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Optimizing a Plone Application to Inform Clinicians

Sanford Guide

Areas of Expertise

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CMS & Intranets
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Performance Optimization


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Technology Used


Sanford Guide, the most trusted name in the treatment of infectious disease and one of the first antimicrobial stewardship tools developed, features a Plone-based application designed to aid decision-making on administering antibiotics effectively, efficiently and responsibly at the point of care. Sanford Guide, first established in 1969, updates its content based on medical and technological advancements, as well as published research. Simultaneously, the application’s Plone-based content management system (CMS) needed to be optimized.

Six Feet Up, the largest Plone consultancy in the United States, was tapped to help the Sanford Guide team expand and enhance its Plone capabilities.

Specifically, Six Feet Up’s plan of action required developers to:

  • conduct a comprehensive review of the application;
  • complete system performance enhancements to simply workflows, improve the app and support increased traffic volume; and
  • train new members of the Sanford Guide team on the application’s features, functionality and maintenance plan.

Implementation Details

In the era of antimicrobial resistance, medical professionals (e.g.: clinicians, pharmacists, physicians, physician assistants and nurses) depend on Sanford Guide for concise, reliable and accessible information about prescribing the right drug, in the right dose, for the right duration. During the implementation, it was critical for the application to remain operational at all times for those who need it.

Application Review

First, Six Feet Up conducted a thorough review of Sanford Guide’s Plone-based application — a technically advanced application which showcases how Plone can be utilized for both content editing/workflow and as a content feed for other systems and applications. For example, in addition to updating content within the Sanford Guide application, the content seamlessly integrates with healthcare technology platforms to provide medical professionals with the tools they need to ensure the appropriate use of antimicrobials.

Performance Improvements

Next, the team identified areas for updates and improvements that could be made on the Plone framework to simplify the deployment workflows. Simplifying workflows allowed Sanford Guide’s team to implement version control in the application and deploy a more efficient release process for new updates and bug fixes. Throughout the process of simplifying, performance and error monitoring systems such as Sentry and Amazon Web Services (AWS) monitoring were put in place to alert the teams of any degradation from the application’s optimal performance. Establishing alerts is key for identifying critical site errors and fixing bugs that could prevent medical professionals from accessing Sanford Guide’s valuable knowledge base — an issue which could have serious consequences.

Developer Training and System Maintenance

Prior to Six Feet Up’s engagement, a single Plone developer at Sanford Guide was charged with maintaining and updating the application. Six Feet Up will document a comprehensive maintenance plan, and, throughout the engagement, train multiple content editors at Sanford Guide who will be able to address performance issues, support the application’s growing content and maintain the application for years to come. Having several individuals who can troubleshoot issues is essential for the health and longevity of the application.


Sanford Guide’s Plone-based application is a life-saving tool used by medical professionals around the world. The collaboration between Six Feet Up’s team of expert developers and the in-house development team at Sanford Guide resulted in an efficient and effective knowledge transfer process that is both maintainable and can be applied to similar Plone sites hosted by the company.


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