pMD Achieves Horizontal Scalability with AWS Migration and Help from Caylent 

Thousands of medical professionals and facilities across the United States depend on pMD software to provide 24/7, HIPAA-compliant communication and practice management solutions. Because of this, high availability is at the center of the company’s brand promise. Historically, pMD had relied on on-premises infrastructure in an offsite, colocation data center to host and run the core components of its software. However, over time, this datacenter facility became a single point of failure that jeopardized pMD’s ability to achieve its goals of 99.999% system availability. 

“When offering a 24/7 system that physicians use to care for critically ill patients, any single point of failure is unacceptable,” said Adam Kenney, senior vice president of technology at pMD. With a goal of delivering the best possible uptime and availability to customers, pMD leadership mandated a six-week timeline to migrate out of its data center and into AWS.

pMD chose to work with AWS Partner Caylent because of the team’s deep AWS knowledge, their responsiveness, and their ability to meet pMD’s aggressive migration timeline. pMD was also able to participate in the AWS Migration Acceleration Program (MAP), which helped reduce costs.  

Over eight weeks, Caylent successfully migrated pMD’s mission-critical workloads to AWS and rearchitected applications with AWS services. Running databases on Amazon Aurora now provides improved reliability and scalability, while AWS Lambda enables easy service prototyping. An efficient, continuous integration, continuous deployment (CI/CD) pipeline from GitHub allows for faster, more frequent deployments. In addition, implementing Amazon Elastic Container Service (Amazon ECS) helped simplify application management and establish secure access to authorized users. The new AWS infrastructure also ensures that pMD always has a recovery buildout ready to go if an entire region goes down due to an emergency or natural disaster. 

“Our goal was to ensure pMD delivers on their promise of high availability,” said Pablo Salamone, senior director, cloud architecture and engineering at Caylent. “This migration ensures that pMD can scale to meet the ever-growing demand forits services.”

Prior to migrating with Caylent, pMD was using a standard MySQL database to power its application. For backups, the IT team used a replica MySQL database that received updates from the main database. However, there was typically a one second delay as the new data hit the replica, which meant limited horizontal scalability. By switching to Amazon Aurora for MySQL, pMD gained near-real-time replicas with single-digit millisecond latency—netting an improvement of 99 percent faster replication. Overall, Amazon Aurora enabled improved disaster recovery and resiliency because of its ability to seamlessly scale. “Our customers expect a certain level of uptime, and Amazon Aurora delivers that for us seamlessly on the database side,” said Kenney.

By rearchitecting their application with AWS services that run across several Availability Zones, the pMD team experienced noticeable enhancements in performance, scalability, and connectivity. “The scalability aspect of being in the cloud just can't be overstated,” says Kenney. “Today, if we have a massive load increase, I change a number in the console and have 100 more servers spun up quickly.” This change is critical at a time when many healthcare providers are transitioning to telehealth platforms like the one from pMD. If there is another uptick in activity like the one pMD saw in 2020, the software can scale to meet that demand.

Working with Caylent and AWS, pMD not only improved its application availability, but it also enhanced security. As Caylent and the pMD team rebuilt the software to run on AWS, they added additional layers of security to stay ahead of potential threats. None of the changes would have been possible without a partner like Caylent. “We knew we didn’t have in-house expertise to do this migration nearly as quickly,” said Kenney. “I have to say, Caylent really knocked it out of the park for us.”