Consumer Grade Care Infrastructure
Brendan Keeler, Senior PM at Zus Health, on building infrastructure for digital health
The real opening for digital health infrastructure is that virtual care companies are not buying software just to store charts, they are buying the freedom to design a consumer grade care journey from scratch. Legacy EHRs are built around visits, claims, and hospital workflows. Zus is built around a shared patient record, API access, and care team tasking, so a startup can assemble intake, messaging, scheduling, follow up, and cross provider coordination into one product instead of forcing patients through a MyChart style side door.
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The concrete difference is workflow shape. Traditional EHRs assume an in person encounter and billing event. Zus describes its product as a patient 360 plus workflow tooling organized around the care plan and care team, with access through app, APIs, embedded components, and direct EHR integrations.
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This matters most for virtual first specialists like Ro, Folx, Omada, or Sword, where the product is the experience. These companies win by making care feel like a modern app, with online intake, asynchronous messaging, home delivery, and tailored follow up. Generic portals were not built for that motion.
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FHIR made this category more buildable. The shift from older HL7 style integrations to JSON based FHIR APIs means developers can build once against a more standard interface, while ONC rules have pushed certified EHRs to expose API endpoints. That lowers the cost of creating healthcare specific infrastructure layers like Zus.
The next phase is a stack split. Incumbent EHRs will remain the system of record for many hospitals, while API native layers become the system of experience for virtual first care. As more digital providers expand across specialties and coordinate with outside clinicians, the vendors that make patient data portable and workflows programmable will sit in the middle of a growing share of healthcare delivery.