To address these challenges, the team developed and deployed a robust, cloud-native EMR system based on OpenEMR, hosted securely on AWS. The compute layer used an EC2 T3.micro instance, optimized for the AWS free tier, significantly reducing operational costs. To maintain high availability and ensure future scalability, the architecture included an additional EC2 instance in standby mode. This instance could be started manually or via automation to handle increased load, enabling load balancing using an Application Load Balancer (ALB) that routes traffic based on health checks and performance metrics.

Security was enhanced at multiple layers. AWS Web Application Firewall (WAF) was configured to filter malicious traffic and protect against common web attacks such as SQL injection and cross-site scripting. SSL/TLS was used to secure all communications. Fine-grained access control was implemented using IAM roles and MFA, restricting access to administrative functions and sensitive data.

Patient data was stored in Amazon RDS with encryption at rest and in transit. Daily backups were managed using AWS Backup and stored in Amazon S3, ensuring reliable disaster recovery. The system was also integrated with CloudWatch to provide real-time monitoring and alerts on metrics like CPU usage, memory, disk space, and network traffic, allowing the client to maintain system health proactively.

OpenEMR itself was customized to reflect the unique billing workflows of the NGO. This included configuring new payment types such as “Donor-Funded” and associating specific funding sources with patient records. Detailed video walkthroughs and user manuals were provided to guide clinical and administrative staff through everyday tasks, ensuring successful onboarding. The implementation of Cloudflare provided an additional security layer, including DDoS protection and improved global content delivery.