WordPress Websites for Engineers: Elevate Your Brand
O novo normal na área da Saúde com AWS
1. O novo normal na área da
Saúde
Melissa Ravanini
Arquiteta de Soluções com foco em Healthcare
ravanini@amazon.com
2. S U M M I T
São Paulo
Transamérica Expo Center
27 de junho de 2019 – quinta-feira
Inscreva-se em: https://aws.amazon.com/pt/events/summits/sao-paulo/
4. Healthcare hoje Healthcare em breve
Subjetivo, alta variabilidade
no atendimento clínico
Consistente, confiável,
melhores práticas no
atendimento clínico
5. Healthcare hoje Healthcare em breve
Medicina reativa: trate
depois de ficar doente
Medicina proativa: trate
antes de ficar doente
6. Healthcare hoje Healthcare em breve
Manual, uso intensivo de
mão de obra
Automatizado, IA/ML
permitindo um atendimento
médico mais personalizado
eHealth iHealth
23. VMware Cloud on AWS for healthcare
Disaster recovery, backup, and business continuity
(imaging, archiving, data retention)
Establish data lake and consolidate healthcare data, analytics, AI/ML
Application migrations (ERP, supply chain, tier 2–3 applications)
Prod, dev, test, lab, research, clinical and non-clinical training
Acquisitions of new healthcare systems, geographic expansion
Burst capacity (open enrollment, cold and flu season)
BAA for PHI
workloads
32. • Discover from 4,800+ product listings
from 1400+ participating ISVs
• Procure new or bring your own license
• Deploy software on demand
• Solutions for established (Healthcare &
Life Sciences) and emerging industries
https://aws.amazon.com/marketplace/
37. “Escolhemos a AWS pela liderança.
São pioneiros e hoje não existe
nada melhor no mercado. Além
disso, a AWS tem na sua estrutura
todos os dados do projeto 1000
Genomes, o que facilita o acesso e
reduz o tempo de processamento”
Dr. Pedro Galante
Pesquisador do IEP
https://aws.amazon.com/pt/solutions/case-studies/sirio-libanes/
44. Global Healthcare Industry Customers and Partners
“Our strength is we understand the clinical
world. We’re not going to waste our capital and
talent on core infrastructure. We want to use it
to craft digital solutions for healthcare.”
Jeroen Tas
Chief Innovation and Strategy Officer
46. S U M M I T
São Paulo
Transamérica Expo Center
27 de junho de 2019 – quinta-feira
Inscreva-se em: https://aws.amazon.com/pt/events/summits/sao-paulo/
[PROVIDE YOUR OWN INTRODUCTION]
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A lot is changing today, and that’s contributing to more uncertainty in the market. First, not that long ago, you could be relatively certain that a successful company would stay successful for your lifetime. But, the average lifespan of an S&P 500 company has shrunk to just 15 years due to the accelerating pace of change in the market. Nonetheless, companies are still largely spending two-thirds of their technology budgets on maintenance activity rather than on new investments that can keep them ahead of the competition. And third, our connected world is empowering a host of bad actors from lone hackers to nation-state espionage, which has led many CEOs to report that they believe their ability to deal with digital risk is failing to keep pace with the sophistication of the threats.
[SOURCES]
15yrs- http://www.theatlantic.com/business/archive/2015/04/where-do-firms-go-when-they-die/390249/
2/3 of IT budget- The Midyear Global Tech Market Outlook For 2015 To 2016, Forrester Research
66% of CEOs- 2015 CEO Survey: Committing to Digital, Gartner
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For technology leaders, this climate has a material effect on your ability to operate. A large portion of your resources are being devoted to maintaining your network to keep pace with the business rather than helping it accelerate. In addition, the functional silos and procurement cycles of data center computing reduces the organization’s ability to pivot and experiment at will. And finally, best effort security operations may not be able to identify and remediate potential risks.
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Responding to this changes requires a new model of engagement. Many companies are looking at the cloud as a way to double down on investments that support the core mission of the company and differentiate it from competitors. As a result, they are looking at new ways to innovate that allow for more experimentation and more customer engagement. And they are doing it in a way that meaningfully reduces their security and compliance risks.
