9am.health: Scaling a medtech platform that delivers metabolic care as an employee benefit
About the project
9am.health is a U.S.-based MedTech startup developing a virtual clinic that supports people with diabetes, obesity, overweight conditions, and users participating in treatment programs based on GLP-1 medications. The product initially operated in a B2C model, but over time evolved into an employee benefit offered to business partners and large organizations.
Today, the platform operates across all U.S. states and supports employees acquired through corporate clients such as Amazon and the State of Georgia. In 2025, approximately 40,000 new users joined the platform, significantly increasing the demands for scalability, automation, and service quality.
fireup.pro has been collaborating with 9am.health since the very beginning. The team joined when the product did not yet exist — fireup.pro developed the first functionalities, including user registration and the initial testing flow. Since then, the company has supported the development of the backend, frontends, internal tools, manual testing, test automation, integrations, and solutions supporting both the care team and physicians.
Business
- Building a scalable MedTech platform from scratch, ready to evolve from a startup MVP into a product serving tens of thousands of users.
- Transforming a B2C application into a B2B solution offered as an employee benefit for large organizations.
- Enabling business partners to create dedicated onboarding paths, questionnaires, and program variants tailored to their employees.
- Reducing the workload of the care team through automation of clinical, administrative, and communication processes, including AI-based solutions.
- Providing users with easier and more affordable access to consultations, laboratory testing, prescriptions, medications, educational programs, and health plans.
Technological
- Designing a backend architecture ready to support rapid product growth and a continuously increasing number of users.
- Developing both the patient-facing application and the internal back office (Patient Management Platform) for doctors, care teams, and other clinical roles.
- Integrating the platform with the U.S. healthcare ecosystem.
- Automating clinical logic, including medication dosing, lab test ordering, result interpretation, task creation for users, and workflow automation based on data hub integrations, while guiding users through subsequent stages of treatment.
- Developing manual, end-to-end, and performance testing processes to ensure the platform could safely support rapid user growth.
Customer experience
Returning to collaborate with the fireup.pro team was a natural move for me during the activities undertaken as part of a new start-up.
Bernhard Schandl
Co-Founder & CTO at 9amHealth
From challenge
Key Challenges
Transforming the product from B2C to B2B
Transforming the product from B2C to B2B
In the United States, the journey between the patient, employer, insurer, payer, physician, pharmacy, and service provider is highly multi-layered. From the user’s perspective, the key factor is whether consultations, lab tests, prescriptions, and medications are covered by benefits or reimbursement programs. As a result, 9am.health shifted its focus toward a B2B model, where employers or partners provide access to the platform as part of an employee benefits package.
For the technical team, this meant redesigning many core processes — from user onboarding and medical qualification to program logic, service financing, integrations, and support for multiple partner-specific variants.
Time pressure and startup-level requirement volatility
Time pressure and startup-level requirement volatility
In practice, this means working under pressure, maintaining a high level of independence, continuously refining requirements, and staying ready to adapt to change. In this project, communication, curiosity, and the ability to ask the right questions are just as important as technical expertise.
Integrations with external provider
Integrations with external provider
One example is the integration with DoseSpot, which expanded prescription management capabilities. Another is Withings, which enables users to receive a smart scale, while measurements are automatically synced with the application to support progress monitoring. The team also implemented an integration with Connective Health, a medical data aggregator that gives the clinical team access to a patient’s treatment and prescription history from external sources.
Scaling the product during rapid user growth
Scaling the product during rapid user growth
Reducing the workload of the care team became especially critical. With thousands of users, manually answering simple questions, handling repetitive tasks, and reviewing every case individually was no longer efficient. To address this, the team developed automations, internal tools, task management logic, and AI-powered solutions supporting the first line of communication with users.
Healthcare in the USA as a complex business domain
Healthcare in the USA as a complex business domain
The project required understanding not only the technology itself, but also the realities of the U.S. healthcare system. Physician licensing, medical and pharmacy insurance, and the relationships between patients, payers, pharmacies, and service providers all operate differently than in many other markets. In healthcare, an error means more than just poor UX - it can affect the treatment process, prescription issuance, medication dosing, patient access to care, or continuity of treatment.
Key functional and non-functional requirements
Functional
- User onboarding with an advanced medical questionnaire.
- Dedicated onboarding paths for B2B partners, including custom branding, eligibility criteria, and support for different user groups.
- Health and educational programs, including Healthy Weight Journey and educational pathways for people with diabetes.
- Automatic creation of user tasks guiding patients through the next stages of the treatment process.
- Prescription management system and integrations with external prescription providers.
- Medication dosing logic, including the ability to suggest maintaining, increasing, or decreasing dosage based on medical data and user feedback.
