Technical architecture review, an honest second opinion.
Is your architecture ready for what's next — the next 10x of scale, the next audit, the next acquirer? We review it independently, find what's fragile, and hand you a prioritized roadmap, not a lecture.
Every dimension that decides whether it holds
We score your architecture across the dimensions that actually break under pressure — weighted by where reviews most often surface real risk.
Security & compliance
Whether the architecture protects PHI and stands up to an audit — the gap that ends companies.
Scalability & performance
Whether the design survives the next 10x of load, or quietly falls over at it.
Reliability & resilience
What happens when a dependency fails — graceful degradation or a 3am outage.
Maintainability & tech debt
Whether the team can still ship quickly, or every change now risks three regressions.
Interoperability
How cleanly the system exchanges data with the EHRs and partners it has to talk to.
Cost & efficiency
Whether the cloud bill scales with value, or just scales.
Reviewed by people who've built and rescued these systems
An architecture review is only as good as the scars behind it. Ours come from years of designing — and fixing — clinical systems at scale.
We've designed and rescued enough clinical architectures to know where the bodies are buried.
A structured assessment across the dimensions that actually break — not a vague “looks fine.”
We're independent. If the architecture is sound, we'll tell you that and save you a rewrite.
Findings prioritized by impact and effort, in a form your board can actually approve.
How the review works
From understanding the system to a board-ready roadmap — a structured assessment that ends in a plan, not a verdict.
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01Discovery
We learn the system, the business context and where you're trying to go — because an architecture is only “good” relative to what you're asking it to do.
- Architecture walkthrough
- Code & infra review
- Team interviews
- Goals & constraints
02Assessment
We evaluate the architecture across every dimension that matters, probing the assumptions that hold until exactly the moment they don't.
- Dimension-by-dimension
- Failure-mode analysis
- Bottleneck identification
- Risk surfacing
03Findings & scoring
We score what we find and rank it by impact and effort — so you can tell the load-bearing problems from the cosmetic ones at a glance.
- Scored findings
- Impact × effort
- Quick wins vs big bets
- Evidence & examples
04Roadmap & readout
You get a prioritized roadmap and a readout that works for both engineers and the board — not a document that dies in a drive.
- Prioritized roadmap
- Engineering detail
- Executive readout
- Decision support
The full surface of the architecture
Architecture & design
The shape of the system — and whether it fits the problem it's solving.
- System decomposition
- Boundaries & coupling
- Patterns & anti-patterns
- Fit for purpose
Scalability & performance
Where the design holds under load and where it quietly gives way.
- Bottlenecks
- Data & query load
- Caching & async
- Load headroom
Security & compliance
Whether PHI is protected and the architecture is audit-defensible.
- Threat surface
- Access & encryption
- HIPAA posture
- Audit readiness
Reliability & operations
How the system behaves when something inevitably fails.
- Failure modes
- Observability
- Recovery
- Operability
Data & integration
How cleanly data flows within the system and out to partners.
- Data model
- Integration patterns
- FHIR / HL7
- Consistency
Code & tech debt
Whether the codebase still lets the team move, or fights them.
- Code health
- Test coverage
- Tech-debt hotspots
- Delivery friction
When you need to know what you're standing on
Straining under growth, heading into due diligence, or newly responsible for a system you didn't build — the question is the same: will it hold?
Growth is straining the system
Usage is climbing and the architecture that got you here is starting to creak. We find what'll break at the next order of magnitude — before your customers do.
- Scale bottlenecks
- Headroom analysis
- Prioritized fixes
- Confidence to grow
Raising or being acquired
An investor or acquirer is about to put your architecture under a microscope. We give you the same view first — so there are no surprises in the data room.
- DD-grade review
- Risk disclosure
- Remediation cost view
- Stronger position
New to a system you didn't build
You've taken over an architecture nobody fully understands and decisions are due. We map it, score it and tell you what's safe, what's fragile and what's urgent.
- System map
- Risk inventory
- What to fix first
- A clear mandate
An opinion, or a plan you can run
The value of a review is entirely in what you can do with it the next morning. Most reviews fail that test.
A reviewer who either rubber-stamps the architecture or recommends throwing it all away — neither of which tells you what to actually do on Monday.
- No real scoring
- Binary verdicts
- No prioritization
- Hard to action
Concrete findings scored by impact and effort, sequenced into a roadmap your team can execute and your board can fund — with the evidence behind each one.
- Scored findings
- Impact × effort ranking
- Sequenced roadmap
- Board-ready readout
From scope to a funded roadmap
Agree the systems and questions in focus.
Walk the architecture, code and context.
Evaluate across every dimension.
Rank findings by impact and effort.
Sequence the fixes into a plan.
Brief the engineers and the board.
Review principles we work by
The convictions that make a review worth more than the opinion of the loudest person in the room.
Independent and honest
We have no stake in the verdict. If your architecture is sound, that's what we'll tell you.
Score, don't vibe
Findings are scored against explicit criteria, not delivered as gut feel dressed up as expertise.
Rank by impact
We separate the load-bearing risks from the cosmetic ones, so effort goes where it matters.
Pragmatic, not purist
We judge the architecture against your context and goals, not a textbook ideal you don't need.
Roadmap, not rewrite
We look for the incremental path first. A full rewrite is a last resort, not an opening bid.
Speak to the board
The readout lands for engineers and executives alike, so the work actually gets funded.
Architecture review FAQ
Are you just going to tell us to rewrite everything?
Almost never. A full rewrite is the most expensive and risky option, and it's rarely the right one. We look for the incremental path — the targeted changes that buy the most resilience for the least disruption — and only recommend a rewrite when the evidence genuinely demands it.
How long does a review take?
Typically a few weeks, scoped to the size of the system and the questions you need answered. We agree the scope up front so you get a focused assessment rather than an open-ended audit.
Do you need access to our code?
Yes — a meaningful review is white-box. We look at the architecture, the code and the infrastructure, and we interview the people who run it. A review based only on diagrams misses exactly the problems you're paying us to find.
Is this suitable for investor or acquirer due diligence?
Yes. We deliver technical due diligence to the standard investors and acquirers expect — an honest read on architecture risk, remediation cost and team capability — whether you're the one being assessed or the one doing the assessing.
Can you fix what you find?
We can. The review ends in a roadmap, and our engineering pods can execute it — or we'll hand it to your team in a form they can run with. The assessment and the fix can live under one roof, or not, as you prefer.
Confident your architecture survives the next 10x?
Tell us what's keeping you up at night about the system. We'll review it honestly and hand you a roadmap you can act on — and fund.
Talk to our team