Case Study

Harnessing the Power of DoiT: How Patients Know Best scaled to new heights amidst rapid growth

Patients Know Best
BigQuery, Cloud SQL, Cloud storage, Google Compute Engine
United Kingdom

Meet Patients Know Best

Patients Know Best revolutionized digital medical records by creating the world’s first patient-controlled data system of record – commonly known as a ‘personal health record’, or PHR. The innovative platform combines data from hospitals, general practitioners, mental health providers, and patients into a single, real-time, unified record. This helps patients take charge of their health, allows physicians to be better informed and more efficient, and enables hospitals to reduce costs.

The challenge

Founded in 2009, Patients Know Best achieved steady growth over its first 10 years, expanding from a few thousand users to more than 100,000 while working in collaboration with government partners such as the UK’s National Health Service. 

Then came the COVID-19 pandemic, which brought about a tremendous spike in care utilization and a surging demand for electronic access to records for healthcare providers. Quickly, Patients Know Best’s platform surged to three million users. Although the company had grown its team from about a half-dozen engineers at startup to nearly 100, maintaining its infrastructure amid fluctuating demand remained a challenge.

“We are the largest patient health record portal in the UK, and it’s more than ‘just’ 3 million users — it’s also the fact that we have multiple times more patient records than that,” says Mate Varga, Chief Technology Officer of Patients Know Best. “We have around 90 people on staff, and one-third of those are in engineering. We’re small and essentially a business-to-government company. As we grow, we are committed to building a robust infrastructure that ensures we also remain nimble and cost-efficient.”

Responding to the data management challenges created by such sudden growth, the company first shifted from an on-premises infrastructure to Google Cloud. But it soon needed a better way to forecast and manage cloud capacity due to ongoing utilization spikes. That’s when one of its account managers suggested working with a reseller that could optimize their Google Cloud infrastructure.

Varga was skeptical at first. “To be honest, the initial few resellers we encountered didn’t provide a distinct advantage compared to the direct offerings from Google,” he said. “That is, until we connected with DoiT. In addition to their customer support capabilities, what really convinced us of their value was that they offered an analytics dashboard — something we didn’t want to invest time and resources into developing ourselves.”

The solution

DoiT began by evaluating Patients Know Best’s current strengths and opportunities for improvement. One notable concern was the company’s huge scope of work — combined with manual processes and a relatively small staff — which limited its ability to manage periodic activity spikes.

“Monitoring and managing the sheer volume of events and logs within our system manually is impractical given the scale we now operate at,” Varga says. “My strategy was to rely more on automation and tooling, both on the security side and on the FinOps side — machine learning tools, anomaly detection, and other automation that doesn’t require much configuration or interaction from humans because the scarcest resource for us is people.”

So, DoiT’s primary goal was to help the IT staff scale its operation through process automation and clearer reporting by leveraging DoiT’s proprietary technology portfolio and three of its primary capabilities:

  • Cloud Analytics: Provides visibility into cloud usage and spend and translates cloud bills into the context needed to drive business decisions.
  • Anomaly Detection: Continuously analyzes cloud billing data, alerting users to abnormal cost spikes and providing detailed analytics and reporting to drive the investigation and remediation of any issues.
  • BigQuery Lens: Provides Google Cloud users with actionable optimization recommendations along with the ability to drill down into individual usage stats, thus reducing costs through better insights and faster decisions.


In the rare situations where automation alone couldn’t solve Patients Know Best’s specific infrastructure problems, DoiT’s Client Services team has provided additional expertise.

“It happens maybe once a month that we need to deal with more complex infrastructure challenges and have to bring human expertise in to manage the problem,” Varga says. “DoiT’s client services has been great, but overall, the automated dashboard has been more than enough to support our people.” 

DoiT also helped Patients Know Best tackle two additional challenges: finance management and talent development.

From a finance perspective, Patients Know Best had experienced occasional outliers in its business analytics spending due to large and unexpected usage spikes that required it to scale up rapidly. “These spikes in cost were hard to detect,” Varga says. “We knew automation could help, but our internal resources and time constraints prevented us from achieving the desired level of monitoring quality independently.”

To give Patients Know Best more visibility, DoiT set up a business intelligence dashboard that offered automated notifications of sudden fluctuations in query costs. “That helped us catch problems early, so we didn’t need to wait until the next monthly bill to figure out if we had misconfigured something,” Varga says.

DoiT also provided staff training and webinar opportunities to help upskill the Patients Know Best team for heightened in-house cloud management and infrastructure maintenance expertise.

The result

Varga says that employing DoiT’s technology was itself the key benefit — above and beyond DoiT’s excellent direct customer support and training capabilities — because the automated functions have been so reliable and effective. DoiT has given Patients Know Best all the benefits of additional hiring, but more efficiently and at less cost.

Moreover, Patients Know Best has achieved smoother operations in general through working with DoiT. “While we don’t have the internal capacity and resources to measure and calibrate all the services we are using and to optimize our cloud usage, the DoiT technology does,” Varga says.

Going forward, Patients Know Best aims to explore the adoption of a unified billing system across all parts of their infrastructure. DoiT’s capabilities offer a pathway for the organization to make progress in this direction. Moreover, the company intends to establish a genuine FinOps practice by leveraging DoiT’s tools.     

“When you’re small, your infrastructure spending is often negligible compared to what you spend on people. As the infrastructure and the volume of data that we handle grows, the infrastructure spending is becoming more significant compared to all our other costs. We are at a level now where optimizing a more robust cloud infrastructure is really important.”

Mate Varga, Chief Technology Officer, Patients Know Best
“Why work with a third party instead of directly with your supplier? Honestly, the first couple of resellers we were introduced to didn’t offer anything superior enough to what we got through Google directly. What really convinced us of [DoiT’s] value was that they offered an analytics dashboard — something we didn’t want to invest time and resources into to create ourselves.”

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