case study

4medica modernizes clinical data infrastructure with Aidbox, powering next-generation healthcare solutions

This case study demonstrates the transformative power of Aidbox in modernizing healthcare IT and driving data-driven healthcare.

Executive Summary

4medica, a leader in healthcare data management, sought to modernize its FHIR infrastructure to meet the escalating demands of its patient health record portal, clinical viewer, lab orders management system, and other critical applications.

Facing performance bottlenecks and infrastructure inefficiencies with their previous FHIR backend clinical data repository (CDR), 4medica partnered with Health Samurai to implement Aidbox, a FHIR-enabled CDR. This strategic move enabled 4medica to seamlessly migrate from FHIR STU3 to R4, unlocking significant performance gains, enhanced scalability, and native SQL capabilities for advanced analytics.

The successful implementation has not only improved 4medica's internal operations but also empowered them to deliver more robust and innovative solutions to their clients, including enhanced Clinical Viewer and Care Coordination applications.

Client

4medica is a healthcare IT company dedicated to improving clinical data quality, patient identity management, and interoperability. Founded in 1998, 4medica offers a suite of cloud-based solutions that unify and standardize data from diverse sources, including labs, hospitals, physician practices, community information exchanges (CIEs), health information exchanges (HIEs), payers, and other public organizations, creating a comprehensive longitudinal whole-person care record.

Their offerings include a feature-rich master person index, clinical viewer, consent management, and lab orders management system, as well as sophisticated data management tools to ensure a 99% record accuracy.

4medica empowers health and community care organizations to streamline workflows, enhance care coordination, and strengthen population health management.

Core Challenge

4medica's FHIR-based clinical viewer, a cornerstone of their SaaS offerings, required a more robust and scalable backend.

While 4medica had experience implementing FHIR solutions with various vendors, their existing implementation on a competitive platform struggled to keep pace with growing data volumes and transaction loads. Performance limitations and infrastructure inefficiencies hindered their ability to deliver optimal user experiences and support future growth.

Critically, 4medica needed a FHIR platform that could seamlessly handle billions of transactions and provide the foundation for advanced analytics and reporting. Furthermore, they sought a partner who could provide responsive and expert technical support.

Aidbox Evaluation

4medica had been evaluating Aidbox for several months. Leveraging the readily available free Aidbox development licenses, 4medica conducted a proof-of-concept (POC) project. These development licenses, while limited to non-PHI data and 5GB of storage, allowed 4medica to thoroughly assess Aidbox's capabilities.

The POC clearly demonstrated Aidbox's strengths: simple deployment, exceptional performance, and native SQL support for FHIR resources. The native SQL capability was particularly compelling, aligning perfectly with 4medica's vision for advanced analytics and reporting.

Impressed by Aidbox's performance and the responsiveness of Health Samurai's Customer Success team, 4medica made the strategic decision to migrate their SaaS offerings to the Aidbox FHIR platform.

Implementation Highlights

The implementation involved a two-pronged approach:

1

migrating from the competitive platform to Aidbox, and

2

upgrading from FHIR STU3 to the more current and robust FHIR R4 standard.

Simplified FHIR Implementation

  • Deploying Aidbox on Google Cloud Kubernetes with FHIR R4 and US Core 3.1.1 was streamlined by Aidbox's intuitive configuration tools.
  • Aidbox simplified the often-complex process of managing FHIR Implementation Guide (IG) dependencies, allowing 4medica to easily select IGs directly within the platform.

Seamless Data Migration

  • 4medica's engineering team first loaded FHIR R4 synthetic data into Aidbox and adapted their physician portal (including the clinical viewer and lab orders management system) to the new FHIR API. This initial phase validated the integration and confirmed Aidbox's performance capabilities.
  • Next, the team migrated real-world data from their existing CDR instance to Aidbox. To overcome limitations in the competition's bulk export functionality, 4medica developed a custom script to extract data via the FHIR REST API.
  • Using their internal libraries and custom scripts, they efficiently converted the data from FHIR STU3 to R4 format and imported it into Aidbox in batches, leveraging Aidbox's flexible data loading capabilities.
  • The entire migration process, including the upgrade to R4, was completed in just four weeks, showcasing the power and maturity of the FHIR standard.
4medica and Aidbox architecture

Results

4medica successfully transitioned its critical applications to the Aidbox FHIR platform, running on FHIR R4. This modernization effort has yielded significant benefits:

Simplified FHIR Implementation

1

Enhanced Performance and Scalability:

Aidbox delivers exceptional performance, handling the high volume of transactions generated by 4medica's applications. Anecdotally, resource utilization (CPU, memory, and disk) is significantly lower with Aidbox compared to their previous CDR implementation, even considering the resource usage of the PostgreSQL database. This translates to lower infrastructure costs and improved efficiency.

2

Foundation for Innovation:

The robust and scalable Aidbox platform provides a solid foundation for 4medica's future innovation. The native SQL capabilities empower 4medica to develop advanced analytics and reporting solutions, enabling them to offer even greater value to their clients. This includes enhanced Clinical Viewer functionality and more streamlined care coordination tools.

3

Strong Partnership:

4medica values the responsive and collaborative support provided by Health Samurai's Customer Success team. This partnership has been instrumental in the successful implementation and ongoing optimization of the Aidbox platform.

4

Metrics:

The compute, memory, and disk resource usage is significantly lower with Aidbox compared to the previous CDR, even when including the resource usage of the PostgreSQL database.

  • Prior CDR: 6 CPUs / 32 GB memory / 1 TB disk
  • Aidbox: 4 CPUs / 12 GB memory / 300 GB disk
Gregg Church

President, 4medica
4medica is committed to delivering the most advanced solutions to our clients. Aidbox's performance, scalability, and powerful analytics, combined with Health Samurai's outstanding support, are enabling us to do just that. This partnership is essential to our FHIR strategy and our ability to drive better client outcomes.

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