Welcome!

Microservices Expo Authors: Stackify Blog, Aruna Ravichandran, Dalibor Siroky, Kevin Jackson, PagerDuty Blog

Related Topics: @CloudExpo, Java IoT, Microservices Expo, Containers Expo Blog, Agile Computing, @DXWorldExpo

@CloudExpo: Article

Healthcare IT and the Cloud

Moving healthcare data into a Cloud Ecosytem

Over the last few weeks I've been hearing a lot of discussion around HIPAA. When we speak about HIPAA, invariably the two components of data security and data privacy arises.

In the traditional data centers, database managers and data owners know where their data resides and implement the necessary processes to preserve privacy and audit access.

However, when we move to the cloud, the cloud being all about data, we are looking at servers, network, and storage that are abstracted. This raises concern that data owners may not necessarily know where their data sets physically reside and we are looking at Cloud Service Provider (CSP) employees who will be handling confidential patient data or Personally Identifiable Information (PII).

Of importance here is that when it comes to leveraging the cloud ecosystem for healthcare segments, the foremost concerns are around HIPAA and the  HITECH Act compliance capabilities and meaningful use provisions.

So what is meaningful use? According to HealthIT.gov

"Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria."

The goal of meaningful use is to promote the spread of Electronic Health Records (EHR) to improve health care in the United States.

Benefits of meaningful use of EHRs include:

  • Complete and accurate information.
  • Better access to information.
  • Patient empowerment.

In the healthcare world, organizations are positioning to attain meaningful use. This to capture the incentives allocated by the Federal Government as well as to ensure that reimbursements do not face jeopardy for providers not in line with the meaningful use provisions.

As healthcare practitioners and organizations increase the use of technology solutions in delivering clinical care, their IT departments are faced with additional stress to provide availability on demand and operate data center approaching 99.999 percent availability. In most cases this is a major challenge that can lead to the risk of unscheduled outages and costly solutions.

Assuring high availability for healthcare applications, means meeting uptime requirements; and in today's environments will require access to more than one data center. This can significantly impact the overall capital investment in data center infrastructure for healthcare organizations.

Looking to the cloud as a solution is not only the next step in services but will ensure high availability of clinical applications. This will allow a healthcare organization to leverage the expertise and financial stability of an established CSP. Another advantage of leveraging a cloud ecosystem, is that of rapid provisioning and deployment, with the ability to change compute capacity as demand changes.

Thus in the event of failure, server instances can be seamlessly moved to alternate hosts or in anticipation can be clustered to provide redundancy.

Some may ask whether it is risky to transfer data from site to cloud. The answer is no as a majority of organizations move data over the Internet via encryption channels. Where we can see concerns arising is with the hand-off of data into the (CSP) environment.

In a seamless environment all data will have site to site encryption up to and including storage. Where we can see some separation is with healthcare application vendors support.

In the cloud, it is a given that we can have a number of people with access to the physical servers and storage that cloud consumers have no control over. For an IT Security person this will elicit conflicting concerns as on one hand there is the presupposition that complete control is being relinquished which can only be assured with prescriptive precautions defined by a CSP.

The cloud computing ecosystem is still evolving and as such there is still a lack of industry-wide certifications. As we mature within this ecosystem the intent is to drive toward processes, best practices and certifications which would provide legal protection that can reduce the complexities of a long negotiation and complex SLA requirements.

Within a regular data center or even a small IT shop, as an IT Security leader one of my first expectation for any shop is some form of centralized logging with automation. Similarly by transferring such a mindset into the cloud ecosystem (they are after datacenters) any healthcare customer security leaders expect the assurance that detailed reporting is a given.

Having worked on the security strategy and assessment separately for a few cloud computing projects I have seen first-hand, that access rights was a major focus. In light of this, it is not a complex process to segment solutions for healthcare. As a result any access to servers and storage dedicated to a healthcare customer by anyone within a CSP organization will be logged and thus can provide the assurance of controls around access.

From a legal perspective, more specifically talking contracts, healthcare customers expect the provisions of strong financial penalties to indemnify against a breech as well as to hold the CSP accountable.

Some CSPs are moving to providing a HIPAA Business Associate Agreement (BAA) for their healthcare customers. The assurance provided by their BAA demonstrates meeting the compliance requirements (enabling the physical, technical, and administrative safeguards required) of the HIPAA and the HITECH Acts.

In closing, I will state that HIPPA compliance and cloud computing do not have to be in conflict. Rather healthcare entities can leverage the benefits of the cloud, coupled with the necessary due diligence and legal contracts to meet their needs.

