AppHatchery: From Service Team to Research Partner - Six Years of Building Digital Health Tools and Infrastructure That Lasts

Most digital health tools built for clinical research disappear shortly after the paper is published. The graduate student or contractor who built it has moved on; the grant has ended; the PI has moved to the next project. This is a familiar story for RSEs, we are brought in to rescue software with a codebase nobody owns, documentation that doesn't exist, and a PI who doesn’t understand the lift. Sustainability is rarely planned for at the time the grant is written. AppHatchery started as a service supporting Emory University's NIH-funded consortium to further clinical and translational science. One RSE, one project. Six years later we are a team of ten with our own product roadmaps, licensing agreements, and brought in when grants are scoped. What that unlocked was the ability to choose our projects based on the potential impact we can have. The Georgia TB Reference Guide is now in the pocket of every tuberculosis clinician in the state of Georgia; TypeU is given to every newly diagnosed Type 1 diabetes patient at our local pediatric hospital; and Fabla supports over $20M in active research across dozens of studies. These tools exist today because we were financially stable enough to invest in projects worth sustaining. This talk is an account of that evolution: what the service model costs us, how we failed many times and learned what to move away from, and our current capacity-building model that isn't selling time by the hour to keep the lights on.