Background

Grand Rounds connects patients with expert medical opinions, which means the data is sensitive, the customers are large employers and health plans, and the integrations are old-school. EDI files. SFTP. Single sign-on with whoever the customer's identity provider happens to be. I was the tech lead on a lot of the time-constrained, business-critical work.

What I did

I built a custom EDI data exchange system and an SSO system for our largest customers, and improved and ran the FTP system they used to send us data. On the product side I worked with the product team on the user-facing apps: clinical case workflow, NPS survey integration, and patient scheduling.

Then there was infrastructure. We had a homebuilt CI and ephemeral environment system based on Docker Swarm, so every branch got its own running stack. I managed and supported it, and planned the next-generation platform on Kubernetes, Istio, and Envoy. I also created the product planning and development process for the infrastructure engineering team, so infra work got planned like product work instead of arriving as interrupts.

And the pager: serviced, monitored, and maintained production, responded to outages, and ran the post-mortems.

Things I learned

1. Ephemeral environments per branch are the single best productivity tool I've seen, and the most expensive to keep running.
2. EDI is not going away. Build the boring parser well.
3. Post-mortems only work if the person on call isn't the one writing the conclusions alone.