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The first core principle is to focus on differentiation and reducing technical debt.
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“Oferece a pacientes e neurologistas uma maneira de inserir e analisar informações sobre condições e atividades que afetam a saúde do cérebro, atendesse aos padrões da clínica de proteção da privacidade dos pacientes. ”
Unless you’re in the hosting business, it’s unlikely that maintaining physical infrastructure was a core reason for incorporation. It’s what you do with the infrastructure that sets the company apart.
The cloud allows you to get rid of the undifferentiated heavy lifting that comes along with data center management. First, it breaks the cycle of large, risky capital purchases that often tend to make people risk adverse, and trades it for greater flexibility via operating expense. It also eliminates the risk and cost of capacity planning by allowing for the business to acquire exactly the capacity needed at any given time and pay only for time it was in use. Third, it simplifies the complex management tasks inherent in keeping a data center filled with heterogeneous technology running smoothly. And last, global operations are a relatively simple matter of replication. The headaches involved in establishing and running data centers in local markets are eliminated.
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GE OIL & GAS: GE Oil & Gas is migrating 500 applications to the cloud by the end of 2016 as part of a major digital transformation, helping it attain a 52 percent reduction in TCO. GE Oil & Gas is a business unit of global conglomerate General Electric, with energy-related operations around the world. The company's cloud migration project entailed reexamining—and in many cases, eliminating—legacy processes, resulting not only in lower IT costs but also in greater speed to market and more agility to compete even better in an industry experiencing immense market challenges. GE Oil & Gas is using the AWS Import/Export Snowball appliance to transfer more than 750 terabytes of data from pipeline inspection machinery to AWS, as well as AWS services such as Amazon Aurora, Amazon CloudWatch, AWS Elastic Beanstalk, and AWS Trusted Advisor. [https://aws.amazon.com/solutions/case-studies/ge-oil-gas/]
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As a result of these benefits, much less time and effort needs to be spent on infrastructure. The reduced investment there allows for more time to focus on new business initiatives that can deliver customer value and competitive differentiation. As a result, you’re able to put more resources on innovation in order to stay ahead of new and existing sources of competition.
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3M HIS - running its applications on AWS, 3M HIS can easily scale up or down without needing to acquire and provision servers months in advance. “The server-provisioning process used to take us 10 weeks or more, but it’s down to minutes using AWS,” says Austin. “That gives us the flexibility to support the scaling events we experience several times per day. We pay for what we need when we need it. We no longer need to pay for and manage unnecessary peak compute capacity. We recently had a customer request a large volume of processing, and we simply spun up an additional 200 instances of our service on AWS. When the large workload completed, we just turned off those instances.”
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The mission of Fred Hutchinson Cancer Research Center is the elimination of cancer and related diseases as causes of human suffering and death.
For cancer patients and the researchers dedicated to curing them, time is the limiting resource.
The process of developing clinical trials and connecting them with the right patients requires research teams to sift through and label mountains of unstructured clinical record data.
With Amazon Comprehend Medical's Entity extraction API built for Health, they can extract disease conditions, medications, treatment outcomes or PHI from medical records for each patient to measure a operational metric.
Amazon Confidential
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No other cloud platform has anywhere near the level of technical capabilities or experience that AWS has in helping enterprises setup a hybrid architecture.
Dow Jones example - chat application, engineers looked over, VPC subnets, new IP addresses, automation to move and done in 45 minutes. Big ah ha moment that gave us the confidence to scale our environment….
A lot of executives ask me how long they’ll be running a hybrid environment. I believe that any organization that has been running it’s own IT environment for any substantial period of time will have a hybrid architecture as part of their journey, and we’d probably count the time in years, but it’s hard for me to imagine a future 10 years from now where an organization of any size will be running their own data centers. I think that AWS’ pace of innovation and how much easier we’re making it to migrate, which I’ll touch on shortly, is only accelerating this transformation.
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Now, if the AWS Cloud can reduce the complexity of your environment, what do you do with the people and budget you’re freed up? You focus on building.
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In 2011, we released over 80 significant services and features; in 2012, nearly 160; in 2013, 280, and in 2014, we launched 516. In 2015, we launched 722 new services and features, up nearly 40% year-over-year. As of September 30th, we have released 1017 new features and services in 2016.
