TRAKnet: Podiatry EHR Platform

Problem and Approach

Podiatry-specific clinical software runs day-in-day-out workflows where any latency or outage stops billing, scheduling, and patient documentation. The platform served hundreds of active practices on Windows desktops, ran clinical charting, billing, scheduling, and practice management, and carried payment flows that had to satisfy PCI DSS. The codebase carried a decade of legacy .NET, and any modernization had to ship without disrupting production clinical work.

• Desktop UI for clinical workflow. WinForms interfaces for clinical charting, billing, scheduling, and practice management, built for practice users who spend the whole clinic day inside them.
• Transactional domain model. Entity Framework over SQL Server 2008 through 2016 with complex T-SQL stored procedures, indexed views, and query tuning for high-frequency reads and writes during clinic-day load. Schema and access paths were sized to the worst clinic hours, not the average.
• Claims and payment integration. TriZetto clearinghouse connectivity with ANSI 837/835 EDI pipelines, ICD-10/CPT code handling, real-time eligibility verification, and PCI DSS-compliant payment processing: scoped access, audit logging, encrypted-in-transit channels, and a payment surface that never lifted card data into application memory. NPI/DEA/EPCS requirements enforced across prescriber and billing workflows.
• Reporting. Crystal Reports for clinical, billing, and operational reports. Telerik RadControls for the grids and form widgets that practice users spent most of the day inside.
• Legacy modernization with no downtime. Older .NET modules were modernized incrementally behind feature flags, never in a big-bang release. Production clinical workflows stayed live throughout.
• Distributed offshore engineering team. Led offshore engineering across sprint planning, code reviews, and release management. US-side ownership of customer-impact and clinical-safety decisions, offshore ownership of day-to-day delivery and the legacy maintenance surface.

Outcomes

• Production platform across hundreds of podiatry practices for the full 6+ year tenure.
• Legacy .NET modules modernized incrementally, without a customer-visible disruption event.
• TriZetto payment integration held PCI DSS compliance throughout.
• Distributed offshore engineering team owned day-to-day delivery of new modules and the maintenance of the legacy surface.