Express is a TypeScript workable choice for healthcare. GreatCTO auto-detects both — adds the healthcare archetype overlay, wires healthcare-specific gates, and runs 83 specialist agents around your existing Express workflow.
GreatCTO reads your package.json and detects express + healthcare archetype from signals: imports, file structure, env vars, README hints.
Attaches the healthcare archetype overlay: HIPAA gates, BAA tracking, PHI encryption review, 21 CFR Part 11 audit-trail. Override if your specifics differ; the defaults are sensible for Express-style projects.
qa-engineer runs tsc --strict / eslint / vitest --coverage; security-officer checks for prototype pollution + XSS sinks; performance-engineer reviews bundle size + cold-start times.
Bugs you've hit before in other Express projects (connection-pool exhaustion, ORM N+1 queries, retry storms) — the agent's Step 0 includes the prior detection order. MTTR drops 94 % on second occurrence (methodology).
$ cd my-express-app && npx great-cto init ✓ scanning manifests… found package.json ✓ stack: express (TypeScript) ✓ archetype: healthcare ⚠ archetype + stack combo is unusual — review overlay manually ✓ 83 agents ready $ /start "add HL7 patient resource endpoint" ▸ architect drafting ARCH-healthcare.md… ▸ pm decomposing into beads tasks… ⚐ gate:plan — your approval needed
Approve → 3 senior-devs run in parallel worktrees → 5 reviewers fan out in parallel → gate:ship → deploy. One real run walked stage-by-stage: /proof.
This is the shape of what senior-dev drafts for "HL7 patient resource endpoint" — auth first, schema validation, and the audit line the healthcare reviewer requires before gate:ship opens.
// src/routes/healthcare.ts — drafted by senior-dev, reviewed by 5 agents
import { Router } from 'express';
import { requireAuth } from '../middleware/auth'; // security-officer: auth first
import { auditLog } from '../lib/audit'; // gate:healthcare: every decision logged
export const router = Router();
router.post('/healthcare', requireAuth, async (req, res) => {
const parsed = schema.parse(req.body); // qa-engineer: zod schema enforced
const result = await handle(parsed, req.user);
await auditLog({ who: req.user.id, what: 'HL7 patient resource endpoint', confidence: result.confidence });
res.json(result);
});healthcare overlay.Patient-facing portals handling PHI under HIPAA.
FHIR / HL7 integration services for EHR data.
Clinical-workflow tools with 21 CFR Part 11 audit trails.
Express (TypeScript) is not a typical fit for healthcare. The archetype overlay still attaches, but you may want to override defaults more aggressively. Check the healthcare archetype page for the typical stack list and decide if your case is the right tool / right archetype.
No black-box "AI does it all" loop. GreatCTO is a deterministic state machine — 8 stages, 22 nodes, 2 human gates. Every node maps to a real agent on GitHub. Inspect the state machine →
$ npx great-cto init
Free, MIT, runs locally. Built as a Claude Code plugin — install with one command.
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One run, one feature, from prompt to merged PR. Time, cost, and gate-by-gate breakdown — no marketing math.
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