- Mechanisms for ordering laboratory tests, defining testing schedules, and automatically interpreting results provided by users.
- Internal EMR tool for physicians and the care team.
- Integrations with the U.S. healthcare ecosystem.
- Sophie AI chat supporting users with simple questions related to the application and treatment process.
Non-Functional
- Scalable backend architecture designed to support rapid user growth.
- High-quality manual, automated, and performance testing processes.
- Stability of critical processes related to prescriptions, medication dosing, laboratory testing, and user qualification.
- Ability to quickly adapt the product to the requirements of B2B partners.
- Clear code architecture based on best practices and team standards.
- A secure approach to medical data and restricted team access to non-anonymized production data.
- The ability to develop custom components, libraries, and tools instead of relying on limiting off-the-shelf solutions.
Through the solution
Through the solution
Partnership from day one
fireup.pro joined 9am.health at an early stage of the product’s development. The team built the API, core functionalities, and the first user flows. Within just a few months, the product went live and began serving its first patients. Over the following years, the collaboration evolved alongside the product itself. The fireup.pro team did not operate as an external vendor delivering a fixed scope of work. Instead, it became an integral part of the 9am.health product team participating in technical decision-making, requirements analysis, code reviews, testing, architecture development, integrations, and process improvements.
Two Product Teams: Member-Facing and Clinicafacing i clinical
As the product scaled, it was divided into dedicated areas of responsibility.
- Team MemberThis team is responsible for the user-facing part of the platform: the application, onboarding, tasks, program pathways, integrations with user-supporting services, and the logic guiding users through the treatment process. The team works on developing the patient application, dedicated flows for B2B partners, a task framework that guides users through subsequent steps, integrations with service providers (such as Withings scales), and the logic used to qualify users for programs and medications.
- Team ClinicalThis team is responsible for the clinical and back-office side of the platform: tools for physicians, the care team, and other roles involved in patient care. Their work includes developing the internal EMR tool and patient data management, presenting laboratory test results, building medication dosing logic and dosage adjustment recommendations, as well as supporting the prescription workflow and creating automations that reduce the workload of the care team.
Architecture designed for startup-scale growth
From the very beginning of the project, the team assumed that the product could scale rapidly. For this reason, the backend architecture was designed in a way that would not limit future growth. In practice, this meant building the platform based on solid architectural principles, including Domain-Driven Design, separation of concerns, CQRS, code review standards, and architectural testing to maintain code consistency.
This approach allowed the product to evolve quickly without creating technical debt that could later prevent the platform from supporting a growing number of users.
LabCadence: Custom-built laboratory testing logic
One of the most unique solutions developed within the project is the laboratory testing cadence logic. The system analyzes the user’s condition, medical history, previous test results, current program, prescribed medications, and clinical requirements to determine which laboratory tests should be ordered and when.
Depending on the results and defined medical thresholds, the system can suggest follow-up tests, postpone testing, recommend repeating a panel after a specific period of time, or modify the subsequent treatment flow. This solution supports, among others, A1C testing, metabolic panels, liver function parameters, lipid profiles, and other markers relevant to metabolic care.
LabCadence is not a simple checklist. It is a complex clinical decision-making mechanism in which many values depend on one another. Thanks to this approach, physicians and the care team receive a more structured process, while users receive recommendations tailored to their individual health situation.
EMR for the care team and physicians
The internal EMR tool was developed as a modern platform for patient management. It is used by physicians and care team members across different roles. The tool allows users to view patient information, status, medical history, laboratory results, tasks, medical conditions, medications, and the next steps in the treatment process.
W przeciwieństwie do wielu przestarzałych narzędzi używanych w healthcare, rozwiązanie 9am.health zostało zaprojektowane jako produkt szyty na miarę: dopasowany do konkretnego flow, konkretnych ról i konkretnych potrzeb zespołu klinicznego. To zwiększa efektywność obsługi i pozwala automatyzować coraz większą część powtarzalnych czynności.
Task automation and guiding users through the process
The 9am.health application is built around task-based logic. After logging in, users see specific tasks to complete, such as providing additional information, uploading laboratory results, filling out questionnaires, completing the next step of a program, or preparing for a consultation.
Integrations supporting the entire care journey
The fireup.pro team developed and maintained integrations connecting 9am.health with the external healthcare ecosystem and user-supporting services. Each integration required separate analysis, testing, exception handling, and adaptation to the realities of the U.S. healthcare market. Examples include:
- integrations with prescription management systems,
- integrations with pharmacies,
- integrations with laboratories and lab result systems,
- integrations with device providers, such as smart scales,
- integrations with messaging and communication systems,
- integrations with B2B partner platforms,
- integrations related to eligibility verification, funding, and benefit management.
