Greenway Health Scales to Hundreds of Terabytes of Data Using Amazon DocumentDB

Greenway’s EHR software and services are currently used by over 50,000 healthcare organizations. Its two EHR solutions, Intergy and Prime Suite, have separate reporting mechanisms that required significant staff resources. Greenway wanted to build a powerful enterprise data hub that would serve as the foundation for all its solutions and reduce the complexity of development. The company had a requirement for scalability, which was a crucial business necessity. It quickly became clear that a cloud solution would deliver the best value to clients. “We have a large number of practices across the United States that rely on our services, so we needed something that would scale up seamlessly,” says Macaluso.

In 2021, Greenway started using Amazon DocumentDB to build both a rapid enterprise data hub solution and a change data capture engine. Because Greenway provides EHR systems, privacy is of the utmost importance. Greenway is committed to delivering highly secure services, and its clients demand full HIPAA and 21st Century Cures Act compliance from all Greenway solutions. The need to protect patient data meant that every phase of the cloud migration had to be secure. However, Greenway was driven by more than a desire to meet regulations—it wanted to apply industry best practices to bring insights to its clients. The company opted to use AWS services to meet its complex project requirements. “AWS had the strongest offering for a number of services we were seeking and was the most willing to collaborate with us on our projects,” says Nick.

Greenway collaborated extensively with AWS Professional Services—a global team of AWS-certified experts that supplements customers’ teams with specialized skills and experience to achieve results—to define the architecture of its new solution and identify the optimal tools for each step of its complex project. “We saw AWS absolutely step up to collaborate with us on this project and picked AWS because of this collaboration,” says Macaluso. By planning out each element of the effort in tandem with dedicated AWS team members, Greenway accelerated the development process by 6–12 months.

After laying out the solution architecture, Greenway used several AWS solutions to implement its project. The company built a change data capture engine on Amazon Simple Storage Service (Amazon S3), an object storage service, and migrated 20 years of historic patient data to the solution. It then transformed the data into regulatory reporting engines. “For us, it was very helpful to choose solutions off the shelf,” says Nick.

The project was complex, and Greenway experimented with several iterations until it found a set of solutions that met its performance requirements. The company succeeded by loading the raw data from Amazon S3 into Amazon DocumentDB, which acts as a mirror database of all its clients’ systems. When clients update their EHRs, the change is reflected in Amazon DocumentDB, and the data is dumped back into the unified model using Amazon S3 data lakes. “At full scale, with all the regulatory reporting functionality, we will be pulling forward nearly 100 TB of data using Amazon DocumentDB,” says Nick. “Greenway is also benefiting from 99.999999999 percent, or ‘eleven nines,’ of durability and lower storage costs.”

Greenway is excited to deliver its new unified data solution to clients. A seamless EHR experience makes it easier for healthcare organizations to center their resources on the provision of high-quality care to patients. The scale and durability that the company achieved using Amazon DocumentDB will have a real impact on customers. “Having this solution available makes things easier for our clients,” says Nick. “By using a cloud-based data solution, Greenway makes it easier for clients to adopt the company’s EHR software without requiring them to invest in their own data centers.”