Insights from Dentulu Co-Founder & CTO Shiva Kumar | The CTO Story: Episode 10
Healthcare technology is changing quickly. But building a healthtech platform isn’t simply about adding new features or adopting the latest AI tools. It requires a careful balance between innovation, infrastructure, security, scalability, cost, and the needs of healthcare professionals and patients.
In Episode 10 of The CTO Story, Dentulu Co-Founder & CTO Shiva Kumar shared lessons from building and scaling healthcare technology at Dentulu.
When a technology platform grows, one natural assumption is that infrastructure costs will grow with it. But scaling efficiently requires a different mindset.
Engineering teams need to continuously evaluate how infrastructure is being used, where resources are being wasted, which services need to scale, where architecture can be optimized, and how performance can be maintained efficiently.
At Dentulu, this approach led to a significant reduction in AWS infrastructure costs from approximately $30,000 per month to $3,000 per month, as discussed in Episode 10 of The CTO Story.
The lesson isn’t simply about reducing a cloud bill. It’s about understanding that good engineering can directly influence the economics of a healthcare technology company.
Infrastructure optimization is rarely one big change. It usually comes from many small, deliberate ones: right-sizing services that were provisioned for peak loads that never arrive, moving infrequently accessed data to cheaper storage tiers, consolidating overlapping services, and questioning whether every workload truly needs to run around the clock. None of these steps is glamorous, but together they compound into a dramatically leaner platform.
Building a consumer technology product and building healthcare technology are different challenges. Healthcare platforms handle sensitive information and operate within a highly regulated environment.
Technology teams therefore need to think about security, privacy, reliability, and appropriate data handling from the beginning, not after a product has already been built.
For healthtech companies, scalability means more than asking whether a system can handle more users. It also means asking whether it can do so while maintaining trust, security, reliability, and appropriate clinical workflows.
In most consumer apps, a bad week of uptime is an inconvenience. In healthcare, an outage can interrupt access to clinical information when patients and providers need it most. Health data is also among the most sensitive personal information a platform can hold, which is why it receives special protection under federal law (HHS, HIPAA). Engineering decisions in healthtech carry clinical consequences, so they must be made with that weight in mind.
AI can analyze information quickly, identify patterns, automate repetitive processes, and help surface information that deserves attention. But healthcare requires context.
Healthcare professionals bring clinical knowledge, experience, judgment, and an understanding of the individual patient. That makes the strongest model for many healthcare workflows: AI plus human expertise.
Dentulu’s technology ecosystem incorporates AI-assisted tools designed to support dental workflows. The objective is not to remove the professional from the process, but to give the professional better information and better tools. You can see how this philosophy is applied in Dentulu’s approach to artificial intelligence and in the AI-assisted insights available through My Dental Chart.
Technology leaders constantly face the decision of what to build internally and what to integrate from existing technology providers.
Building everything internally can provide control, but it can also require significant time and resources. Integrating proven technology can accelerate development, but requires careful evaluation of security, reliability, interoperability, cost, scalability, vendor dependency, and healthcare requirements.
For a healthtech platform, the right answer is rarely the same for every technology. The goal should be to determine where the organization creates unique value and where integration can accelerate that value.
Shiva’s suggested starting point is a simple question: where does this platform create unique value for patients and providers? Where the answer is “nowhere special,” integrating a proven vendor is usually the faster and more reliable path. Where the answer is “this is our core,” building gives the team control over quality, security, and the roadmap. Everything in between is a case-by-case trade-off, revisited as the platform and the vendor landscape evolve.
Artificial intelligence is also changing the engineering process itself. Developers can use AI-assisted tools to accelerate research, coding, testing, documentation, and problem-solving.
But speed alone isn’t the objective. In healthcare, faster development still has to be balanced with quality, security, testing, reliability, and clinical responsibility.
AI can help engineering teams move faster, but responsible engineering determines whether that speed translates into a better healthcare product.
Healthcare is often fragmented. A patient may interact with a dental office, specialist, telehealth provider, diagnostic service, laboratory, pharmacy, and multiple technology platforms. Each interaction can create another piece of data.
The opportunity for digital health platforms is to connect those pieces. Dentulu’s broader ecosystem is designed around connecting patients, providers, digital tools, virtual care, diagnostics, and preventive health experiences, from virtual dental appointments to at-home diagnostics and sleep health services.
The long-term opportunity isn’t simply creating another healthcare app. It is creating a connected healthcare experience.
Dentistry has traditionally been treated as a separate category of healthcare. But oral health is part of a person’s broader health journey, creating an opportunity for dental technology to participate in a more comprehensive health ecosystem. Research continues to link periodontal disease with systemic conditions, reinforcing the case for treating oral health as part of whole-body health (PubMed; NIDCR).
Dentulu is building toward this connected model through technologies spanning virtual dental care, AI, at-home tools, diagnostics, monitoring, and other health services.
The future isn’t necessarily about separating dental care from healthcare. Technology can help connect them.
The next generation of healthcare technology won’t be defined by a single technology. It will be defined by how technologies work together:
When these components are connected effectively, healthcare can move toward a more continuous and preventive experience.
That is the direction Dentulu continues to pursue: using technology to make care more accessible, connected, and patient-centered. For a broader view of this vision, read our article on the Dentulu integrated health ecosystem.
In Episode 10 of The CTO Story, Dentulu Co-Founder & CTO Shiva Kumar discusses the realities of building and scaling healthtech, including infrastructure optimization, AI, healthcare technology, engineering leadership, and the future of connected care.
Watch Episode 10: https://tinyurl.com/4abjfzfx
Shiva Kumar is the Co-Founder and Chief Technology Officer of Dentulu. He leads the engineering and technology strategy behind Dentulu’s teledentistry platform, AI-assisted diagnostic tools, and connected at-home care ecosystem, and he represents the company in industry discussions on the future of healthcare AI.
The CTO Story is a series that interviews technology leaders about the real decisions behind building and scaling technology products. Episode 10 features Shiva Kumar discussing infrastructure optimization, healthcare AI, and connected care.
That scaling is an engineering discipline, not a spending exercise. By continuously auditing how infrastructure is used and where resources are wasted, Dentulu reduced its AWS costs from roughly $30,000 per month to $3,000 per month while continuing to grow the platform, as discussed in the episode.
Dentulu uses AI-assisted tools to help analyze dental images, support second opinions, and streamline practice workflows, always under the review of licensed dental professionals. AI surfaces information and speeds up analysis; clinical judgment and treatment decisions remain with the dentist.
Technology in healthcare isn’t about replacing the people who deliver care. It’s about giving them better tools, making information more accessible, reducing friction, and helping patients receive more connected and preventive care.
That’s the opportunity Dentulu is building toward.
Patient Subscription
Dental Professionals
Vendors