Case Study
Free Clinics of Iowa
Free Clinics of Iowa is a donor-supported nonprofit and the largest network of free medical clinics in the state. eWay designed, built, and continues to operate the custom EMR platform that powers patient care across more than 30 member clinics.
- Industry
- Healthcare
- Platform
- ASP.NET MVC on Microsoft Azure
- Services
- Custom Application Development + Managed Operations
- Engagement
- Ongoing since 2017
Client Snapshot
About Free Clinics of Iowa
- Founded
- Approximately 1995 (30-year anniversary observed in 2025)
- Scale
- 30+ member clinics across Iowa
- Website
- www.fciowa.org
Everyone deserves access to the healthcare they need. Free Clinics of Iowa guides communities to start clinics and supports their operations through shared resources and expertise, ensuring professional and compassionate health services are available throughout Iowa.
Member clinics serve uninsured and underinsured Iowans across both rural and urban settings, with care delivered entirely by volunteer physicians, nurses, and other health professionals at no cost to patients. Through the years, more clinics have emerged across the state and the network's services have expanded in response to community need.
Beyond direct medical care, the network supports translation in more than 300 languages and electronic prescribing in compliance with Iowa law. The organization is observing its 30-year anniversary in 2025, marking three decades of building healthcare access in the communities that need it most.
The Challenge
A legacy EMR that could no longer carry the network.
Free Clinics of Iowa coordinates a statewide network of volunteer-run free clinics. The platform that holds patient records, manages provider workflows, and supports compliance reporting is the operational backbone of every member clinic.
The original system was built on a legacy stack that no longer met the organization's needs. Browser support was breaking. The application framework could not be patched to current security standards for handling patient health information. Clinic staff needed a modern, user-friendly interface for service providers, and patients needed a self-service way to register and update their information.
For a healthcare nonprofit serving uninsured Iowans, this was not just an operational issue. It was a patient-trust and compliance issue.
What had to change
Aging application framework no longer meeting modern security standards
Browser compatibility issues degrading day-to-day clinic operations
No patient-facing portal for self-registration or information updates
Compliance reporting required manual effort each cycle
No integrated path for the new state e-prescribing mandate
The Solution
Rebuilt the EMR from the ground up. Operating it ever since.
eWay was awarded the contract to modernize the Free Clinics of Iowa platform. We designed and built a new EMR application on a modern stack, deployed it on Microsoft Azure, and have continued to operate and extend it through every regulatory and feature change since 2017.
Rebuilt the EMR from the ground up to manage patient records across the member clinic network
Public-facing site so patients can find a nearby clinic, learn about services, and access information
Patient portal with self-registration for new and returning patients
Reports module for compliance reporting against state and grantor requirements
Integrated e-prescribing through DoseSpot to meet Iowa's electronic prescription mandate
Continuous framework, dependency, and security upgrades operated by eWay on a managed cadence
Architecture
A glimpse of the stack
Application Framework
ASP.NET MVC, N-Tier Architecture
Cloud
Microsoft Azure
Reporting
Telerik Reports for compliance reporting
E-Prescribing
DoseSpot, Surescripts-certified
The Outcome
A modernized platform the network can rely on, year after year.
One platform, statewide
Patient records, provider workflows, and clinic operations are managed through a single eWay-operated platform that serves every member clinic in the network.
Self-service for patients
Patients can register, update their information, find a clinic, and learn about available services through a public site and patient portal designed around their needs.
Compliance reporting without the scramble
A purpose-built reports module replaces manual effort with on-demand reports for state and grantor compliance.
Modern security, continuously maintained
eWay operates framework upgrades, dependency updates, and security patches on a managed cadence, so the platform stays current without the organization needing to staff for it.
The platform has evolved through five major phases since 2017, including the original rebuild, regulatory reporting compliance, e-prescribing integration with DoseSpot, and ongoing framework and security upgrades. Free Clinics of Iowa has not had to rebuild, replatform, or change vendors once during that time. eWay has continued to own the platform end to end.
Common questions about this engagement
What buyers ask before engaging us on a project like Free Clinics of Iowa
What technology platform was used for the rebuild?
The application is built on ASP.NET MVC using an N-Tier architecture, deployed on Microsoft Azure. Reporting uses Telerik Reports. E-prescribing is integrated through DoseSpot, a Surescripts-certified platform. The stack was chosen for security, longevity, and the ability to evolve over a multi-year engagement.
How long has eWay been the platform operator?
Continuously since the original rebuild in 2017. The engagement spans the application redevelopment, compliance reporting work, an e-prescribing integration to meet the Iowa electronic prescription mandate, and ongoing framework and security upgrades. The organization has not had to replatform, rebid, or rebuild the system during that period.
What does eWay actually own day-to-day?
eWay owns the application platform end to end, including infrastructure on Microsoft Azure, application maintenance, framework and dependency upgrades, security patching, and feature additions. New regulatory or operational requirements are scoped, built, and deployed through eWay rather than handed off to a separate vendor.
Why a custom EMR instead of an off-the-shelf product?
Member clinics in the Free Clinics of Iowa network operate under workflows, reporting requirements, and a service model that does not match commercial EMR products designed for revenue-generating clinical settings. A custom platform allowed the network to support the specific patient-population needs of free-clinic care, including statewide reporting, volunteer-driven workflows, and integrations such as DoseSpot for e-prescribing compliance.
How are security and compliance handled over time?
Framework and dependency upgrades, security patching, and platform-level monitoring are operated by eWay on a managed cadence. The platform is built to handle protected health information, and each major phase of the engagement has included security and framework refresh as part of the scope rather than as a separate project.
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