Should we get an EHR/EMR application or continue with our custom build? Patient/data/order management for COVID testing company? Would appreciate any guidance/advice…

New healthcare startup CTO here, getting outside of my knowledge base and would really appreciate any input! I’ll preface by saying I do have a tech background but not in healthcare, and we have in-house counsel advising on the HIPAA/privacy aspects of what we’re doing. Our startup does bulk COVID-19 testing for businesses and some government agencies. What we do different from other providers is that we bring a team onsite to conduct testing on location, up to 1,000 at a time, and also share results with the employer (with patient consent) so they can monitor the health of their workforce. (We collect via nasopharyngeal swab and courier samples to a local lab with FDA EUA for COVID-19 PCR test.) We bootstrapped this thing big time to get off the ground quickly. Patients register with an encrypted web form which dumps into Google Sheets (under BAA), then we use that to generate our own lab requisitions, securely send CSVs to our lab to generate orders, download result CSVs from lab, and then distribute results to patient and their HR representative. We’re working on building our own end-to-end portal in a HIPAA-friendly AWS environment: data encrypted at rest, all APIs secured, etc. This includes a patient portal for registration/results, client portal for viewing their testing events and patients/results, and admin interface for managing tests, checking in patients, and generating/printing lab requisition forms. However, things keep getting more complicated: we’re starting to administer flu vaccines now, and are also in the process of building antigen testing capabilities, which mean more changes to our portal and processes. I’m second-guessing our build over buy decision now that things are getting more complex, and wondering if we’d be better off with an off-the-shelf solution. Our main reason for not going that route was that we needed to have not only a patient portal, but also a client portal for HR reps to be able to see who has registered for their testing event, view results, etc. in a secure manner. But I’m wondering now if we’d be better off with an off-the-shelf solution that we just find a way to sync up with our portal. If we could buy a solution that could house all the patient data, handle ordering of lab tests and retrieval of results, and link with an external system we build (or even have another access layer where we can grant our clients access to certain patient records), that might be a better alternative than our portal in the long run. Is there a solution that’s well suited to this? We’ve done about 20,000 COVID-19 tests so far and are doing at least 2,000/week right now so the main issue we’ve run into — and what’s been driving our requirements — is that we need to be able to manage things in bulk rather than have to mess around in one patient record at a time generating orders and dealing with results. What would you do? Any particular solution(s) I should look at? Or stay on the build-it course?
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