When to Build vs. Buy Your Healthcare Compliance Infrastructure
For healthcare organizations, compliance is the backbone of sustainable clinical quality and scale. But as digital health companies expand across state lines, onboard new clinical teams, and diversify care offerings, the question may arise: Do we build our compliance infrastructure in-house, or do we buy a solution?
It’s not a minor decision. The wrong move can slow your growth, expose your business to risk, or drain resources better spent on care delivery. And while early-stage teams often cobble together spreadsheets, PDF protocols, and manual audits, that approach buckles under the weight of scale.
In this article, we’ll explore the key factors that help healthcare organizations decide when to build versus buy their healthcare compliance infrastructure—so you can scale care confidently and in full regulatory alignment.
The Case for Building: When Internal Infrastructure Makes Sense
There are scenarios where building your own compliance infrastructure may be the right strategic choice.
1. You Have Deep Regulatory Expertise In-House
If your leadership team includes compliance officers, healthcare attorneys, or clinicians with direct experience managing complex operations, you may be equipped to own and operate the system internally.
2. Your Model Is Narrow and Static
If your care delivery model is limited to one specialty, one state, or a single provider type, the complexity of regulatory maintenance is lower. A small, focused operation may be able to operate compliantly with a lean tech stack and manual oversight.
3. You Have Significant Engineering Resources and Time
Building a healthcare compliance infrastructure isn’t just about documentation. At its best, it requires secure data environments, audit logging, automated workflows, and regular regulatory updates. If you have a large engineering team with bandwidth and a long time horizon, building might be an option.
But these situations are rare. Most healthcare organizations outgrow this model quickly.
The Case for Buying: When a Purpose-Built Platform Is the Right Move
More often, the smarter path—financially, operationally, and legally—is to buy. Here’s when it makes sense to invest in a dedicated compliance solution.
1. You're Scaling Across State Lines
Each state has its own scope-of-practice laws, chart review rules, collaboration requirements, and licensure pathways. As you expand nationally, the regulatory complexity multiplies.
A platform that automates these nuances can be the difference between smooth expansion and legal roadblocks.
2. You're Managing Healthcare Collaborations Between Physicians and Advanced Practice Providers
Manual tracking breaks down fast when you have dozens of Advanced Practice Providers (APPs) and multiple collaborating physicians across various locations.
You need a system that centralizes agreements, tracks state-specific obligations, and maintains audit-ready records automatically.
3. You’re Preparing for Due Diligence or Strategic Partnerships
If you're planning to raise capital, pursue payer contracts, or partner with health systems, compliance hygiene matters. Investors and partners don’t want assurances—they want systems.
A robust platform demonstrates operational maturity and reduces perceived risk.
4. You Want to Focus on Care Delivery, Not Compliance Maintenance
Every minute your clinical or operations team spends managing protocol templates, formatting collaboration agreements, or chasing down compliance records is a minute they’re not improving care.
Offloading compliance infrastructure frees up your team to do what they do best.
The Hidden Costs of Building In-House
It’s tempting to assume building is cheaper. But consider the hidden costs:
Legal fees: Without a purpose-built system, most organizations rely on in-house counsel or third-party attorneys to draft, review, and update agreements, protocols, and regulatory filings—costs that can quickly add up with every new state or provider.
Engineering time diverted from core product development: Compliance tracking, document management, and workflow automation divert engineering resources away from product innovation and patient-facing tools.
Operational delays: Onboarding new providers or launching in a new state can grind to a halt while documents are reviewed, protocols are customized, and compliance standards are validated.
Risk of human error: Manual tracking across spreadsheets, email chains, and shared drives increases the likelihood of errors. Each one is a potential regulatory exposure.
Lack of scalability: What works for a team of five won’t work for a team of fifty. Without custom workflows, compliance becomes harder as your organization scales.
Reactive fire drills during audits or legal reviews: Last-minute scrambles to produce documentation or validate protocols can strain internal teams and expose gaps in oversight.
Over time, these risks compound. And they can be existential.
Why Healthcare Compliance Needs Specialization
Healthcare compliance is a specialized domain that intersects clinical operations, regulatory law, provider credentialing, and multi-state variability. It demands real-time updates, legal expertise, and clinician usability.
Zivian Health helps healthcare organizations operationalize compliance. Our platform enables organizations to:
Automate physician-APP collaboration agreements and filings
Guide providers through state-specific chart review and QA requirements
Maintain a continuous audit trail of compliance activity
Manage multistate growth without operational upheaval
The Zivian Health platform is built for the realities of modern care delivery and designed to support you as you scale.
Build What Differentiates. Buy What Scales.
As a general rule: build what differentiates your company in the market. Buy what needs to scale reliably, repeatedly, and compliantly.
Your product, your brand, your care model—those are your competitive edges. Compliance infrastructure is essential, but it shouldn’t be your bottleneck. And the sooner that foundation is in place, the more confidently you can grow while staying focused on high-quality care.
Need help deciding whether to build or buy your compliance infrastructure? Our team has supported digital health startups and multi-state healthcare organizations through every stage of growth.
Connect with us today, and let’s talk about what’s right for you!
