Custom AI in Healthcare: An ROI-Driven Alternative to SaaS.
The SaaS boom promised agility, scale, and simplicity, but for many healthcare organizations, it’s starting to feel more like a long-term tax than a long-term solution.
Between rising subscription fees, rigid feature sets, and integration gaps, health systems and managed service organizations are rethinking whether they’re truly getting value from SaaS-style solutions. This article explores how custom AI and software development—done right—can offer a more flexible, cost-effective alternative. From smarter claims and CDI workflows to unified billing dashboards and scalable integration layers, we’ll unpack how a strategic, ROI-focused build approach can go beyond one-size-fits-all SaaS.
The typical argument against custom development is cost and risk.
However, modern tools and frameworks have changed the equation so building internal tools or tailored AI systems no longer means starting from scratch or staffing a full engineering org. Instead, modular, purpose-built teams can deliver solutions that directly support various workflows. Take clinical documentation improvement (CDI) and claims optimization, for example: while SaaS vendors often promise to uncover “missed” charges, their black-box rules may not match internal documentation patterns or billing logic. A custom solution can instead ingest an organization’s specific notes, coding history, and payer behavior to surface more relevant, context-aware opportunities, reducing false positives while increasing recoverable revenue.
The same applies to billing dashboards. Many provider groups struggle to get a unified view of billing status across their EHR, clearinghouses, and payers. Off-the-shelf dashboards often can’t pull from all sources or allow for role-specific filtering and reporting. A custom-built app can combine those data streams into a single, tailored view that supports cohort tracking, drill-downs, and alerts tied to internal priorities. For managed service orgs, this can mean less time reconciling across platforms and more time focusing on improving collections and throughput.
And then there’s integration—an often underappreciated cost of going SaaS.
Each new tool means a new integration project, often with a third-party partner who specializes in one product or one EHR. But the better model might be to treat integration as a capability, instead of a vendor relationship. A flexible integration team can build across multiple systems (Epic, MedPlum, Redox, internal APIs) and keep evolving those connections as needs change. Instead of paying for one-off point solutions, the reward for investment is a durable interoperability infrastructure that stays aligned with the organization’s specific data and workflows.
In a market flooded with hot takes and vendor pitches, this isn’t about rejecting SaaS outright—it’s about rebalancing the equation. For the right use cases, custom AI and application development can deliver better ROI, clearer insight, and more adaptability than an off-the-shelf solution ever could. The key is not just building software, but building it with a partner who understands healthcare’s complexity and your organization’s goals.
Partnering for Real Impact
At Toboggan Labs, we’ve helped healthcare orgs navigate some of their thorniest challenges. From integrating across complex EHR environments to building targeted tools that surface real, usable insights, our team is focused on solving the problems that off-the-shelf solutions often overlook.
We believe that custom development—done pragmatically and with the right expertise—can be a force multiplier for healthcare teams trying to do more with their data. If you’re exploring alternatives to SaaS or looking for a more flexible approach to building technical capacity, we’re always open to a conversation.