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Case Study
Healthcare

Regulated Healthcare Platform Leadership

Daniel Voigt served as CTO of AZZLY, with TeqEngine’s software-development team building the regulated EHR and RCM platform. The work continued through acquisition by an a16z-backed company and into enterprise platform and data engineering.

Role: CTO & TeqEngine development team
CTO LeadershipPlatform EngineeringData PlatformTechnical DiligenceRegulated Software
platform and engineering leadership
CTO
data layer built after acquisition
Fabric
healthcare reports and analytics
100+
as foundation after acquisition
Selected

The Engagement

TeqEngine supplied the software-development team for this engagement, with Daniel serving as CTO. Together, Daniel and the TeqEngine developers built the core EHR/RCM system across web applications, APIs, clinical integrations and infrastructure.

The work spanned a regulated clinical platform — HL7-based order entry and lab results, embedded telehealth, and a bidirectional patient portal — alongside the operational systems required to run it.

The architecture had to connect clinical workflows, revenue operations and patient access in a working system. That meant carrying permissions and data boundaries through each integration, alongside the features visible to clinicians.

The Acquisition

The company was acquired by an AI-native company whose Series A was led by a16z and included other top venture-capital firms. They chose the platform built at AZZLY as their technology foundation.

Daniel led technical diligence through the acquisition and continued platform and data engineering afterward. This included a Microsoft Fabric enterprise data layer supporting more than 100 reports and analytics used by hospitals and healthcare organizations across clinical, financial and operational work.

Selected Platform Work

Work delivered across the engagement and post-acquisition transition included:

Microsoft Fabric Data Layer

Post-acquisition enterprise data layer on a Bronze/Silver/Gold medallion architecture, supporting 100+ reports and analytics for hospitals and healthcare organizations

Semantic Models & Power BI Embedded Reporting

Embedded reporting suite with row-level security, replacing a legacy reporting system

Legacy Reporting Migration

Migration of the legacy reporting estate onto the new data layer, with automated visual and filter parity checks run before each cutover

CFO & Financial Analytics Suite

Executive financial reporting across collection waterfall, revenue recognition, AR and RCM analysis, and month-end close

Revenue Cycle Management

Claims, ERA, denials, and payer and provider revenue workflows connected to the clinical and billing surfaces

Payments, Refunds & Recurring Billing

Payment, refund and recurring-payment workflows, with validation and parity verification ahead of each release

Row-Level Security & Tenant Isolation

Governed multi-tenant analytics so each organization sees only its own data, on shared infrastructure rather than per-client stacks

Telehealth Video Platform

In-app video consultations embedded directly into the EHR and web application through a Zoom-based workflow

Patient Portal

Transformed a provider-only application into a full patient portal — bidirectional patient–provider messaging and document exchange, built from scratch

CPOE & Labs Integration (HL7)

Clinical Provider Order Entry and lab-results integration over HL7, with bidirectional ordering and result delivery across the platform

Patient, Encounter & Scheduling Workflows

Core clinical operations across patient records, encounters, calendar and scheduling, and admissions

Clinical Forms Platform

Configurable clinical form definitions wired through to the data and reporting layer, so form content became reportable

eChart PDF Rendering Engine

Clinical form PDF generation pipeline used by every provider on the platform

External Partner API

Documented external API surface letting third-party partners integrate with platform data and financial workflows

eFax System

Third-party eFax integration replacing manual faxing workflows

SSO Authentication

Azure AD B2C single sign-on for partner platform integration

Release & Live Operations

Release management, hotfix response and root-cause analysis across a platform carrying live clinical and financial workloads

Post-Acquisition Data Layer

Following the acquisition, TeqEngine built the Microsoft Fabric data layer beneath the platform's analytics: a Bronze/Silver/Gold medallion architecture feeding semantic models and embedded Power BI, replacing a fragmented legacy reporting estate across financial, clinical, operational, claims, CRM and compliance reporting.

Fabric
data layer
Analytics
workload
Reporting
delivery focus
Post-acq.
engagement phase

This work extended the engagement into the platform's post-acquisition phase.

The Results

Platform Selected as Core Foundation

The platform continued as a core technology foundation after the acquisition, with further platform and data delivery.

CTO-Level Platform Leadership

Led the engineering organization while contributing directly to architecture and delivery.

Mission-Critical Platform Delivery

Built and evolved the clinical, revenue-cycle and operational systems of a regulated healthcare platform.

Post-Acquisition Data Layer

Built the Microsoft Fabric data layer after the acquisition, behind 100+ reports used by hospitals and healthcare organizations.

Continuity through a technical transition

  1. Understand the estateArchitecture, dependencies and technical risks
  2. Make the decisionDiligence findings · leadership communication
  3. Carry the platform forwardSystem and data delivery after acquisition
  4. Maintain ownershipOperational context · decisions · handoff
CTO responsibilities, from the build through the acquisition.

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