Consultanist

Technology stack

The engineering foundation behind the work.

One reusable foundation for regulated systems across healthcare, legal, finance, automotive, and enterprise IT — open standards, replaceable components, and deterministic controls.

Open standards, replaceable components, isolated data, and deterministic controls are the point.

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Shared packages

42+

Reusable packages across patient, staff, EMR, and regional application layers.

Clinical scale

26+

Specialty configurations supported by the EMR foundation.

Engineering foundation

A reusable stack for regulated, cross-vertical work.

One reusable engineering foundation: healthcare first, and built for sensitive legal retrieval, finance automation, industrial systems, and enterprise IT.

Domain 01

Frontend

Next.js 15 App Router, React 19, Turbopack

React Compiler for automatic memoization

Tailwind CSS v4 token architecture

TypeScript strict mode

TanStack Query, Zustand, service worker, next-intl

Domain 02

Backend and Auth

tRPC v11 internally, REST/OpenAPI externally

Drizzle ORM, PostgreSQL, pgvector

Database-per-tenant isolation where required

PgBouncer, pgboss, SSE, Socket.io for chat only

Better Auth with MFA, OAuth, and passkeys

Domain 03

AI Core

Custom AI layer in @emr/ai-core

Seven agents across clinical workflow

GPT-4o, Gemini, Claude, and local OSS toggle points

PHI pseudonymization before external LLM calls

DINOv2 visual similarity and tenant-scoped search

Domain 04

Infrastructure

Docker Compose and self-hosted deployment paths

Caddy for automatic HTTPS and custom domains

Cloudflare for DNS, WAF, DDoS, and edge cache

Doppler secrets, Grafana, Prometheus, Loki

GitHub Actions, Turborepo, pnpm workspaces, Payload CMS

Domain 05

Security and Compliance

236,000+ interaction pairs

294 clinical rules and 65 red flags

Immutable clinical audit trails

FHIR R4 export and granular consent

HIPAA, PIPEDA, GDPR, and regional data-residency alignment

Domain 06

Scale

42+ shared @emr/* packages

159 database tables

275+ pages across four apps

26 clinical specialties supported

Five languages and two RTL scripts

Architecture principles

Built for systems that cannot be casual with risk.

01

Safety-first

AI can recommend. Deterministic rules, clinicians, CPAs, attorneys, and principals keep authority where the risk lives.

02

No lock-in

Docker-first deployment, open standards, FHIR export, and replaceable components keep operators in control.

03

PHI and data isolation

Sensitive data is isolated by tenant, environment, and jurisdiction. PHI is pseudonymized before any external AI provider sees it.

04

Zero-vendor posture

No single managed service owns the architecture. Auth, queues, search, observability, and AI layers remain replaceable.

Work together

Use the foundation where failure is expensive.

Bring the operating environment, the data boundaries, and the users who have to trust it.

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