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AI Voice Agent Development · Boston
Voice agents in Boston live or die on one question: can they handle PHI without leaking it. An appointment-scheduling agent for a Mass General Brigham practice group has to verify the caller, look up a slot in Epic, capture the visit reason, and write the booking back, all while never logging the caller's name into a non-BAA observability sink. A clinical-trial recruiting agent for a Cambridge biotech has to read an IRB-approved script, capture consent, and route qualified candidates to a study coordinator.
We build voice agents for healthcare, biotech, and EdTech teams in the metro with HIPAA built into the architecture from the first call. BAA-covered STT, LLM, TTS, and telephony. Epic on FHIR, athenahealth, and Healow integration for scheduling. Veeva CTMS, Medidata, and OnCore integration for clinical-trial recruiting. Hard escalation rules for any clinical concern.
Every engagement is scoped fixed-price after discovery, which includes a regulatory walkthrough, and the build ships with a written compliance memo.
Tell us about the regulated call flow.
The telephony layer is Twilio with their BAA in place, Amazon Connect under the AWS BAA, or Azure Communication Services under Microsoft's BAA. The agent runtime sits on ECS Fargate or Azure Container Apps in the same region as the telephony provider, never crossing region boundaries with PHI. STT is Deepgram Nova-2 under their BAA or AWS Transcribe Medical, which is purpose-built for clinical vocabulary.
The LLM layer routes to Anthropic Claude Sonnet 5 or Haiku 4.5 through AWS Bedrock under signed BAA, or to Azure OpenAI GPT-5 under Microsoft's BAA. The agent runtime never reaches a public OpenAI or Anthropic endpoint. TTS goes through ElevenLabs Enterprise (BAA available) or Amazon Polly under BAA, with custom voice models pinned for consistency across calls.
Epic on FHIR is the integration target for most health-system work in the metro. The agent uses SMART on FHIR OAuth scopes tightly bounded to the resources it needs (Appointment.read, Appointment.write, Schedule.read, Patient.read with pre-verified identity). For practices on athenahealth the equivalent surface is athenaNet API, and for eClinicalWorks it is Healow. Tool calls log the FHIR transaction ID or equivalent so a practice manager can reconcile the booking.
Observability is a careful split: latency, error rates, and tool-call success go into CloudWatch or Application Insights under BAA. PHI-bearing call transcripts are stored in an encrypted S3 bucket with KMS keys you control, retention policies aligned to your covered-entity policy, and access logged through CloudTrail. The two streams never mix.
Six components that show up in every regulated voice agent we ship for healthcare, biotech, or clinical-research clients.
Twilio, Amazon Connect, or ACS for telephony; Deepgram or AWS Transcribe Medical for STT; Bedrock Claude or Azure OpenAI for LLM; ElevenLabs Enterprise or Polly for TTS. Every layer has a signed BAA.
SMART on FHIR OAuth scopes per practice. Tool wrappers for Appointment.read, Appointment.write, Schedule.read. Multi-provider routing logic for practices with multiple visit types and modalities.
Practice-specific endpoints for athenahealth and Healow for eClinicalWorks. Scheduling, intake, and pre-visit confirmation workflows. Equivalent audit logging to the FHIR path.
IRB-reviewed scripts, verbal and DTMF consent capture, pre-screen questionnaire flow, structured intake into Veeva CTMS, Medidata, or OnCore. PHI handling per the trial Data Management Plan.
Conversation transcript, structured intent, pre-verified identity, and proposed action attached to the warm-transfer payload. Nurse, scheduler, or coordinator picks up with the caller's history on screen.
Keyword and sentiment triggers (chest pain, suicidal ideation, severe symptoms) route immediately to a human queue with no further agent dialog. The escalation list is reviewed with your clinical leadership before deployment.
Boston has more clinical operations footprint per square mile than any other US metro. Mass General Brigham runs Epic across the network. Beth Israel Deaconess, Tufts Medical Center, and Boston Children's each run sizable practice groups and ambulatory operations. Kendall Square hosts the densest biotech cluster on the planet, with Moderna, Vertex, Biogen, Takeda, and hundreds of smaller companies all running clinical-trial recruiting and patient outreach at meaningful scale.
The volume problem in Boston is concrete. A typical 12-provider ambulatory practice in Brookline or Cambridge handles 800 to 1,200 inbound calls a week, with peak hours around lunch and 4pm when human staff are stretched. A clinical-trial recruiting site running three concurrent studies has thousands of pre-screen candidates to call. The miss-rate on these calls is measurable revenue and enrollment loss. A voice agent that handles routine scheduling and pre-screen intake gives staff back the hours they need for the clinical work only humans can do.
We work remotely with Boston clients on Eastern time, with regulatory walkthroughs included in discovery and a written compliance memo shipped with the build. Code transfers to a repo you own, including the Terraform or CDK for the BAA-covered topology.
Industries where we see strongest fit: ambulatory practice scheduling, health-system patient outreach, clinical-trial recruiting and pre-screen, sponsor-direct recruiting at biotechs, EdTech onboarding calls with FERPA handling, and life-sciences inside-sales for specialty instruments.
Describe the call flow, the regulatory frame, and which EHR or CTMS the agent has to integrate with. We'll reply within one business day with a rough architecture and a price range.