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How BioReference Laboratories Handled a 25x Volume Spike

Adopting Private Cloud deployment allows the lab services giant to scale testing capabilities in the era of COVID-19


Secure access for everyone. But not just anyone.

About BioReference Laboratories

BioReference is at the center of progress for patient care, providing testing and related services to physicians, clinics, hospitals, long-term care facilities, employers, government units, correctional institutions and more. We are a diversified commercial laboratory, humanizing and streamlining the process between data and diagnosis. As the third largest full-service clinical diagnostic laboratory in the US, and with a leading position in genetics, women’s health and cancer, we are advancing the course of modern medicine.

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Since its founding in 1981, BioReference Laboratories, Inc., an OPKO Health company, has been at the forefront of laboratory testing in the United States. However, until recently, customer experience in medical data lagged behind others. BioReference wanted to challenge that status quo, and has spent the past 18 months transitioning from a B2B operation—in which patients had to go through health providers to get test results—to a B2C model, directly connecting patients with the lab.

BioReference’s strategic decision turned out to be very timely, especially given the onset of COVID-19 and all of its horrible ramifications. “With the onset of the pandemic, we experienced an influx of what I’d describe as ‘nontraditional customers’ who aren’t a hospital or a doctor’s office,” says Vinny Pacione, BioReference’s vice president of consumer technology and digital solutions.

BioReference faced an exponential rise in new users who needed a secure and easy way to monitor their test results. To handle this unprecedented spike in demand in the midst of ongoing digital transformation, BioReference turned to its identity and access management (IAM) partner.

“COVID-19 has caused a seven to ten year acceleration in consumer and digital trends.”
Richard Schwabacher
Senior VP for Digital Health & Chief Digital Officer

The Balancing Act of Security and UX

Identity management was at the heart of BioReference’s transition to a more patient-centric model. “Being able to deliver result data to individuals in a self-service way using digital platforms that are scalable and automated was the key problem to solve,” explains Pacione. “And, of course, the most fundamental piece of that is securing that data and making sure that only the individuals who have appropriate access to it can get to it.”

To accomplish these goals, BioReference used Auth0 to create a new patient portal, through which patients could see results, pay bills, and schedule appointments. Before signing with Auth0, BioReference’s patient portal was tied to a provider-facing platform, so patients were dependent on their health care provider to create accounts.

BioReference’s challenge was to streamline user experience while still maintaining HIPAA compliance and protecting user data. Auth0’s customizable Rules helped BioReference meet this challenge by adding an extra layer of identity verification upon account creation. “That’s a call to another third-party system that we then pull into our account creation workflow with Auth0, to enable that step to be completed seamlessly,” Pacione says.

“The most fundamental piece of that is securing that data and making sure that only the individuals who have appropriate access to it can get to it.”
Vinny Pacione
VP of Consumer Technology and Digital Solutions

Facing a 25x Volume Increase

When BioReference implemented Auth0 in 2018, they averaged 8,000 to 9,000 monthly active users. Then came COVID-19, and by April, it was a whopping 148,000. “I don’t think anybody was anticipating a 25x increase in volume overnight,” Pacione says. At the time, BioReference was using Auth0’s public cloud, and according to Pacione, “we were testing the upper limits of the throughput there.”

Worried about the traffic spikes, Pacione reached out to Auth0 for support. “The Auth0 team very graciously jumped in. They sat down side-by-side with our development team and basically went through the entire implementation, top to bottom, and optimized every bit of code that we possibly could to reduce the strain,” Pacione recalls. “And I'm happy to say that we never experienced any downtime due to ongoing volume.”

The experience convinced BioReference to migrate onto Auth0’s Private Cloud to handle the surge in users. Within six weeks, the new system was up and running. “Being in the private cloud gave us the breathing room and bandwidth to not only keep doing things at scale but also build on additional capabilities and customizations,” says Pacione.

“Being in the private cloud gave us the breathing room and bandwidth to not only keep doing things at scale but also build on additional capabilities and customizations.”
Vinny Pacione
VP of Consumer Technology and Digital Solutions

Putting Patients at the Center of Medicine’s Future

“COVID-19 has caused a seven to ten year acceleration in consumer and digital trends,” says Richard Schwabacher, BioReference’s senior VP of digital health and chief digital officer. “Securing, transmitting, and authorizing patient access to health information digitally is now critical to the practice of medicine and core to what is needed from a modern digital health solution.”

With Auth0 as a partner, BioReference is ready to help drive those trends. The company is already seeing the benefits in terms of fewer customer support calls, thanks to Auth0’s self-service capabilities. That’s important because, as Pacione explains, “for every one person that contacts support, there's probably half a dozen more that had the same issue and just gave up.”

Looking ahead, BioReference plans to use Auth0 for more third-party integrations they're developing, to give patients a more holistic view of their health. They’re also implementing multi-factor authentication (MFA) to maintain their focus on their security. Knowing BioReference can trust these issues to Auth0 is a relief to the team. “I don't ever have to worry about security or user access. I have Auth0,” says Pacione.

“I don't ever have to worry about security or user access. I have Auth0.”
Vinny Pacione
VP of Consumer Technology and Digital Solutions

About Auth0

The Auth0 Identity Platform, an independent product unit within Okta, takes a modern approach to identity and enables organizations to provide secure access to any application, for any user. Auth0 is a highly customizable platform that is as simple as development teams want, and as flexible as they need. Safeguarding billions of login transactions each month, Auth0 delivers convenience, privacy, and security so customers can focus on innovation. For more information, visit https://auth0.com.

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Secure access for everyone. But not just anyone.