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“We are able to run 3 times the amount of servers we used to run on premises by the same cost”
These innovations help your organization innovate to further differentiate and provide value on behalf of your patients. This can come in the form of modernization and innovation across patient engagement tools by taking advantage of new modalities in which information is presented and consumed by patients.
One example of how customers have used AWS to drive innovation and scale is our work with the Centers for Medicare and Medicaid Services (CMS). This organization is part of the U.S. Department of Health and Human Services and is responsible for Healthcare.gov, the portal where consumers can find information and sign up for insurance plans under the Affordable Care Act. CMS turned to Amazon Web Services to launch three new features for the website, including an identity management system, a feature for comparing insurance plans, and a tool to determine eligibility for specific plans based on a consumer’s income and other variables. By using AWS, CMS has been able to deliver a stable and highly scalable set of features capable of handling hundreds of thousands of simultaneous users during peak insurance signup periods.
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But of course, exploring new opportunities is a moot point if security and compliance can’t be maintained.
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As healthcare data grows in volume, variety, and veracity, organizations are challenged to derive value from the data. Across foundational areas for data management, AWS has made key investments in services to help you in key areas to help you across your journey, whether it is related to data streaming from IOT devices or migrating and managing petabytes of data.
[Point out applicable key capabilities that align with the customers business and portfolio of products as examples.]
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One of the reasons that all manner of healthcare organizations are turning to the AWS Cloud is because they now have the ability to build a full analytics pipeline using cloud-based infrastructure. That means you can ingest data, whether it is structured or unstructured data. That means a managed Hadoop framework that processes data across a dynamically scalable fleet of instances, and also access to our full ecosystem of popular Big Data frameworks. That means using our visualization tools, or many other popular tools, like those from Tableau or Qlik. And of course you can store your results both short- and long-term. And this storage process can be automated using policies, so that you can minimizing what data needs to be available for retrieval, what can be archived, and when data can be disposed.
Many of you likely know Change Healthcare; they were formerly known as Emdeon and recently combined with McKesson’s technology business. Change’s Intelligent Care Network processes approximately 30% of US healthcare claims data, so this is an incredible amount of scale that they have to deal with. They adopted AWS to solve several of their Big Data problems. For example, they were being asked by their customers to better understand the referral patterns of hospital employees and affiliated physicians to see where their referrals were going. To do this, they aggregated 24 months of claims data, which was essentially 1.8 billion claims, and in the first 6 months were able to save their customer $10M.
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[REPLACE THIS SLIDE WITH A CUSTOM USE CASE IF WE ALREADY KNOW THE CUSTOMER’S CHALLENGES]
Amazon Redshift is a fast, fully managed, petabyte-scale data warehouse that makes it simple and cost-effective to analyze all your data using your existing business intelligence tools. One of the frustrating things about traditional data warehouses is that their very complicated and very expensive, which means you can’t make them available to everyone. But, given that Redshift costs only 1/10th of competitive solutions, you can put this valuable analytical tool in the hands of many more teams to scale the number of people looking for new business insights.
Redshift is able to obtain very high query performance on datasets ranging in size from a hundred gigabytes to a petabyte or more. It also handles all the work needed to manage, monitor, and scale your data warehouse, from monitoring cluster health and taking backups to applying patches and upgrades. To keep your data safe, Redshift uses SSL to secure data in transit and hardware-accelerated AES-256 encryption for data at rest.
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OSCAR Insurance is a new New York–based health insurance company that leverages technology to guide its customers to better care and help them keep track of their health. The company built its new HIPAA-compliant health insurance platform and analytics solution on AWS in just three months. By using AWS, the company can scale to support the traffic spikes of open enrollment season as well as support more than 125 production changes a day that continually improve customer experience. The company was able to take advantage of many AWS innovations to make their systems faster, simpler, and less expensive for their customers.
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Farmaceutica
In order to help customers with their data management strategy, we’ve developed solutions to help store, protect, and optimize healthcare data. In doing so, your data can be centralized and downstream use cases are unlocked. Celgene, for example, deployed their data lake on AWS to drive analytics across their global business units.
