Once the platform is live, keeping it stable, secure, and performing requires consistent operational discipline. This phase covers the monitoring, hosting management, security oversight, and platform stewardship that sustains the infrastructure over time.
Platform health does not sustain itself. The infrastructure, security posture, and compliance controls established during build require active stewardship to remain effective. Phase 06 is the structured cadence that keeps them that way.
Monitoring is continuous, reporting is regular, and every operational decision is documented. When something requires attention, it is identified and addressed by the operations team before it reaches the practice or its patients.
Every layer of the platform is monitored in real time. Issues are surfaced to the operations team, triaged by severity, and resolved within defined SLA windows.
Continuous monitoring across uptime, error rates, latency, and infrastructure health. On-call routing ensures issues are surfaced and addressed around the clock, not discovered the next morning.
Request latency, database query performance, API response times, and image processing throughput are tracked continuously. Degradation trends are identified and addressed before they affect clinical workflows.
Authentication anomalies, unusual PHI access patterns, failed login surges, and unexpected administrative actions generate immediate alerts. The operations team reviews and escalates before issues compound.
Critical platform flows — patient login, intake submission, eRx routing, telemedicine consult entry — are tested synthetically on a scheduled cadence. If a core workflow breaks in production, it is caught before a real user encounters it.
A structured monthly report delivered to leadership covering uptime, performance summary, incident log, security posture, hosting cost, and forward recommendations. Formatted for operational review, not engineering consumption.
Defined triage process for issues reported by providers or staff, categorized by severity and resolved within documented SLA windows. Root causes are documented and feed back into the platform to prevent recurrence.
Hosting is not a set-and-forget decision. Capacity, cost, BAA coverage, and patch posture all require active management as the platform and its usage evolve.
Production hosting maintained against the architecture defined in Phases 02 and 04. Capacity reviewed regularly, costs tracked against utilization, and any service additions or version changes reviewed against BAA coverage before deployment.
Operating system, runtime, framework, and dependency patches applied on a documented cadence. Critical CVEs in PHI-touching paths are treated as incidents and remediated outside the normal patch cycle.
Automated backups are verified regularly and recovery drills are performed quarterly. Recovery time and recovery point objectives are tested against real conditions, not estimated from the architecture document.
As patient volume grows and additional locations come online, hosting capacity is reviewed proactively. Scaling decisions are planned, not reactive, and are evaluated against both performance requirements and cost efficiency.
Every vendor relationship that touches PHI is tracked. When a vendor is added, replaced, or modifies its services, the BAA is reviewed, updated, and the registry is kept current. Coverage does not drift quietly.
CI/CD pipelines, environment configurations, and deployment tooling are kept current alongside the platform. Releases are controlled, reviewed, and reversible. Nothing reaches production without a documented deployment record.
Security posture decays without active stewardship. Platform value grows when the roadmap is maintained with intention.
Quarterly review of who holds access across the platform, covering providers, staff, integration accounts, and service principals. Stale access is revoked and excess privilege is dialed back. Reviewed with the practice, not in isolation.
Periodic sampling of audit logs for patterns that warrant attention, including unusual export volumes, after-hours access, and unexpected administrative actions. Findings are escalated and documented when they arise.
HIPAA guidance and adjacent regulatory requirements are tracked. Material changes are surfaced in the monthly operations report with a clear recommendation and adequate lead time to act.
Once per year, a formal review of architecture, controls, BAA coverage, staff training, and incident runbooks. Delivered as a documented artifact for leadership, the clinical team, and any future audit or diligence process.
A maintained forward roadmap covering features, integrations, and optimizations, sequenced against operational reality and the organization's growth plans. Leadership has visibility into what is coming, when, and why.
Once per quarter, a working session with leadership and engineering covering platform metrics, roadmap status, and strategic next steps. The platform is treated as the operational asset it is.
Phase 07 covers multi-location expansion, white-label deployment, and the licensing structures that allow the platform to generate value beyond a single organization.