OpenEvidence Cost Tuning

OpenEvidence Cost Tuning

Overview

Optimize OpenEvidence API costs while maintaining clinical decision support quality.

Prerequisites

• OpenEvidence billing dashboard access
• Usage metrics configured
• Understanding of pricing model
• Budget authority

Pricing Model Overview

Instructions

Step 1: Usage Tracking & Budgeting

// src/​cost/​usage-tracker.ts
interface UsageBudget {
  dailyQueryLimit: number;
  dailyDeepConsultLimit: number;
  monthlyBudget: number;
  alertThreshold: number; // 0-1
}

interface UsageRecord {
  queries: number;
  deepConsults: number;
  estimatedCost: number;
  period: 'daily' | 'monthly';
}

export class UsageTracker {
  private redis: Redis;
  private budget: UsageBudget;
  private costPerQuery = 0; // Included in subscription
  private costPerDeepConsult = 10; // Example - check actual pricing

  constructor(redis: Redis, budget: UsageBudget) {
    this.redis = redis;
    this.budget = budget;
  }

  async trackQuery(userId: string): Promise<void> {
    const today = new Date().toISOString().split('T')[0];
    const month = today.substring(0, 7);

    await this.redis.hincrby(`usage:daily:${today}`, 'queries', 1);
    await this.redis.hincrby(`usage:daily:${today}`, `user:${userId}:queries`, 1);
    await this.redis.hincrby(`usage:monthly:${month}`, 'queries', 1);

    await this.checkBudgetAlerts(today, month);
  }

  async trackDeepConsult(userId: string): Promise<void> {
    const today = new Date().toISOString().split('T')[0];
    const month = today.substring(0, 7);

    await this.redis.hincrby(`usage:daily:${today}`, 'deepConsults', 1);
    await this.redis.hincrby(`usage:daily:${today}`, `user:${userId}:deepConsults`, 1);
    await this.redis.hincrby(`usage:monthly:${month}`, 'deepConsults', 1);

    await this.checkBudgetAlerts(today, month);
  }

  async canMakeQuery(): Promise<{ allowed: boolean; reason?: string }> {
    const today = new Date().toISOString().split('T')[0];
    const dailyQueries = parseInt(
      await this.redis.hget(`usage:daily:${today}`, 'queries') || '0'
    );

    if (dailyQueries >= this.budget.dailyQueryLimit) {
      return {
        allowed: false,
        reason: `Daily query limit (${this.budget.dailyQueryLimit}) reached`,
      };
    }

    return { allowed: true };
  }

  async canRunDeepConsult(): Promise<{ allowed: boolean; reason?: string }> {
    const today = new Date().toISOString().split('T')[0];
    const dailyDeepConsults = parseInt(
      await this.redis.hget(`usage:daily:${today}`, 'deepConsults') || '0'
    );

    if (dailyDeepConsults >= this.budget.dailyDeepConsultLimit) {
      return {
        allowed: false,
        reason: `Daily DeepConsult limit (${this.budget.dailyDeepConsultLimit}) reached`,
      };
    }

    // Check monthly budget
    const month = today.substring(0, 7);
    const monthlyUsage = await this.getMonthlyUsage(month);
    if (monthlyUsage.estimatedCost >= this.budget.monthlyBudget) {
      return {
        allowed: false,
        reason: `Monthly budget ($${this.budget.monthlyBudget}) reached`,
      };
    }

    return { allowed: true };
  }

  async getMonthlyUsage(month: string): Promise<UsageRecord> {
    const queries = parseInt(
      await this.redis.hget(`usage:monthly:${month}`, 'queries') || '0'
    );
    const deepConsults = parseInt(
      await this.redis.hget(`usage:monthly:${month}`, 'deepConsults') || '0'
    );

    return {
      queries,
      deepConsults,
      estimatedCost: queries * this.costPerQuery + deepConsults * this.costPerDeepConsult,
      period: 'monthly',
    };
  }

  private async checkBudgetAlerts(today: string, month: string): Promise<void> {
    const monthlyUsage = await this.getMonthlyUsage(month);
    const usagePercent = monthlyUsage.estimatedCost / this.budget.monthlyBudget;

    if (usagePercent >= this.budget.alertThreshold) {
      await this.sendBudgetAlert(usagePercent, monthlyUsage);
    }
  }

  private async sendBudgetAlert(percent: number, usage: UsageRecord): Promise<void> {
    // Send alert to admins
    console.warn(`[Budget Alert] ${(percent * 100).toFixed(0)}% of monthly budget used`);
    // Implement notification service call here
  }
}

Step 2: Smart DeepConsult Management

// src/​cost/​deepconsult-optimizer.ts
// DeepConsult costs 100x+ more than regular queries

interface DeepConsultDecision {
  shouldUseDeepConsult: boolean;
  reason: string;
  alternativeApproach?: string;
}

export function shouldUseDeepConsult(
  question: string,
  context: ClinicalContext,
  userTier: 'free' | 'professional' | 'enterprise'
): DeepConsultDecision {
  // Never use DeepConsult for simple questions
  const simplePatterns = [
    /​what is the (dose|dosage)/​i,
    /​half-life of/​i,
    /​contraindications for/​i,
    /​side effects of/​i,
  ];

  if (simplePatterns.some(p => p.test(question))) {
    return {
      shouldUseDeepConsult: false,
      reason: 'Simple question - regular query sufficient',
      alternativeApproach: 'Use standard clinical query',
    };
  }

