“Successful athletes know the power of having a strong core, no matter what the sport.” – Verne Harnish.
After the successful launch of our first go-to-market solution at Holon, winning long-term contracts with market-leading innovative organizations and being awarded Healthcare Informatics “2018 Innovator of the Year” award, like any other technology solutions organization out there, there are common questions asked by some of our potential customers:
- Is this solution sustainable when deployed to my 1,000 physician offices?
- How much of an impact would I, as a customer, cause to Holon if I bring on 3 new use cases for your platform?
- How do you make sure that your systems stay in good health?
- How many physician offices can you install simultaneously?
- And several more.
There seems to be a general theme around scalability in these questions and since this is one of my favorite topics, I would like to highlight the methodology that we use at Holon, that prepares us for rapid scale.
The Scalability Tripod
During the early phases of my career whenever I heard the term “scalability”, the very first thoughts that came to my mind would be – “failure in the error chain”, or “performance tuning of systems”. Over time, having experienced scalability lessons through diagnosing problems, interviewing end users, watching traces of application logs and designing solutions to help prevent the problems, I have come to a conclusion that scalability is not about just the technology. Scalability is more of an art that you practice, perfecting every day, rather than a set of scientific formulae that you develop over time.
Here at Holon, Scalability is thought of as a “tripod” built with 3 mutually balancing legs – the right-minded people, the necessary processes, and a highly scalable architecture. More than the methodology of the tripod, it is the balance between the three legs that creates a model for us to build upon.
Leg 1 – Scaling the organization
“Talent wins games, but teamwork and intelligence win championships.” – Michael Jordan.
Having an organization of the right people doing the right job and with the right behaviors is top of our mind as we scale up. At the foundational level Holon’s leadership team possesses several decades worth of collective experience in building scalable businesses inside and outside healthcare technology. Possessing unique capabilities to wear multiple hats at the same time makes a considerable difference as we collectively devise the best paths to scale up the organization from multiple directions.
Together, every day, we work very hard to infuse a culture of growth, innovation, simplicity, excellence and empowerment. These serve as core principles in our hiring process where we evaluate everyone we hire to ensure they fit into our culture and skill set.
At Holon, our internal team structures are carefully and intentionally comprised of small cross-functional teams rather than siloed pods. We subscribe to the idea of a “Two-Pizza” size team where if two pizzas are not enough to feed our cross-functional units, they are broken down. Each cross functional team is paired with operations and customer facing services groups. We have proactively observed that some of the best tools have been developed by our technologists when they work in these environments. Every member of the Holon team is given goals to achieve rather than results to produce. They are empowered to use their creative abilities to help the organization scale up achieving the overall goals of the business.
Leg 2 – Scaling the processes
“Efficiency is doing things right; effectiveness is doing the right things.” – Peter Drucker.
There is a right time, a maturity level of each organization to introduce the right process.
At Holon we believe in leadership from within and beyond the obvious disciplines of SDLC and software change control. Most of our processes are focused on assisting with management tasks and standardization.
Instead of a top-down management approach, a collective decision is made to introduce an optimal amount of process and depending upon the case, after the process is established, either the teams or individuals within the team are assigned as owners of that process. The teams continuously gather feedback through measurements and observations to suggest and implement necessary changes in the process.
Built using remote distributed computing principles, our application is comprised of several moving parts interconnected over the internet and deployed remotely from each other all the way from our cloud hosted services to customer sites, to clinician desktops. Due to this architecture, we incur the need for mass software upgrades that are practically impossible to carry out by hand. To remedy this, we devised an auto-upgrade capability in our application components managed through a software release management process.
Because of the multiple deployment models, each of our software releases goes through rigorous cycles of QA including automation testing, deployment testing, regression testing, load testing and test harness environments. We built continuous monitoring for all of our systems and employed best practices of discovery, analysis and notifications to report on incidents, problems and crisis situations in a proactive manner. The analyses collected through these cycles goes into the feedback loop for the developers to identify bottlenecks in the codebase.
