Pros
1. Real impact on healthcare, not just slideware Most of my time is spent building and deploying automation that actually touches patient access, payments, and clinical workflows (scheduling, med rec, record submission, etc.), not “innovation labs” that never see production. You can point to flows in production at large health systems and say, “I built that.” I think the "Theranos" comments are coming from people who haven't actually spoken to our customers. 2. Very strong technical bar if you care about platform work Day-to-day involves FHIR and HL7 integrations, EHR APIs (Epic, Oracle Cerner, Athena, etc.), SFTP pipelines, and a fairly sophisticated internal platform. 3. Autonomy and ownership by default You’re often the DRI for an entire problem: chartering new flows with customers, scoping integrations, coordinating with R&D, and then getting it over the finish line. Nobody is going to spoon‑feed requirements; the expectation is that you go get the context, write it down clearly, and drive. 4. Collaborative, high-initiative colleagues Delivery, builder education, and engineering are generally aligned around “how do we make this work?” not “why this isn’t my job.” It’s normal to pair on flows, integration quirks, or training content with folks across teams, and people do show up when something is go‑live critical. 5. Opportunities to shape the ecosystem, not just execute tickets Beyond customer work, there’s meaningful room to improve how everyone builds: writing charters, designing training curriculums, creating templates, and giving structured feedback into the product. If you care about raising the floor for other builders, there’s support for that.
Cons
1. High context switching and persistent staffing gaps It’s common to juggle several customer projects, internal training, and platform feedback in the same week. When upstream teams are under‑resourced, delivery ends up doing a lot of coordination and escalation to keep things moving. 2. Pace and expectations are not for everyone The company moves quickly and customers rarely show up with perfect specs. You’re expected to operate in ambiguity, write your own structure (charters, plans, test matrices), and keep nudging things forward even when dependencies are stuck. If you want a narrow, clearly bounded role, this will be uncomfortable. Some people find this difficult, I find it helps me learn and grow in places I wouldn't have independently sought otherwise.