EASE - Neurofeedback Therapy Platform

Domain: Healthcare / Mental Health / Neuroscience Engagement: Client project (backend development, alongside client's in-house team) Team Size: Backend-focused

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The Problem

A mental health startup was developing a neurofeedback therapy platform that required processing real-time EEG (electroencephalogram) brain data during therapy sessions. The client had an in-house team handling frontend and product, and brought us on to build the backend. They needed a backend that could:

• Manage complex patient-doctor-admin relationships
• Ingest and process live EEG sensor data via MQTT
• Track therapy sessions with clinical-grade data integrity
• Generate clinical reports and analytics
• Handle multi-role access with healthcare-grade security
• Scale to support multiple clinics and practitioners

Off-the-shelf healthcare platforms couldn't handle the real-time EEG data pipeline or the specialized neurofeedback workflow.

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What We Built

We handled the entire backend for the therapy management platform, delivering real-time brain data processing capabilities while the client's in-house team managed frontend and product.

Patient & Doctor Management

• Full patient profiles with medical history
• Doctor profiles with specialization and scheduling
• Patient-doctor assignment and session tracking
• Multi-clinic support with institutional isolation

Therapy Session Engine

• Session creation, scheduling, and lifecycle management
• Real-time EEG data capture during sessions
• Session notes and clinical observations
• Progress tracking across multiple sessions
• Protocol-based therapy workflows

EEG Data Pipeline

• MQTT integration for real-time sensor data ingestion
• EEG signal processing and storage
• Session-linked brain data with temporal indexing
• Data export for clinical analysis

Clinical Reporting

• Automated report generation from session data
• Progress analytics across therapy programs
• Patient outcome tracking
• Exportable clinical summaries

Multi-Role Access Control

Role	Capabilities
Patient	View sessions, reports, progress
Doctor	Manage patients, run sessions, write reports
Admin	Clinic management, staff oversight
Finance	Billing, payment tracking

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Technical Highlights

Architecture

• NestJS with modular, feature-based architecture
• Dual database: MongoDB (Mongoose) for flexible clinical data + PostgreSQL (TypeORM) for relational structures
• Bull queues (Redis-backed) for async processing (emails, reports)
• MQTT protocol for real-time EEG sensor communication
• AWS S3 for secure document and data storage
• AWS SES for transactional emails
• Sentry for error tracking and monitoring

Codebase Scale

• 25,000+ lines of TypeScript
• 150+ source files
• Feature-based module organization
• Comprehensive DTO validation layer

Security & Compliance

• JWT authentication with role-based guards
• Healthcare data isolation between clinics
• Secure file storage on AWS S3
• Audit-ready session and data logs

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Tech Stack

Layer	Technology
Backend	NestJS 8, TypeScript 4.3
Primary DB	MongoDB (Mongoose)
Secondary DB	PostgreSQL (TypeORM)
Queue	Bull (Redis-backed)
Real-Time	MQTT for EEG sensor data
Storage	AWS S3
Email	AWS SES
Monitoring	Sentry
Auth	JWT with refresh tokens

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Outcome

• Production platform managing therapy sessions with real-time EEG data capture
• Dual-database architecture balancing flexibility (MongoDB for clinical data) with integrity (PostgreSQL for relational models)
• MQTT pipeline enabling sub-second EEG data ingestion during live sessions
• Multi-role system supporting the full clinical workflow from scheduling to reporting

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Key Takeaway

Working alongside the client's in-house team, we owned the backend entirely -- from the MQTT-based EEG pipeline and dual-database strategy to clinical-grade access controls. This demonstrates our ability to integrate into existing teams and deliver specialized healthcare backend systems that go far beyond standard CRUD applications.