Modernizing a 20-Year-Old Healthcare Accreditation Platform Without Disrupting Critical Operations

Our client accredits the organizations that provide continuing education to healthcare professionals across the United States, spanning medicine, pharmacy, nursing, and related fields. At the center of that work is a reporting platform used by accredited providers to submit activity and learner credit data, which flows out to licensing boards, certifying bodies, and credit tracking services.

The client set a goal of reaching more than 80 percent of learner data reported into the platform by 2026. Reaching that target required making data submission easier and more reliable for accredited providers and the learning management systems they use.

Foxbox joined the client's engineering organization to provide senior architecture and engineering expertise, working alongside its existing technical team and under the direction of its product leadership.

The Challenge

The platform's architecture dated back over 20 years. It ran on Azure but predated cloud native practices. Its APIs used XML based protocols from an earlier generation of web services, and the system was built around SQL Server as its conceptual center. For a platform meant to connect providers, learning management systems, and boards, aging interfaces limited what every connected system could do.

The harder problem was the business itself. Accreditation involves layers of validation and specialized rules accumulated over two decades. Modernization could not simply replace old technology with new technology. It had to preserve two decades of accumulated behavior because providers, boards, and healthcare professionals depended on the platform producing predictable results.

A Consultative Approach

With a system this established, architectural change had to be justified rather than assumed. For each major decision, our Senior Architect and engineering team presented the available approaches, industry patterns, tradeoffs, operational implications, and risks.The client made informed choices and kept ownership of the direction, with enough context to continue evolving the system after the engagement.

The same applied to new components. When we proposed Azure Functions, which the client had never run in their environment, we walked through the purpose, setup, pricing, and the specific reasons it fit their platform.

We also proved concepts before introducing them into production. In one case, we created a parallel process that observed existing API traffic, collected metrics, and generated reporting without affecting the production execution path. The approach let the client evaluate a new architectural pattern with effectively no operational risk before deciding whether to adopt it more broadly.

The Work

API modernization

We began transforming the platform's legacy XML based interfaces to REST and JSON. This was the core of the engagement: providers, learning management systems, and downstream boards all interact with the platform through these interfaces, and modernizing them supports the kind of easy, error free integrations the client set out to achieve, while preserving compatibility for providers who rely on existing submission methods.

Improvements to existing integrations and tooling

We also made targeted improvements to the platform's existing integrations and internal tools, including an updated error handling system implemented in both the modernized API and the client's legacy systems. Clearer, more consistent error handling means providers and partners can diagnose failed submissions faster, with less support burden on the client's team.

Cloud native architecture

We introduced serverless components through Azure Functions and brought a more event oriented approach to targeted layers of the architecture, establishing patterns the client's team can extend as the platform evolves.

Behavioral parity

Replacing an API is straightforward compared with reproducing 20 years of undocumented business behavior. We worked closely with the client's team to identify implicit rules, capture edge cases, expand test coverage, and verify that the modernized services produced the same business outcomes as the legacy platform. As previously undocumented behaviors surfaced, we incorporated them without destabilizing the migration.

Agentic development, introduced deliberately.

The client was initially cautious about AI-assisted development, so we introduced it first in bounded areas such as code analysis, test generation, and targeted refactoring. AI-assisted changes remained subject to the same engineering conventions, code review, and testing requirements as any other contribution. As confidence grew, these tools became part of the team's regular development workflow, helping engineers navigate the legacy codebase and accelerate well-defined implementation work.

The Results

The modernized services reached production while existing provider workflows continued operating uninterrupted. The client now has REST/JSON interfaces alongside its legacy submission mechanisms, more consistent error handling across both generations of the platform, reusable Azure Functions patterns, and documented behavioral rules that were previously known primarily through institutional knowledge.

The work also changed Foxbox's role within the organization. What began as a larger proposed delivery team ultimately evolved into a highly embedded engineering relationship, with a Foxbox engineer working directly within the applications team and trusted to identify issues, propose solutions, and contribute to the ongoing modernization of the platform.

Our Experience in Healthcare

Healthcare modernization requires more than replacing legacy technology. Systems often encode years of regulatory requirements, operational workflows, partner dependencies, and business rules that cannot simply be redesigned away.

Foxbox has worked with healthcare organizations including K Health and Anthem across platform modernization, interoperability, AI-enabled products, mobile applications, and regulated data environments. That experience helps our teams modernize critical systems incrementally while maintaining the reliability, security, and operational continuity healthcare organizations require.