Optimizing System Performance and Engineering Custom Integrations
A leading clinical communications platform needed to scale to meet rising demand – and then evolve to meet the needs of an entirely new care setting. The first initiative focused on hardening system performance through automated load testing and optimization. That success laid the foundation for our second engagement: transforming the product to support outpatient workflows and a custom EHR integration. Together, these projects accelerated time to scale and unlocked new revenue through product extensibility.
The Client & The Challenge
Secure, real-time clinical communication & collaboration (CC&C) between physicians, nurses, hospital rooms, and medical equipment in healthcare is nothing short of mission-critical. So when an enterprise healthcare CC&C platform provider engaged us, we understood the immense responsibility in proactively preparing for its next stage of growth
Challenges & Pain Points
Scaling for Enterprise Demand
Fueled by major healthcare customer acquisitions and planned post-acute care expansions, the platform required a systematic approach to performance testing and infrastructure tuning. Without visibility into system thresholds, the client knew it was risking performance degradation under increased load as new medical providers were continually onboarded.
Evolving to Support Post-Acute Care
A newly contracted global healthcare customer required expanded functionality for outpatient and chronic care settings – including complex patient-care team modeling and integration with a proprietary electronic health record (EHR) system. But, the platform was designed for in-patient care and integrated with only Epic and Cerner – two dominant EHRs in the market.
Consequences of Inaction
Without performance testing and architectural validation, the platform risked failure during large-scale rollouts. And without extensibility, it could not meet the evolving needs of high-value enterprise clients – limiting revenue potential and future growth of the platform.
The Partnership & The Proposition
DevIQ partnered with the client across both initiatives – first to build a performance testing framework, and second to expand platform capabilities for new outpatient use cases. In both cases, DevIQ operated as a tightly integrated extension of the client’s engineering team.
Collaborative Engineering Fit
- Integrated Sub-Teams: Embedded alongside client teams with autonomy in execution and alignment through weekly syncs
- Strategic Staff Extension: Delivered value while ensuring long-term self-sufficiency post-engagement
- Outcome-Focused Delivery: Completed the second engagement ahead of schedule by transferring extensive knowledge and efficient tooling
The Solution
Strategy & Approach
Each initiative began with a targeted inception phase to define scope, success metrics, and architectural boundaries. Our focus was on delivering measurable performance improvements and well-architected product extensibility – the technical chops – under the collaborative guidance of the client's sponsors.
We designed a high-scale test architecture, built load test generators, and then, based upon the results, we tuned and configured their clusters to deliver performance that would scale.
— Shawn Davison, CTO | DevIQ
Technical Execution
The Results
DevIQ delivered critical improvements to both platform performance and product extensibility. Messaging throughput increased 10x under load tests, and overall performance improved by 62%. The platform outpatient features were delivered ahead of schedule, enabling an initial rollout to 6,000 new care providers and supporting a full deployment target of 30,000+.
Built and Shipped
The scheduling platform, once beset by outages and constant firefighting, now runs on a stable, scalable foundation – enabling both growth and operational confidence. Key results and milestones delivered include:
- Stabilized Core Systems: Eliminated recurring outages and established a resilient baseline after years of instability and emergency remediation.
- Feature Delivery Reignited: Transformed a stalled and unpredictable roadmap into a steady stream of feature releases, making it possible to hit aggressive business goals.
- Client Retention Secured: Retained all major enterprise healthcare customers who were previously at risk of churn by delivering reliability and faster response to critical incidents.
- Product & Engineering Team Upskilled: Mentored client developers and product owners, introducing modern software practices and empowering the team to sustain improvements.
- Proactive Issue Management: Deployed targeted monitoring and alerting, allowing the team to address system performance issues before they reached customers.
By the Numbers
- 30 Days to Stability: Resolved two years of recurring outages in the first month.
- 60% Performance Improvement: Reduced API response and page load times by more than half across all clients.
- 3.5x Release Acceleration: Annual feature releases increased from 22 (2023) to 76 (2024).
- Emergency Fixes Nearly Eliminated: Hotfix rate dropped from 82% to just 8% of releases year-over-year.
The Conclusion
In a high-stakes healthcare environment, communication infrastructure must scale with precision and evolve with purpose. DevIQ’s partnership with this clinical communications leader enabled just that: a system ready for growth and built to serve a broader continuum of care. Our engineering precision, performance insights, and collaborative approach helped unlock both short-term wins and long-term product agility.
Today, the client continues to advance on its roadmap with a stronger foundation – empowered by tools, patterns, and processes designed for scale. From inpatient to outpatient, from scaling pain to scaling confidence, DevIQ helped guide the way towards a healthier future.
