01_Glimpses of the Emerging C-DAC Healthcare Cloud (1)

7/27/2019 01_Glimpses of the Emerging C-DAC Healthcare Cloud (1)

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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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01_Glimpses of the Emerging C-DAC Healthcare Cloud (1)

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