EHR System for Patients in Correctional Facilities

Business Challenge

The customer company had an existing HIPAA-compliant EHR system written in MVC .NET 4.5 framework and Razor that had been operating for many years and provided patient medical history management. At the first stage, the customer was looking for a service provider who could take on the maintenance and support of this solution, including bug fixing, development of additional features, and assistance in the resolution of client requests.

As the second stage, the organization decided to rewrite the legacy EHR solution with .NET 9 on the back-end and React 18 on the front-end due to several factors:

• Outdated architecture, which made the application difficult to scale
• Data fragmentation, where data was stored within a specific facility, made it difficult to access all patient records in the event of an emergency or when transferring from one correctional facility to another
• The factor of the need to improve performance
• Outdated user experience approach
• Difficulties in updates

Solution

The Chudovo development team took over the legacy electronic health record software in maintenance and support mode. The onboarding of the full-stack .NET development team went smoothly, and the engineers quickly understood the architecture, dependencies, and overall business logic of the project thanks to their previous experience working on similar solutions. The developers have been proactively working on the project for over a year and have been delivering productive results. 

As soon as the customer requested an upgrade of the legacy solution and its rewriting on a newer stack, Chudovo began planning and preparing. The engineering team used Onion software architecture combined with domain-driven design. Onion pattern enabled the organization of the solution’s code by layers of responsibility, decoupling the core business logic from the infrastructure, and keeping the software maintainable with a modular design and horizontal scaling.

Core Functionality of the EHR System

This is a system for doctors and nurses who treat patients who are currently in prisons and jails. The main entity of the solution is patients, and they have their own EHR card. A doctor is attached to the patient, who, after the consultation, describes the disease, makes a record, and can prescribe treatment. If the doctor prescribes medication (e-Prescribing feature), the system transmits a request to another connected application. In this case, these medications are automatically purchased from the supplier, and delivery is organized to a specific facility via UPS. 

In addition, the system with records contains all information on the patient’s medical history, their diagnosis, treatment, history of ordering and receiving medications, vaccination card, etc. Also, it includes lab and imaging results integration.

Business Impact

The .NET development team has been working fruitfully on the EHR project for over 3 years, and the customer has benefited from:

• Ongoing support and maintenance of the existing legacy application to ensure its stable operation and provision of services to patients and correctional institutions
• Prompt bug fixes and development of new functionality
• Setting up an automation solution deployment to IIS
• .NET consulting, auditing, and optimization of the legacy solution
• Rewriting of the legacy solution to .NET 9 and React 18