My AWS account install exceeded over 1700 requests in 8 days

Can someone help me understand this? I do not know if this is normal.

I opened an AWS account and installed openEMR 8 days ago. I got an email that I am about to exceed the AWS 12 month free tier of 2000 requests.
This seems a lot of requests since I only been on there a few times.

See image.


Well, that’s how AWS makes their money, they charge for every single disk operation, and it’s why AWS isn’t a viable solution for any medium to large medical group/practice, unless they have very high margins and a huge IT budget.
Remember, every user login and operation you do inside the EMR, may generate dozens of database queries and read/write actions. When you load a patient chart, save data, create/save/alter an encounter, perform an eRX transaction, send a message, run a billing report, etc, all those seemingly trivial things lead to multiple queries across multiple tables. Then include things like opening/viewing documents or patient ID images, it all adds up. Depending on how your database and storage are set up, 2000 requests as defined by AWS won’t go far at all.

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Thanks for the explanation. I understand now. A local install seems more cost effective for my use.

Well, check what the per-request pricing is before you make any firm decisions, you might be looking at an “overrun” of pennies.

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May I ask, to what purpose are you using S3?

If you are going to run OpenEMR in the cloud, I recommend Google Cloud Project (GCP). The Google Console is much more intuitive and I’ve had very few issues with it. I’ve seen some customers rack $2500/month bills using AWS but GCP has a billing tool that lets you estimate how much is being used.

The other cool thing with GCP is it gives advice on how to save money if your server isn’t being used to its full capability. Depending on your usage you can keep your costs between $40 - $250 per month.

Amazon S3 is good for backing up documents but Google also has solutions for that.

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I do not know what S3 is. I just set up on AWS with the instructions provided for Express Plus install.

I got it, if you are planning to use OpenEMR for a small clinic, I suggest to start with a shared service (you will setup an EC2 or virtual server and install MySQL or MariaDB as database and Apache or Nginx as web server).
I can help you to setup your environment for a fee (I am AWS Solutions Architect certified).

Thanks, I appreciate the advice. I will stick my local install for now since I will be saving on hosting fees and also I will not have to get internet for my office for additional savings. My understanding is that I am not able to use a shared service to comply with HIPAA regulations. I might use AWS as an additional place to store backups though as @growlingflea suggested it might be good for.

If you’re curious, Express Plus uses S3 to store patient document backups. See openemr-devops/packages/express_plus at master · openemr/openemr-devops · GitHub for what’s going on in there.

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