The secret to building Scalable Data Infrastructure in PE-Backed Businesses
A guest post from our Partners at South Shore Analytics
This post was written by Nick Lisauskas, co-founder of one of our partners, South Shore Analytics. Nick and James Burke at SSA work with small to mid-market private equity firms and their portfolio companies on a variety of data challenges to unlock value creation opportunities.
A common challenge they help private equity portfolio companies solve is to unify data sources for multi-location businesses such as dental practices, quick service restaurants, and home services providers. Orchestra has been a vital component of their process for bringing company-wide insights to life in a manner that ensures data quality, reliability, and is user friendly enough to pass directly off to clients post-implementation.
In a recent implementation of Orchestra, South Shore processed the extraction of practice management software data from 45 dental locations hosted on 45 different remote servers all in parallel and with the use of a beautiful visual interface. They also managed the load of this data to Snowflake for downstream use in reporting and business intelligence software. In this particular example, SSA used Orchestra to manage EC2 servers, Lambda functions, custom python, a dbt core project, and Snowflake.
How To (and How Not To) Solve the Multi-Location Data Problem
Scaling Data for Dental Service Organizations (and other PE-Backed Businesses)
We've been helping healthcare organizations untangle their data mess for years, and DSOs represent the perfect storm of complexity. You've got 10+ (sometimes 100+?!) locations, each running different practice management systems, often on separate servers, with executives spending weekends manually compiling reports from dozens of spreadsheets.
The good news? We've cracked the code. At South Shore Analytics, we've implemented modern data orchestration for a DSO with 40+ locations using Orchestra as the backbone that powers it all. The results are dramatic: new location setup time has decreased from at least a week to an hour, and we’re able to ensure that data is fresh across all practices before building datasets that power executive reporting.
Here's what we've learned - and why the legacy approach to DSO analytics is no longer a viable solution.
The Multi-Million Dollar Problem Nobody Talks About
The DSO market is exploding. We're looking at $429.4 billion by 2030¹, with market penetration growing from 20% to 65% by 2025³. But here's what nobody mentions in those growth projections: the path to best-in-class analytics in this space is completely broken.
Several DSOs have over 1,000 locations and even those with just 5-10 practices face nearly the same magnitude of challenges when it comes to data strategy. Each acquisition brings its own tech stack - Denticon, Open Dental, Eaglesoft - often running on premises with separate servers. As a result of this complexity, PE firms are essentially flying blind during the most critical growth phases post-acquisition.
The impact is staggering when it comes to the opportunity for data orchestration in DSOs:
Reduction in the time it takes to integrate a new acquisiton into the existing data architecture from 1 week to 1 hour
Multi-practice top down analyses that used to take days can now be conducted in minutes
Labor hours required to maintain the stack can be reduced by up to 75% (often the most expensive part of a stack)
These opportunities represent a potential financial impact in the range of hundreds of millions of dollars between gained time & labor efficiencies as well as speed to insights that drive top-line DSO performance improvements.
Why Traditional Solutions Don't Work for Healthcare
We've seen DSOs try everything. Expensive enterprise consulting firms that take 18 months to deliver basic dashboards. IT teams struggling with Apache Airflow setups that require dedicated platform engineers. BI tools that can't handle the complexity of HIPAA compliance and disparate data sources.
The fundamental problem is healthcare-specific complexity:
System heterogeneity: Each practice brings its own PMS, often running on separate servers
Speed requirements: PE firms need real-time visibility for acquisition decisions
Cost sensitivity: Fixed pricing models matter when you're scaling from 10 to 100+ locations
Regulatory requirements: Regulatory compliance isn't optional - every data pipeline needs complete audit trails
Traditional orchestration tools like Airflow require weeks of platform engineering setup. Managed services like Dagster Cloud have unpredictable compute costs that scale unexpectedly. Enterprise consultants deploy junior resources who've never worked with patient data.
You need something different.
The Orchestra + South Shore Analytics Solution
This is where our partnership gets interesting. Orchestra provides the unified control plane for data operations, while South Shore Analytics brings deep healthcare implementation expertise.
Orchestra's advantages for healthcare:
Setup in hours, not weeks: No platform engineering required
Fixed pricing: Predictable per-location costs as you scale locations
Flexibility in where data is processed: Ability to keep all data processing fully restricted to your servers and network while Orchestra manages the sequencing
Native integrations: Direct Snowflake partnership for healthcare data warehousing
South Shore Analytics brings the healthcare analytics expertise:
Specialized experience: Co-founders with backgrounds in healthcare consulting and multi-location analytics
Rapid implementation: Full data stack deployment in weeks, not months
Healthcare-native tools: Experience working with vendors across the data stack that will execute a BAA and support all required compliance.
Boutique attention: Experienced professionals, not junior consultants
Real-World Implementation: 40+ Location DSO Case Study
Let us walk you through a recent implementation that illustrates what's possible.
