DrFirst operates the nation's largest medication management network, routing prescriptions and clinical data between 420,000 prescribers, 71,000 pharmacies, 270 EHR systems, and 2,000+ hospitals serving over 100 million patients annually across the U.S. and Canada. The threat model is straightforward: medication data flows across fragmented systems where errors, delays, and coordination failures directly impact patient safety. The company's products - Rcopia for e-prescribing and medication history verification, and Backline for secure clinical communications - sit at critical integration points where PHI crosses organizational boundaries and regulatory domains.
The infrastructure runs on AWS with Spring Boot microservices, PostgreSQL/Aurora databases, and Apache Kafka for event streaming, monitored via AppDynamics and Grafana. The stack handles real-time prescription routing and prior authorization workflows while maintaining HL7 and FHIR interoperability standards. Security operates under HIPAA requirements with data moving between hospital systems, pharmacy networks, and ambulatory EHRs - each with distinct access controls, audit requirements, and compliance postures.
Founded in 2000 and headquartered in Rockville, Maryland, the team includes engineers alongside clinicians and healthcare domain experts. The technical challenge isn't just scale but correctness: prescription errors, authorization delays, and care coordination gaps have direct clinical consequences. The work involves securing data pipelines across heterogeneous healthcare IT environments, managing identity and access across organizational boundaries, and maintaining system integrity where downtime or data corruption affects patient care delivery.
