Breaking the Meta: Shrike Build Ana
This build aims to maximize Ana's healing, damage, and utility by applying doses on multiple enemies. Normally Ana wants to stand in the back of fights but this build takes advantage of Shrike's leech effect to let Ana spread her doses and stay healthy. Due to Ana's low mobility and health pool, it's best to pair her up with allies who can peel for her. This build works well if the enemy team has multiple frontliners and no divers to let you stack doses freely. It's an extremely demanding playstyle that requires you to pay attention to multiple things all at the same time while having the mechanical skills to execute it.
First, you're still a healer and need to pay attention to your teammate's health bars. This becomes especially important when you pick up Concentrated Doses at level 16 as that is when her healing potential skyrockets. It's easy to tunnel vision on stacking doses that you don't pay attention to your teammate's health. You're missing out an on demand cleanse with Active Reload for more healing.
Second, you need to spread doses. The success of this build lies within the burden of execution to spread your doses. This becomes important at level 7 when you pick up Mind Numbing Agent and at level 16 with Concentrated Doses as that is when this build comes fully online. You're going to want 5 doses applied in every fight, either spread out or on 1 target. Don't be too greedy with stacking and never force 5 stacks on a target if they're retreating- it will put you in bad position. At 5 stacks, Concentrated Doses matches Sharpshooter's healing at 10 stacks. If an Orphea or Mephisto jumps in front of you, stack doses to reduce their spell damage. Your doses also reduce the healing done by healers, another tool in your arsenal to accompany her utility. Post-10 you should start to stack only when it is safe. At level 16 you should be finished stacking and focus on empowering your Concentrated Doses by having at least 5 doses active in fights.
Third, you need to learn to stay alive using your Shrike. Combined with your ability to spread doses is your ability to kite and avoid burst damage. The lower your health, the bigger the target is on your back. You're going to take damage being so close in the fights, but kite back to heal up when your health falls below 80%. If you've been stacking Vampiric Rounds well and constantly apply doses to minions and structures, 5 stacks in a fight is enough to sustain you.
Even though it is not a meta build because of how dangerous it is to stack doses, as well as being countered by smart enemies that won't let you stack for free, I think it's the highest potential build Ana has. In ideal fights, I was hitting 1k heals per shot. In other cases, it's easy to get caught out of position and bursted down if you don't have Mind Numbing Agent on the right targets. It's difficult to get into the rhythm of Shrike build but if things go your way, it makes Ana an absolute monster in fights.