BioReference

BioReference Laboratories, Inc., a subsidiary of OPKO Health, is the third-largest full-service clinical diagnostic laboratory in the United States. Specializing in genetics, oncology, women's health, and infectious diseases, BioReference serves a wide range of clients—from hospitals and clinics to government agencies and correctional institutions. To manage over 15 million lab messages annually across a highly customized and distributed environment, BioReference relies on the Iguana Integration Engine.

From Legacy Systems to Iguana

Before Iguana, BioReference's environment was stitched together using a mix of proprietary APIs, FileMaker-based systems, and third-party integration vendors. As the company scaled, these legacy approaches couldn’t keep up with demand or security expectations.

In 2017, BioReference began consolidating its integration architecture—selecting Iguana as the core platform to support its growing network of hospital and EMR connections, including Cerner, Epic, and many others. Iguana was chosen for its:

• Cloud-readiness and strong performance in hybrid Azure/on-prem environments
• Enterprise features like HIPAA-compliant encryption, LDAP user management, and built-in high availability
• Ease of use and rapid deployment, enabling internal teams to move quickly and avoid vendor lock-in

How BioReference Uses Iguana Today

Iguana now acts as the orchestration layer for all lab orders and results:

• Inbound HL7 ORM messages from providers are routed to BioReference's Lab Information System (LIS)
• Outbound HL7 messages provide real-time updates on orders, registration, status, and results
• Over 675 active channels run across BioReference's systems, with Iguana handling message transformation, routing, and monitoring
• The platform supports integrations with over 100 EMRs and hospital systems, reflecting the scale of BioReference's national reach

This streamlined architecture has significantly improved performance, observability, and time-to-integration across EMRs, clinics, and partner systems.

Scaling COVID-19 Testing with Iguana

During the COVID-19 pandemic, Iguana enabled BioReference to expand lab testing and reporting infrastructure at an unprecedented scale.

Working with iNTERFACEWARE, the team:

• Deployed Iguana as a secure API gateway to expose internal ordering systems to hospitals and government partners
• Controlled authentication and access to prevent security risks
• Delivered results for critical partners including the NBA and NHL — powering high-profile testing workflows across the country
• Supported 18-hour turnaround times for COVID test results at peak national demand

This initiative underscored Iguana's agility in supporting urgent healthcare needs and building secure, production-grade APIs in record time.

Ongoing Integration Improvements

Even beyond the pandemic, BioReference continues to evolve its architecture with Iguana. Legacy FileMaker systems are being phased out, and modern Iguana-based integrations now support:

• Real-time web services for external partners
• Centralized monitoring and alerting
• Flexible API-first designs for internal apps and services

These changes have streamlined internal operations, reduced manual effort, and enhanced transparency across technical teams.

Key Results and Business Outcomes

• 20% YoY growth supported through faster integration timelines
• National recognition through secure delivery of COVID results for professional sports leagues
• Improved developer efficiency with reusable channels and centralized management
• Enhanced security through encrypted logging, HA architecture, and LDAP control

As BioReference continues to modernize its infrastructure, Iguana remains a critical enabler — powering secure, scalable data exchange across lab systems, EMRs, and national testing programs. What began as a way to simplify integrations has grown into a strategic foundation for innovation and resilience.