Fullstack Software Engineer - Canada - Synapse International

Description

Join Anima and save lives

Join Anima, and you'll solve super interesting technical problems that will save lives.

Hi - I'm Shun, an MD and CEO of Anima. Thanks for checking out our job ad We're tackling a problem that has affected everyone in some way.

1. Millions die every year because their medical problems aren't treated quickly enough. Hundreds of millions suffer pain, worry and discomfort needlessly because of long waiting times. I founded Anima because I was tired of breaking bad news to patients who later died, because they didn't get a great care plan quickly. So many of those deaths were avoidable.

2. We've built an ambitious 'Care Enablement Platform' to automate the entire healthcare workflow, starting with primary care - combining online consultation with productivity tools and a single source of patient data truth. Anima has next generation features like autogenerating coded clinical notes and patient comms, and a real time multiplayer dashboard with a Slack-like chat experience that supports 1000s of discussion channels per clinic.

3. By enabling care, we get patients optimal care within 24 hours and 10x the clinical workflow in the process.

Since our launch and first pilot in March 2022, we're now used in dozens of clinics across the country, serving 100,000s of patients. We've been growing more than 80% MoM in terms of users and revenue. We're default alive, and currently have over a decade of runway - though we expect to be strongly cashflow positive by the end of 2023.

Users love our product. The biggest testament to this is that most of our growth comes from virality and referrals with $0 spent on marketing, despite being B2B/enterprise. We have never churned a clinic.

We are pretty unique among health techs: we have both medical and engineering domain expertise. I wrote the Anima 1.0 backend in Node, 80% of which is still used. I also built Annie 1.0, a tuned LLM coupled with a policy engine, that can output structured medical summaries, potential differential diagnoses and management plans. As a doctor and former HM Treasury health policy advisor managing £4bn budgets in UK health spending, I'm a technical, product-focused CEO with full stack domain knowledge and personal experience of the problem we're solving.

**Anima has a unique hacker culture: Everyone is technical with almost complete autonomy akin to 'Knights of the Round Table'.**Over 80% of the product team are ex-technical founders, former CTOs. We also have many technical domain experts ('fullstack Clinical Engineers', ex-MDs) who are their own users.

Everyone in product is technical at Anima and can write production code. This makes for a truly flat hierarchy. There's no separate founder, product or customer team - there is very little communication loss because we all deeply understand the problem, engineering, grading for potential features, and trade-offs. Deep domain knowledge & a tight feedback loop between product dev and user pain is how launched in the highly complex health space, growing from 0 to over 100,000 MAUs in months.

The quickest way to get your code into the hands of users. In 14 months, we built the most advanced Care Enablement platform that exists.

When everyone is technical and make great decisions, it's much easier to stay on the same page & execute rapidly. This means we have a super short latency from ideation to real usage.

Here are 3 concrete examples with specs and timelines (I'd be delighted to demo any of these to you):

• Jay, built an verticalized analytics platform for Anima with Elasticsearch, supporting advanced features like a no-code query builder (similar to Amplitude) in 6 weeks. He also recently built semantic search and released Annie 1.5, a semantic search enabled, global context aware LLM that can converse and answer any question about any patient in the clinic.

• Alex, a clinical engineer, built 'Slack for medical teams', supporting 1000s of channels per organisation and a real time single source of truth for patient data, in 4 weeks, picking up a large set of new technologies on the way (ground up built from low-level services like Appsync, GraphQL, not Twilio).

• Dennis built a lightning fast cloud document library for clinics in a few days, with <100ms traversals through preloading. Recently, when faced with an ancient legacy API that took 30s to return an array of hits, he hacked together an async indexing service with caching that reduced latency to <2s without harmful race conditions. He built and deployed to prod this in under 24 hours.

If high growth delta and joining an elite scrappy crew is your priority, you're gonna love it here.

Does this sound like you?

