Nice Healthcare, from spreadsheets to a team of their own

Nice Healthcare launched in 2017 on spreadsheets, automation tools, and rented practice-management software. Within a couple of years it had outgrown all of them. Cloudburst became Nice's product and technology team and stayed in that seat for years, rebuilding the platform piece by piece while the company grew from one state to many. Then Nice got big enough to build an engineering team of its own, and we handed the software over.

That last part is the point of this story. It's also the least common ending.

Where they started

Nice Healthcare is a primary care company that comes to you: virtual visits, in-home visits, prescriptions delivered, labs and x-rays at the kitchen table, all offered to employers as a benefit at a flat monthly cost. In 2017 that was a radical model, and the founders got it to market fast with the tools they had. Sheets, Zapier, a third-party clinical system, and a lot of manual work.

It worked well enough to prove the business. Then the tools became the limit. Every new customer added rows, workarounds, and monthly software bills that grew faster than revenue. The founders needed software they controlled, and they needed it without a large engineering payroll or a large raise.

What we did

Cloudburst started with the migration everyone was afraid of: patient and provider apps that let Nice move off the expensive third-party system and onto software of its own. From there the work never really stopped. Scheduling, care coordination, the patient experience, the operations behind a visit that happens in someone's living room. Each piece was rebuilt when it earned it, not before.

Two things about how that worked matter more than the features.

Scope was managed against cash, not ambition. Nice was tight on money the way any growth-stage company is. We prioritized what would move the business next and integrated existing services where rebuilding wasn't worth it yet. Nothing was built because it would be impressive.

The relationship deepened as trust was earned. After the first stretch of work together, Cloudburst and Nice put a Shared Success Agreement in place: a portion of development cost was deferred in exchange for a share of future revenue. It let Nice take on more product work and close more customers without raising money to do it. We mention it here because it's what a Shared Success Agreement is for. It came after the collaboration was proven, not as the opening offer.

For much of this period, Cloudburst was effectively Nice's chief product officer and chief technology officer. Thompson Aderinkomi, Nice's CEO, put the arrangement this way:

"Trusting Cloudburst as our dev team has allowed us to focus on doing the things that founders are uniquely positioned to do, that leverage our expertise."

And on what he wanted from a technology partner:

"Building a company is more than building its technology. There are many decisions and factors that go into building a company and Cloudburst is interested in understanding and impacting all of those things."

Where they are now

Nearly a decade in, Nice operates in fifteen states across the Upper Midwest and the West, with a venture round behind it, a string of best-workplace recognitions, and, as of this fall, an employer health plan of its own built around its clinical model. Thompson has written about the early growth in his own words and about what he learned scaling it. We'd rather you read his account than our summary of it.

Somewhere along that curve, Nice reached the size where an in-house engineering team made sense, and they built one. Our job at that point was the hand-off: the documentation, the context, a clean transition from our team to theirs. Then we stepped back.

Why we tell this story

Because it's the whole arc. Software built fast on borrowed tools, a business that outgrew them, a team that stayed after launch and ran the software for years, and an owner who kept his attention on the business the entire time. That's what run and grow means when it works.

It's also worth saying plainly: most companies never build their own engineering team, and most shouldn't. The common path is a business that keeps running on Operate for as long as the software matters, with priorities set by the owner and the work done by us. Nice went further because Nice got bigger than most companies do. Helping a client outgrow you is a strange thing to count as a win. We count it anyway.