The Challenge:
40+ practice locations across multiple states
Practices running on separate on-premises servers
PE investors & DSO operators demanding real-time visibility across all practices in a unified manner
The Technical Architecture:
Amazon EC2 servers for secure data extraction via custom Python scripts
Hub-and-spoke VPN network connecting all practice locations to the centralized VPN server
Airbyte for data extraction across other relevant data sources for the business
Lambda functions for real-time data validation and transfer from s3 to Snowflake
S3 staging → Snowflake data warehouse → dbt transformations
Omni dashboards for executive visibility
Orchestra manages all of the above, making sure everything happens in the correct order so that downstream users can feel confident in the accuracy and freshness of their reporting
The Results:
Executive report generation: 3 weeks → 3 hours
New practice integration: 2+ weeks → hours
BI Stack Cost savings: 50% plus reduction in direct software costs compared to legacy setup
Enormous time opportunity cost savings: The team’s most critical resource, time, is now spent on improving the business rather than just trying to identify current performance through a web of manual reports
Implementation: What Actually Happens
We've refined this to a four-phase approach that minimizes disruption:
Month 1: Foundation
HIPAA-compliant connections to practice management software and other critical reporting sources
Snowflake Business Critical setup
Orchestra platform deployment
Month 2: Integration
dbt transformation workflows applied to standardize KPI definitions
Data quality monitoring frameworks installed
Month 3: Clarity
Dashboards developed spanning Executive reporting, RCM, Marketing, Practice Operations and more
Real-time monitoring and alerting
Performance optimization and cost management
Months 4+: Scale
Opportunities for agentic AI & automated practice ops workflows
Machine learning models for predictive insights
Self-service analytics capabilities
Cross-portfolio optimization for PE firms
Change management is critical. Healthcare organizations need careful coordination between technical implementation and clinical workflows. We include comprehensive training and graduated rollouts to build confidence in our solutions.
Why This Partnership Works
Most data consultants don't understand healthcare. Most healthcare consultants don't understand modern data infrastructure.
South Shore Analytics bridges this gap:
Healthcare-native expertise: Years of experience with DSOs, dermatology clinics, commercial insurers and multi-location healthcare
Technical depth: Native expertise with the full modern data stack
Implementation speed: 90 days; not quarters or years
Boutique model: Senior consultants, not junior staff
Orchestra provides the platform foundation:
Healthcare-optimized: HIPAA compliance and healthcare data requirements built-in
Cost predictable: Predictable pricing that scales with your growth
Integration ready: Native connections to Snowflake, dbt, and modern data tools
User-friendly: The data stack’s orchestration can be maintained by less technical resources compared to legacy orchestration tools
The combination creates something unique: healthcare-native data orchestration that actually works.
Below: leveraging the Orchestra MetaEngine to create repeatable modular pipelines that are the same across different locations / databases.
The Market Reality Check
Here's what we're seeing in the market:
DSO consolidation is accelerating: With 100-200 PE-backed DSOs operating and typical 5-year recapitalization cycles, the ability to rapidly integrate acquisitions is becoming a competitive necessity
PE firms are demanding real-time visibility: The days of quarterly board reports are over. Portfolio managers want daily dashboards showing EBITDA optimization, same-store growth, and operational KPIs across every location.
Regulatory requirements are increasing: HIPAA compliance automation is transitioning from competitive advantage to operational necessity
Technology expectations are rising: AI and machine learning capabilities require unified, high-quality data infrastructure as a foundation.
What does that mean? Organizations that establish modern data orchestration today position themselves to capture advanced capabilities as they mature. Those that don't will face valuation discounts and reduced acquisition attractiveness.
Getting Started
The DSO market is moving toward data-driven operational excellence. Don't let fragmented systems limit your growth potential.
If you're a DSO executive or PE leader:
Schedule a consultation: [Book a call with our joint team](mailto:partnerships@getorchestra.io,hello@southshore.llc?subject=DSO%20Data%20Orchestration%20Consultation) to assess your current infrastructure
Get benchmarked: [Request our DSO Data Maturity Assessment](mailto:hello@southshore.llc?subject=DSO%20Data%20Maturity%20Assessment) to see how you compare to industry leaders
See the platform: Request a demo tailored to healthcare use cases
The question isn't whether to invest in modern data orchestration—it's how quickly you can implement these capabilities before competitive pressures make transformation more difficult and expensive.
The organizations moving first are building the data-driven advantages that will define DSO leadership and best practices for the next decade.
Footnotes
¹ Grand View Research. "Dental Service Organization Market Size, Share Report, 2030."
² Number Analytics. "Achieving 100% ROI with Market Access Analytics in Healthcare."
³ Towards Healthcare. "U.S. Dental Services Organization Market Booms 17.9% CAGR by 2034."
⁴ Monte Carlo. "Measure The Impact Of Your Data Platform With These Metrics."
⁶ DrBicuspid.com. "Heartland, Aspen, Pacific Dental top DSO list."
⁷ Future Market Insights. "Data Orchestration Tool Market 2034."
Learn more
To learn more about South Shore Analytics check out their work here.