case study 01 / 05 — healthcare

legacy systems into a modern, scalable platform

a twenty-year-old patient administration system, retired module by module while every hospital stayed open.

client
a private hospital network, 14 sites
sector
healthcare ↗
duration
11 months
team
8 engineers, 1 product lead, 1 clinical lead
the result, in numbers
0hours of unplanned downtime during migration
38%lower infrastructure cost
4×faster release cycle
the brief

the network's patient administration system had grown over two decades into a single on-premise monolith. every change needed a weekend freeze, and three of the five people who understood it were close to retirement.

a full replacement had already been attempted once and abandoned. the board wanted modernization without a second big-bang project — and without a single hour of clinical disruption.

the build

47 weeks, 4 phases, one team.

  1. 01system mapping3 weeks

    dependency graph of 212 modules, ranked by risk and coupling.

  2. 02first slice6 weeks

    appointment scheduling extracted behind an api, run in parallel for four weeks.

  3. 03strangler migration30 weeks

    nine further domains moved, each reversible until reconciled.

  4. 04decommission8 weeks

    legacy retired, licenses reclaimed, runbooks handed over.

before
  • weekend release freezes
  • one shared database for everything
  • knowledge held by three people
  • on-premise hardware at end of life
after
  • weekly releases, no freeze
  • ten services, clear ownership
  • documented, tested, observable
  • managed cloud with finops reporting
they moved the ground under us and not one clinic noticed. that was the whole brief.
— chief information officer, a private hospital network
the result

the monolith is gone. scheduling, admissions, billing, and records now run as independently deployable services on a managed cloud, with fhir apis that partner clinics integrate against directly.

the internal team now ships weekly without a freeze — and owns the platform outright.

practices
stack
  • c#/.net
  • fhir
  • azure
  • kubernetes
  • kafka
  • postgres
  • terraform
next case study02 / 05mvp shipped in record time, quality intact
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