and who fixes the findings.
- Their incident process: how fast you would be told about a suspected breach.
Separate the developer's practices from the hosting provider's attestations. Major cloud providers publish their own audit reports, and those cover the data centre, not the app built on top. Our mobile app security guide lists the app-level controls to expect.
A scorecard for comparing developers
Score each developer from 1 to 5 on the same criteria so the decision does not come down to the best sales call. Weight the first three rows most heavily.
| Criterion | What a strong answer looks like |
|---|---|
| Privacy understanding | Names the law that applies to you, explains custodian and vendor roles, offers to support your privacy impact assessment |
| Integration experience | Describes a past EMR or device integration in detail, including what went wrong |
| Security practice | Shows logging, encryption, environment separation and a penetration test plan |
| Accessibility | Designs to WCAG, tests with screen readers and large text, considers older and less technical patients |
| Process and communication | Fixed scope or clear sprints, weekly demos, one accountable lead |
| Ownership | You own the code, the accounts and the data from day one |
| After launch | Defined maintenance plan, response times and OS update policy |
| Price clarity | Written scope, what is excluded, how changes are priced |
To compare quotes fairly, give every developer the same brief. See how to write an app development brief, and the cost factors in healthcare app development cost.
Red flags
Walk away, or at least slow down, if you see any of these.
- They claim the app will be "compliant" out of the box, or wave a certification that does not exist.
- They cannot say where data will be hosted.
- They plan to use real patient data for testing.
- They propose building their own video, chat or encryption from scratch when proven services exist.
- They want to hold the app store accounts or code repositories in their own name.
- They quote without asking about integrations, user roles or consent.
- Third-party analytics or advertising tools appear in the plan with no discussion of what data those tools receive.
- No mention of accessibility.
What to put in the contract
The contract should state who owns what, how data is protected, and what happens when the relationship ends. Have your lawyer review it. At minimum, look for:
- Intellectual property assigned to you on payment.
- A data protection or agent agreement, or a business associate agreement in the United States, covering confidentiality, permitted use, breach notice and subcontractors.
- Data location and a ban on moving it without written consent.
- Return and deletion of data at the end of the contract.
- Acceptance criteria, a warranty period for defects, and a change process.
- Maintenance terms after launch, including security patches.
Your next step
Shortlist three developers, send each the same brief, and run the scorecard above on a one-hour call with your privacy lead in the room. You will learn more from how they answer the integration and logging questions than from any portfolio.
If you would like us on that shortlist, see how we approach healthcare app development, then send us your brief. We will tell you plainly what we have done before, what we have not, and give you a fixed-scope quote.