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Cloud Computing and SoftwareCloud Computing and Software as a Service in BMI as a Service in BMI

Timoteus ZiminskiComputer Science & Engineering Department

The University of Connecticuttbz@engr.uconn.edu

Spring 2011

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Overview Overview Background Background

Definition Providers Technologies

BMI in the CloudBMI in the Cloud Application Fields Example: Virtual Patient Chart Limitations

ConclusionConclusion Critique Research topics

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Overview Overview

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BackgroundBackground

What is the Cloud?What is the Cloud?

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DefinitionDefinition NIST definition:NIST definition:

Bottom line: computing paradigm that hides Bottom line: computing paradigm that hides complexity through a notion of abstract resourcescomplexity through a notion of abstract resources

Although this paradigm is still considered to be under Although this paradigm is still considered to be under development, several very mature platforms are development, several very mature platforms are apparent.apparent.

“Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction.”

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ProvidersProviders GoogleGoogle

Mail, Calendar, Health, Maps, Docs, Google Apps AmazonAmazon

Amazon Web Services (AWS), Simple Storage System (Amazon S3)

IBMIBM SmartCloud Services, LotusLive, Blueworks,

Collaborative Care MicrosoftMicrosoft

Azure, WindowsServer Hyper-V, Office 365 And many, many more…And many, many more…

Enormous range of products covering a variety of tasks: development, testing, training, archiving, analysis, and collaboration

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Service ModelsService Models Heterogeneous types of service can be embedded into Heterogeneous types of service can be embedded into

the cloudthe cloud All options hide underlying infrastructure to a

certain level Software as a Service (SaaS)Software as a Service (SaaS)

Provides applications Cross-device and cross-platform capabilities

Platform as a Service (PaaS)Platform as a Service (PaaS) Access to the cloud hosting environment Deployment of applications

Infrastructure as a Service (IaaS)Infrastructure as a Service (IaaS) Provides access to basic resources CPU, network, storage

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CharacteristicsCharacteristics On-demand self serviceOn-demand self service

Services are mostly automatic Broad network accessBroad network access

Usage of standard mechanisms Allows thin clients

Resource poolingResource pooling No control about physical instances

Rapid elasticityRapid elasticity Resources are presented as unlimited Capacities grow and shrink automatically

according to requirements Measured serviceMeasured service

Pay for what you use Little up-front capital needed

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Deployment Models for Cloud InfrastructureDeployment Models for Cloud Infrastructure PrivatePrivate

Access by one organization Management in-house or by third party

CommunityCommunity Shared across multiple organizations

PublicPublic Accessible by general public or large number of

organizations Typically used for selling cloud applications

HybridHybrid Composite of multiple clouds

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Importance to IT MarketImportance to IT Market

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Technologies: On the Hard SideTechnologies: On the Hard Side Cloud computing requires reliable, efficient and Cloud computing requires reliable, efficient and

powerful data centers powerful data centers General hardware progress gives advantagesGeneral hardware progress gives advantages

Disc space, memory, energy efficiency More important, networking and virtualization More important, networking and virtualization

technologies are fueling the development of cloud technologies are fueling the development of cloud applicationsapplications Omnipresent access to low latency broadband

internet Multiplexing architectures Hardware virtualization support Clustering techniques

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Technologies: On the Hard Side (ctd.)Technologies: On the Hard Side (ctd.)

Lightweight, always connected end devices are Lightweight, always connected end devices are increasingly popularincreasingly popular Tablet PCs, Smartphones, Laptops (Cr-48)

Usage of multiple platforms simultaneously creates Usage of multiple platforms simultaneously creates synchronization issuessynchronization issues

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Technologies: On the Soft SideTechnologies: On the Soft Side On the server side virtualization software plays an On the server side virtualization software plays an

important role important role VMware, VirtualBox, Virtual PC, Xen

From an organizational perspective, Service-oriented From an organizational perspective, Service-oriented Architectures allow the decomposition of IT processesArchitectures allow the decomposition of IT processes Encapsulation into service with interfaces Create potential for replacement of local services

with options from the cloud Possible implementations

REST: HTTP/S or SOAP RPC Web Services: XML, WSDL, UDDI, SOAP CORBA

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Technologies: On the Soft Side (ctd.)Technologies: On the Soft Side (ctd.) Development of operating systems which heavily rely Development of operating systems which heavily rely

on cloud applicationson cloud applications Android, iOS, Chromium OS

Increasingly sophisticated web browsersIncreasingly sophisticated web browsers IE9, Firefox 4, Chrome, Safari 5 HTML5, JavaScript/AJAX, Flash, Silverlight

To some extent also programming language concepts To some extent also programming language concepts and librariesand libraries Java, Python, Perl, Ruby, Scala

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OverviewOverview

Cloud ResourcesCloud ResourcesUseUse

Provid

ePro

vide

Provide

Provide

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Overview Overview

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Application FieldsApplication Fields In which BMI areas can we leverage the benefits of In which BMI areas can we leverage the benefits of

Cloud Computing?Cloud Computing?