  // DeepConsult good for complex research
  const complexPatterns = [
    /​compare.*treatments?/​i,
    /​systematic review/​i,
    /​evidence (for|against)/​i,
    /​recent advances/​i,
    /​emerging therapies/​i,
  ];

  if (complexPatterns.some(p => p.test(question))) {
    if (userTier === 'free') {
      return {
        shouldUseDeepConsult: false,
        reason: 'DeepConsult not available for free tier',
        alternativeApproach: 'Upgrade to Professional or run multiple targeted queries',
      };
    }

    return {
      shouldUseDeepConsult: true,
      reason: 'Complex research question benefits from DeepConsult',
    };
  }

  return {
    shouldUseDeepConsult: false,
    reason: 'Standard clinical query recommended',
    alternativeApproach: 'Try regular query first, escalate if insufficient',
  };
}

// Cache DeepConsult results aggressively
const DEEPCONSULT_CACHE_TTL = 7 * 24 * 60 * 60; // 1 week

export async function getCachedOrRunDeepConsult(
  question: string,
  context: ClinicalContext,
  cache: ClinicalQueryCache
): Promise<DeepConsultReport | null> {
  // Check for similar cached reports
  const cacheKey = `deepconsult:${hashQuestion(question, context)}`;
  const cached = await cache.get(cacheKey);

  if (cached) {
    console.log('[Cost] Using cached DeepConsult report');
    return cached;
  }

  return null; // Caller should run DeepConsult and cache result
}

Step 3: User Quotas & Tiering

// src/​cost/​user-quotas.ts
interface UserQuota {
  dailyQueries: number;
  monthlyQueries: number;
  deepConsultsPerMonth: number;
  features: string[];
}

const USER_TIERS: Record<string, UserQuota> = {
  free: {
    dailyQueries: 10,
    monthlyQueries: 100,
    deepConsultsPerMonth: 0,
    features: ['clinical_query'],
  },
  professional: {
    dailyQueries: 100,
    monthlyQueries: 2000,
    deepConsultsPerMonth: 10,
    features: ['clinical_query', 'deepconsult', 'guidelines'],
  },
  enterprise: {
    dailyQueries: 1000,
    monthlyQueries: 30000,
    deepConsultsPerMonth: 100,
    features: ['clinical_query', 'deepconsult', 'guidelines', 'api_access', 'ehr_integration'],
  },
};

export class UserQuotaManager {
  async checkQuota(userId: string, feature: string): Promise<{
    allowed: boolean;
    remaining?: number;
    upgradeMessage?: string;
  }> {
    const user = await db.users.findUnique({ where: { id: userId } });
    const tier = user?.tier || 'free';
    const quota = USER_TIERS[tier];

    if (!quota.features.includes(feature)) {
      return {
        allowed: false,
        upgradeMessage: `${feature} requires Professional tier or higher`,
      };
    }

    const usage = await this.getUserUsage(userId);

    if (feature === 'clinical_query') {
      const remaining = quota.dailyQueries - usage.dailyQueries;
      return {
        allowed: remaining > 0,
        remaining,
        upgradeMessage: remaining <= 0 ? 'Daily query limit reached. Upgrade for more.' : undefined,
      };
    }

    if (feature === 'deepconsult') {
      const remaining = quota.deepConsultsPerMonth - usage.monthlyDeepConsults;
      return {
        allowed: remaining > 0,
        remaining,
        upgradeMessage: remaining <= 0 ? 'Monthly DeepConsult limit reached. Contact sales.' : undefined,
      };
    }

    return { allowed: true };
  }

  private async getUserUsage(userId: string): Promise<any> {
    // Implementation to get user's current usage
    return { dailyQueries: 0, monthlyDeepConsults: 0 };
  }
}

Step 4: Cost Reporting Dashboard

// src/​cost/​reporting.ts
export async function generateCostReport(
  startDate: Date,
  endDate: Date
): Promise<CostReport> {
  // Aggregate usage data
  const usage = await aggregateUsage(startDate, endDate);

  const report: CostReport = {
    period: { start: startDate, end: endDate },
    summary: {
      totalQueries: usage.queries,
      totalDeepConsults: usage.deepConsults,
      estimatedCost: calculateCost(usage),
      costPerQuery: usage.queries > 0 ? calculateCost(usage) / usage.queries : 0,
    },
    breakdown: {
      bySpecialty: usage.bySpecialty,
      byUser: usage.byUser,
      byDay: usage.byDay,
    },
    recommendations: generateRecommendations(usage),
  };

  return report;
}

function generateRecommendations(usage: any): string[] {
  const recommendations: string[] = [];

  // Check for high DeepConsult usage
  if (usage.deepConsults > usage.queries * 0.1) {
    recommendations.push(
      'DeepConsult usage is high. Consider caching results or using regular queries for simpler questions.'
    );
  }

  // Check for low cache hit rate
  if (usage.cacheHitRate < 0.5) {
    recommendations.push(
      'Cache hit rate is low. Review caching strategy and TTL settings.'
    );
  }

  // Check for concentrated usage
  const topUser = Object.entries(usage.byUser)
    .sort((a, b) => (b[1] as number) - (a[1] as number))[0];
  if (topUser && (topUser[1] as number) > usage.queries * 0.5) {
    recommendations.push(
      `User ${topUser[0]} accounts for over 50% of usage. Review for potential optimization.`
    );
  }

  return recommendations;
}

Cost Optimization Checklist

• Usage tracking enabled
• Daily/​monthly budgets set
• Alert thresholds configured
• DeepConsult decision logic in place
• User quotas implemented
• Caching maximized
• Cost reports automated

Output

• Usage tracking and budgeting system
• Smart DeepConsult management
• User quota enforcement
• Cost reporting dashboard
• Optimization recommendations

Error Handling

Resources

• OpenEvidence Pricing
• OpenEvidence API Terms

Next Steps

For architecture best practices, see openevidence-reference-architecture.