Build vs. buy for regulated clinical alerting systems?

In regulated health software (EU MDR IIa), teams often need clinical alerting: thresholds, audit logs, patient prioritisation, etc.

Some teams build everything in-house, others integrate pre-certified components or platforms. From your experience:

When does building in-house make sense?

When does buying or integrating save real time (not just move work elsewhere)?

Any unexpected trade-offs?

Would love to hear real-world lessons, especially from teams shipping in 2024–2026.