Outsource Healthcare Software Development: When to Hire, What to Outsource, and How to Build a Telehealth Team

Most companies—about 70%—choose outsourcing IT functions mainly to cut costs. Companies can slash development costs by 30 to 60% through strategic healthcare software development outsourcing. The telehealth software segment's value will reach $22.11 billion by 2029. This creates many chances for founders to build optimized team structures.

Telehealth entrepreneurs still struggle to determine what to outsource at each growth stage. The global telehealth market's value stood at $123.26 billion in 2024. Success in this market depends on making the right team-building decisions. This piece offers a stage-by-stage approach to outsourcing healthcare software development. You'll learn to scale your telehealth business from startup to enterprise level without disruption.

Key Takeaways

• Outsource for speed and cost early, but keep compliance, security, and clinical quality in-house
• Match hiring vs. outsourcing decisions to the revenue stage to avoid bottlenecks and technical debt
• Bring revenue-critical roles in-house once growth accelerates (~$100k/month)
• Shift from freelancers to teams, then departments, as scale increases
• Standardized infrastructure reduces custom dev and enables faster, safer scaling

Why Telehealth Founders Hit Team Bottlenecks Fast

Telehealth ventures hit operational roadblocks faster than traditional healthcare businesses. McKinsey research shows that 60% of HealthTech startups miss their launch dates by more than 3 months. This delay creates immediate pressure from investors and pushes back ROI. Startup founders face this timing squeeze as their first major challenge.

The 'roles by stage' reality (what breaks first)

The operational infrastructure starts falling apart first. Successful telehealth clinics need administrative teams that can handle multiple tasks. They must manage calendars, video platforms, patient communications, and documentation—often using systems that don't work together. After telehealth use stabilized at 38X higher than pre-pandemic levels, many platforms found that there was no way their backend operations could keep up.

Technical debt piles up faster. Most telehealth platforms realize their core integrations are fragile only after they crash during production. This includes connections to EMRs, payment processors, and communication tools. A telehealth startup could only release updates every three weeks—mostly fixing bugs—until they fixed their basic infrastructure problems.

Staff shortages surface next. Sterling/HCA surveys indicate 47% of HR teams struggle to find specialized healthcare talent. Telehealth companies feel this pinch even more as roles change constantly. What one startup calls a "digital operations manager," a health system might label a "telehealth coordinator."

What you should never outsource in healthcare ops

Keep compliance and regulatory oversight in-house. Telehealth platforms expanding in different states face a maze of licensing requirements. Provider credentialing takes 60-120 days and needs up to 20 hours of work for each application. This process becomes a critical bottleneck that outside vendors can't handle well.

Data security and privacy protection must stay under your control. Online care creates more opportunities for security breaches, making cybersecurity expertise crucial. Teams without proper metrics tracking work blindly—spending investor money without measuring vital indicators like DAU, retention, activation, and churn.

Clinical quality assurance demands your direct oversight. Telehealth platforms that outsource core clinical workflows often face integration nightmares as their provider networks grow. The pandemic allowed temporary cross-state practice, but these shortcuts are going away. Founders must now build lasting clinical operations models.

Telehealth founders should know which operational parts need direct control and which technical components they can safely outsource as they grow.

Early Stage ($0–$100k/month): Stay Lean, Outsource Smart

Building a sustainable telehealth operation requires a balance between in-house talent and strategic outsourcing during early revenue stages. Health systems that meet the Triple Aim successfully exploit data and move faster. This strategy becomes crucial with limited resources.

Minimum viable team (founder + clinical + ops)

A lean team structure works best in your first growth phase. Founders take on multiple roles to set vision, build core teams, and drive growth. Your foundational telehealth team should include:

The clinical leader establishes treatment protocols and oversees care quality. This person acts as your medical authority, and you cannot outsource this role effectively.

An operations lead manages compliance, credentialing, and workflows. This role keeps everything together and handles essential tasks like healthcare professional licensing.

The founder often serves as both product manager and marketing strategist, focusing on building your Minimum Viable Product and proving it right.