Our core agile culture emphasizing empowerment and incentivizing the right behavior serves as a catalyst to define the right measurable processes that help us make the right decisions at the right times.
Leg 3 – Scaling the architecture
“We can’t make the horse any faster, we need cars for where we are going.” – Henry Ford.
Our goal to is to underpin the US healthcare IT infrastructure with Holon’s breakthrough technology and allow us to “own the provider’s desktop.” This outlook warranted the need for designing our CollaborNetä platform as a hybrid client-cloud architecture built on top of remote distributed computing principles. From inception, we anticipated the power our platform would bring to the healthcare IT marketplace and the scale that implies, and so we developed our solution with this concept top of mind.
The components of our platform are deployed on a clinician’s desktop and optionally in their network connected with the EMR, with the brains behind the platform residing in our cloud hosted environment. Keeping the extensibility of use cases to be built around patient context awareness and knowing that we will be building end user facing applications that would need to scale for massive deployments, we chose Amazon’s AWS as our cloud hosting environment. With the heavy programmatic nature of AWS services, we are able to template and automate our deployments with reactive auto-scaling capabilities, rendering our systems expandable, resilient and highly available to meet the growing demands of our deployments and user interactions.
To allow us to deliver value to our customers with speed and agility we designed our core technology utilizing rapidly scalable microservices that enables us to deploy applications as suites of discrete, modular services, each running its own process with a minimal amount of centralized management. This architecture of microservices encourages our development teams to decouple software into smaller, functional components that have their own lifecycles of scalability thus making the overall management of our application platform manageable.
The remotely deployed components of the platform that comprise of the desktop application and the EMR connected network application are built with auto-upgrade capabilities that can be commanded from other remote endpoints for triggering automated workflows.
The UI application is designed with the end user’s perspective in mind and with a minimally invasive presence on a clinician’s desktop so that we do not interfere with their primary goal of patient care and provide relevant interventions to them only when they are relevant to the patients they are working with.
The road ahead
Holon’s CollaborNet platform is deployed on a large scale already with 909 locations and 6377 users currently provisioned. We anticipate that growth to continue with our customers and additional applications deployed to the current customers demanding more throughput and scale from our application platforms. This presents an interesting opportunity ahead: to remain focused on the simplification and automation of our deployment technology. As our organization grows, we constantly look for opportunities to further streamline our internal processes to achieve consistent results across multiple project iterations. One aspect of the platform that is critical for us to remember is that it is a clinician’s tool and there are a lot of user utilization level data points that are very critical to solve as it pertains to patient care workflows. Looking back, our team is humbled by what we have accomplished in 2018 with the official commercial launch of CollaborNet.
Looking ahead, we are guided by our massive deployments and highly collaborative customer relationships keeping us ahead of their needs and the market’s needs. We remain focused on making our agnostic, first-to-market solution even more powerful, yet incredibly simplistic for the user. Follow us to stay connected to our team of innovators as we continue to “Liberate the Data” and “Liberate the Care”.
Saurabh Mathur leads the research, development, architecture and infrastructure activities at Holon. After graduating as an Electrical Engineer from the National Institute of Technology in India, Saurabh started his career at McKessson Provider Technologies, Alpharetta GA, in 2001 as an integration developer, where he built a HL7 interface engine that integrated various disparate applications within a healthcare system. After McKesson, Saurabh joined Novo Innovations, Alpharetta GA in 2006 as the first developer in the startup organization. Saurabh contributed directly to the growth of Novo Innovations to merge into Medicity and later Aetna, by inventing, architecting and building the Novo Grid, iNexx Platform, HISP, and Notify platforms. Prior to coming onboard at Holon, Saurabh served as the Chief Architect at Medicity and was rewarded 4 patents for his work over the 9 years of his journey at Medicity.