Unifying 200,000+ Healthcare Users Across Japan with Keycloak on Azure
Introduction
By implementing Keycloak SSO on Azure, a major Japanese pharmaceutical company unified authentication across its 2M+ user application ecosystem and launched an e-pharmacy platform serving 750+ pharmacies nationwide. The platform onboarded 200,000+ users in four years with 30,000+ mobile app installations, significantly reducing wait times and improving accessibility for aging populations and remote communities while ensuring strict regulatory compliance.
Challenge: Scaling Pharmacy Services for an Aging Population While Meeting Strict Compliance Standards
Japan’s aging population has driven a surge in demand for pharmacy services, with pharmacies managing significantly increased patient volumes and prescriptions. The pharmaceutical company faced multiple technical and operational challenges in delivering accessible healthcare services across their application ecosystem. Accessibility presented a major challenge, particularly for individuals living in remote areas where geographic and infrastructural limitations restricted their ability to access essential medications and consultations. Lengthy waiting times at pharmacies affected both patient satisfaction and operational efficiency, creating a pressing need for digital alternatives. From a technical perspective, the company needed to develop an online video consultation platform with multiple payment options that would be easy to use across web, desktop, and mobile applications. The solution needed to adhere to Japanese government security standards while offering a user-friendly experience regardless of the user’s location or device.
Projects used
By the numbers
2M+
users across unified application ecosystem
200,000+
users onboarded in four years
30,000+
installations of native mobile applications
Solution: How Keycloak Secured 2M+ user logins
To address these challenges, the company implemented Keycloak as a centralized identity and access management solution. Keycloak enabled seamless Single Sign-On (SSO) across web, desktop, and native applications, allowing users to log in once and access all applications without re-entering credentials. This approach heightened security, enhanced user experience by reducing password fatigue, and ensured full compliance with Japanese government security regulations, including Multi-Factor Authentication and strict data privacy standards.
For existing users, a careful migration process transferred user data into Keycloak while establishing links between legacy records and the new authentication system, ensuring continuity of service for long-standing customers without disrupting their access. For new users, the process was streamlined; upon account creation in Keycloak, additional registration steps within the application gathered all information relevant to the pharmacy platform, enhancing personalization and security of user profiles. Consolidating all user data in one centralized location simplified administration and enabled more effective analysis of user behavior.
The solution leveraged a robust cloud architecture utilizing Azure to support web applications, desktop applications, native apps, and backend services. For system development, NodeJS was utilized on both frontend (Web App) and backend, reducing context switching and improving developer productivity. Azure Function App’s support for NodeJS further enhanced development and deployment capabilities.
To meet business requirements for supporting iOS and Android with near-native app performance and faster release to production, the team selected a Flutter framework for mobile development, enabling high-performance applications with faster release cycles. In order to ensure seamless management of user lifecycle events, the solution addressed user unsubscription through Azure Service Bus integration. Whenever a user unsubscribed, whether via Keycloak or the application system, Azure Service Bus orchestrated the deletion of corresponding user data across all relevant databases. This automated process safeguarded data privacy and compliance while maintaining data integrity by promptly removing access and personal records.
Impact: 30,000+ Installations, 400+ Weekly Video Calls, Millions Served
The platform has become a vital time-saving solution, particularly for aging individuals and working mothers balancing childcare responsibilities, delivering improved access to pharmacy services and reducing waiting times. Supported by over 750 pharmacies and more than 4,000 pharmacists logging in daily, the system demonstrates impressive scalability, evidenced by over 30,000 native app installations and more than 400 weekly video calls; efficiently managing increased patient and prescription volumes.
“Keycloak delivered a unified identity platform, enforcing consistent login states across web and native channels while centralizing MFA, token lifecycle management, and realm-level policies—strengthening security and ensuring a frictionless authentication experience across all client applications.”
Senior Consultant, Infosys Ltd. Client
The adoption of e-pharmacy services continues to accelerate, welcoming more than 200,000 users in four years and achieving notable improvements in customer satisfaction. By providing seamless availability across both web and native applications, the solution has enhanced user experience and facilitated smoother navigation within the client’s broader application ecosystem, which now serves over 2 million users. The team successfully integrated three external systems, including the national electronic prescription system, while deploying Single Sign-On through Keycloak across all client applications, ensuring both regulatory compliance and seamless access for patients and pharmacists alike.
“Adopting Keycloak de-risked our growth by providing standards-based authentication for 2M+ users, streamlining logins across multiple client apps, and ensuring compliance with Japan’s strict health-data security laws—helping us avoid penalties of up to USD 660,000 for breaches while accelerating e-pharmacy feature delivery.”
Senior Project Manager, Infosys Ltd. Client
Key Impacts Include:
- 750+ pharmacies supported across all 47 prefectures in Japan
- 4,000+ pharmacists logging in daily to serve patients
- 30,000+ native app installations demonstrating strong user adoption
- 400+ weekly video calls enabling remote medication guidance and consultation
- 200,000+ users onboarded over four years with continued growth in e-pharmacy service adoption
- 2M+ users served across the unified application ecosystem with smooth navigation to e-pharmacy platform
- 3 external systems integrated, including the national electronic prescription system
- Enhanced accessibility for individuals in remote areas through online video consultation platform
- Reduced waiting times at pharmacies
- Improved operational efficiency managing increased patient and prescription volumes
- Full compliance with Japanese government security regulations
- Simplified user experience with Single Sign-On
- Secure and scalable environment supporting multiple payment options and integration with existing pharmacy systems