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What Should You Choose Between Microservices and Monolithic as Healthcare App Architecture?

To align itself with newly emerged market possibilities, healthcare apps have evolved greatly.

While the change is largely unnoticeable to every user, a lot happens on the backend of the new-age healthcare apps that deliver remarkable experiences.

Be it tech stack, performance, features, and architecture, the current versions of healthcare apps have very rare similarities with healthcare apps that used to be developed 5 years ago.

So, in this blog, we will discuss the two major healthcare app architecture models or practices – Microservices Vs. Monolithic which somewhere defines the success of your healthcare app.

Not only this but since the app architecture you select for your healthcare app largely influences the operating and developing cost of your app, you must have basic knowledge of it before approaching a company to build your dream healthcare project.

What is Healthcare App Architecture?

To understand it, you need to know how a healthcare app is built.

A healthcare app is made out of multiple services or modules.

These modules are generally divided into frontend and backend.

There is a database too.

For example, if you are building a telemedicine app, there must be frontend and backend modules or services for video calling, ePrescription, payment, appointment booking, etc.

Frontend generally deals with the user interface of app modules whereas backend deals with the business logic of app modules and a database.

To have a working app, you must interconnect all of these modules or put these modules together and deploy them on the server.

So, the pattern, practice, or architecture you follow to put these modules together with regards to how it processes the user request is called healthcare app architecture.

Based on the way you put these app modules together to later deploy on the server, there are major microservices and monolithic architecture.

Healthcare App Architecture Vs. Healthcare App Tech Stack

Several healthcare entrepreneurs lacking technical knowledge find themselves confused between healthcare app architecture and healthcare app tech stack.

Though both are crucial elements of successful healthcare app development, both are very different things.

Healthcare app architecture is more focused on defining how different app modules are bundled together to deploy on the cloud or server.

Whereas, the healthcare app tech stack is more focused on technologies that are used to build those app modules.

Tech stack generally includes programming languages, frameworks, APIs, 3rd party platforms, databases, cloud, OS, etc.

Monolithic Architecture for Your Healthcare App: The Working, Pros & Cons, and the Best Time to Choose It

Monolithic architecture is one of the traditional ways to build a mobile app.

It is like putting all eggs into one basket!

Here, ‘mono’ means single and ‘lithic’ means stone.

Thus, monolithic means one giant rock, box, or container which contains everything of your application.

But with the rising complexity of mobile apps, monolithic architecture somewhere fails to meet performance and scalability requirements.

A monolithic app does have all modules built and bundled as a single unit.

In other words, all modules of the monolithic app are tightly coupled to each other or have very high dependencies on each other.

By saying tightly coupled, what we are trying to say is, every module of the app resides in a single instance of the server.

As you can see from the following diagram, all modules of the telemedicine app are bundled together and placed together in a tightly coupled manner as a single codebase and use the same database even though they have different functionalities.


Since everything is interconnected and tightly coupled, you need to either update the entire stack with access to the entire codebase in order to make changes in one of its modules or you cannot update any module ever.

For example, if you want to update the payment module of the app, you need to have access to the entire app’s codebase and need to redeploy the app as a whole after making changes in the payment module.

The worst part is that when you are updating the payment module, the performance of all other modules also gets affected as nothing works independently, everything is a single unit.

For basic applications, monolithic architecture works best as everything can be deployed at once in a single shot and can also be managed with ease.

But for applications that are complex in nature and demand extreme performance and scalability, monolithic architecture is not an answer because of the lack of individual scaling and flexibility.

Pros of Choosing Monolithic Architecture for Your Next Healthcare Application

Monolithic architecture offers some significant advantages.

However, these advantages sometimes result in technical debt in the long term.

  • Easy development of applications:

The learning curve of building monolithic applications is very low.

Since everything is supposed to be bundled in a single unit with a single database, it is very easy for developers to build the app from scratch, and for new developers too, it is very easy to understand the structure of the app and carry it forward.

  • Easy testing of the applications:

You test one single codebase with clear expectations.

