Case Study - OCA Aspire Reduces Hosting Costs and Builds for Growth on Azure
We partnered with Aligned to assess our technology stack and co-create a strategic roadmap aimed at maintaining Aspire as the leading EHR solution for chiropractors and allied health professionals. They swiftly identified critical areas for improvement and designed an ambitious plan to accelerate innovation while enhancing performance, scalability, and cost efficiency - achievements many other providers dismissed as unattainable or overly complex.
Remarkably, Aligned delivered results in under six months and within budget, all without disrupting our ongoing operations. Their expertise not only transformed our platform but also positioned us for sustainable growth. Today, they continue to support us as we fulfill our commitment to clients with a modernized foundation built for the future.
OCA Aspire needed a CTO-level assessment of its EHR platform: the codebase, architecture, infrastructure, and cost of serving each clinic. That assessment led to a six-month engineering program, followed by a year of development, maintenance, support, and production operations. The engagement concluded after we trained OCA’s internal team to take over.
Developed by the Ontario Chiropractic Association, Aspire provides electronic health records and practice management for chiropractors and allied health professionals, including booking, scheduling, billing, and payments.
The Assessment
Over one month, we evaluated the platform and its unit economics. The assessment identified opportunities to lower per-clinic hosting costs, simplify the application stack, and make provisioning repeatable as Aspire grew.
We recommended a multi-tenant architecture, updated Java and frameworks, and an Azure environment that OCA could operate with its own team. The roadmap connected those engineering changes to running costs, continued product development, and future operating responsibilities.
Re-Architecting the Platform
We completed the platform upgrades and re-architecture in six months. While building the new foundation, we patched the existing solution and supplied updates to the incumbent provider.
Multi-Tenant Architecture and Automated Clinic Provisioning
We replaced the single-tenant architecture with a multi-tenant design and automated clinic provisioning, reducing the infrastructure and manual work needed to add clinics.
Updated Java and Fewer Frameworks
We upgraded from Java 8 to a supported Java release, consolidated frameworks with duplicate responsibilities, and brought the retained frameworks up to date. The smaller codebase gave engineers less software to maintain and change.
Azure Infrastructure and Production Migration
We provisioned a secure Azure landing zone, with role-based access controls, tenant isolation, and privileged identity management. We migrated the platform’s data to the new infrastructure, fully accessible to OCA. Each clinic’s infrastructure migration took place overnight, without disrupting clinic operations.
A Data Foundation for Reporting and AI Readiness
We built a data platform to aggregate anonymized clinical data across clinics for reporting, research, and advocacy. This also established a foundation for future AI-assisted analysis, with consolidated data available beyond the day-to-day transactional application.
Value Delivered
The case reports these results from the architecture, provisioning, and technology changes:
- $1M+ in Annualized Cost Savings.
Reduced reliance on legacy technology and right-sized cloud resource allocation.
- 90% Reduction in Incremental Hosting & Operating Costs.
Slashed per-instance costs through automated capacity adjustments.
- Doubled Throughput & Halved Response Times.
Achieved significant performance gains, enabling seamless Canada-wide expansion.
- 75% Reduction in Codebase Size.
Drastically increased developer productivity and removed delivery friction.
Migrating Customers from the Desktop Product
OCA also needed to move customers from an older desktop-based product into Aspire. Our knowledge of the platform let us implement the migration tooling and carry out the migration of a few hundred clinic organizations over eight months, against the required timeline.
This customer migration was a separate project from moving Aspire’s infrastructure into OCA’s Azure environment.
Operating the Platform and Handing Over
For a year following the platform upgrades, we took responsibility for development, maintenance, support, and production operations. As OCA built its internal team, we trained its engineers and handed over responsibility. We exited when the team was self-sufficient.
The testimonial above was provided during the support period. OCA subsequently took over with its own team.
OCA finished with lower hosting costs, a platform ready for further product development, a data foundation for reporting and future AI work, and an internal team able to operate it.
If you need to take responsibility for an existing application, reduce its running costs, or arrange ongoing engineering and support, let’s talk.
- Application Engineering
- Azure Infrastructure
- Platform Operations
- Knowledge Transfer
- AI Readiness