What to outsource first (ads, content, design, dev bursts)

Early-stage telehealth companies can accelerate growth while managing costs through strategic outsourcing. A telehealth MVP typically needs 3-6 months and between $20,000 to $50,000 to develop, making it perfect to outsource.

You should outsource:

• Development sprints: External teams can handle focused, time-bound projects instead of full-time developers
• Marketing content: Healthcare writers can create specialized content on a freelance basis
• Design work: UX/UI designers can build telehealth interfaces on contract
• Administrative tasks: Outsourced support works well before building internal teams

This outsourcing approach can reduce development costs by 30-70%, saving capital for core operations.

Red flags you outsourced the wrong thing

Your outsourcing strategy might need changes if you spot certain signs. Wrong partners can create compliance problems, patient frustration, and operational issues.

Look out for these warning signs:

• Unclear answers about HIPAA compliance and security measures
• Missing healthcare industry experience or references
• Poor transparency in reporting or project management
• Pricing that seems unrealistic
• Hidden costs or unclear long-term maintenance fees

Quality partners should offer clear communication, healthcare expertise, and transparent pricing. Stay away from teams without their own software or those pushing inflexible solutions.

Growth Stage ($100k–$400k/month): Bring Revenue-Critical Work In-House

Your telehealth business must review revenue-generating functions as it reaches the growth stage. Healthcare startups typically focus on faster product development, specialized talent acquisition, and regulatory compliance after their original funding.

First in-house hires (growth + lifecycle + support)

The time comes to bring revenue-critical functions in-house once monthly revenue exceeds $100k. Successful telehealth companies prioritize permanent staff hiring in three core areas—this applies to seven out of eight companies:

Growth specialists who understand healthcare's unique customer acquisition challenges, and Lifecycle managers who optimize patient experiences from enrollment through care delivery

Support personnel who handle both clinical and technical troubleshooting

These roles directly affect customer acquisition and retention—essential elements for business expansion. Research shows that in-house teams help standardize processes effectively during critical growth periods, according to hiring managers.

Clinical coordinator + patient support structure

Telehealth coordinators become indispensable at this stage. RAND researchers found that "health centers achieved rapid growth with a modest staffing investment" through dedicated coordinators. These professionals:

• Handle appointment logistics and scheduling
• Lower no-show rates through personal patient outreach
• Provide consistent training to medical assistants and support staff
• Help communication between departments

A health center emphasized that "If we didn't have a coordinator to monitor all the complex moving parts, staff and providers would not support this technology due to inherent frustrations."

The Medical University of South Carolina's Telehealth Centralized Support team achieved remarkable results. They supported over 75,000 visits with 1,500+ providers and served 46,000+ unique patients in just 18 months.

The right time to stop 'freelancer stacking'

Freelancers' benefits diminish as you keep adding contractors. Seven- and eight-figure entrepreneurs find that their time's value exceeds any cost savings from contractor management.

Signs that indicate the need to transition from freelancers:

• Too much time spent managing multiple contractors
• Contractors resist adapting to company changes
• Core processes become scattered across multiple external partners

A healthcare CEO noted, "When you hire freelancers, it tends to be with a role in mind...but if you ask this of your freelancers, chances are they'll simply point to your original job description."

Scale Stage ($400k–$1M/month): Build Departments, Not Just Roles

Your telehealth organization needs to evolve from individual contributors to specialized departments when scaling beyond $400k monthly revenue. This phase needs well-laid-out team structures that can handle complex operations while maintaining quality and compliance.

Full marketing team map (acquisition, creative, lifecycle)

Telehealth organizations must move beyond marketing generalists as they grow. Scattered freelancers no longer cut it. Your company needs:

• Acquisition specialists who run paid campaigns and optimize channels
• Content creators who develop healthcare materials that strike a chord with patients and providers
• Lifecycle managers who keep patients coming back
• Social media experts who build community and brand presence

Bringing marketing in-house at this stage helps you retain "strong brand identity, communications, and cohesive "creative"—something external agencies often struggle with. Healthcare messaging needs content creators who know your brand's voice inside out as you grow.