More Stories By Jon Shende

Jon RG Shende is an executive with over 18 years of industry experience. He commenced his career, in the medical arena, then moved into the Oil and Gas environment where he was introduced to SCADA and network technologies,also becoming certified in Industrial Pump and Valve repairs. Jon gained global experience over his career working within several verticals to include pharma, medical sales and marketing services as well as within the technology services environment, eventually becoming the youngest VP of an international enterprise. He is a graduate of the University of Oxford, holds a Masters certificate in Business Administration, as well as an MSc in IT Security, specializing in Computer Crime and Forensics with a thesis on security in the Cloud. Jon, well versed with the technology startup and mid sized venture ecosystems, has contributed at the C and Senior Director level for former clients. As an IT Security Executive, Jon has experience with Virtualization,Strategy, Governance,Risk Management, Continuity and Compliance. He was an early adopter of web-services, web-based tools and successfully beta tested a remote assistance and support software for a major telecom. Within the realm of sales, marketing and business development, Jon earned commendations for turnaround strategies within the services and pharma industry. For one pharma contract he was responsibe for bringing low performing districts up to number 1 rankings for consecutive quarters; as well as outperforming quotas from 125% up to 314%. Part of this was achieved by working closely with sales and marketing teams to ensure message and product placement were on point. Professionally he is a Fellow of the BCS Chartered Institute for IT, an HITRUST Certified CSF Practitioner and holds the CITP and CRISC certifications.Jon Shende currently works as a Senior Director for a CSP. A recognised thought Leader, Jon has been invited to speak for the SANs Institute, has spoken at Cloud Expo in New York as well as sat on a panel at Cloud Expo Santa Clara, and has been an Ernst and Young CPE conference speaker. His personal blog is located at http://jonshende.blogspot.com/view/magazine "We are what we repeatedly do. Excellence, therefore, is not an act, but a habit."

