Health care and social assistance
Health care and social assistance is about 8.2% of metro GDP, and the region's large health systems run Salesforce for patient access, referrals and contact centers. Managed services in that setting is change control under privacy rules: every permission change reviewed, sandbox testing before releases touch patient-facing processes, and an audit trail of what changed and why. We also maintain the integrations that feed scheduling and referral data, which break quietly when source systems upgrade.