Innerwell

The situation

A US startup offering psychiatric care and ketamine therapy online needed a patient-facing platform: intake, scheduling, video visits, prescriptions, payments, insurance, and a clinical back office. No engineering team, a launch deadline three months out, and a regulated domain (HIPAA).

What I did

• Designed and built the first production version from scratch and launched it in three months.
• Set the architecture the platform still runs on: a TypeScript monorepo (NestJS, Next.js, Prisma on PostgreSQL, Redis) with contract-first APIs (Zod, oRPC), now 500k+ lines of code.
• Built the payments stack: NMI first, then a migration to Stripe with subscriptions, one-time purchases, and a custom pre-authorization-to-subscription flow.
• Designed and built the "data-driven care" automation service: an event-driven AWS Lambda running 40+ scheduled jobs (copay charging, patient billing, failed-payment retries, insurance eligibility checks, outcome reports, patient discharge).
• Built and operate the AWS infrastructure: EKS with Karpenter spot nodes, Helm, GitLab CI with a complete preview environment per merge request (API, web, workers, own database), monitoring and alerting.
• Led the AI work on AWS Bedrock: a multi-agent clinical pre-note system (orchestrator plus four specialist agents with typed tool schemas), intake summaries, automated assessments, an ambient-scribe integration.
• Drove AI adoption in the team: Claude Code in daily development, a custom AI code reviewer in GitLab CI on every merge request.
• Integrated the clinical and business ecosystem (Welkin EHR, TimeTap, pharmacy, Sohar eligibility, Candid / Claim.MD claims, Zoom, Twilio, Zendesk, Customer.io, headless Magento 2) and built the internal admin panel that gives operations one view of each patient instead of multiple vendor UIs.
• Hired and led a team of 4–6 engineers as a member of the leadership team, working directly with the CEO. Modernized the stack in production (Turborepo, pnpm, PostgreSQL 17, Next.js 16, React 19) without pausing delivery.

What came out of it

• 10,000+ psychiatric patients served across the US.
• ~500 new patient plans and $400k+ in initial-plan revenue per month through the payments stack.
• Claim and copay charging, which had taken about 40% of the billing team’s time, now runs as scheduled jobs.
• The Karpenter rollout cut the monthly EC2 bill by ~19%.

Stack