Healthcare SoftwareHealthcare data outlives the software that stored it.So this record speaks the standard from day one.
Most electronic medical records invent their own database schema, then bolt on an interoperability layer years later when a lab or a hospital needs the data. EMR Nest is built the other way around: every patient, encounter, and observation is a FHIR resource from the first commit, on a FHIR-native backend. The healthcare standard is the foundation, not an export format.
The status quo
Why clinic software ages badly
An electronic medical record has to be correct, auditable, and portable for decades. Most are none of those things, because of decisions made on day one.
01Proprietary schemas trap dataA custom database makes every later integration a translation project, and holds the clinic's data hostage to a single vendor.
02Interoperability is an afterthoughtHL7 and FHIR support gets added once a partner demands it, and is never as clean as if it had been designed in from the start.
03Clinics cannot run DevOpsA medical practice has no deployment team. Updates are risky, opaque, and a failed one can take the system down silently.
04Fuzzy role boundaries are a liabilityA receptionist, a nurse, and a physician should not see the same screens. Getting that wrong is a privacy and compliance problem.
How it works
FHIR-native, from the data model up
EMR Nest is a clinician-facing application built on a FHIR-native backend, with the access model and the operations tooling treated as first-class concerns from the start.
FHIR-native recordsPatients, encounters, observations, and appointments are stored and queried as standard FHIR resources through Medplum, an open healthcare data backend. Interoperability with labs and other systems is the default, not a later migration.
Role-aware clinician UIA modern interface on a consistent component and theme system, with distinct, access-scoped experiences for the physician, nurse, receptionist, office manager, and administrator. A six-role harness makes every view reproducible in development.
Operations built inA self-contained deployment dashboard manages the application over SSH, with build verification that catches an incomplete build before it can crash-loop the live service. The clinic does not need a DevOps team.
An engineering disciplineStructured logging, defensive error handling, and a documented learning log. The build holds itself to a written engineering doctrine, because healthcare software has to be auditable.
Under the hood
A clinic system that respects the standard
In plain termsRather than designing a private database and hoping it can be made to interoperate later, EMR Nest stores everything as the healthcare industry's own data format. That decision, made first, is what keeps the record portable, auditable, and able to grow.
The engineeringA Next.js and React application. The data layer is Medplum, a FHIR-native backend; clinical entities use standard FHIR resource types throughout. The UI is built on a consistent component and design-token system. Authentication is token-based with hashed credentials, and a six-role harness makes every access-scoped view reproducible in development. The repository ships its own deployment dashboard, an SSH-driven pipeline with build-ID verification, with Redis and PostgreSQL in support.
Next.jsReactTypeScriptMedplumFHIRPostgreSQLRedisTailwind CSS
Where it is
Early-stage, foundation first
The FHIR data model, the role-based clinician UI, the authentication system, and the deployment tooling are in place. EMR Nest is an early-stage build, not yet in production clinical use. The priority is getting the data and security model right before scale; clinical workflows are the active work.
FHIR-native
every clinical record stored as a standard resource
6 roles
distinct, access-scoped clinician experiences
v0.1
early-stage build, foundation and tooling in place
Self-deploying
an SSH deployment dashboard ships inside the repo
ShippedFoundationThe FHIR-native data layer on Medplum, the role-based authentication model, and the shared component and theme system.
ShippedOperations toolingThe modular deployment dashboard with SSH management and BUILD_ID build verification, so a failed build cannot crash-loop the live service.
ActiveClinical workflowsPatient encounter forms, the clinician dashboard, scheduling, and mobile-responsive layouts for tablet use at the point of care.
PlannedInteroperability and devicesLab-result automation, external system integration, and feeds from connected diagnostic devices.
EMR Nest is a deliberate bet: that getting the data model and the security model right, on an open standard, is worth more than a fast demo. It is healthcare software built to be auditable, and to outlive its first version.
