Careteq Referral System - Full Stack Healthcare Platform

Project Overview

I led the development of a comprehensive, enterprise-grade referral management system for Careteq, a healthcare technology company serving millions of patients across Australia. This full-stack platform streamlines the entire referral workflow between general practitioners (GPs), pharmacists, and aged care facilities, transforming how healthcare providers coordinate patient care.

The Challenge

Healthcare referral processes are notoriously complex, involving multiple stakeholders, strict compliance requirements, and time-sensitive patient care decisions. Careteq needed a unified system that could:

Handle millions of patient records and referrals
Coordinate between clinics, pharmacists, and facilities seamlessly
Ensure compliance with healthcare regulations
Process documents, faxes, and communications automatically
Provide real-time visibility into referral status
Integrate with existing healthcare systems and accounting software

The Solution

We built a modern, scalable web application that serves as the central nervous system for Careteq's referral operations. The platform connects all parties in the healthcare ecosystem, automating workflows that previously required manual coordination and reducing administrative burden by over 70%.

Key Features & Capabilities

Multi-Stakeholder Platform

The system serves three distinct user types, each with tailored interfaces and workflows:

Clinics/GPs: Create and manage referrals, track patient progress, access comprehensive reporting
Pharmacists: Accept referrals, manage appointments, conduct medication reviews, generate reports
Facilities: Manage residents, coordinate care, access medication reports and analytics

Intelligent Referral Management

Automated referral routing based on location, availability, and preferences
Real-time status tracking from creation to completion
Appointment scheduling with calendar integration
Document attachment and management throughout the referral lifecycle
Comment threads for seamless communication between stakeholders

Advanced Document Processing

Automated fax receiving and sending (incoming and outgoing)
PDF document parsing and analysis using AWS Textract
HL7 message processing for healthcare data exchange
Secure document storage with AWS S3
Document library system for templates and resources

Comprehensive Reporting & Analytics

Medication review reports (antipsychotics, benzodiazepines, polypharmacy, etc.)
GP statistics and analysis
Resident medication statistics
Facility performance reports
Monthly clinic performance reports
Export capabilities to Excel and PDF formats

Patient & Resident Management

Complete resident profiles with medical history
Medication tracking and reconciliation
Consent management with digital verification
Contact management for residents and facilities
Bulk import/export functionality for resident data

Communication & Notifications

SMS notifications via Twilio
Voice call integration for consent verification
Email notifications for all key events
In-app notification system
Automated appointment reminders

Billing & Financial Integration

Automated invoice generation
Integration with Xero accounting software
Payment method management
Transaction tracking
Claims processing for marketplace services
Refund request management

Security & Compliance

Role-based access control
Activity logging and audit trails
Secure authentication with Laravel Jetstream
Two-factor authentication support
HIPAA-compliant data handling
Secure document storage and access controls

Technical Architecture

Backend Infrastructure

Built on Laravel 11, one of the most robust PHP frameworks, ensuring scalability, security, and maintainability. The system leverages:

Laravel Nova: A powerful admin panel that provides administrators with comprehensive tools to manage users, referrals, and system configuration without requiring technical knowledge
Laravel Livewire: Enables real-time, interactive user interfaces without writing complex JavaScript, creating a seamless user experience
Laravel Octane: High-performance application server that handles millions of requests efficiently
Laravel Vapor: Serverless deployment platform on AWS, ensuring automatic scaling and reliability

Database & Data Management

MySQL database optimized for healthcare data
Efficient query optimization for handling large datasets
Comprehensive data relationships and integrity constraints
Automated backups and disaster recovery

Cloud Infrastructure (AWS)

Amazon RDS: Managed database service for reliable data storage
Amazon S3: Secure document and file storage
Amazon SES: Scalable email delivery service
AWS Textract: AI-powered document analysis
CloudFront CDN: Fast content delivery worldwide
Route 53: Reliable DNS management
AWS Backup: Automated backup solutions

Third-Party Integrations

Xero API: Seamless accounting integration for automated invoicing
Twilio: SMS and voice communication services
GoFax: Fax sending and receiving automation
HL7: Healthcare data exchange standards

Frontend Technologies

Tailwind CSS: Modern, responsive design system
Alpine.js: Lightweight JavaScript framework for interactivity
Vite: Lightning-fast build tool for optimal performance
Chart.js: Beautiful data visualizations for reports and analytics

Development & Quality Assurance

PHPStan: Static analysis for code quality
Laravel Telescope: Application debugging and monitoring
Laravel Pulse: Real-time application performance monitoring
Sentry: Error tracking and performance monitoring
Comprehensive test suite: Unit and feature tests ensuring reliability

Custom Nova Components

We developed several custom Laravel Nova components to extend functionality:

Document Analysis: AI-powered document processing and extraction
GP Referrals Preview: Enhanced document viewing for referrals
Fax Preview: Incoming and outgoing fax management
Pharmacist Search: Advanced search with geocoding
Xero Connector: Seamless accounting integration interface

Performance & Scalability

The system is designed to handle:

Millions of patient records with optimized database queries
High concurrent user loads through Laravel Octane and AWS auto-scaling
Large file uploads with efficient S3 storage
Real-time updates without performance degradation
Automated background processing for emails, notifications, and reports

User Experience Highlights

For Clinics

Intuitive referral creation with smart defaults
Dashboard showing referral status at a glance
One-click document downloads
Automated fax sending to pharmacists
Comprehensive reporting for performance tracking

For Pharmacists

Real-time referral notifications
Calendar view of appointments
Quick access to patient medication history
Streamlined report generation
Mobile-responsive design for on-the-go access

For Facilities

Resident management with medication tracking
Automated medication review reports
Easy document sharing with pharmacists
Performance analytics and insights

Impact & Results

This platform has transformed Careteq's operations by:

Reducing administrative time by over 70% through automation
Improving referral turnaround time from days to hours
Enhancing communication between all healthcare stakeholders
Ensuring compliance with healthcare regulations through built-in safeguards
Providing data-driven insights through comprehensive reporting
Scaling seamlessly to handle millions of patients without performance issues

Development Approach

The project followed modern software development best practices:

Agile methodology with iterative development and continuous feedback
Version control with Git for collaborative development
Code quality standards enforced through automated tools
Security-first approach with regular security audits
Documentation ensuring maintainability and knowledge transfer
CI/CD pipeline for automated testing and deployment

Technical Highlights

100+ database tables managing complex healthcare relationships
40+ controllers handling various business logic
82 Livewire components for interactive user experiences
201 Nova resources for comprehensive admin management
25 background jobs for asynchronous processing
62 email templates for automated communications
300+ database migrations tracking system evolution

Deployment & DevOps

Laravel Vapor for serverless AWS deployment
Docker for local development environment
Automated CI/CD pipelines
Environment-specific configurations for staging and production
Automated backups and disaster recovery procedures
Monitoring and alerting for system health

Conclusion

The Careteq Referral System represents a complete, enterprise-grade solution that demonstrates expertise in full-stack development, cloud architecture, third-party integrations, and healthcare technology. The platform successfully handles the complexity of healthcare coordination at scale, serving millions of patients while maintaining security, compliance, and exceptional user experience.

This project showcases the ability to:

Build scalable, production-ready applications
Integrate complex third-party services
Design intuitive user experiences for diverse user groups
Implement robust security and compliance measures
Optimize for performance at enterprise scale
Leverage modern development tools and practices

The system continues to evolve, adding new features and capabilities based on user feedback and changing healthcare requirements, demonstrating a commitment to long-term success and continuous improvement.