How SUMC Unified Four Practices Under One Technology Partner​

Southeast Urology Management Company (SUMC) is a growing management services organization — an MSO — that manages urology practices across the Southeast. Founded by Hawk Sindel, SUMC runs operations end-to-end for the groups it manages: HR, clinical operations, revenue cycle, accounts payable. The model is full-service — practices under SUMC’s umbrella get centralized infrastructure and operational support, with on-site office managers who work in close coordination with the SUMC leadership team.

As the MSO added practices, the IT question became unavoidable: how do you bring each new group onto a shared, standardized infrastructure in a way that doesn’t break the budget or the team?

Hawk had known Bruce at Focus for nearly 15 years, going back to their time as consultants together during the Greenway era. When SUMC was ready to make a move, that relationship and the right platform at the right price point made the decision straightforward.

We needed to look for options that gave us the same service for less cost.

— Hawk Sindel, Founder at Urology Management Company

The Challenge

What scaling an MSO actually requires from your IT infrastructure

SUMC’s challenge wasn’t a broken IT environment. Mobile had been running well, and the IT vendor they’d been using was technically capable. The problem was structural: as SUMC grew from one practice to multiple, the cost model of their existing vendor no longer made sense, and the vendor wasn’t purpose-built to support the kind of multi-practice, unified-infrastructure model SUMC was trying to build.

When you’re running an MSO, you’re not just managing IT for one practice. Every new group that comes under your umbrella arrives with its own technical environment, its own setup, and its own integration requirements. Onboarding that practice means migrating or connecting systems, dealing with interface complications, and getting everyone onto a shared platform without disrupting clinical operations mid-transition. The question isn’t just whether the technology works. It’s whether you have a partner who understands that process and can work through it alongside you every time.

What had to be solved

• IT costs were climbing without a path to scale. As SUMC grew, the cost of the existing vendor model grew with it in a way that didn’t align with MSO economics. Hawk needed a model that offered the same quality of service at a cost structure that made sense for a group adding practices over time.
• Every new practice brings a different technical environment. Each group SUMC onboards has its own history: different systems, different interfaces, different configurations. There’s no clean plug-and-play. The onboarding process requires experience, flexibility, and the ability to anticipate where the complications will be before they surface.
• Splitting IT across multiple vendors creates accountability gaps. When IT, EHR hosting, and security are spread across separate vendors, nobody owns the full picture. When something goes wrong across two systems, each vendor points at the other. Hawk wanted one partner who was accountable for everything.
• Building a repeatable process for practice onboarding. Onboarding the first practice is an education. Onboarding the second is better because you understand the pain points. By the third and fourth, you should have a process. Building that institutional knowledge into a partnership, rather than starting over with each new group, is what makes an MSO actually scalable.

I want it under one person.

— Hawk Sindel, Founder at Urology Management Company

How we approached it

One platform, one partner, and a process that learns from itself

The decision to move SUMC to Azure under a single IT partner was the foundational choice. Rather than managing practice-by-practice with different vendors or configurations, Focus put everything on a unified Azure cloud platform. All four practices, standardized infrastructure, one team responsible for it. That consolidation matters for an MSO because it means operational issues don’t get lost between vendors, and new practice onboarding happens on a known, documented platform rather than a different one every time.

The relationship with Bruce mattered practically as well as personally. A 15-year professional relationship, shared history in healthcare IT, and mutual understanding of how these systems work meant that Hawk didn’t have to explain the urology context from scratch or educate the team on what healthcare IT actually requires. That starting point shortened every conversation and made problem-solving faster when complications came up.

Onboarding SUMC’s practices honestly wasn’t frictionless at the start, and Hawk was direct about that. The Mobile onboarding had bumps. Some of the early groups were rougher than expected. But the team worked through the issues together, and the key shift came with Augusta: by that point, the team knew where the interface complications typically appeared, knew which elements needed more attention upfront, and were able to get ahead of the problems before they became disruptions. That’s what a partnership that learns looks like.

From there, we followed a clear path

• Unified Azure cloud infrastructure across all practices. Every group SUMC manages is on the same platform. Standard configuration, centralized management, one point of accountability for the full environment.
• Single partner for IT, EHR hosting, and security. No more splitting responsibility across vendors. Everything Hawk needs to run the SUMC IT environment runs through one relationship, with one team accountable for the outcome.
• Integration and migration support for each new group. We designed dashboards and reports for USSM’s board-level needs, ready to use without extra formatting.
• An onboarding process that gets better with each practice. The Augusta onboarding was meaningfully smoother than the earlier ones because the team understood the pain points and addressed them earlier. That institutional knowledge stays in the partnership and carries into the next group.
• Security configured to match SUMC’s needs and budget. SUMC is actively working with Focus on the right security configuration, balancing the level of coverage they need with what makes economic sense for an MSO at their stage. That conversation is ongoing and practical.

There’s always issues, but we worked through them as a team and so far it’s gone well.

— Hawk Sindel, Founder at Urology Management Company

What we built together

Four practices on one platform, costs controlled, and a process that keeps improving

SUMC accomplished what they set out to do. All four practices run on a unified Azure infrastructure under a single IT partner. The cost model is better than what they had before. And the onboarding process, which was genuinely rough in the early days, has evolved into something repeatable — one that carries lessons from each group into the next.

The consolidation under one partner has also changed how Hawk manages the IT layer of the business. There’s no vendor coordination to do, no accountability gap to navigate when something crosses system boundaries. One relationship owns the outcome, which is how Hawk said he wanted it from the beginning.

Building a multi-practice MSO and need IT infrastructure that scales with you?

Focus works with urology and specialty MSOs building unified infrastructure across multiple practices. If you’re growing and need a model that scales with you, let’s start with a conversation.