Database Engineering for Healthcare
Clinical and billing systems often sit on decades of Oracle data. We map the PL/SQL, move it to PostgreSQL or Aurora with CDC so the system stays up, and tune the new database after cutover.
Architecture, performance, reliability, modernization, migration, and cost are one skill set applied to the same databases. Describe the problem once. We route it to whichever sub-area actually fixes it.
We work hands-on with: PostgreSQL, MySQL, MongoDB, Redis, Snowflake, BigQuery, MariaDB.
Database Engineering is a single service, architecture, performance tuning, reliability, modernization, migration, and cost, applied to your PostgreSQL, MySQL, Oracle, SQL Server, MongoDB, or Redis databases by one team.
Database work used to get sold in pieces: a managed DBA retainer here, a migration project there, a separate cost audit, a separate troubleshooting call. The customer had to know in advance which of six services their problem belonged to.
Database Engineering is that work as one service, delivered across six internal sub-areas: architecture, performance, reliability, modernization, migration, and cost. You bring us the problem: a slow query, an upcoming migration, a cloud bill that doesn't add up. We diagnose which sub-area it actually belongs to and price the engagement accordingly, one-time diagnostic or ongoing retainer.
Commodity DBA coverage is a crowded market. The part that still commands a premium is the complex architecture, migration, and modernization work inside the same relationship, which is why unifying the sale doesn't mean discounting the work.
Typically an engineering lead, CTO, or platform team responsible for production databases without a dedicated in-house DBA, or with a DBA stretched across more systems than one person can own.
A quick lookup. Every row maps to one of the six sub-areas below.
| Situation | Likely Solution |
|---|---|
| A specific report or endpoint is slow and getting slower as data grows | Performance — query optimization, indexing, and connection tuning |
| An Oracle license renewal is coming up and the cost no longer makes sense | Migration — Oracle to PostgreSQL migration with a tested cutover |
| You need a tested failover and cross-region replication for an uptime SLA | Reliability — HA, replication, backup verification, and DR |
| RDS or Aurora spend is climbing and nobody's re-sized the instances | Cost — right-sizing, storage/IOPS audit, Reserved Instance strategy |
| Schema changes ship without review and one already broke production | Architecture — schema design and pre-deploy review |
| An acquisition or platform merge left you with a sprawl of databases | Modernization — consolidation and version upgrades |
One customer-facing service, delivered internally across whichever of these six sub-areas your problem needs.
Schema design and review, multi-database environment architecture, and distributed database design across PostgreSQL, MySQL, SQL Server, Oracle, MongoDB, Redis, and Aurora.
Schema change review before every deployment, not after it breaks production.
Query optimization, indexing, connection management, and workload tuning — the work most people call database optimization — diagnosed with EXPLAIN ANALYZE and pg_stat_statements, not instance resizing as a first move.
Autovacuum tuning, PgBouncer pooling, and lock contention fixes included.
High availability, replication, failover, backup verification, and disaster recovery, backed by proactive monitoring and on-call incident response.
Ongoing database support with prioritized response, not a queued ticket.
Database version upgrades, architecture changes, cloud database modernization, and consolidation of sprawling multi-instance environments.
Sequenced so upgrades don't become their own outage.
Cross-engine migration (Oracle, MySQL, SQL Server to PostgreSQL), AWS RDS and Aurora migration, and CDC-based cutover with a rollback path.
Often a meaningful TCO cut versus staying on Oracle licensing.
Database resource right-sizing, storage and I/O optimization, and Reserved Instance strategy for RDS and Aurora specifically.
Fixes are typically structured to help offset the cost of the engagement.
PostgreSQL, MySQL, Oracle, SQL Server, MongoDB, Redis, and their managed cloud equivalents, AWS RDS, Aurora, Google Cloud SQL, Azure SQL Database, and Cloud Spanner, shown in full above. Multi-engine environments are the norm among our clients, not the exception.
Specific numbers from three real DharmOps engagements, not sitewide averages, every environment is different.
| Metric | Before | After |
|---|---|---|
| Reporting query time (340GB PostgreSQL) | 4 minutes | 17 seconds |
| Financial reporting query (fintech) | 45 seconds | 4 seconds |
| Dashboard load time (B2B SaaS) | 8 seconds | 200 milliseconds |
| Downtime during the fix | n/a | Zero, across all three |
| Basis | DharmOps | Full-time in-house DBA | Generic dev/IT shop |
|---|---|---|---|
| Coverage | A team, not one person's vacation-limited hours | Business hours, one person, single point of failure | Ticket queue, generalist coverage |
| Specialization | Multi-engine depth: PostgreSQL, MySQL, Oracle, SQL Server, MongoDB, Redis | Usually deep on one or two engines | Broad but shallow across the stack |
| Cost structure | Scoped after diagnosis, one-time or retainer | Full salary and benefits year-round | Hourly or project rate regardless of fit |
| Response on incidents | Prioritized response on active engagements | Depends on one person's availability | Standard support SLA, not database-specific |
The database problem looks different in each industry: a licence bill, a peak-hour slowdown, a tenant that starves the rest. The fix starts with which one you have.
Clinical and billing systems often sit on decades of Oracle data. We map the PL/SQL, move it to PostgreSQL or Aurora with CDC so the system stays up, and tune the new database after cutover.
Oracle licensing and lock-in push core systems toward PostgreSQL. We test compatibility, rewrite the incompatible stored logic, and run old and new side by side before switching.
A payment ledger that slows at peak volume loses transactions and trust. We fix indexes and slow queries, design replication and failover, and add connection pooling before anyone resizes the instance.
In a multi-tenant database, one large customer can slow everyone else. We add partitioning, tenant-aware indexing, and read replicas so heavy tenants stop affecting the rest.
Sale days are when the database saturates. We load-test against peak traffic, fix the queries that collapse first, and right-size RDS or Aurora for the season instead of year-round.
Shipment tracking is write-heavy and never stops. We partition time-series tables, tune the write path, and keep reporting queries off the primary database.
Slow query, upcoming migration, a bill that doesn't add up, or a DBA hire you're trying to avoid: describe it and we'll scope the right fix, one-time or retainer.
One call, one diagnosis, and a scoped fix, whether that's a query, a migration, or a retainer.