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Clinical Informatics ChallengesClinical Informatics Challenges Patient recordsPatient records

Electronic Medical Records, Personal Healthcare Records

Inherit need for efficient and reliable large-scale data storage and exchange

Collaboration betweenCollaboration between Healthcare professionals

Team-based collaboration Transition of care

Healthcare organizations Practices, Labs, Pharmacies, Clinics, Hospitals

Domains Providers, Payers, Researchers

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CC Benefits for Clinical InformaticsCC Benefits for Clinical Informatics Personal Healthcare RecordsPersonal Healthcare Records

Google Health, Microsoft Health Vault, WebMD Electronic Medical RecordsElectronic Medical Records

First attempts to organize EMRs in private clouds Modular approaches with plug-in architectures

Health information exchange Decision support Automatic note processing, voice recognition Patient education

Opens the door for stepwise integration via a cloud of clouds Hybrid clouds regulate the amount of exchanged data

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CC Benefits for Clinical InformaticsCC Benefits for Clinical Informatics Implementing HIE in the context of small practicesImplementing HIE in the context of small practices

Application service provider model Limits requirements and costs

Technical knowledge can remain on provider side Maintenance reduces to thin clients Compliance with regulations becomes provider task

Data warehousingData warehousing Example: Data from the pathology laboratory In-house solutions create further data silos The cloud concept opens the doors for affordable

generic solutions

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Virtual Patient ChartVirtual Patient Chart

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CC benefits for Clinical Informatics (ctd.)CC benefits for Clinical Informatics (ctd.) Virtual chartVirtual chart

Cloud computing services can provide very abstract storage resources

Space and performance is presented as limitless and automatically adjustable

Highly accessible and easy to synchronize across platforms

We are starting to have experience real-life proof platforms for real-time collaboration on documents

Is that enough?Is that enough?

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A Word of Warning…A Word of Warning…

Cloud Computing is Cloud Computing is another useful tool, another useful tool, not the silver bullet!not the silver bullet!

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Bioinformatics ChallengesBioinformatics Challenges Heavy computational analysis tasksHeavy computational analysis tasks

DNA sequencing Genomics Protein microarrays Mutation analysis

In addition to the specific hardware for the analysis, In addition to the specific hardware for the analysis, we needwe need Storage

Petabyte scale CPU cycles

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CC Benefits for BioinformaticsCC Benefits for Bioinformatics The cloud starts to offer elegant solutions for large-The cloud starts to offer elegant solutions for large-

scale data storagescale data storage Know-how about hardware and data management

can cumulate at service providers Elastic nature and “pay as you go” payment

models increase accessibility for institutions Do research rather than worrying about backups

Algorithmic tasks are the more at home in the domain Algorithmic tasks are the more at home in the domain of Grid computingof Grid computing

However, the cloud can increase discoverability and However, the cloud can increase discoverability and streamline the access to Grid resourcesstreamline the access to Grid resources

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Medical Imaging InformaticsMedical Imaging Informatics Essentially very similar arguments as discussed for the Essentially very similar arguments as discussed for the

field of Bioinformaticsfield of Bioinformatics

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Public Health Informatics ChallengesPublic Health Informatics Challenges Tracking trendsTracking trends

Large scale data warehousing Regional State-wide Population wide

Disease Control and PreventionDisease Control and Prevention Emergency responseEmergency response

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CC Benefits for Public Health Informatics CC Benefits for Public Health Informatics Collection of public health dataCollection of public health data

Virtual chart would a valuable source Inter-cloud communication

The nature of the cloud facilitates:The nature of the cloud facilitates: Storage of public health data Analysis of public health data

Outcomes can be provided through cloud servicesOutcomes can be provided through cloud services

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Clinical Research Informatics ChallengesClinical Research Informatics Challenges Repositories and DatabasesRepositories and Databases

Data acquisition De-identification Data sharing Cohort building

Support of clinical trialsSupport of clinical trials Data collection Data management Data analysis

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CC Benefits for Clinical Research InformaticsCC Benefits for Clinical Research Informatics Outsource responsibility for regulation conform de-Outsource responsibility for regulation conform de-

identificationidentification Data management servicesData management services

Break open data silos Reuse collected data

Template based solutions for trial managementTemplate based solutions for trial management Promotion of best practices Supporting tools

Exploit mobile devices and adequate apps for data Exploit mobile devices and adequate apps for data collection during trialscollection during trials Mobile phones, tablets

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HIT Training ChallengesHIT Training Challenges Training is an important and often underestimated Training is an important and often underestimated

componentcomponent Who requires training?Who requires training?

