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Modernizing the Healthcare platform with a GraalVM Proof of Value
Imagine a Fortune 5 company, empowering millions of people worldwide with the information, guidance, and
tools to make personal health choices, setting out to work on two parallel streams for modernizing their
HealthCare platform’s Cloud-Native tech stack.
Technical Director, Asia Pacific Center of Excellence.
For the past 16 years, Ali has held technical presales, architect and industry
consulting roles in BEA Systems and Oracle across Asia Pacific, focusing on middleware
and application development. Although he pretends to be Thor, his real areas of
expertise are Application Development, Integration, SOA (Service Oriented Architecture)
and BPM (Business Process Management). An early and worthy Docker and Kubernetes
adopter, Ali also leads a few open source projects (namely terraform-oci-oke) aimed at
facilitating the adoption of Kubernetes and other cloud native technologies on Oracle
Imagine a Fortune 5 company, empowering millions of people worldwide with the information,
guidance, and tools to make personal health choices, setting out to work on two parallel
streams for modernizing their HealthCare platform’s Cloud-Native tech stack.
Stream 1: Existing Microservices comprise Java 8 + Spring + OpenJDK
JIT as JRE, to be containerized in a Hybrid Cloud platform.
Stream 2: New Microservices with Kotlin + SpringBoot + OpenJDK 11 /
GraalVM JIT, to be containerized in a Public Cloud platform.
Tactical Solution — just-in-time with
Lift and Shift Stream 1 from existing Hotspot JIT to GraalVM JIT
Evaluate memory footprint, execution time improvement, and peak throughput with GraalVM
Benchmark Stream 1 with GraalVM JIT vs HotSpot JIT on performance heuristics
Endurance Testing with business-critical Healthcare API for benchmarking
Strategic Solution — ahead-of-time with
Application re-writes are planned and primarily targeted for the Public Cloud Platform
Stream 2 tech stack is being considered with GraalVM Enterprise as an option depending
on the outcome of Stream 1 benchmarking results
Serverless (initial thoughts) has got some excitement for GraalVM’s Native-Image due to
memory footprint and cold-startup optimization
Interoperable healthcare IT enables clinicians to improve care coordinations and ensure that
the information available to view in the healthcare services is part of a practitioners’
In terms of the technology stack, here are some considerations and goals:
Huge employee base, hundreds of APIs, and countless integrations and external systems
Optimize healthcare technology in order to provide a scalable tech infrastructure
Eliminate Local Resource Constraints for Building Cloud-Native Applications
Implement patterns and practices defined by DevOps and Cloud Centre of Excellence
Support for Open Healthcare Standards
HL7 FHIR is a standard for health care data exchange published by HL7 (HL7 and its members
provide a framework for the exchange, integration, sharing, and retrieval of electronic
The CNCF Cloud Native Computing Foundation serves as the vendor-neutral home for many of the
fastest-growing open-source projects
Research and Evaluation Proof of Value
The engineering team identified key Proof-of-Value initiatives to optimize the existing tech
stack with GraalVM without code changes, iteratively running performance loads with
identified heuristics, benchmark observations, and comparisons. Initial performance load on
GraalVM and benchmarking it against conventional JDKs (OpenJDK) for feasibility analysis.
This included two rounds for performance evaluation.
As a leading healthcare company (Fortune #5), the peak season is typically at the start of
the year for all health plans renewables in the US, hence the priority at that time was to
support business peak load in tech frozen state for 1–2 months. This resumed towards the end
of Q1 2021.
GraalVM EE v21.x on JDK8
Actual load runs on Dev Environment Sandbox.
Load Configuration Details:
Concurrency: 100 users
Ramp-up: 4 seconds
Duration: 4 hours, 14400 seconds
The Clinical API was subjected to a medium spike load as part of the warm-up phase and peak
The evaluation results are summarized in the table below. GraalVM performed better than Open
JDK8 in most of the runs and gets better for longer runs.
This collaboration has been mutually beneficial. Specfically, from learning about the
implications of GraalVM in the healthcare domain by optimizing its workflow and improving
patient outcomes and experience.
To learn more and get started with GraalVM, visit https://www.oracle.com/graalvm
Thanks to Pratik Prakash, Senior Member of Engineering at UnitedHealth Group, and Amitpal
Singh Dhillon, Regional Director for Oracle Labs in Asia-Pacific & Japan, for their help
in writing this blog post.