Data/analytics hire (what they actually own)

You'll need data professionals who can turn raw information into useful insights at this scale. These specialists should handle:

• Performance metrics from every department
• Integration between operational and clinical data
• Compliance monitoring and reports
• Predictive modeling to plan capacity

Telehealth companies at scale "risk falling short on compliance, credibility and growth" without strong analytics capabilities. These roles also help connect structured data (EHRs, lab results) with unstructured data (clinical notes, imaging, video)—a challenge that grows with your organization.

Provider network expansion + QA layer

Quality becomes crucial as your provider network grows. Mental health services face unprecedented pressure on their telehealth networks. So, you need a dedicated quality assurance layer to maintain standards while scaling.

Your QA framework should include thorough credential checks, efficient onboarding, and ongoing compliance monitoring. Companies using "

enterprise-grade APIs

have automated credential verification and compliance monitoring" with great results, making provider screening much faster. A dedicated provider network team helps you handle integration requirements in different healthcare systems—one of the toughest challenges in growing telehealth operations.

Enterprise Stage ($1M+/month): Standardize and Verticalize

Telehealth companies need to change from reactive to proactive operations once they reach $1M in monthly revenue. Standardization serves as the foundation that supports lasting growth.

Process ownership by function (ops, clinical, growth, finance)

At this stage, a telehealth organization needs dedicated leaders for each function, with clear responsibilities. The Clinical Operations Manager plays a vital role by building high-performing research teams and maintaining strong relationships with investigative sites. These leaders track country-level performance metrics, ensure quality in clinical services, and maintain regulatory compliance.

Healthcare Operations Managers create strategies that boost service quality. They streamline both clinical and administrative processes while managing resources effectively across staff, equipment, and facilities.

Multi-niche expansion without chaos

Leading enterprise telehealth companies expand into complementary verticals strategically. Ro showed this by integrating vertically—they built their own pharmacy network and bought capabilities in home diagnostics. Hims & Hers took a similar path by utilizing a multi-category approach. They covered sexual health, mental health, dermatology, and weight management, which increased their customers' lifetime value through cross-selling.

Advanced ops roles that protect margins

CFOs now see protecting outpatient profitability as a strategic priority. Roles focused on revenue cycle management make a real difference. They can determine whether a service line stays profitable or faces financial challenges.

The organization needs experts who can automate denial prevention on top of that. They must improve order accuracy and strengthen claim discipline—factors that directly affect cash flow and overall financial health.

Where Bask Health Fits

What Bask replaces (custom builds, workflow glue, manual admin)

Bask Health eliminates the need for custom development that can get pricey and typically takes 6-9 months with substantial resources. The platform automates administrative workflows, which saves healthcare providers from building separate systems for EMRs, e-commerce, compliance frameworks, and pharmacy integrations. Organizations that use similar platforms handle 200% more virtual consultations without adding staff.

What your team still owns (brand, acquisition, clinical strategy)

Your telehealth company must keep control of vital elements. Rather than outsourcing everything, your team should maintain control of brand positioning, patient acquisition strategy, and clinical protocols. Bask Health enhances these functions without taking them over—it helps "turn your positioning into a repeatable patient experience" while you keep strategic oversight.

How does this change your outsource vs hire plan at each stage

This infrastructure transforms hiring priorities during different growth stages. Early-stage founders can wait to hire technical staff and focus on clinical expertise. Companies can move resources from development to patient experience roles during growth phases. Teams can build specialized departments faster at scale because Bask's "API-powered infrastructure combines smoothly with third-party systems." This enables a more strategic approach to expanding the team.

Org Charts You Can Copy

A clear vision of your telehealth organization's structure at each growth stage creates a roadmap for scaling. The adaptable org charts show proven frameworks that balance clinical excellence with operational efficiency.

