Strategy and Solutions
A multi-state healthcare provider ran patient management (EHR lite, scheduling, billing, patient portal) on a constrained on-prem setup. Pandemic-era telemedicine exposed limits: bandwidth contention, maintenance windows that clashed with care, and difficulty scaling for spikes. At the same time, HIPAA obligations and zero-downtime expectations made any migration high-risk.
The provider engaged Zymr to plan and execute a HIPAA-compliant cloud transformation with no service interruption, airtight data protection, and a roadmap that enabled new care models like video visits and remote patient engagement.
Success meant continuity of care every minute, verifiable privacy safeguards, and a platform that could grow without adding operational fragility.
Risk was two-sided—security and availability. We had to raise both at the same time, not trade one for the other.
Administrative, physical, and technical controls (encryption, access, audit, BAAs) had to be demonstrably enforced. Evidence collection could not be an afterthought.
Clinicians, schedulers, and patients used the platform continuously. Even planned outages impacted care, prescriptions, and lab orders.
PHI migration required encrypted transport, complete reconciliation, and immutable logs. Any discrepancy was unacceptable.
Video sessions and portal engagement demanded elastic resources and modern messaging—capabilities the legacy stack could not sustain.
The mission: move safely, prove control, and leave behind a system that can flex with demand while staying compliant by design.
Zymr delivered a HIPAA-strong cloud platform that sustains care delivery, lowers cost, and enables new digital services. The provider can expand telemedicine, integrate remote monitoring, and add partners with less risk and effort.
Healthcare wins when systems are stable, secure, and simple to evolve. That’s the platform we left behind.
Clinicians experienced a faster, steadier system; patients booked and joined visits reliably; operations saw fewer after-hours pages. The platform now supports care without being the center of attention—a sign of healthy infrastructure.
Availability stayed high because we treated cutover like an SRE exercise and compliance like code. The result was quiet, which is exactly what clinical software should be.
These gains reduce everyday toil and keep risk low even as features grow—compliance stays current because it’s embedded, not recreated.
The organization now runs on rails: guardrails in code, visibility in dashboards, and clinical time protected from IT turbulence.
Zymr migrated by proving, not by assuming: measure, compare, and only then switch. HIPAA controls ran as systems, not documents.
We sequenced migration by impact: read-only analytics → portal content → scheduling → billing → core patient records. Each step packed a fallback plan, objective rollback triggers, and go/no-go gates.
Data moved over encrypted channels with checksums at chunk and dataset levels. Reconciliation scripts checked counts, referential integrity, and sentinel records (e.g., adverse events) one-for-one. Every step generated signed logs.
HIPAA Control Fabric
We ran blue/green for portal and API layers; feature flags allowed cohort-based routing for clinics. If latency or error budgets exceeded thresholds, we flipped traffic back instantly.
SLOs are defined for latency, error rate, and availability; synthetic probes tested logins, chart opens, orders, and video handshake continuously. On-call runbooks documented doctor-friendly incident comms.
We integrated a HIPAA-eligible video API, queued visits with retry logic, and added secure messaging plus document exchange. Media paths never traversed storage without encryption; expiring links prevented exposure.
SAST, SCA, IaC scanning, container image policies, and signed artifacts entered the CI/CD flow. Non-prod used de-identified data sets; prod access required just-in-time approvals with session recording.
The program combined safe movement (phasing and flags), provable security (controls and evidence), and new capability (telemedicine) without asking clinicians to slow down.
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