Case Studies › Spencer Health

Healthtech & Digital Health

From hardware to platform: remote care at scale

Spencer Health had the hardware — a smart medication dispenser with real clinical promise — but lacked the software infrastructure to turn it into a connected care platform. Techdots built the end-to-end system: device ingestion pipeline, clinician dashboard, patient mobile app, and alerting engine. The result is a FDA-regulated-class remote patient monitoring product deployed across home health and clinical settings.

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Spencer Health

Healthtech & Digital Health

68%

Reduction in missed doses

4.2x

Faster care coordinator response to alerts

3 min

Average time to flag a critical adherence event

20 weeks

timeline

This engagement is best for

Healthtech companies with hardware that need companion software platforms

Digital health startups approaching FDA or clinical validation milestones

Home health agencies needing remote monitoring infrastructure

Care coordination teams managing chronic or post-acute patients at scale

The Transformation

Before & After

Before

✕ Device data was collected locally with no real-time transmission to care teams

✕ Nurses relied on manual phone check-ins to confirm medication adherence

✕ No alerting system existed for missed doses or critical dispense events

✕ Clinical staff had no unified view across their patient panel

✕ Onboarding a new patient onto the dispenser took 45+ minutes of manual configuration

After

✓ Real-time telemetry from dispensers flows into a live clinician dashboard with sub-60-second latency

✓ Automated escalation alerts notify care coordinators within 3 minutes of a missed dose

✓ Patient panel view surfaces adherence trends, device status, and vitals in a single screen

✓ Patient onboarding reduced to under 8 minutes via guided mobile setup flow

✓ Care coordinators manage 3x more patients per shift without additional headcount

What We Built

Deliverables & Scope

Every item below was chosen because it directly addressed a business bottleneck — not because it was technically interesting.

HIPAA-compliant device telemetry ingestion pipeline handling dispense events, tamper alerts, and battery status from Spencer dispensers via secure MQTT broker

Clinician web dashboard (React + Rails API) with real-time patient panel, adherence timelines, and configurable alert thresholds per care protocol

Patient-facing iOS and Android mobile app for dispense reminders, medication history, and two-way messaging with care coordinators

Rules-based alerting engine with tiered escalation logic (missed dose → coordinator ping → prescriber notification) backed by a Redis job queue

EHR integration layer connecting to Epic via FHIR R4 for bi-directional medication list sync and care plan updates

Audit logging and compliance reporting module generating CMS-aligned RPM documentation for billing reimbursement workflows

ROI Logic

Why This Generated
Real Business Value

Remote patient monitoring reimbursements under CMS CPT codes 99453–99458 require documented device setup, ongoing data transmission, and clinical review minutes — Spencer Health's platform automates the capture of all three, turning each enrolled patient into a recurring revenue line. By reducing missed doses and enabling earlier clinical intervention, health system customers also saw measurable reductions in 30-day readmissions, making Spencer Health a defensible ROI story in contract renewals.

Key Outcomes

68%

Reduction in missed doses

4.2x

Faster care coordinator response to alerts

3 min

Average time to flag a critical adherence event

Why It Worked

The Decisions That
Made the Difference

Good execution matters. But the right early decisions matter more.

We treated the dispenser hardware as an event source and built the software around reliable, idempotent event processing — giving the system resilience to spotty home network connectivity

Clinician workflows were designed with care coordinators in daily co-design sessions, not retrofitted after engineering — reducing training time and driving real adoption on go-live

FHIR-first integration design meant EHR connectivity was extensible beyond the initial Epic deployment, enabling fast onboarding of new health system clients

We scoped the MVP tightly around CMS RPM billing requirements, so the first production release immediately supported Spencer Health's revenue model rather than delaying it

Tech Stack

React Native

Integrations

Epic EHR (FHIR R4) AWS IoT Core (MQTT device broker) Twilio (SMS + voice escalation alerts) Stripe (subscription billing for health system clients) Surescripts (medication history lookup)

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