@MicroservicesExpo Stories
How is DevOps going within your organization? If you need some help measuring just how well it is going, we have prepared a list of some key DevOps metrics to track. These metrics can help you understand how your team is doing over time. The word DevOps means different things to different people. Some say it a culture and every vendor in the industry claims that their tools help with DevOps. Depending on how you define DevOps, some of these metrics may matter more or less to you and your team.
For many of us laboring in the fields of digital transformation, 2017 was a year of high-intensity work and high-reward achievement. So we’re looking forward to a little breather over the end-of-year holiday season. But we’re going to have to get right back on the Continuous Delivery bullet train in 2018. Markets move too fast and customer expectations elevate too precipitously for businesses to rest on their laurels. Here’s a DevOps “to-do list” for 2018 that should be priorities for anyone w...
If testing environments are constantly unavailable and affected by outages, release timelines will be affected. You can use three metrics to measure stability events for specific environments and plan around events that will affect your critical path to release.
In a recent post, titled “10 Surprising Facts About Cloud Computing and What It Really Is”, Zac Johnson highlighted some interesting facts about cloud computing in the SMB marketplace: Cloud Computing is up to 40 times more cost-effective for an SMB, compared to running its own IT system. 94% of SMBs have experienced security benefits in the cloud that they didn’t have with their on-premises service
DevOps failure is a touchy subject with some, because DevOps is typically perceived as a way to avoid failure. As a result, when you fail in a DevOps practice, the situation can seem almost hopeless. However, just as a fail-fast business approach, or the “fail and adjust sooner” methodology of Agile often proves, DevOps failures are actually a step in the right direction. They’re the first step toward learning from failures and turning your DevOps practice into one that will lead you toward even...
DevOps is under attack because developers don’t want to mess with infrastructure. They will happily own their code into production, but want to use platforms instead of raw automation. That’s changing the landscape that we understand as DevOps with both architecture concepts (CloudNative) and process redefinition (SRE). Rob Hirschfeld’s recent work in Kubernetes operations has led to the conclusion that containers and related platforms have changed the way we should be thinking about DevOps and...
While walking around the office I happened upon a relatively new employee dragging emails from his inbox into folders. I asked why and was told, “I’m just answering emails and getting stuff off my desk.” An empty inbox may be emotionally satisfying to look at, but in practice, you should never do it. Here’s why. I recently wrote a piece arguing that from a mathematical perspective, Messy Desks Are Perfectly Optimized. While it validated the genius of my friends with messy desks, it also gener...
The goal of Microservices is to improve software delivery speed and increase system safety as scale increases. Microservices being modular these are faster to change and enables an evolutionary architecture where systems can change, as the business needs change. Microservices can scale elastically and by being service oriented can enable APIs natively. Microservices also reduce implementation and release cycle time and enables continuous delivery. This paper provides a logical overview of the Mi...
The next XaaS is CICDaaS. Why? Because CICD saves developers a huge amount of time. CD is an especially great option for projects that require multiple and frequent contributions to be integrated. But… securing CICD best practices is an emerging, essential, yet little understood practice for DevOps teams and their Cloud Service Providers. The only way to get CICD to work in a highly secure environment takes collaboration, patience and persistence. Building CICD in the cloud requires rigorous ar...
The enterprise data storage marketplace is poised to become a battlefield. No longer the quiet backwater of cloud computing services, the focus of this global transition is now going from compute to storage. An overview of recent storage market history is needed to understand why this transition is important. Before 2007 and the birth of the cloud computing market we are witnessing today, the on-premise model hosted in large local data centers dominated enterprise storage. Key marketplace play...
The cloud revolution in enterprises has very clearly crossed the phase of proof-of-concepts into a truly mainstream adoption. One of most popular enterprise-wide initiatives currently going on are “cloud migration” programs of some kind or another. Finding business value for these programs is not hard to fathom – they include hyperelasticity in infrastructure consumption, subscription based models, and agility derived from rapid speed of deployment of applications. These factors will continue to...
Some people are directors, managers, and administrators. Others are disrupters. Eddie Webb (@edwardawebb) is an IT Disrupter for Software Development Platforms at Liberty Mutual and was a presenter at the 2016 All Day DevOps conference. His talk, Organically DevOps: Building Quality and Security into the Software Supply Chain at Liberty Mutual, looked at Liberty Mutual's transformation to Continuous Integration, Continuous Delivery, and DevOps. For a large, heavily regulated industry, this task ...
Following a tradition dating back to 2002 at ZapThink and continuing at Intellyx since 2014, it’s time for Intellyx’s annual predictions for the coming year. If you’re a long-time fan, you know we have a twist to the typical annual prediction post: we actually critique our predictions from the previous year. To make things even more interesting, Charlie and I switch off, judging the other’s predictions. And now that he’s been with Intellyx for more than a year, this Cortex represents my first ...
"Grape Up leverages Cloud Native technologies and helps companies build software using microservices, and work the DevOps agile way. We've been doing digital innovation for the last 12 years," explained Daniel Heckman, of Grape Up in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
The Toyota Production System, a world-renowned production system is based on the "complete elimination of all waste". The "Toyota Way", grounded on continuous improvement dates to the 1860s. The methodology is widely proven to be successful yet there are still industries within and tangential to manufacturing struggling to adopt its core principles: Jidoka: a process should stop when an issue is identified prevents releasing defective products
We seem to run this cycle with every new technology that comes along. A good idea with practical applications is born, then both marketers and over-excited users start to declare it is the solution for all or our problems. Compliments of Gartner, we know it generally as “The Hype Cycle”, but each iteration is a little different. 2018’s flavor will be serverless computing, and by 2018, I mean starting now, but going most of next year, you’ll be sick of it. We are already seeing people write such...
Defining the term ‘monitoring’ is a difficult task considering the performance space has evolved significantly over the years. Lately, there has been a shift in the monitoring world, sparking a healthy debate regarding the definition and purpose of monitoring, through which a new term has emerged: observability. Some of that debate can be found in blogs by Charity Majors and Cindy Sridharan.
It’s “time to move on from DevOps and continuous delivery.” This was the provocative title of a recent article in ZDNet, in which Kelsey Hightower, staff developer advocate at Google Cloud Platform, suggested that “software shops should have put these concepts into action years ago.” Reading articles like this or listening to talks at most DevOps conferences might make you think that we’re entering a post-DevOps world. But vast numbers of organizations still struggle to start and drive transfo...
Let's do a visualization exercise. Imagine it's December 31, 2018, and you're ringing in the New Year with your friends and family. You think back on everything that you accomplished in the last year: your company's revenue is through the roof thanks to the success of your product, and you were promoted to Lead Developer. 2019 is poised to be an even bigger year for your company because you have the tools and insight to scale as quickly as demand requires. You're a happy human, and it's not just...
"Opsani helps the enterprise adopt containers, help them move their infrastructure into this modern world of DevOps, accelerate the delivery of new features into production, and really get them going on the container path," explained Ross Schibler, CEO of Opsani, and Peter Nickolov, CTO of Opsani, in this SYS-CON.tv interview at DevOps Summit at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.