Bryce Harlan: A Decade of Rails in Healthcare

In this episode of On Rails, Robby is joined by Bryce Harlan, a senior engineer at Phamily, the text-based chronic care management platform built by Jaan Health. Bryce has spent the last decade helping evolve Phamily's Ruby on Rails platform, which helps clinical practices coordinate between-visit care for patients with chronic conditions — sending and receiving roughly 100,000 Twilio SMS messages a day across hundreds of medical groups.Bryce and Robby trade stories about a long-lived Rails app: the unconventional Rails 4-to-6 leap Phamily made during the spring 2020 surge in virtual care, the bespoke "Action Responders" pattern the team built to keep API serialization, authorization, and testing close to the model layer, and how an article from Judoscale on naming Sidekiq queues by their SLA reshaped how the team thinks about background work. They also dig into how Phamily is using Claude Code skills to give engineers "superpowers" on smaller features, and why Bryce now sees test suites as the closest thing to Peter Naur's idea of programming as theory building.Links:PhamilyJaan HealthProgramming as theory buildingJudoscale blog: Planning Sidekiq QueuesSend us Fan MailOn Rails is a podcast focused on real-world technical decision-making, exploring how teams are scaling, architecting, and solving complex challenges with Rails. On Rails is brought to you by The Rails Foundation, and hosted by Robby Russell of Planet Argon, a consultancy that helps teams modernize their Ruby on Rails applications.