Clinical testing with next generation sequencing requires a complex bioinformatics pipeline to process raw DNA sequence into  interpretable variants for medical reporting. With sequencing costs dropping and medical testing trending towards larger targeted panels, exomes, and even genomes, bioinformatics pipelines are under a pressure test to perform at scale. This talk will provide a high level overview of best practice recommendations for leveraging team resources to build scalable bioinformatics solutions that can seamlessly scale from small to large sample volumes. This talk will highlight best practice strategies and automation tools to efficiently build and validate clinical bioinformatics pipelines to handle large sample volumes without sacrificing quality and discuss solutions for monitoring performance of a scalable bioinformatics ecosystem in production.