How Patients Know Best scaled to 3 million users with automated cloud optimization

September 2023

DoiT's Cloud Analytics and anomaly detection helped the UK's largest patient health record portal manage pandemic-driven growth efficiently.

3 million: users

“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

The Challenge

During COVID-19, Patients Know Best experienced explosive growth from 100,000 to 3 million users. The company struggled to manage fluctuating cloud infrastructure demand with a small engineering team. Manual monitoring of events and logs became impractical at scale, and unexpected usage spikes caused hard-to-detect cost outliers.

The Solution

DoiT implemented automated cloud management through Cloud Analytics for usage visibility, Real-Time Anomaly Detection for cost spike alerts, and BigQuery Lens for optimization recommendations. The solution included business intelligence dashboards with automated alerts and training to upskill the internal team.

Results

Achieved automated monitoring and management at scale without additional hiring
Gained early detection of cost spikes through automated alerts instead of waiting for monthly bills
Enabled smoother operations through automated cloud optimization and anomaly detection

Meet Patients Know Best

Patients Know Best revolutionized digital medical records by creating the world's first patient-controlled data system of record. 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.

Pandemic-Driven Growth Challenge

Founded in 2009, Patients Know Best grew steadily to 100,000 users while collaborating with the UK's National Health Service. The COVID-19 pandemic drove explosive growth to 3 million users. Although the engineering team expanded from six to nearly 100 people, maintaining infrastructure amid fluctuating demand remained challenging. Manual monitoring became impractical at the new scale.

Automated Cloud Management Solution

DoiT implemented three key capabilities: Cloud Analytics for usage visibility, Real-Time Anomaly Detection for cost spike alerts, and BigQuery Lens for optimization recommendations. The solution focused on automation and tooling rather than manual processes, addressing the company's scarcest resource - people. DoiT also provided training and webinars to upskill the internal team.

Financial Visibility and Control

DoiT set up business intelligence dashboards with automated alerts for sudden fluctuations in query costs. This enabled early detection of problems instead of waiting for monthly bills to identify misconfigurations. The automated monitoring helped catch cost spikes quickly and provided detailed analytics for faster investigation and remediation.

Delivering Results Through Automation

The key benefit was DoiT's reliable automated technology that delivered the benefits of additional hiring more efficiently and at lower cost. Patients Know Best achieved smoother operations and better cloud optimization without the internal capacity to measure and calibrate all services independently. The company now explores unified billing across their entire infrastructure.

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Story overview

What they say

DoiT was a true partner, not a vendor. They helped us understand the problem, refine the vision, and build something production-ready far faster than we could have on our own. Their expertise, responsiveness, and commitment made all the difference.

Dr. Anish Kapur, Founder & CEO, Promptly

DoiT's Customer Success and Forward Deployed Engineering teams work very closely with us. The regular sessions with our CSM keep us focused on the right priorities, and the FDEs provide the deep technical guidance we need to validate decisions and optimize our environment. That combination has been genuinely valuable for us.

Alexander Lundberg Santos, Platform Engineer at Extenda Retail

When we started working with DoiT, we deployed Flexsave to save time and reduce complexity. We still use it today. But what really stands out is the expert support. Having someone to collaborate with on deep cloud cost topics, someone who really understands the nuances, is incredibly valuable.

Jesper Terkelsen, CTO at Monta

DoiT's Cloud Accelerator turned our AI idea into a shipped product, saving at least three months of development and delivering reliable, explainable insights our customers trust.

Scott Desgrosseilliers, CEO and co-founder, Wicked Reports

DaySmart

Working with DoiT gave us the speed of a startup and the rigor of an enterprise R&D lab. We launched an AI feature in ninety days with zero engineering lift, unified our cloud visibility across multiple products and built a foundation to scale AI responsibly.

Tim Green, SVP of AI, DaySmart

Our AWS environment had grown rapidly, and complexity was outpacing control. DoiT helped us bring structure and clarity, aligning financial and technical decisions through a shared foundation.

Maurizio Trezzi, Director of IT, Vivaticket

DoiT gives us contextual insight into what's happening in our cloud environment. That helps us ensure we're meeting customer needs while managing our costs. It's that central pane of glass that lets engineering and finance work together, powered by the technology and backed by DoiT's people.

Matt Warner, Co-Founder and CEO at Blumira

For anyone considering DoiT: do it. The tools pay for themselves. We've reduced costs, improved visibility, and built a platform that can scale globally with control and confidence.

Matej Serbec, CTO, TradeLocker

DoiT didn't just give us a product – they gave us clarity. Cloud Diagrams has helped our teams understand what we're running, why we're running it, and where we can improve. The real-time visibility is a game changer for engineering, leadership, and everything in between.

Donnie Green, VP of Platform Engineering, Bloomerang

Sentric Music

With maybe 5-10 minutes, Ava had guided me right down into the low-level detail of the services that we were running in our compute environment, named the exact instances that were starting to chew through our money, produced a report for me that showed that this was almost a direct correlation to the cost growth that we were seeing, which meant that we were able to get on top of it pretty much immediately.

Stephen Roughley, Head of Engineering at Sentric Music

Atadex

With DoiT Cloud Intelligence™ managing our procurement and DoiT's engineers acting as an extension of my team, my costs are down, my efficiency is up, and my profitability is up

Mitch Bernet, Founder and CEO at Atadex

Skyral

A key takeaway for me working with DoiT is that the level of professionalism is extremely high. They're an obvious choice if you're looking for a partner to help implement best practices in your cloud environment and reduce cost.

Oliver Young, Senior Technical Manager at Skyral

We knew WhatsApp was the perfect channel for global remittances, but building secure, real-time conversations across languages was a massive challenge. DoiT helped us break through. They didn't just advise, they helped us architect and launch a GenAI solution that's 100x more powerful than what we had. We're now in a completely different league.

Jaime Gonzalez-Gasque, CEO, Reimagination Technologies

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