Where Healthcare Mergers Meet Code: Building Reliability Across Systems

In the digital age, reliability has come to define the difference between trust and uncertainty. Nowhere is this more consequential than in healthcare and the insurance industry. Outages are not merely an inconvenience for them but also potential disruptions to treatments, delays in coverage, and erosion of public confidence. EMA study placed the average cost of IT downtime at over $14,056 per minute, but the figures tell only one side of the story. For patients waiting on approvals or providers depending on real-time data, the consequences are measured in care and continuity, not just dollars. The task of keeping a complex, distributed infrastructure reliable grows more difficult. This is due to enterprises expanding into multi-cloud systems, adopting sprawling microservices, and embedding machine learning into their operations.

This is the backdrop in which Prakash Velusamy has spent the better part of two decades ensuring that the systems people depend on continue to function as intended. A Solution Architect and Site Reliability Engineer, he has built a career at the intersection of observability, telemetry, Kubernetes, and performance monitoring. He is not simply a technologist; he translates technical fluency into resilient systems for organizations operating at the Fortune 10 scale.

His contributions have often come into focus during periods of change, particularly mergers and acquisitions. While such deals are reported in terms of financial magnitude, they also require the careful integration of disparate IT systems. Prakash has been central to this process, guiding requirements gathering, platform design, and capacity planning, all while ensuring that customers never experienced interruption. Millions of people continued to access healthcare services as integrations proceeded in the background; their experiences remained unchanged despite the architectural transformation.

The most challenging of these came during a $70 billion acquisition of a major U.S. health insurer. The task of combining observability and monitoring systems across two large enterprises carried immense complexity. For Prakash, the responsibility was to ensure continuity. He had encountered similar situations before, having overseen integrations after the acquisitions of a nationwide pharmacy chain and a long-term care services provider, but the health insurer merger presented an unparalleled scale.

“The goal was simple but demanding,” he recalls. “Make the transition invisible for customers, no matter how complex it is for us behind the scenes.”

His responsibilities extended beyond mergers. Prakash recognized the inefficiencies of overlapping systems. He initiated a rationalization effort to consolidate four monitoring platforms: NetIQ, SiteScope, IBM Tivoli, and Micro Focus OBM, into one. The project required collaboration across more than twenty teams, standardizing processes and embedding monitoring into build pipelines. The shift also enabled automated, self-healing incident responses. The financial savings were significant: $450,000 in licensing fees, along with the retirement of unnecessary servers and databases.

He applied a similar approach to enterprise alerting. Large organizations depend on paging systems to coordinate responses during outages. Prakash led the effort to merge two existing systems into a unified xMatters platform, covering both Pharmacy benefits management services and retail operations. The result was a more reliable, faster notification framework, ensuring that teams could react quickly when issues arose. In sectors where every minute matters, that improvement carried weight well beyond technical metrics.

The outcomes of these endeavors were evident: there was a faster closing of mergers, more efficient infrastructure, and consistently greater services. For those relying on healthcare coverage, patients, providers, and regulators, the changes were largely invisible, which was precisely the point. The systems continued to function, uninterrupted, while the architecture behind them grew more sustainable.

He approaches technology with pragmatism. He developed multi-year roadmaps. Emerging trends, automation, machine learning, and observability are aligned to organizational needs in these roadmaps, avoiding innovation for its own sake. His work underscores how resilience requires more than technical skill; it requires foresight and discipline. 

His career also points to a broader reality of enterprise IT: the professionals who design resilient systems often remain in the background. Their influence, however, is substantial. They are the ones who ensure that major acquisitions are not derailed by technical incompatibility, that outages are avoided before they become public crises. And they make sure that trust in large institutions is maintained through reliable service delivery.

“Reliability isn’t just about uptime, it’s about trust,” Prakash says. “In healthcare and insurance, it means people can count on us when they need it most. That’s what motivates me every day.”

As infrastructures become more complex, the contributions of engineers like Prakash Velusamy remind us that behind every seamless interaction lies a sustained human effort. Reliability is not accidental. It is built, maintained, and safeguarded by those whose names may not appear in headlines, but whose work allows organizations to keep their promises.