• Hungry and wants their shot to change the world - a force of nature when empowered with the tools, resources and development to do it. Sees joining Anima as potentially their shot to do this, and takes duty to crew and mission extremely seriously.

• Obsessively concerned with UX, and optimises for this when building features rather than arbitrary technical goals.

• Bored and frustrated at big companies; feel held back by red tape, bureaucracy and poor decisions.

• Keen to understand the big picture & entire context of the company and vertical; impatient for growth towards a senior executive role.

• Expert competency in TS, and reasonably tech + language agnostic. Comfortable with key frameworks/libraries like Angular, Node and React. Able to work full stack in JS/TS. Values pragmatism and open discussion from first principles rather than dogma.

• Seeks to maximise not only self productivity, but combined team productivity, communicating the right things at the right time through the right channels (verbal/Slack/Notion).

• Disciplined towards best practice version control, CI/CD and code extensibility. Values 'interface safety' through dimensionality reduction at interfaces.

• Exceptional at 'breadth-first search' through Googling when tackling new challenges, and consistently mindful of local maxima.

• Intellectually curious with a growth mindset - able to tackle entirely novel challenges that lack prior precedent through applying strong CS fundamentals and first principles thinking, creatively using the right data structures & algorithms to solve problems 90/10.

• Familiarity with AWS (APIG, DynamoDB, Lambda, Cognito, Amplify, CloudFormation) and/or hungry to learn.

We don't enforce any particular experience level, but you'll need to demonstrate most of the above through past projects and/or our assessment process.

Our current stack & what to expect from the roleWe are tech agonistic, and collectively choose the best tools for the job. We're constantly looking to maximise our productivity and minimise what we call "discounted dev time cost" for shipping features. We have 2 separate fully functional web apps in prod: one for clinical users and one for patients. Our stack is currently entirely in JS/TS: Angular + Capacitor + Electron, React (internal tools), Amplitude (analytics), a fully serverless backend in AWS (Cognito, Appsync GraphQL, Lambda, DynamoDB). We have good functional & unit test coverage and CI/CD.

Our stack is in a great place already: highly scalable, cost effective, good test coverage, easily maintained, secure and performant with minimal to zero Ops. The product and codebase are stable and loved by our users. We write, test, deploy & ship new features rapidly.

Strategically, we prioritise strong frontend-backend decoupling through GraphQL and strong modularisation of frontend and backend into hierarchical pure modules, with high abstraction internal services and helpers, allowing ephemeral lances (similar to 'squads') to work on functional modules without needing to understand or be overly concerned about other parts of the codebase.

We're looking to add talented engineers who are hungry and understand the urgency and importance of what we're doing for society.

First month - some examples of what to expect:

• Help add further key third party API integrations, including with legacy EMR systems and national APIs like e.g. the electronic prescribing service, allowing Anima to directly issue prescriptions.

Iterate on a proprietary graph traversal algorithm to improve patient care and clinical value, and increasingly move away from explicit curation to implicit curation by NNs.Ship important features that will directly increase delta lives saved in your first 2 weeks.

• Join customer calls to develop a deep understanding of their fundamental motivations and needs/pain points.

Next 6 months - some examples of what to expect:

• Help architect and deploy a scalable & cost effective ETL data pipeline with version control, outputting clean data ready for tokenisation.

• Help deploy our active deep learning training & validation architecture to prod, so that we can correctly eat up our '1.0' systems at the right time

• Build cutting edge products like global context aware chat with semantic search, care orchestration and LLM-enabled cloud telephony e2e

• Hire/scale the team, while implementing the right processes at the right times to maximise discounted team productivity and minimise discounted dev time cost for shipping.

6+ months - some examples of what to expect:

• Potential to transition to a more managerial/executive role. Lead an autonomous lance of elite engineers to fix healthcare and save lives.

• Work with the ML/data team to creatively ideate and ship features to improve ETL pipeline throughput and quality through a data-driven approach powered by analytics.

• This is a permanent role: things get even more exciting down the line