Building a Compliance-Ready Cloud: Zivian Health’s AWS to Azure Migration

Zivian Health’s compliance tracking platform is at the heart of its business, ensuring Advanced Practice Providers (APPs) and clinics remain licensed and operational across multiple U.S. states. Each compliance document and regulatory record must be accurate, traceable, and fully aligned with state-specific requirements.

Before this project, the company faced several structural bottlenecks:

• Legacy cloud environment: Containerized workloads were running on AWS ECS, but the customer lacked a clear end-to-end migration strategy to Azure, introducing high risk of downtime during the transition.
• Supporting service dependencies : Core services for file processing needed to be re-architected for Azure equivalents without disrupting operations.
• Operational inefficiencies: The legacy setup demanded manual oversight for compliance-critical workflows, limiting scalability and slowing delivery of new features.
• Performance and cost challenges: Maintaining high availability, security, and observability in the old architecture was increasingly expensive and resource-heavy.
• Client dissatisfaction: Delayed feature releases and an outdated user experience further heightened the pressure to modernize the platform.

Operationally, Zivian Health was at a crossroads: the platform needed to scale while remaining compliant, stable, and cost-efficient. Strategically, the inability to migrate smoothly and deliver updates faster risked client trust and limited growth opportunities in the competitive healthcare SaaS market.

We treated this as a full-scale cloud migration and modernization, ensuring zero disruption, compliance, and cost efficiency from the start.

Step 1: Platform & Containers
We began by designing a new architecture on Azure Container Apps, tailored for scalability and high availability:

• Rebuilt containerized workloads previously hosted on AWS ECS.
• Adopted a scale-to-zero approach to reduce costs during idle periods.
• Implemented Terraform-based Infrastructure as Code (IaC) for reproducible, reviewable, and environment-aware deployments.

Step 2: Observability & Operations
To match and improve upon AWS CloudWatch, we introduced enhanced monitoring:

• Integrated Azure Monitor and Log Analytics for real-time metrics, logs, alerts, and dashboards.
• Created structured runbooks and health checks for pre- and post-cutover verification, ensuring stability during migration.

Step 3: Storage & Event Processing
Critical workloads relying on AWS S3 and Lambda were re-engineered for Azure:

• Migrated object storage to Azure Blob Storage, maintaining lifecycle compatibility and secure access via SAS + RBAC.
• Rewrote the Lambda function as an Azure Function, preserving business logic and ensuring idempotency.
• Centralized all secrets in Azure Key Vault to enhance security and simplify configuration management.

Step 4: DNS & Traffic Management
We executed a near-zero downtime migration of DNS services:

• Transferred zones from Amazon Route 53 to Azure DNS.
• Reduced TTLs and staged NS updates to ensure a seamless cutover.
• Where global routing was required, we evaluated Azure Front Door and Traffic Manager to replicate Route 53’s health checks and policies.

Step 5: Security & Governance
Security controls were rebuilt to align with compliance requirements:

• Translated AWS IAM policies into Azure RBAC with strict least-privilege enforcement.
• Enforced network segmentation with private endpoints for Blob and Key Vault.
• Activated Defender for Cloud baseline policies for continuous compliance monitoring.

Step 6: Migration Strategy & Cutover
We minimized downtime through careful execution:

• Performed incremental data syncs, followed by a final delta sync during a controlled maintenance window.
• Ran parity tests functional, load, and failover before decommissioning AWS resources.

Provider Experience: Migration as a Catalyst for Modernization

For Zivian Health, the transition to Azure was not simply an infrastructure project , it was a strategic investment in the future of their platform. Migration set the foundation, but modernization reshaped the way providers interact with the platform.

• Streamlined product experience: A unified interface reduced complexity for providers and administrators, lowering support needs and increasing adoption rates.
• Faster innovation cycles: Moving from Angular to React enabled quicker releases and the ability to respond to customer demands with greater agility.
• Operational resilience: Automated compliance updates replaced manual processes, minimizing human error and ensuring uninterrupted service delivery.
• Scalable cost model: Elastic workloads on Azure optimized resource consumption, cutting operational expenses while maintaining enterprise-grade performance.

Through this dual focus on migration and modernization, Zivian Health redefined its role in the healthcare SaaS market: from a compliance tool to a modern operations platform.

Outcome

Dedicatted took end-to-end responsibility for Zivian Health’s migration and modernization journey – delivering a seamless transition from AWS to Azure without disrupting the clinicians and administrators who rely on the platform every day.

1. Seamless migration of all containerized workloads from AWS ECS to Azure Container Apps with near-zero downtime.
2. Smooth transition of supporting services: Route 53 to Azure DNS, S3 to Azure Blob Storage, and AWS Lambda to Azure Functions, without breaking workflows.
3. Stronger compliance posture with centralized secrets in Azure Key Vault and governance policies aligned with HIPAA and HITRUST standards.
4. Reduced operational drag through Terraform-based Infrastructure as Code, making deployments faster, safer, and repeatable.
5. Future-proof security with Azure RBAC, private endpoints, and Defender for Cloud baseline policies.