About LUKE
We built the platform we couldn't find.
Telehealth practices deserve better than six disconnected tools held together with manual workflows and crossed fingers. LUKE is the vertically integrated platform that handles the full lifecycle — from lead capture through clinical care, FHIR-connected lab ordering, to product fulfillment — with the compliance posture to operate in regulated healthcare.
The Origin
Practices were drowning in tools.
Every telehealth practice selling prescription products online was stitching together the same Frankenstein stack — a video platform here, a CRM there, an e-commerce tool that didn't know about prescriptions, and a compliance layer bolted on top. Patient data scattered across six vendors. Six separate BAAs. Manual processes bridging the gaps. Every handoff a compliance risk.
- Patient intake in one system, prescriptions in another
- Manual prescription checks before every shipment
- Lead-to-patient conversion reconciled by hand
- Audit trails spread across six platforms
- Six vendors, six BAAs, six points of failure
Philosophy
Integrated at the database level. Not bolted together with APIs.
One Database, Not Four
When a lead converts to a patient, it's one atomic transaction. When a prescription is verified, the checkout gate opens automatically. When any action occurs, the audit trail captures it. No webhooks between internal systems. No data synchronization. One source of truth.
Compliance as Foundation
Security isn't a feature we added — it's the architecture we started with. Per-tenant encryption, row-level security, and hash-chained audit trails were in the first commit, not the last.
Build for Extraction, Not Decomposition
The clinical domain, commerce domain, and CRM domain have different scaling characteristics and change velocities. We structured them so they could be extracted into separate services later without a rewrite. Microservice-ready, not microservice-burdened.
By the Numbers
How We Think
Every decision is deliberate.
Why field-level encryption instead of transparent database encryption?
Because TDE protects against disk theft, not application-layer breaches. Field-level encryption means even database administrators can't read PHI without the application keys.
Why a single service instead of microservices?
Because at current scale, a monolith with clear domain boundaries is simpler to deploy, debug, and reason about. The boundaries are drawn so extraction is possible when scale demands it.
Why build a CRM instead of integrating HubSpot?
Because the CRM needs to know about prescriptions, clinical status, and order history. A third-party CRM would require constant synchronization of PHI, creating both a compliance risk and an engineering burden.
Why hash-chained audit trails?
Because append-only logs can be silently truncated. A hash chain makes tampering mathematically detectable. If a regulator asks for proof of access history, we can prove the record is complete and unmodified.
Why build an AI agent instead of integrating a chatbot vendor?
Because a third-party chatbot can't read your patient records, prescriptions, or CRM pipeline. Our AI agent lives inside the platform — it knows which patients have active prescriptions, which leads are warm, and which questions require a clinical response. That context is the difference between a helpful conversation and a liability.
Why integrate Health Gorilla instead of building a lab interface from scratch?
Health Gorilla already connects to LabCorp, Quest, and BioReference through FHIR R4. Building direct integrations with each lab network would take 6-12 months per network and require individual compliance certifications. Health Gorilla abstracts the network complexity — if a lab network is substituted, the FHIR interface stays the same. One integration, three networks, zero lock-in.
The Team
An agency that builds its own tools.
LUKE is built by Cullari Media — an agency that got tired of recommending tools that didn't exist. We build platforms for regulated industries where compliance, data integrity, and operational reliability aren't optional. LUKE is the telehealth platform we wanted to deploy for our clients and couldn't find anywhere else.
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