EHR platform modernization

Case study

Modernizing legacy platform by enabling microservices architecture and CI/CD for a leading EHR platform

Due to fast-changing regulations, payment models, and patient expectations, independent medical practitioners face a deluge of challenges, and physician burnout is becoming a common phenomenon. Technology plays a big role in having a more manageable practice. There are electronic health record (EHR) platforms that offer services to make the business of running an independent practice easier right from delivering care, getting paid and engaging with patients.

Our customer is a leading EHR management, medical billing and patient engagement solutions provider who is on a mission to digitize day-to-day operations of over 50,000 medical practitioners and improve the patient experience. The solutions are meant to be used in a highly regulated healthcare space that mandates compliance with stringent government norms

Requirements

What started as an innovative product addressing the unique needs of the industry, over time grew into a large monolithic platform. This resulted in system incompatibilities, deployment and integration issues with frequent application breakdown, restricting the platforms ability to evolve with the market. The customer wanted to:

  • Modernize the existing platform to scale.
  • Achieve data consistency across their web and mobile applications
  • Integrate with external applications like claims processing
  • Make their solution MU2 certified and ICD compliant
  • Support independent consultants and offer:
    • Practice Management
    • Clinical Module
    • Medical Billing

Challenges

  • The existing platform’s monolithic architecture was complex and difficult to maintain
  • The EHR platform’s frontend was tightly coupled with the backend, and changes in user interface was time-consuming and prone to errors
  • Product updates required the application to be shut down for a few hours
  • The initial analysis uncovered critical platform vulnerabilities, such as outdated technology stack and lack of load balancing mechanism

Solution

To improve the overall platform performance, Imaginea offered to modernize the EHR platform. The modernization included:

  • Transitioning from a monolithic to a microservices architecture, with a continuous deployment model
  • Upgraded client’s complex existing architecture to scale up on-demand and facilitate addition of new features
  • Iron out performance issues of critical processes such as billing by implementing services for sending/receiving information using HL7 standards
  • Developed features for MU2-certification
  • Enabled one-click ICD Code mapping system to make the platform ICD 10-compatible
  • Integrated with Zirmed, a Revenue Cycle Management (RCM) platform to speed up the claims payment process – it facilitates the insurance coverage verification to reduce claims rejection and denials, automatically submit and track claims, prevent denials and automate appeal
  • Extended the platform capabilities with third-party vendor systems such as Practice Fusion, WebPT, Care360, ChartLogic, DigiChart, Falcon, Zocdoc, FlexScanMD, DemandForce, ChrionHealth
  • Automated QA and testing that drastically reduced the time and error rates

Tech stack

How Our Solution Helped

The modernized EHR platform is now MU2 certified, ICD compliant and extended with third-party integrations, which includes Zirmed. This led to a 20x growth in user onboarding.

Overall approach

Our first priority was to ensure platform stability. To achieve this, we transitioned from a Single Monolithic Architecture (SMA) to Service Oriented Architecture (SOA). In this method, functionalities were broken down into single independent services with its own environment, lightweight communication mechanism, so that they can be continuously deployed without having to shut down the application. These services can be dynamically deployed either as a VM or Containers. To achieve data consistency across platforms and manage application issues, a Common Services Framework was designed, and several functionalities were moved to REST client services (APIs). Key benefits include:

  • Teams can develop, deploy and scale their services without having a dependency on other teams
  • Our custom deployment architecture has a built-in load balancing functionality to facilitate zero downtime deployment
  • Improved fault isolation, for example, in case of a memory leak, only that specific service will be affected
  • No need for a long-term commitment to a technology stack
  • Eliminates tight coupling between the front end and back end applications
  • Plug and play modules for third-party integration

Results

  • Accelerated time to market with zero downtime deployment
  • 100% availability of load-balancer
  • Zirmed integration in record time without disrupting the existing customer experience
  • Ranked as #1 integrated EHR product by a reputed annual survey
  • Seamless integration across products
  • Increased users – more than 10,000 healthcare providers on-boarded after this modernization
  • 20x growth due to feature addition and mobile access

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