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Waterpark: Transforming Healthcare with Distributed Actors
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Waterpark: Transforming Healthcare with Distributed Actors - Bryan Hunter - NDC Oslo 2025
NDC Conferences
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- Presented by Bryan Hunter
Intermediate. Assumes working knowledge.
5.7K views1 year ago1 recommendation
Distributed systemsProgramming languagesElixir and ErlangSoftware architectureConcurrency and parallelism
Bryan Hunter explains how HCA Healthcare built Project Waterpark, an enterprise integration platform using Elixir and the BEAM virtual machine.
This talk was recorded at NDC Oslo in Oslo, Norway. #ndcoslo #ndcconferences #developer #softwaredeveloper Attend the next NDC conference near you: ndcconferences.com ndcoslo.com/ Subscribe to our YouTube channel and learn every day: / @NDC Follow our Social Media! facebook.com/ndcconferences twitter.com/NDC_Conferences instagram.com/ndc_conferences/ #architecture #functionalprogramming What happens when you design a system to process real-time healthcare data for millions of patients across 185 hospitals—without ever going offline? Enter Project Waterpark, an enterprise integration platform built at HCA Healthcare using the BEAM (Erlang Virtual Machine) and Elixir. Waterpark ensures continuous availability, handles massive concurrency, and powers life-saving interventions by delivering actionable insights in real time. Since going live in 2020, Waterpark has achieved zero downtime—not even a millisecond. It’s a RAM-based system that doesn’t touch disk or use a database, yet it can survive the loss of an entire data center without losing a message. In this session, we’ll explore Waterpark’s architecture, including: + How the distributed actor model represents millions of patients as long-lived digital twins. + The use of consistent hashing and event-driven algorithms for scalability and fault tolerance. + Challenges faced in building a real-time platform for critical healthcare environments. This isn’t just a technical deep-dive. We’ll share how Waterpark’s real-time signals save lives and ease the burden on caregivers, showcasing the profound human impact of thoughtful system design. Whether you’re curious about Elixir, intrigued by distributed computing, or passionate about leveraging technology for good, this talk will leave you inspired to rethink how your systems handle complexity at scale.Why it's here
1 person recommends thisu/bryanhunterin r/elixir • Mentions
On “Elixir in Enterprise Systems”
It’s hard to get more enterprise than this:
link to this video
Waterpark is the enterprise integration platform for a Fortune 100 healthcare company, and it is 100% Elixir.
u/gargar7in r/elixir • Mentions
On “Regrets of using Elixir for production app?”
We just use Erlang clustering. WhatsApp currently uses a full mesh of 50,000 nodes from what I heard recently. Here's a fairly recent talk on our system:
link to this video
u/bryanhunterin r/elixir • Mentions
On “Is Hot Code Swapping still a thing? How do you do zero-downtime deploys?”
Hot code loading is absolutely a thing. I’ve used it in most of the Erlang/Elixir systems I’ve built. Without it the Waterpark system would not have achieved 6 years of zero downtime. You can learn about that here: link to this video including a section on deployments and hot-code loading.
Upgrade releases can be tricky, but single-module BEAM updates on a running distributed systems works and is easy to reason about. If you need to do state upgrades you are likely making things harder than they need to be so re-evaluate what you need the hot code for.
I trust the ErlangVM far more than I trust LLMs. If an LLM agent told me to avoid proven, differentiating features of the BEAM, I’d avoid the LLM ag…