[If this resonates with customer, refer to SPO industry solution as followup]
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Open Data -> TCGA, ICGC
“cada indivíduo tem cerca de 3 GB de informações de DNA, o que demanda muita capacidade de processamento para encontrar pequenas diferenças dentro dessa enorme quantidade de informações.”
Na área de oncologia, por exemplo, já não são raros os pedidos de sequenciamento de parte do DNA de pacientes com o objetivo de entender a origem de determinados tumores ou predizer a resposta a um determinado medicamento. Quando esse trabalho é feito, as informações podem, em caso de consentimento do paciente, ficar disponíveis em bancos de dados abertos a toda a comunidade médica para consulta e benchmark.
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As you think through your data management strategy, there are opportunities in areas like enterprise-wide DR/backup or vendor neutral archives for medical imaging, there are storage options that align with your data retention policies while providing access when you need it. Philips Health, for example, migrated 15PBs of PHI into HIPAA-eligible storage services and continue to grow.
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Customers across the healthcare industry trust AWS with many of their key workloads because of our ability to drive scalable services. We use our expertise and competencies in cloud technologies to support your healthcare organization so you can focus on your patients and members. That’s why organizations, like UPMC Enterprises, rely on AWS for their key services. Our ability to provide durable services that are easily scalable, while providing fine-grained access control, has allowed them to innovate on behalf of their patients and communities.
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But of course, exploring new opportunities is a moot point if security and compliance can’t be maintained.
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For a long time, most organizations have had to make a choice between moving fast or maintaining a high degree of security. It’s a difficult choice, and inevitably security trumps all.
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But, one of the fundamental benefits of the cloud is that you’re able to do both, because the security of the infrastructure is handled by the AWS global security team. This frees your resources up to focus completely on the security of your applications.
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Infrastructure security can be one of the most complex elements of your operation, because the high degree of interconnected systems across a wide range of hardware vendors makes it difficult to have good visibility into what’s going on and what new threats may have been recently identified in the wild.
But, with AWS, we operate together under a Shared Responsibility Model that makes us responsible from the hypervisor down, and you for the operating system up, which puts our respective attention on what we know best.
The AWS infrastructure is custom-built for the cloud, with all element designed to intercommunicate well and present the smallest attack surface possible. In addition, the physical security controls present in our data centers has been designed to be the most stringent in the world. This pursuit has led to AWS being trusted by governments, military organizations, global banks, healthcare institutions, and other high-sensitivity organizations.
Finally, our security team is monitoring the infrastructure all-day, every-day, and is well-connected with all major security watchdog groups and vendors to ensure that potential threats are identified immediately. And, they are doing this at massive scale, which is something that sets the AWS security organization apart. By looking across more than 1 million active accounts each month running virtually every conceivable type of workload, we can see issues that may only occur once in a billion operations multiple times a day. When we remediate the issue, we do so for the entire platform. That kind of visibility and response simply isn’t achievable for the vast majority of organizations.
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CAPITAL ONE: Capital One is using AWS to reduce its data centers from eight to three by 2018. Capital One is one of the nation’s largest banks and offers credit cards, checking and savings accounts, auto loans, rewards, and online banking services for consumers and businesses. The bank is using or experimenting with nearly every AWS service to develop, test, build, and run its most critical workloads, including its new flagship mobile-banking application. Rob Alexander, Capital One's chief information officer, says, "The financial service industry attracts some of the worst cyber criminals. We work closely with AWS to develop a security model, which we believe enables us to operate more securely in the public cloud than we can in our own data centers." Capital One selected AWS for its security model and for the ability to provision infrastructure on the fly, the elasticity to handle purchasing demands at peak times, its high availability, and its pace of innovation. [http://aws.amazon.com/solutions/case-studies/capital-one/]
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Shared Responsibility Model for Infrastructure Services
Infrastructure services, such as Amazon EC2, Amazon EBS, and Amazon VPC, run on top of the AWS global infrastructure. They vary in terms of availability and durability objectives but always operate within the specific region where they have been launched. You can build systems that meet availability objectives exceeding those of individual services from AWS by employing resilient components in multiple Availability Zones.
