The Playbook for Running a Multi-Partner Engineering Organization

Randy Horton

Published on: May 8th, 2025

Executive Summary

Running a multi-partner engineering organization is no small feat, especially in the high-stakes world of MedTech, where compliance, safety, and innovation intersect. As digital health products and Software as a Medical Device (SaMD) become increasingly integral to healthcare solutions, companies face tough questions: When is it appropriate to build an in-house engineering organization, and when is it better to develop partnerships with external engineering organizations? Ultimately, what is the best way to increase your engineering capabilities by optimizing across speed, safety, innovation, and regulatory rigor?

In a recent webinar hosted by Orthogonal, a panel of MedTech industry experts addressed these challenges, sharing real-world insights and lessons on how to establish successful multi-partner engineering organizations. Their conversation unpacked the decision-making processes, best practices, and integration strategies that can help companies avoid common pitfalls and maximize value when working with external partners.

When to Scale with External Partners

Sometimes, you hit a wall. Your internal teams are at full capacity, and your development pipeline is overflowing. The question becomes: Do you slow down, burn out your people, build up your internal talent or bring in external partners?

The panelists made it clear: external partners can be a powerful strategic lever, but only when used intentionally. They’re not just “extra hands.” You bring them in when you need:

Fresh perspectives and “new DNA” to shake up entrenched ways of thinking.
Skills and expertise that are hard to hire for, especially in emerging domains such as AI or digital therapeutics.
Acceleration in velocity without making long-term hiring commitments, particularly when facing project peaks or regulatory deadlines.

“You’re not really necessarily wanting to bring in the vendor… because you need 10 identical software engineers. You’re going to bring in a team that has a team capability, where the whole is greater than the sum of the parts.” – Larkin Lowrey

This mindset of viewing external partners as a cohesive, high-functioning unit rather than interchangeable resources can unlock significant value.

Build vs. Buy: Making the Right Call

Deciding when to build capabilities internally vs. buy it through external partnerships is an eternal question for engineering leaders. Amir Zur shared that, in his experience, the choice often depends on a combination of factors, including your long-term strategic goals, the cost and time required for onboarding, and the nature of the expertise needed.

For instance, if you’re launching a novel product that demands end-to-end expertise outside your company’s core DNA, an external partner might be the right move. On the other hand, for roles that involve deep integration into your internal culture, stakeholder landscape, and long-term vision (e.g., product managers), building in-house capabilities is often essential.

“Flexibility and adaptability, those are key. A partner needs to grow with you.” – Amir Zur

Selecting the Right Partner: It’s Not Just About the Price

Price tags and hourly rates can be deceiving metrics for looking at your ROI on external partners. What matters is whether a partner understands your challenges, adapts to your processes, and adds value beyond simply following instructions.

“Being clear as an organization as to what you are trying to achieve and what your actual situation is, is super important.” – Bernhard Kappe

Without that self-awareness, companies risk falling into common traps: treating partners as vendors, chasing “more bodies” externally to compensate for deeper internal issues, or failing to align incentives and outcomes.

The panelists also stressed the need for partners who can:

Offer end-to-end solutions, not just provide narrow services and deliverables.
Bring to bear prior knowledge and lessons learned from past customers.
Be adaptable in scaling up or down, as project needs evolve.
Integrate effectively into your quality management system (QMS) and regulatory processes.

Onboarding External Teams: Avoiding the Pitfalls

Bringing in a partner isn’t a plug-and-play proposition. Successful onboarding of external partners requires a variety of elements including:

A common vision of what defines success for a vendor
Clear definitions of roles and responsibilities.
Transparent communication, including how and when to share progress.
A shared understanding of regulatory frameworks, QMS alignment, and compliance expectations.

The panelists highlighted that the real magic happens when external teams feel like an extension of the internal organization. This isn’t about handoffs, it’s about collaboration, trust, and shared ownership of outcomes.

“I would definitely treat them (my partner’s staff) as I treat my employees, although I have different tools, but still the same goal: to keep them motivated, to make sure that they will be appreciated, that they will be compensated.” – Amir Zur

This mindset of treating partners as part of the team, rather than as a distant resource, builds alignment, accountability, and shared success.

AI, Data Strategy, and the Evolving Landscape

The conversation also touched on how AI is reshaping the MedTech partnership landscape. While AI tools can augment internal capacity, they don’t replace the need for skilled internal staff and sound data strategies. With or without an external AI partner, companies that fail to build robust, compliant, and adaptable data infrastructures risk falling behind.

As AI capabilities grow, the distinction between “build” and “buy” becomes even more nuanced. The key takeaway? Leaders need to think holistically about data, tools, and partnerships, ensuring they have the right balance of internal talent and external expertise to navigate the complexities of AI-driven healthcare innovation.

Conclusion

Running a multi-partner engineering organization in MedTech is as much about mindset as it is about mechanics. Successful companies:

Leverage external partners for their unique expertise, fresh thinking, and team capabilities.
Maintain clarity about what they need, what they can handle internally, and where they need help.
Build relationships based on flexibility, adaptability, and a shared commitment to delivering safe, effective, and innovative medical solutions.

The bottom line? Strategic partnerships aren’t just about getting the job done, they’re about shaping the future of healthcare together.

Watch Webinar Recording

Bernhard Kappe orthogonal software as medical device

Randy Horton, VP of Solutions and Partnerships, Orthogonal