Lean org chart (early)

Early-stage telehealth companies succeed with a simple structure built around three vital functions. The core team has:

• Executive Sponsor/Telehealth Director who sets strategic vision and secures funding
• Clinical Lead (often CMO) who ensures patient safety and regulatory compliance
• Operational Manager who runs day-to-day workflow management

This structure combines hierarchy with a flat design that speeds up decision-making and promotes direct communication between leaders and staff.

Growth org chart (team pods)

Successful telehealth organizations use a pod-based structure during their growth phase. Each pod works as a specialized unit with care coordinators, nurses, benefits experts, and behavioral health professionals.

Pods serve specific clients and really understand their benefits plans. This team approach creates better collaboration and provides backup support for every function.

Scale/enterprise org chart (department leads + SOP ownership)

Enterprise-level telehealth needs a matrix organizational design that connects departments effectively. This structure serves organizations well in competitive environments.

Key departments include:

• Clinical Operations with dedicated managers who oversee quality delivery
• Data Analytics & Reporting that tracks performance metrics
• Patient Engagement that handles onboarding and follow-up communications

Each department owns clear SOPs that align resources with the organization's mission and goals.

Conclusion

Smart decisions about building in-house versus outsourcing components can make or break a telehealth business's growth. This piece outlines key stages every telehealth founder must guide their business through—from basic operations to full enterprise verticalization.

The most successful telehealth companies keep direct control of their core operations like compliance, clinical quality, and data security. They outsource development, design, and administrative tasks when needed. Data shows that founders who strike this balance can reduce development costs by 30-60% while keeping full control of their healthcare vision.

Your team's structure evolves naturally as your telehealth business grows. A small core team of clinical, operational, and founder leadership runs the business in its early days. Growth creates the need to bring revenue-critical functions in-house. This becomes vital when you have patient support teams and specialized coordinators who drive your expanding operations.

A key transformation happens when monthly revenue moves from $400K to $1M. Individual contributors form into specialized departments at this stage. Data analytics, marketing teams, and quality assurance become must-haves rather than optional extras. Enterprise-level operations need standardized processes and clear ownership to protect margins and enable expansion into multiple niches.

Bask Health's platform removes many common roadblocks. It replaces custom builds and manual administration while letting telehealth companies control their brand, acquisition strategy, and clinical protocols. This reliable setup changes hiring priorities at every growth stage.

The right team-building decisions at each growth phase determine your telehealth business's success. These org charts serve as tested blueprints for telehealth companies of all sizes. The goal extends beyond cost reduction through outsourcing. You need to create a balanced strategy that helps your telehealth venture scale smoothly during rapid growth.

References

1. Bask Health: The platform powering the future of telehealth and digital healthcare. BizTrib. https://biztrib.com/2025/03/24/bask-health-the-platform-powering-the-future-of-telehealth-and-digital-healthcare/
2. Elbasiony, A. (n.d.). General ideal telehealth organizational structure. LinkedIn. https://www.linkedin.com/pulse/general-ideal-telehealth-organizational-structure-ahmed-elbasiony-2zrmf/
3. Forbes Technology Council. (2025, July 24). 20 hurdles for healthcare tech startups in scaling solutions. Forbes. https://www.forbes.com/councils/forbestechcouncil/2025/07/24/20-hurdles-for-healthcare-tech-startups-in-scaling-solutions/
4. Medical research article. (n.d.). PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10454091/
5. Medallion. (n.d.). Breaking through licensing and credentialing bottlenecks for telehealth providers. https://medallion.co/resources/blog/breaking-through-licensing-credentialing-bottlenecks-for-telehealth-providers
6. Quantum Health. (n.d.). The power of a pod: The science behind teamwork in healthcare navigation. https://quantum-health.com/blog/the-power-of-a-pod-the-science-behind-teamwork-in-healthcare-navigation/
7. Team Work Spirit. (n.d.). Top challenges in telemedicine platforms and how to fix them. TWSGO. https://www.twsgo.com/blog/top-challenges-in-telemedicine-platforms-and-how-to-fix-them/
8. Outsource healthcare software development guide. (n.d.). Mismo. https://mismo.team/outsource-healthcare-software-development-guide/amp/