Healthcare professionals Students of related fields

In what areas can we trainIn what areas can we train Medical education

Transfer of new knowledge Skills in using software components

EHR, Practice Management, e-Prescribing Adherence to best practices

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CC Benefits for HIT TrainingCC Benefits for HIT Training Virtualization has proven to be a powerful tool to Virtualization has proven to be a powerful tool to

provide training environments and programsprovide training environments and programs Training in a Cloud is a popular productTraining in a Cloud is a popular product

Scalable Flexible Cost efficient

Deployment and management of training Deployment and management of training environments is largely simplified by the “disposable” environments is largely simplified by the “disposable” nature of virtual platformsnature of virtual platforms

Service providers can offer cost efficient programs Service providers can offer cost efficient programs and cover a larger variety of topicsand cover a larger variety of topics

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LimitationsLimitations Cloud computing and SaaS has some risks and Cloud computing and SaaS has some risks and

limitations that we need to recognize in the context of limitations that we need to recognize in the context of BMIBMI Trust and Security Reliability and Availibility Performance Standardization Overhead

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Trust and SecurityTrust and Security Loading data off sensitive outside of organizational Loading data off sensitive outside of organizational

boundaries is by definition a security risk that has to boundaries is by definition a security risk that has to be weighted against potential benefitsbe weighted against potential benefits Third parties are gaining access

Service providers, governmental institutions Limitations through policies and regulations have to Limitations through policies and regulations have to

be taken into consideration be taken into consideration Cloud computing does not make any assumptions Cloud computing does not make any assumptions

about physical locationsabout physical locations Data can travel outside of country boarders

Employ suitable secure data transfer and encryption Employ suitable secure data transfer and encryption techniquestechniques Currently still performance problems

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Reliability and AvailabilityReliability and Availability BMI systems are frequently of critical importanceBMI systems are frequently of critical importance

Clinical care systems can directly influence decisions that can have potentially crucial impact on the well being of patients

Risk system outages and performance problemsRisk system outages and performance problems Recent outage of AWS Not an acceptable scenario for many BMI settings

Absorbing the impactAbsorbing the impact Local failover Sacrifices advantages of low complexity

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PerformancePerformance SaaS solutions have matured over the past yearsSaaS solutions have matured over the past years

Sophisticated Frontends Low latency broadband internet

However, the healthcare domain tends to be very However, the healthcare domain tends to be very unforgiving towards workflow disruptionsunforgiving towards workflow disruptions Potential fluctuations in QoS can have harsh

impact on the acceptance of services

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StandardizationStandardization Cloud Computing does not give any immediate Cloud Computing does not give any immediate

advantages regarding interoperabilityadvantages regarding interoperability Data models, standards and ontologies are a

completely separate issue. Even worse, there are binding standards for cloud Even worse, there are binding standards for cloud

interfacesinterfaces Potential vender lock

Over 10 national and international organizations are Over 10 national and international organizations are currently working on establishing standardscurrently working on establishing standards

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OverheadOverhead Technologies such as Web Service and SOAP RPC Technologies such as Web Service and SOAP RPC

which are used in Cloud Computing might be still too which are used in Cloud Computing might be still too heavy weight for building a system that is aiming to heavy weight for building a system that is aiming to span over the complete healthcare systemspan over the complete healthcare system

From this ultra large scale system perspective we From this ultra large scale system perspective we might need to rely on even more abstract concepts might need to rely on even more abstract concepts such as HTTP/S REST.such as HTTP/S REST.

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Overview Overview

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CritiqueCritique Just another hype?Just another hype?

A lot of advertisement Similar buzz-word overload as with SOA

In fact, often no solid distinguishing of the patterns Nothing new?Nothing new?

Similar middleware concepts and ideas go far back Existent services get tagged with the Cloud label

But noteworthyBut noteworthy Aligns with the current development of clients Conceptually targets many BMI problems Hardware and network progress enabled well

convincing platforms and application suites

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Research TopicsResearch Topics Improving the CloudImproving the Cloud

Trust and Security Scheduling and Virtualization Mobile Cloud Computing Inter-cloud communication (cloud of clouds)

Leveraging the CloudLeveraging the Cloud Data Analysis Data Management Data Modeling Text and Voice recognition

ConferencesConferences IEEE CLOUD, Cloud Expo, Cloud Connect

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Thank you!Questions?