Mayden Increases Reach and Reliability of Healthcare Software by Migrating 300 Servers to AWS in 6 Weeks

Founded in 2000, Mayden launched the iaptus patient-management system in 2008 as part of the pilot program for what became NHS IAPT. Today, iaptus supports 65 percent of all referrals to the NHS IAPT service; in 2021 alone, iaptus facilitated the care of 1.2 million out of the 1.8 million total referrals. The solution serves as an electronic health record (EHR) management system and hosts online patient services, such as appointment booking, self-referrals, and integrated video appointments. All the iaptus services are delivered through the cloud.

In August 2021, Mayden’s technical team began assessing the benefits of moving to a cloud hyperscaler. The company searched for a new provider, expecting to meet with a lot of faceless websites. Instead, when Mayden approached AWS in November 2021, the team was greeted by people who provided personalized service and swiftly connected them with the experts and answers they needed.

To migrate efficiently while still supporting patient services, Mayden joined the AWS Migration Acceleration Program (AWS MAP), a program to build strong cloud foundations, reduce risk, and offset the initial cost of migrations. Mayden also worked with Sourced, an AWS Partner, which offered expertise and augmented Mayden’s DevOps team during the migration. “We wouldn’t have gotten this done as quickly and with the low amount of downtime that we had if we hadn’t had the support of AWS MAP and worked with the Sourced team,” says Tom Dawson, product owner for the systems team at Mayden.

After migrating test workloads at the end of April through May, Mayden migrated live workloads to AWS in June through mid-July 2022. It rebuilt about 40 percent of its servers using AWS-native services and cloud tools, such as Terraform, an open-source infrastructure-as-code service. The other 60 percent were rehosted to AWS with no downtime using AWS Application Migration Service. By using AWS Application Migration Service, Mayden moved these legacy applications to AWS with minimal or no changes to the code or core architecture. “Using AWS Application Migration Service, we rehosted the more complicated legacy parts of our application very quickly and with no downtime,” says Dawson. “The fact that the service runs entirely within the operating system meant that we didn’t need to get into the underlying physical infrastructure to do the replication.”

To further accelerate its migration, Mayden used AWS Cloud Migration Factory, an orchestration solution powered by AWS Application Migration Service that coordinates and automates large-scale migrations to AWS. Using this service, Mayden migrated groups of 30 machines at once.

Since migrating to AWS, the availability and reliability of Mayden’s service has improved. “The stability is notable,” says Chris Eldridge, director of operations at Mayden. “Since migrating to AWS, we haven’t had any major service issues.” It’s crucial for Mayden’s solution to be available 24/7 because people might need to access its applications, such as self-referrals, at any time of day. “If you’re working in mental health, you’re always aware of the importance of your system being online and available,” says Eldridge. “If somebody can’t access a patient’s record when they need to, we’re aware of the weight of that responsibility.”

As NHS IAPT services are increasingly offered virtually, iaptus supports 200 mental health services with 40,000 users in the iaptus application. Even before the migration, an NHS-commissioned survey of users rated iaptus at 80.1 percent for reliability and responsiveness, compared with the NHS average of 58.1 percent. “Despite not having the level of stability that we might have liked from our former provider, we did a good job mitigating what we could,” says Rebecca Prestland, business development and marketing strategist at Mayden. “Given how important it is for our system to be available, fast, and responsive, we’re excited to see how that rating will improve now that we’re on AWS.”

Using AWS, Mayden’s IT team can do its job faster. Building the 75 database servers that make up a key part of Mayden’s infrastructure—a task that previously would have taken hours—took 2 minutes on AWS. “The speed of AWS is astonishing. The ability to create infrastructure that quickly makes such a massive difference to our small DevOps team,” says Eldridge. Mayden also uses managed services on AWS—including Amazon Route 53, a domain name system web service; AWS Client VPN, a fully managed remote access VPN solution; and Elastic Load Balancing, which distributes network traffic. Using these services frees up the team to concentrate on building and supporting its applications.

A few weeks after completing the UK migration, Mayden used the tools and knowledge that it had gained to build a new environment in Canada. The infrastructure, which will support mental health and addictions services, took only 10 days to build. After this system is launched, Mayden will begin building new infrastructure in another geographic location. It will also apply its learnings to consolidate its infrastructure in Australia onto AWS. 

Mayden is growing and has ambitious plans. The company is exploring AWS machine learning tools to analyze the data collected in the IAPT program to drive better outcomes for patients. The team is also expanding into physical health services. “We believe that tech has an important role to play in creating sustainable healthcare systems,” says Prestland. “The migration to AWS was an important move for Mayden to support us strategically as we continue to grow.”