●Next.js + Healthcare

Healthcare software operates under unique constraints that Next.js is particularly well-suited to address. The primary concern is always patient data protection—HIPAA violations carry penalties up to $2.13 million per category annually, and breaches destroy patient trust. Next.js Server Components fundamentally change the security model compared to traditional SPAs. Patient data never needs to exist in client-side JavaScript; it's rendered server-side and sent as HTML. This eliminates entire categories of vulnerabilities: no PHI in Redux state that could be logged, no patient names in browser developer tools, no sensitive data cached in service workers. The middleware architecture provides a single enforcement point for access control. Every request passes through middleware before reaching any route handler, ensuring consistent authentication, authorization, and audit logging. This is essential for HIPAA compliance where you must demonstrate that access controls are uniformly applied. For the clinical users, Next.js streaming and partial prerendering deliver the performance that modern healthcare demands. A patient portal can show navigation instantly while clinical data loads. A telemedicine app can display the UI shell immediately while establishing the video connection. Clinicians working through dozens of patient encounters daily notice every fraction of a second—performance isn't a nice-to-have, it's a requirement for adoption.

Healthcare projects begin with compliance mapping before any code is written. I document every data flow: where does PHI enter the system? How is it stored and encrypted? Who can access it and under what conditions? How is it eventually deleted? This produces the foundation for HIPAA documentation and guides every architectural decision. The Next.js application structure enforces security boundaries. Protected routes for authenticated users, admin routes with elevated access requirements, and middleware that validates session state on every request. Server Components handle all PHI rendering, ensuring patient data never crosses to the client as raw JavaScript objects. For EHR integrations, I implement an adapter layer that normalizes different EHR APIs behind a consistent interface. Whether you're connecting to Epic via FHIR R4 or a legacy system via HL7 v2, the rest of your application sees the same TypeScript types. This makes the system testable—you can mock the adapter without touching network code. The database schema encodes PHI protection. Sensitive columns use PostgreSQL's pgcrypto for application-level encryption—the database itself can't read the data without application keys. Audit triggers automatically log every modification to PHI tables. My testing approach for healthcare emphasizes end-to-end flows with realistic but synthetic data. Synthea generates synthetic patient records that exercise clinical edge cases without exposing real PHI. Integration tests run against de-identified copies of production data where HIPAA allows.