Backend and API development in Boston
Boston's digital health companies eventually meet the same wall: the hospital. A pilot works on data typed in by hand, then the customer asks for it to read from their electronic health record, and the backend has to accept HL7 messages from an interface engine or query a FHIR API it has never seen. Messages arrive out of order, twice, or without fields the specification calls optional and the product assumed were always there.
We build the integration layer as its own service. Every inbound message is stored as received, processed idempotently and matched to a patient by rules you can inspect, so a duplicate admission does not become a duplicate record. Failures land in a queue a person can work through, not a log nobody reads. Patient data stays in your own cloud account, every access to it is logged, and each new hospital's quirks become a mapping you can read rather than a change to the code.
Boston's software buyers mostly work in science, medicine, education and money: biotech and pharmaceutical companies in Cambridge and the Seaport, the hospital systems, digital health start-ups, the universities and the companies spun out of them, and the asset managers and insurers downtown. In most of them, software supports something else, an experiment, a patient or a portfolio. The people who commission it are often scientists and clinicians, many of whom write some code themselves and know exactly what they need the data to do. What they want from an engineer is not a new idea. It is the idea they already have, made reliable.
The work follows the science. Biotech labs need instrument output picked up as it lands and linked to the notebook entry that explains it, and internal tools that stay fast on thousands of assay results. Digital health companies need a backend that can read from a hospital's records system, and patient apps that save offline and keep the time each entry was made. Edtech companies selling to universities need platforms that know a teaching assistant from a department administrator. Lab suppliers need commerce that runs on purchase orders and negotiated prices, and the investment firms downtown need internal tools to replace the workbooks that run their operations.
Hiring has its own shape. Built In puts the average software engineer base salary in Boston at about $137,000, and the city's engineers are pulled between big tech offices, well-funded biotech and university spin-outs. The universities keep research talent in good supply. What teams more often lack is someone who has taken a system from a notebook or a prototype to something that runs unattended, is monitored, and survives its author going back to the lab. That gap, between a result that works once and a system that keeps working, is where we are most useful.
We are in Bengaluru and move our working day for Boston. Four hours of every working day overlap with your morning in Eastern time, stand-up included, so questions, reviews and decisions happen live with the engineer who writes the code. Runbooks and architecture notes are written as we go, so the system keeps running when the people who commissioned it go back to the lab.
We are the right fit for the gap between a result that works once and a system that keeps working: a pipeline, a hospital integration, a patient app, an internal tool. Senior capacity starts within days, the first piece is a fixed-price two-week engagement, and it can carry you from a funding round or grant to your first engineering hire.
Four ways this arrives.
We read the code, write down what it does versus what everyone believes it does, and give you the list of the five things most likely to page someone at night. Then we fix those first.
Usually queries, not architecture. We profile under real traffic, fix the plans and the indexes, and only then discuss whether anything needs splitting apart.
A mobile client, a partner integration, a public API. We design the contract first, version it properly, and write the docs your consumers will read.
Jobs that silently vanish, retries that duplicate charges, a queue nobody monitors. We make it idempotent, observable, and boring.
A moderated messaging backend where sends acknowledge in-band and the review runs behind them.
Read the write-up →Asked by Boston teams.
How do you work with teams in Boston?+
We are in Bengaluru and move our working day for Boston, so four hours of every working day overlap with your morning in Eastern time, stand-up included. We join your Slack, push to your GitHub and track the work in your Linear, so progress shows up where your team already looks. The person on every call is the engineer who writes the code, whether you are a scientist, a clinician or a CTO.
Do you build for Boston's biotech and life sciences companies?+
Yes. The work is usually the software around the science: pipelines that pick up plate reader, sequencer and imaging output as it lands and link it to the notebook entry, internal tools that stay fast on thousands of assay results, and search over protocols and SOPs that always cites the current version. We work alongside your computational scientists, turning what already works in their notebooks into systems that run unattended.
How does your rate compare to hiring in Boston?+
Built In puts the average software engineer base salary in Boston at about $137,000, before bonus and benefits. Our published rate is $35/hour, or $5,400 a month for an embedded engineer, with a $5,000 minimum. There is no recruiting time and no employment overhead, and work starts within days of the call. The first piece is a fixed-price two-week engagement at $2,800, so you judge us on what it produces.
What do the first two weeks look like?+
You share the context: the code, the data and the problem. Within two days you have a 30-minute call with the engineer who would do the work, and within a week a written plan. Then comes a fixed-price two-week piece at $2,800, such as turning one notebook or prototype into something that runs on its own. At the end you have working code in your repository, notes on how it runs, and a clear view of what comes next.
Can you work in our existing codebase?+
Yes, and it is most of what we do. We do not require a rewrite as a condition of working with you. If we think a rewrite is genuinely the right call we will say so, with the reasoning and the cost, and you can decide.
What if the backend is in a language you do not list?+
Then we will tell you. We are useful in Node, Python and TypeScript. We can read Go and PHP well enough to migrate off them. We would not take a Rust or Elixir project and learn it on your budget.
Do you write tests?+
For anything with money, permissions or data loss in it, yes. We do not chase a coverage number. We will tell you which parts are covered and which are not in the handover notes.
Who owns the code?+
You do, from the first commit. Repositories live in your organisation. If we set them up, we transfer them before the first invoice.
What happens when the engagement ends?+
You get runbooks, architecture notes and a recorded walkthrough. We stay available for questions for a month at no cost, because a handover that needs us on retainer is not a handover.