There is nothing easier than this!

  • Simplicity in deployment:

In monolithic healthcare apps, the backend, frontend, and database, all are bundled and deployed on the server as a single deployment unit.

Since everything exists and changes in one place, it is easy to identify the errors during deployment and if there is a need for redeployment, all you have to do is redeploy the entire codebase as a whole.

  • Affordability in the early stage of application:

Nothing needs to be handled individually.

The entire source code is available in a single unit and is deployed at once.

This reduces resource requirements and the possibility of errors that would add more hours to billing.

Cons of Choosing Monolithic Architecture for Your Next Healthcare Application:

Monolithic architecture has several limitations that matter the most in the era when apps are known for their performance and scalability!

  • Development takes time:

Since there is one single code base, with every small change even in a single app module, you need to test the entire codebase as everything is tightly coupled and a small change in a single module can influence the code of other modules too.

Such a limitation makes overall app development velocity very slow.

Additionally, you cannot implement CI/CD practices as either you build the app as a whole or you build none.

Because, in a monolithic application, you cannot take out one particular module of the app and try to make changes to it.

  • App updates take time:

The application appears too large as all modules of the app are loaded together.

Because of this, it takes time for developers to fully understand the business logic, update a single app module, test the entire codebase, and redeploy the codebase as a whole.

This represents how complex it is to update the monolithic application and make it workable again.

  • Slow performance:

The server has to process the entire code base to satisfy one single request of the user.

For example, if a user makes a request for appointment booking, the server has only the option to process the entire codebase which contains all modules like ePrescription, and video calling which do not have anything to do with appointment booking.

This slows down the response time and offers awful app performance.

  • Poor scalability:

This is a major limitation of a monolithic application.

To scale up the application to accommodate the rising number of users, you cannot scale up individual modules of the app.

Instead, you need to scale up the entire application which is both a time-consuming and a costly affair.

  • Single point of failure:

Since you are putting all of your eggs into one basket, if you lose your basket, you will lose all of your eggs!

In our case, if the server somehow fails, your entire application will stop working!

And in the worst case, an issue with a single app module of the app can bring down the entire application.

Best Time to Choose Monolithic Architecture for Your Healthcare App

Monolithic is not bad in all cases.

It varies from business to business.

So, it is advisable to not completely disregard the monolithic architecture.

Make rational decisions based on facts and your requirements.

The following are the scenarios when monolithic architecture can do wonders for your healthcare app.

  • When there is only one developer or a very small team of developers working on your healthcare app development project.
  • When the nature of your application is very simple and serves a very basic use case.
  • When you are building an application for internal use or for a limited number of users where advanced performance and scalability are not what you are looking for.
  • If you are only ready to spend limited upfront costs, go for a monolithic application as it is more affordable to build.

However, in the future, if you need to scale up your application or update it, you will end up investing more.

So, decide today based on your future goals!

Microservices Architecture for Your Healthcare App: The Working, Pros & Cons, and the Best Time to Choose It

So now when you know everything about monolithic architecture, let us explain microservices architecture by comparing it with the former one.

Unlike monolithic architecture, you are not putting all eggs into a single basket when it comes to microservices.

Instead, what you do is, break down your entire application into small services and these services have very less dependencies on each other or are very loosely coupled.

That does not mean that these services cannot interact with each other.

Yes, they can interact with each other but they work as independent services.

As you can see in the following image, some different services or modules are deployed separately with separate databases.


Since every module is deployed separately, it is important to route user requests to related services/modules.

For example, if a user is requesting for appointment booking, his/her user request must be sent to the appointment booking module of the app.

And here is where API Gateway comes into the picture.

It acts as an entry point.

It understands the type of user request and based on it, it routes that request to a particular service or module which is supposed to process that request.

Pros of Choosing Microservices Architecture for Your Next Healthcare Application

All big brands like Netflix, Amazon, and Uber have opted-in for microservices architecture due to the following reasons.

