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Engagement

One sequence. Learn, Assess, Strategy, and Translate run back to back: two weeks, two weeks, four weeks, two weeks. DevOps then runs in 90-day blocks, one weekday a week, until the written stop condition is met.

There is no price list on this site. Scope and fee are agreed after the discovery call, in an engagement letter. The work sequence does not change with the fee.

Who is in the room

• A sponsor who can grant access and sit in the opening and the readout. Usually the owner or the general manager.
• The person who operates the workflow: practice manager, clinic lead, front office, revenue cycle, or the equivalent on a property.
• The engineering lead, or the person who actually changes production. That is sometimes an in-house lead, sometimes an MSP or a vendor engineer. If they are not in the room, the delivery score stays “not observed.”
• The people who do the work during Learn. Managers alone produce the policy, not the map.

Decision rights

I decide, inside the engagement:

• Whether a proposed change still serves the locked strategy.
• Whether the delivery bar for the system in scope is met or broken.
• Which of three blockers I will take because the team lacks the authority, and which go back to the lead.

I recommend, and the sponsor decides:

• Build, buy, or integrate.
• Which bets are in the strategy, and in which order.
• Which risks are accepted, funded, or left unknown.
• Whether a 90-day block continues.

I do not:

• Become the engineering manager or the ticket assigner.
• Sign as the HIPAA security official. That role stays with the covered entity or business associate.
• Complete a PCI SAQ or issue a compliance opinion.
• Pick a vendor during Learn.

What ends it

The ten-week sequence ends when the roadmap is published and reviewed. DevOps ends a block with a one-page note: continue on the same system, move to the next system on the roadmap, or stop. Stop is a normal outcome when the lead can hold the next block, or when the fit was wrong.

A send-back of the strategy diagnosis does not start the roadmap. Translate waits until the board has accepted the strategy or accepted it with one named change.

What a fit looks like

The organization already operates. There is a patient path or a guest path to stand next to, and a system someone can show. The sponsor will put the people who do the work in the room for two weeks, and will read a short paper at the end of each step.

This is the wrong shape when there is no production system to shadow, when the need is a staff augmentation bench, or when the company has already decided to hire a full-time CTO and wants a bridge of a few status meetings. I will say so on the discovery call.

Book a discovery call

The call is to decide whether this engagement fits. The answer can be no.