Post on 02-Apr-2018
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Glimpses of the Emerging
C-DAC Healthcare Cloud
Priti Razdan, Praveen Srivastava, Rajiv Yadav
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Points Covered
Cloud Computing?
Cloud and Healthcare
C-DACs Integrated Initiative in Cloud Computing
Traditional Vs IHIS Architecture
Layers of the IHIS Architecture
Implementation Model
Conclusion
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Cloud Computing
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Cloud Computing
Cloud Computing used to denote the use of cloud or internet
based computers for variety of services.
Cloud Computing now implies the user experience moving
away from in-house data centers into remote applications
running in a cloud of computers.
The technical foundations of Cloud Computing include
Service-Oriented Architecture (SOA) and Virtualizations of
hardware and software.
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Cloud and Healthcare
Healthcare providers at automating processes
Lower cost
Higher gains
Use the HMIS as a Service and no need to undergo the
challenges
Technology
Administration Implementation
Patient Health Record moves to Internet.
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CDACs Integrated Initiative
in Healthcare
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CDACs Integrated Initiative in
Healthcare C-DAC has been working in the healthcare sector for more than
a decade and half.
Different C-DAC centers (Noida, Mohali, Trivandrum and
Pune) have taken up projects in various areas of healthcare
(HMIS, Telemedicine, PACS, Development of SDKs,Interworking Standards, etc.).
These efforts were user driven and hence standalone. However,
they were complimentary to each other.
Considering the unification opportunity provided by the cloudapproach, the centers are presently working on an Integrated
HIMS (IHIMS) solution that can work very well over the cloud.
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Traditional HMIS
Vs
IHISArchitecture
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Client Server Architecture.
Server - Data Center of the hospital Client machines- Various segments of the hospital.
Advantages-The load on the server reduced by making the
client perform many computationally intensive tasks.
Drawbacks -Inability to scale to large number of concurrentusers using thin clients.
Processing load was given to the client while the server acted as
a traffic controller between the application and the data.
Applications forced to make multiple requests for data beforeeven presenting anything to the user. Increasing the
communication load.
Modification in client side software needed their roll-out in all
the clients that use them.
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N-tier Architecture
Application typically runs on server machines with client sideinteraction handled by a thin computer able to run an internet
browser.
The application is split in several pieces - Logically and
physically. Each piece performs a specific task (displaying UI, Data
Access, Business logic etc). Applications based on this
architecture employed Model-View-Controller (MVC) pattern.
Disadvantages -Tight coupling in the application with thelayers.
Any change in the application involves re-work at different
layers.
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Restful SOA Architecture
Restful SOA architecture- loose coupling within the IHIS. Representational state transfer (REST) is a style of software
architecture for distributed hypermedia systems such as the
World Wide Web.
Conforming to the REST constraints is generally referred to asbeing "RESTful".
REST-style architectures consist of clients and servers.
Clients initiate requests to servers; servers process requests
and return appropriate responses. Requests and responses arebuilt around the transfer of representations of resources. REST
relies on human readable documentation that defines requests
URIs and responses (XML, JSON).
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IHIS- Architecture
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Layers of IHIS
IHIS consists of four layers-
User Interface Layer : The UI layer is based on the
flow and sensitivity of the user and hence is left for
implementation as per need of the user. The UI layer is
responsible for data capture and visualization.
Functional Module layer : The overall functionality of
the system is broken into cohesive set of functions andtreated as modules. Examples are Registration, Billing,
Pharmacy, etc. The functions of the module will be
consumed by the UI layer.
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Layers of IHIS
System Core Layer :This layer comprises the model part of thesystem. It provides the basic functionalities that are utilized by
the FM layer modules to carry out its functions.
The components of SC layer are:
EHR: The Electronic Health Record (HER)
HIR: The Hospital Information Repository (HIR)
Security
Rules
License
Data Storage Layer: The DS layer provides persistence
functions to SC layer.
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Communication Interfaces
IHIS has two prominent communication Interfaces
Health Bus (HB)
The HB Layer will be message exchange interconnectlayer between functional modules and the System
Core (SC).
Data Storage Bus (DSB).
The components at the system core layer will send
messages to the Data Storage Bus.
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Implementation Model
The roll out model of IHIS will support Software as a Service
(SaaS) paradigm.
Functional modules -entities for the SaaS usage.
Modules will have price per usage for the module. (A floatingpoint number. )
The conversion to monitory terms is left to the SLA with hospital.
Having a price per usage value for each module allows the
administrator to configure the modules that he proposes to use inhis hospital in the most cost effective manner.
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Implementation ModelThere is large variability in the functional requirements of the HIS
modules.
Approach One -All encompassing super Registration module that
can be configured as per the requirements of a specific hospital
using a separate configuration process.Alternative Approach -Allow multiple Registration modules to co-
exist.
Different prices for different modules catering to the same
functional area. Ultimately, modules that are heavily used willbecome cheap and specialized modules not used much will become
costlier.
Facilitation of beta testing of the modules initially and fine tuning
the prices based on user responses and volume of usage.
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Conclusion The Cloud Computing infrastructure - an ideal tool to leverage
computing power at low cost. The IHIS solution over CDAC Computing Cloud- an attempt to
provide seamless functioning of HIS solutions over the Cloud
Infrastructure for the large number of Government hospitals in the
country where the ICT penetration is very poor. The development of IHIS is in its infancy. The challenge is to
modify the large Repository of Modules across C-DAC as per the
architectural needs of IHIS.
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