Modernizing legacy systems is never just a technical upgrade—it’s a deep, transformative effort that impacts architecture, security, scalability, and ultimately, business outcomes. This blog dives into our journey of modernizing a decade-old Revenue Cycle Management (RCM) platform for a healthcare organization, moving from a tightly coupled monolithic system to a modular, microservices-based architecture.

The goal? To improve system scalability, enhance data security, and lay the foundation for future innovation—all while ensuring minimal disruption to business-critical operations.

What’s in place?

While the RCM platform continues to serve multiple clients, Minfy's client is facing significant challenges in scaling the business due to architectural and operational limitations.

• The platform, originally envisioned as a product, has undergone extensive client-specific customizations over the years.
• Built as a monolithic MVC application, it evolved through feature additions and is now maintained as separate code and database copies per client.
• Recurring feature requests have been handled —either as modules within the existing monolith application or spun off as standalone apps.
• The system runs on a Microsoft stack: .NET Framework, MSSQL, and Windows OS, designed as a server-side rendered MVC app.
• Data ingestion relies on legacy tools: a Visual Basic app for limited data loads and a no-code ETL tool for patient data extraction—both Windows-based.
• External RPA tools are used for web scraping and integration with third-party systems, adding further complexity.

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Minfy’s Approach to modernize the Application and Database

As per this approach, a detailed strategy was created to modernize the application as per event-driven microservices architecture, with a massive code rewrite (80% or above) on a comprehensively crafted infrastructure on AWS cloud, to suit client’s business roadmap in non-functional scope and to make the application easily manageable overall.

This application modernization exercise is targeted for healthcare audience, care is taken to secure patient data as per HIPAA compliance guidelines and to also secure personally identifiable information (PII) as per Indian DPDP and California’s CPA acts.

The database modernization exercise comprises of different aspects that includes database re-modelling activity to create database tables that are organized in different database schemas (in the context of microservice with the use of database per service design pattern). Denormalization approach is used where required to scale read traffic better while reducing the needs of using nested stored procedures, cross-database joins and sub-queries. Adding to this, database column-level encryption is implemented with limited querying capabilities at column-level and data security is enforced with usage of TDE at storage-level overall. Security keys are managed using AWS Secrets manager & AWS Key management service.  

New Application architecture diagram:

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‍Results and Outcomes

The re-architected RCM platform was designed with scalability, security, and maintainability at its core. Key advancements include:

• Modular & Configurable Architecture: Client-specific customizations are now handled through dynamically defined configurations. Core modules are centrally deployed and managed, while others are selectively enabled per client deployment—ensuring flexibility without code duplication.
• Secure Handling of Patient Data: The system implements authenticated encryption at the application layer. Encrypted data is stored alongside its digital signature, with blind indexing enabling limited querying on encrypted fields—aligning with modern privacy standards and healthcare compliance norms.
• Security & Scalability by Design: The new architecture adheres to OWASP security best practices and follows the 12-factor app methodology, enabling horizontal scalability and ensuring "secure by design" and "privacy by default" principles.
• Issue Resolution at Scale: Over 100 documented issues in the legacy platform—spanning ETL, database, and application layers—were addressed through:
  
  • A React-based UI and .NET microservices
  • RCM Flow-specific data models
  • A customized ETL strategy tailored to project needs
• Service-Oriented Data Access: Each microservice now owns its database using the "Database per Service" pattern, significantly reducing row lock contentions and improving isolation.
• Application-Level Business Logic: Business logic previously handled by over 1,000 stored procedures has been refactored into application code. Now, fewer than 20 stored procedures remain, with the rest replaced by efficient ORM-based queries.
• DevSecOps Integration: The team has adopted DevSecOps practices, and application delivery is fully automated through a CI/CD pipeline, improving deployment speed, consistency, and security posture.

Summary

Over time, legacy systems often accumulate layers of abstractions built over existing code, leading to redundancy, performance bottlenecks, and scalability challenges. This was no different for this healthcare RCM platform as well —where years of incremental enhancements had made the application increasingly resource-intensive and difficult to maintain.

To address this, a comprehensive and tailored modernization strategy was implemented across both the application and database layers. The result is a streamlined, high-performing platform reimagined as a SaaS solution, purpose-built to support the client’s growing customer base with improved agility, scalability, and maintainability.