Working at a Health Tech Startup: How Does It Differ from Outsourcing?

My Background

From 2013 to 2018 I worked at outsourcing companies, first DFT JSC then Savvycom JSC, building apps for international clients in social media, restaurant management, ecommerce, and more.

In 2019 I joined Jio Health, an American health tech startup in Vietnam, where I've spent over 5 years building patient and doctor apps.

Ownership and Impact

Outsourcing

You build what the client specifies. Requirements come from across the ocean through project managers, you rarely talk to end users, and when the project ends you move on.

I built 10+ apps at Savvycom. I'm proud of the work, but I never saw how people used the products or got to iterate on feedback.

Product Company

At Jio Health I own the mobile experience. When a patient reports a confusing booking flow, I see the feedback, investigate, ship the fix, and check analytics to see if it helped. You feel the impact of your work directly.

Verdict: If you want your work to matter, product companies win.

Technical Depth vs Breadth

Outsourcing

Every 3 to 6 months you start a new project with new requirements, sometimes a new stack. At Savvycom I worked with:

• Live streaming (WebSocket, Core Animation)
• Restaurant POS (SQLite, Bluetooth printers)
• Social apps (realtime chat, media handling)
• Ecommerce (payment integration, push notifications)

Breadth is valuable early on: you learn fast because the problems keep changing.

Product Company

At Jio Health I've spent 5+ years going deep:

• WebRTC: for video consultations: SRTP, TURN servers, call quality metrics
• HealthKit: integration: syncing health data with clinical systems
• E2EE: for patient data: encryption meeting healthcare compliance standards
• gRPC: for service communication

After 5 years I understand healthcare app development at a level jumping between projects takes far longer to reach.

Verdict: Outsourcing gives breadth, product gives depth. Breadth matters early, depth differentiates you later.

Code Quality and Technical Debt

Outsourcing

There's constant pressure to ship and move on. Code quality suffers because:

• Clients prioritize features over architecture
• No maintenance incentive: someone else inherits it
• Budgets are fixed, so refactoring is seen as waste

I've shipped code I wasn't proud of because the budget didn't allow for proper architecture.

Product Company

At Jio Health I maintain code I wrote 5 years ago. That changes how you work:

• You write code knowing you'll debug it later
• You invest in testing because production bugs affect real patients
• You refactor early because technical debt compounds
• Code reviews are thorough because everyone shares ownership

Verdict: Product companies build better habits because you live with your decisions.

Work and Life Balance

Outsourcing

Deadlines are external and rigid. When a client demo is on Friday, you work late. When projects overlap, you switch context constantly. I went through stretches of crunch at Savvycom.

Product Company

At Jio Health we set our own deadlines, and when something runs long we cut scope instead of forcing overtime.

Healthcare has its own pressure. When the telemedicine platform goes down, patients can't see their doctors. Production incidents are stressful in a way outsourcing rarely is.

Verdict: Product companies offer better balance, but production incidents can be more stressful.

Career Growth

Outsourcing

Growth is tied to projects managed or team size. The path is Junior Developer → Senior Developer → Team Lead → Project Manager. Technical growth can plateau because you repeat the same patterns.

Product Company

Growth is tied to domain expertise and impact. At Jio Health I've grown by:

• Becoming the person people ask about mobile architecture
• Migrating the apps from native to Flutter
• Mentoring junior developers on iOS and Flutter
• Contributing to technical strategy

Verdict: Product companies reward deep expertise, outsourcing rewards management skills.

Compensation

This varies by company, but in Vietnam:

• Outsourcing pays competitively for junior and mid level developers
• Product companies and startups often pay more for senior roles, especially with equity
• International product companies like Jio Health tend to pay more than local outsourcing firms

Verdict: Depends on the companies. Research and negotiate.

My Recommendation

Start in outsourcing if you're early in your career. You'll work with different codebases, communication styles, and problems.

Move to a product company once you have the foundations, typically after 3 to 5 years. Depth, ownership, and impact accelerate your growth as a senior engineer.

Choose your domain carefully. In health tech, fintech, and edtech, deep expertise lasts. Knowing healthcare regulations, security requirements, and the domain makes you hard to replace.

I don't regret the outsourcing years. They made me versatile. But joining Jio Health was the best career decision I've made.