  • Extreme flexibility and agility:

Since in the case of microservices, different modules of the application work independently, you can upgrade a single module of the application while the rest of the application works as it is.

For example, while the video calling service or module is being upgraded, users can still use the application to book the appointment and make payment because these modules have nothing to do with the video calling module which is currently being upgraded from the backend.

This is the beauty of microservices as having such a level of flexibility matters the most in an agile business environment!

  • Faster development and testing:

When you are following microservices architecture, it is seamless for you to implement independent development and testing of the modules as these modules are ultimately going to be deployed separately – the way it is currently being developed and tested!

This enables a development team to branch out into multiple teams and work on different modules at the same time which eventually makes development faster even for complex applications!

  • Performance and scalability:

Since every module or service of the application is very isolated, working independently, processing specific requests to each service/module, and having its own separate database, very high performance of the application can be easily achieved.

And talking about its scalability, you can effortlessly take out and scale up each module separately.

You can avoid unnecessary efforts and development costs in scaling up the application!

  • Flexible technology stack:

Microservices application delivers flexibility in the technology stack as well.

For different modules of the application, you can use different technologies as each module of the app works independently.

For example, you can use Vue.js for the appointment booking module and React.js for the video calling module.

Such flexibility is important to achieve maximum performance and usability of the application by choosing a tech stack based on the nature of each business process.

  • Error isolation:

Unlike monolithic architecture, an error in one module of the app does not affect the entire application when the app is working on microservices architecture.

The reason is pretty simple:

Since every module of the app works independently with its database, it works the same way even while other modules of the application are having errors and facing downtime.

Cons of Choosing Microservices Architecture for Your Next Healthcare Application

In the world of technology, everything has its limitations.

Nothing serves all available purposes.

  • Complexity:

Building a microservices application is very complex.

A very well-versed app architect must play his/her role extremely well to prepare the app architecture that works perfectly as per the requirements.

Later, the applications must be built, tested, and deployed with precision as there are multiple instances that all need to work without errors.

Not only this but managing the microservices applications is also very complex as you always need to have an eagle eye on what and where errors are popping up.

You need to deploy some automation solutions for that.

So, overall, a big team is required to successfully architect, build, deploy, and monitor the microservices application.

  • Consistency:

Several times, two services or modules of the application need to work together to process a single requirement of the users.

For example, both ePrescription and video calling modules must work in perfect rhythm while the doctor is writing ePrescription and at the same time, having a video call with a patient.

During such an event, the extreme level of synchronization or consistency between these two modules and their databases is inevitable.

Best Time to Choose Microservices Architecture for Your Healthcare App

Out of our 100 developed healthcare apps, we have selected microservices architecture for almost 68 applications under the following scenarios.

  • When the nature of the application is very complex.
  • When it is estimated that the app will have more users in the future as it is serving a larger industry and multiple regions.
  • When the client has the plan to make frequent updates to the live app in order to cope with ever-changing market demands.
  • When there is an unavoidable requirement to use multiple tech stacks for building a single application.
  • When the app category belongs to an overly intensified market where app performance is one of the major factors that define the success of the app.
  • When we are building very innovative apps which need to have agility and flexibility!

Sit, relax, and Witness Your Dream Healthcare Project Taking Shape!

Under a pro team of healthcare CTOs, developers, app architects, and DevOps engineers.

We’re an Ontario-based healthcare IT company.

It has been 8+ years since we have been dealing with healthcare apps and software development 8 hours a day for 5 days a week.

Being a healthcare-specific IT company, we think, talk, discuss, execute, and brainstorm only healthcare IT.

Such a level of madness over healthcare helps our healthcare clients to accomplish the impossible with modern healthcare solutions.

Whether you want to migrate your healthcare app from monolithic to microservices architecture or build one fresh app or software from scratch, we have experts, experience, and expertise.

Our developers are known for bringing American standards of innovation and Canadian standards of quality into whatever we build.

So, let’s have clear conversations about your healthcare app vision and how we can make you see it coming to life – with our deadly passion for healthcare excellence and innovation!