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MedTech · Digital Health

Pioneering Internet-Based Mental Health Treatment at Scale

Designing and building the backend infrastructure for Kry's first ICBT mental health programmes — a genuine first in Nordic digital healthcare, delivering clinical-grade treatment to patients on their own terms.

Client Kry
Nordic Digital Health Platform
Sector MedTech · Digital Health · Mental Health
Standards FHIR · Clinical-grade QA · Patient data security
Year 2021 · Full delivery
When you help patients individually, you also help society as a whole. This project embodied the pioneer spirit — being the first of its kind, it was an immense milestone for mental health.
Kry Engineering Team · Stockholm, 2021
The Situation

Mental healthcare that works — but only if patients can actually access it

Kry was already transforming primary care in the Nordics, giving patients access to qualified doctors and nurses within minutes via smartphone. But the harder challenge — delivering structured, clinically validated mental health treatment digitally — remained unsolved.

Internet-Based Cognitive Therapy (ICBT) had strong research backing. The evidence for its effectiveness in treating anxiety, depression, and related conditions was solid. What didn't exist was a production-grade platform that could deliver ICBT programmes safely and reliably to patients at scale, integrated with Kry's existing clinical infrastructure, meeting the exacting standards healthcare regulators and clinical teams demand.

The platform had to manage complex patient treatment journeys, coordinate digital consultations with doctors and nurses, handle sensitive health data with zero tolerance for error, and perform reliably under production load — all while the team was, by definition, doing something that had never been done before in this form.

ICBT — Internet Based Cognitive Therapy — is a structured, therapist-guided treatment programme delivered digitally. It requires precise sequencing of treatment modules, patient progress tracking, clinical oversight integration, and secure communication between patients and healthcare providers. Building the infrastructure for it is categorically different from building a general-purpose healthcare app.

Our Approach

Clinical rigour, engineering precision, and the discipline to lead a team under genuine pressure

We operated in a dual role — Scrum Master and Senior Backend Engineer — which meant holding responsibility for both the technical delivery and the team's ability to sustain it. In a project breaking genuinely new ground in regulated healthcare, those two responsibilities were inseparable.

On the engineering side, we designed and implemented the core microservices managing patient treatment programmes — the sequencing logic, progress tracking, clinical validation hooks, and the integration layer connecting patients with healthcare providers for digital consultations. The architecture was built on a reactive, event-driven foundation using Vert.x, designed to handle the asynchronous nature of patient journeys without sacrificing the data integrity that clinical systems require.

FHIR (Fast Healthcare Interoperability Resources) compliance shaped every data model decision — ensuring the system could communicate with the broader healthcare ecosystem today and integrate with future clinical infrastructure as standards evolved. The full DevOps pipeline was built on AWS with Docker and Terraform, with comprehensive load testing and QA including direct patient interviews and feedback cycles baked into the delivery process.

As Scrum Master, we ran sprint planning, retrospectives, and the ongoing stakeholder communication that kept a complex, multi-disciplinary team — engineers, clinicians, QA specialists — moving in the same direction throughout.

Java 11 & 17Kotlin MicroservicesReactive / Vert.x FHIRPostgreSQL ElasticsearchKibana AWSDocker TerraformJenkins / Bamboo PythonAgile Scrum
Outcomes & Impact

The first ICBT treatment programmes delivered. A new standard established.

The project delivered and released Kry's first online ICBT treatment programmes on schedule, with the agreed clinical quality standards met in full.

  • First ICBT mental health treatment programmes successfully launched on Kry's platform — a genuine milestone in Nordic digital healthcare
  • Production-grade microservices architecture managing complete patient treatment journeys — from programme enrolment through clinical sign-off
  • Seamless digital consultation infrastructure enabling real-time video interaction between patients and qualified healthcare providers
  • FHIR-compliant data architecture — interoperable, future-proof, meeting the healthcare interoperability standards regulators and clinical partners require
  • Clinical QA validated through direct patient interviews and feedback — not just technical testing, but evidence that the system worked for real people in treatment
  • AWS infrastructure scaled, load-balanced, and hardened for production — resilient to the unpredictable demand patterns of a consumer health platform
"
Tobias is a really skilled and passionate developer and Scrum Master. He always aims to add business value to the team and organisation by using the best practices and solving technical debt. We paired up many times on solving technical problems and I really enjoyed these times. I can highly recommend Tobias.
EE
Ertug Ertugsuz
Tech Lead · Kry · Published on LinkedIn
Why It Matters

Healthcare software is not ordinary software

The stakes in clinical infrastructure are categorically different. A bug in a patient treatment sequencing system is not an inconvenience — it is a clinical risk. A data integrity failure in a healthcare platform is not a support ticket — it is a potential patient safety event. Building in this domain demands a different standard of engineering discipline, and a different kind of relationship with the clinical teams who depend on the system.

What the Kry engagement demonstrated is that rigorous engineering and genuine innovation are not in tension. The ICBT programmes were the first of their kind precisely because the team held both to a high standard simultaneously — moving fast enough to pioneer, carefully enough to be trusted with patient care.

This is the model we bring to every healthcare engagement: the technical depth to build it right, the process discipline to build it sustainably, and the understanding that in healthcare, quality is not a constraint on delivery — it is the delivery.

Precision engineering for systems that matter.

Whether you're building in healthcare, energy, or defence — if the stakes are high, we want to talk.

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