Clinical informatics at the speed of tech.
Move EHR improvements 2-3× faster using proven practices from leading software companies. For healthcare IT & informatics teams supporting large scale clinical environments.
Sound familiar?
Your informatics team is overwhelmed, physicians are frustrated, and high-value EHR improvements sit in backlogs for months. Here's what's really happening:
The answer isn't more headcount. Demand keeps growing. Budgets aren't.
Physician requests disappear into a black hole
Your clinical team submitted an order set request 8 months ago. They've followed up three times. Nobody can tell them when it's happening, or if it's even being worked on.
You can't answer "when will this be done?"
The CMIO asks when the cardiology build will deploy. Your informatics director can't give you an answer because four dependencies are invisible across different teams.
Burnout-reducing improvements get deprioritized
The workflow that could save ED physicians 20 minutes per shift sits buried beneath a year of lower-impact requests because there's no systematic way to surface high-value work.
Your team drowns in reporting instead of delivery
Your informatics staff spend hours preparing status updates for governance meetings instead of building the improvements physicians are waiting for.
From intake to
deployment,
faster and more predictable.
The software industry perfects how to ship complex, high-stakes work faster without cutting corners. These practices work in healthcare. We adapt them for clinical stakes and governance requirements.
Tikva fills this gap. We bring the operational playbook (WIP limits, flow optimization, transparency systems). Your informatics team delivers the EHR improvements physicians and nurses need, faster, more predictably, and with less overhead.
Intake
Complete tickets from day one. No chasing clinicians for requirements.
Governance
Async approvals. Streamlined committee prep. Fewer delays.
Build
WIP limits. Clear handoffs. Analysts on the right work.
Test
Coordinated environments. Faster cycles. Less rework.
Deploy
Predictable go-lives. Clinicians get what they were promised.
Process & Backlog Assessment
A rapid diagnostic of your full EHR optimization pipeline. We surface where work is stalling, identify duplicate efforts, and find the high-value items buried under louder requests so you can focus resources where they'll have the most impact.
Intake Redesign
Rebuild how requests enter your system so tickets arrive complete, are routed correctly, and can move without weeks of back-and-forth. Applying UX discipline to intake alone can unlock significant capacity.
Flow & Throughput Optimization
Apply proven software delivery practices (WIP limits, dependency mapping, queue management) to move more work through the same team without adding headcount.
Governance & Reporting
Restructure approval workflows to cut cycle time and preparation burden. Build the portfolio visibility your leadership needs without it requiring a weekly slide deck from you to exist.
Proven best practices from software organizations.
Software delivery expertise brought into healthcare
25 years optimizing software delivery in tech, now applied to hospital informatics. Different constraints, same bottlenecks.
UX thinking applied to process, not just product
Poor process design creates friction that compounds across hundreds of tickets per year. Small UX improvements to your intake or governance flow can unlock weeks of team capacity that's currently invisible.
Throughput over heroics, improvements that last
WIP limits and flow optimization produce 2–3× throughput without burnout. The goal: systems that perform, not people who push harder.
Five Dimensions of Delivery Maturity
Our assessment measures your team's performance across five critical dimensions. High-performing informatics teams excel in all five areas.
Intake & Prioritization
Clear priorities from day one
Requests arrive complete with the right information. High-value work that reduces physician and nurse burnout surfaces automatically, not buried under lower-impact requests.
Ready to assess your delivery maturity?

Two Ways to Partner
Direct Partnership with Hospitals
We work directly with hospital IT and informatics teams to implement proven delivery practices. From assessment through implementation, we help your team move faster without adding headcount.
Consulting Partner Network
We partner with healthcare consulting firms to complement their advisory services with operational delivery practices. Whether you focus on clinical workflows, IT strategy, or governance, we help your clients execute faster.

with tech industry DNA
Daniel Shapiro
Founder
Tikva brings proven software delivery practices to hospital informatics teams. Our goal is to close the gap so physicians get the EHR improvements they need faster, without burning out the teams trying to keep up.
Prior to founding Tikva, Daniel led large product and engineering organizations as Chief Product Officer at Workleap, PartnerStack, and eight years at Microsoft. He now works in healthcare, bringing his experience from heavily regulated, governance-intensive environments to help informatics teams deliver faster without cutting corners.