Case Study: Automated global deployments on AWS with HIPAA Best Practices

About Perxhealth

Perx Health is pioneering a motivational health community for everyone. We are using leading-edge behavioural science, consumer tactics and technology to help and motivate people living with chronic conditions to stick to their treatment plans. Importantly, Perx has already helped thousands of patients increase their engagement, improve their adherence and see better health outcomes. We want a future where managing a chronic condition is simple, exciting and rewarding.

The business challenge

Already running healthcare solutions on AWS, Perxhealth aimed to leverage an elaborate multi-region automated deployment strategy in a HIPAA compliance way where it requires to move from a higher-level AWS service like Ligthsail to services with more operational control. Achieve this aspect without adding infrastructure operations was crucial to keep a collaborative and innovative environment for the development team.

To accomplish these requirements DNX Solutions was involved in the architecture definitions and together we decided to go for containers orchestration pushing stateless applications through CI/CD pipelines along with IaC (Infrastructure as code) using Terraform.

The Solution

We started assessing the existing infrastructure using HIPAA Best Practices and our DevOps Transformation guidelines. The project started by deploying our DNX Well-Architected AWS foundation, also called DNX.One, which implements operational excellence, security, reliability, performance efficiency, and cost optimization using Infrastructure as Code, so that applications can thrive, while the business can remain focused on customer solutions.

With minimum infrastructure operations in mind, Elastic Container Service on AWS was chosen for the application modernisation strategy. It is important to mention that DNX used spot instances for the ECS cluster, focusing on availability while reducing AWS costs.

As security and privacy were of paramount importance to Perx Health we were able to develop systems to ensure production data was well secured from development workloads and that access was only via a secure VPN to a secure subnet in their VPCs which is not accessible to the public internet. Additionally, high levels of security best practices were enabled during the Foundation stage including: A separate audit only account, centralized cloud trail, AWS Config, AWS Guard Duty and AWS KMS.

Implementing a blue-green deployment approach in a multi-region environment, we automated existing database migrations and deployments that were previously manual processes, providing the team confidence to release new features that can be easily tested in a production-like environment before every deployment.

Perx Health also required an analytics solution to manage its multi-region environment. Using Terraform to manage Infrastructure as Code (IaC) enabled simple provisioning of a Data Warehouse cluster, which was essential to bring automation, security, and information management and control.

CI/CD Pipelines

Previously the deployments were manual, where the team would connect to the EC2 Instance manually to release new features. The application was already living in Bitbucket that has a pipeline solution. At DNX we use the client’s current CI/CD tool to provide the best pipeline architecture, focusing on the best approach for the client’s needs.

Also, each container is scanned for vulnerability using ECR feature.
You can refer to this article to find out more details:

Some of the AWS Services provisioned:

  • AWS Elastic File System (EFS)
  • System Manager
  • CloudTrail
  • Aurora Cluster
  • Cloud Watch
  • Code Deploy
  • AWS Papertrail


Perx Health’s project was highly collaborative and ultimately delivered beyond expectation. With an engaged and helpful development team working together with DNX, we built a resilient, secure and reliable AWS platform for Perx Health applications. Now the team is able to focus on what they do best, using leading-edge behavioural science, consumer tactics and technology to help and motivate people living with chronic conditions to stick to their treatment plans on a HIPAA compliance platform and automated deployments. Using spot instances for the ECS (Elastic Container Service) has been generating a 50% cost reduction on average.

With modern and efficient DevOps-oriented practices, Perx Health can test and release new features to the market, faster. Reducing operational constraints on AWS, the new platform is prepared for a global HIPAA compliant strategy.

At DNX Solutions, we work to bring a better cloud and application experience for digital-native startups in Australia.

Our current focus areas are AWS, Well-Architected Solutions, Containers, ECS, Kubernetes, Continuous Integration/Continuous Delivery and Service Mesh and Data Solutions (movement, transformation, lakes, warehouses and analytics).

We are constantly hiring cloud engineers for our Sydney office, focusing on cloud-native concepts.

Check our open-source projects at and follow us on our Twitter or Linkedin

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