QA as a critical foundation for medical product safety
In a healthcare project, testing plays a particularly critical role. The QA team was responsible not only for manual functional testing, but also for requirements analysis, identifying edge cases, validating medical logic, working with databases, conducting end-to-end testing, and performing performance testing.
Sophie AI: Supporting the care team with basic user inquiries
As the number of users grew, so did the volume of questions directed to the care team. Many of them concerned simple issues: where to find a feature, what information still needed to be completed, how to proceed to the next step, or what was blocking a prescription or consultation.
To reduce the team’s workload and shorten response times, Sophie AI was implemented within the application — a chat assistant supporting users with basic questions related to the platform and treatment process. If the AI is unable to help or the user prefers human support, the conversation can be redirected to the care team.
This solution does not replace medical decision-making. Its purpose is to relieve the team from repetitive, low-complexity inquiries and allow human specialists to focus where their expertise is truly needed.
To the success
Technological outcomes
A platform ready for B2B scale
9am.health has evolved from an early-stage product for individual users into a MedTech platform offered as an employee benefit. Its architecture, integrations, internal tools, and QA processes have enabled the platform to support a significantly larger number of users and business partners.
40,000+ new users in 2025
In 2025, more than 40,000 new users joined the platform. This confirmed the effectiveness of the B2B model while also validating the product’s technological readiness for rapid growth.
EMR tool for the clinical team
fireup.pro co-developed a tool that supports physicians and the care team in their daily work - from reviewing patient data and laboratory results to managing prescriptions, tasks, and ongoing care decisions.
Automation of clinical and operational processe
The LabCadence logic, task framework, medication dosing mechanisms, integrations, and care team tools reduce the amount of manual work and make it possible to support a growing number of users without linearly expanding the operational team.
Comprehensive testing process
Manual testing, end-to-end automation, performance testing, API validation, log analysis, and testing of medical scenarios all contributed to improving product safety. In the healthcare domain, this is critical - a single error can quickly affect a large number of users and directly impact the treatment process.
Custom solutions instead of limiting off-the-shelf tools
The team developed its own libraries, components, and mechanisms whenever off-the-shelf solutions did not meet the product’s requirements. This approach provided greater control over the platform’s logic, UX, and future development possibilities.
Business benefits
9am.health gained a scalable product ready to support large B2B partners.
The platform can be offered as an employee benefit for organizations across the USA.
Dedicated partner flows make it possible to tailor the application to different business requirements and user groups.
Automations reduce the workload of the care team and support the management of a growing number of patients.
Clinical solutions help physicians make decisions based on structured and organized data.
Health programs such as Healthy Weight Journey increase the product’s value beyond medication prescribing alone.
The product is evolving toward broader metabolic care, not just diabetes management.
Project team
Łukasz
Senior Backend Developer / Backend Architect
Tech stack
Java
TypeScript
JavaScript
REST API
Playwright
Cypress
Postman
Python
Cursor AI
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Innovations
Dedicated EMR System – a modern, custom-built tool designed specifically for physicians and the care team.
Automation of Continuation & Refill Processes – mechanisms supporting qualification, consultations, and medication dosing.
Healthcare Integrations – extensive connections with the U.S. healthcare ecosystem.
Custom Technology Solutions – proprietary libraries and tools tailored to the product’s needs.
Collaboration with the U.S.-based team across three time zones – efficient communication, code review, and work handover processes despite the time differences between Poland and both the East and West Coasts of the United States.
Sophie AI – an intelligent assistant that reduces the care team’s workload by handling simple user inquiries.
We have a team that truly knows its stuff — we'll help you find a solution that works.
Conclusions & recommendations
Healthcare requires a higher level of responsibility than standard software development
Every error can impact treatment, medication dosing, prescriptions, or a patient’s access to care.
A startup can scale rapidly only if its architecture does not limit future growth.
At 9am.health, architecture and code standards were prioritized from the very beginning, enabling the product to evolve from an MVP into a platform serving tens of thousands of users.
Custom solutions are worthwhile when the domain is highly specialized.
Custom-built components, libraries, and tools made it possible to tailor the system to the needs of 9am.health more effectively than off-the-shelf solutions.
QA in healthcare is more than just testing tickets
Testers must understand the process, be familiar with medical logic, and verify whether business requirements make sense within the context of the product.
AI helps, but it does not replace domain expertise
In healthcare, AI-generated output requires validation by people who understand the product and its business implications.
Automation becomes essential when the care team cannot scale linearly
The task framework, LabCadence, EMR, and Sophie AI enable the clinical team to focus on cases that truly require human decision-making.