Building on the AWS secure global infrastructure, you install and configure your operating systems and platforms in the AWS cloud just as you would do on premises in your own data centers. Then you install your applications on your platform. Ultimately, your data resides in and is managed by your own applications.
Unless you have more stringent business or compliance requirements, you don’t need to introduce additional layers of protection beyond those provided by the AWS secure global infrastructure.
For certain compliance requirements, you might require an additional layer of protection between the services from AWS and your operating systems and platforms, where your applications and data reside. You can impose additional controls, such as protection of data at rest, and protection of data in transit, or introduce a layer of opacity between services from AWS and your platform. The opacity layer can include data encryption, data integrity authentication, software- and data-signing, secure time-stamping, and more.
AWS provides technologies you can implement to protect data at rest and in transit. See the Managing OS-level Access to Amazon EC2 Instances and Secure Your Data sections in this whitepaper for more information. Alternatively, you might introduce your own data protection tools, or leverage AWS partner offerings.
These security tools are incredibly powerful.
Of note, we have, Virtual Private Cloud, the ability to logically isolate your resources in a virtual network that you define.
The Key Management Service, the ability to encrypt your data in the Cloud and if you choose, to bring your own encryption key.
Cloudtrail, is a service that records API calls for your account and delivers log files for you, enabling detailed compliance auditing.
And new services like Macie - A machine learning-powered security service to discover, classify, and protect sensitive data.
Networking
[COVER THIS ONE] Amazon VPC: Amazon Virtual Private Cloud lets you provision a logically isolated section of the AWS Cloud where you can launch resources in a virtual network that you define.
[COVER THIS ONE] AWS KMS: AWS Key Management Service is a managed service that makes it easy for you to create and control the encryption keys used to encrypt your data, and uses Hardware Security Modules (HSMs) to protect the security of your keys. AWS KMS is integrated with several other AWS services to help you protect the data you store with these services and is also integrated with AWS CloudTrail to provide you with logs of all key usage to help meet your regulatory and compliance needs.
[COVER THIS ONE] AWS CloudTrail: AWS CloudTrail is a web service that records AWS API calls for your account and delivers log files to you. The recorded information includes the identity of the API caller, the time of the API call, the source IP address of the API caller, the request parameters, and the response elements returned by the AWS service. With CloudTrail, you can get a history of AWS API calls for your account, including API calls made via the AWS Management Console, AWS SDKs, command line tools, and higher-level AWS services (such as AWS CloudFormation). The AWS API call history produced by CloudTrail enables security analysis, resource change tracking, and compliance auditing.
[SOME SELECTED CUSTOMERS ARE LISTED BELOW. HOWEVER, WE’RE AT THE END AND IT’S RECOMMENDED THAT YOU NOT DEEP DIVE ON THIS SLIDE UNLESS THERE’S A PARTICULAR STORY YOU WANT TO TELL. THE MAIN POINT OF THIS SLIDE TO SHOW THE STRENGTH OF OUR PORTFOLIO.]
We’ve helped thousands of enterprises, and we’re extremely excited about how we can help you.
[CLICK]
We believe there’s no more capable cloud provider in the world to unlock the latent innovation within your people.
AWS can free you up to pursue innovative, high-value business opportunities by eliminating time spent on undifferentiated maintenance and operations. This in turn can allow you to put more resources on creating, testing, and releasing new products faster to drive more customer value and gain more competitive advantages. And, you can do it while simultaneously improving your security posture and compliance efforts.
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GENERAL ELECTRIC: General Electric (GE) is migrating more than 9,000 workloads, including 300 disparate ERP systems, to AWS while reducing its datacenter footprint from 34 to four over the next three years. The company is the world’s Digital Industrial Company, transforming industry with software-defined machines and solutions that are connected, responsive, and predictive. Jim Fowler, General Electric's chief information officer, noting that GE has been around for 140 years, says, "AWS is our trusted partner that is going to run our company for the next 140 years.” As an example, the GE Oil & Gas division has started this journey by migrating more than half of its core applications to AWS while achieving a 52 percent reduction in its total cost of ownership. [http://aws.amazon.com/solutions/case-studies/general-electric/]
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[PROVIDE YOUR OWN INTRODUCTION]
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