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Should Healthcare abandon the Cloud?
Antonio Piraino, CTO, ScienceLogic
www.sciencelogic.com
@antoniopiraino
Should Healthcare Abandon the Cloud?
1. Why consider the cloud?
2. Healthcare Success and Failure –
why has this happened?

3. Considerations on day 1
4. Considerations on day 2

5. So do you abandon the cloud?

© 2013 ScienceLogic Inc. All rights reserved

2
Drivers of Cloud

Greater Financial
Containment
•
•
•

•
•
•

Staffing levels
Hosted Apps
Reducing TCO
• Less Capex
• Shrink Opex
IT Unit costing,
Chargeback
IT spend ratios
Projections

Greater IT
Complexity

More Regulation
•
•
•
•
•
•
•
•

© 2013 ScienceLogic Inc. All rights reserved

HIPAA
ICD-10
EHR adoption
Accounting of
Disclosures
FISMA
Disaster Recovery
HITECH Act
Internal Governance

•
•
•
•
•

Auditability
Performance and
availability
demands
Hybrid
architectures
HA and high
performance Apps
Consumer, OSS,
Bus Productivity
Apps

More Pressure
on IT
•
•
•
•

•

Latest Technologies
Improved
Performance
Retain Security and
Uptime
More data analytics
available
Fundamental to
business
operations

3
Cloud Failures & Successes

© 2013 ScienceLogic Inc. All rights reserved

4
What Healthcare Enterprises are Looking for
Enterprise

Cloud Vendor

1. Trusted Partner

Provisioning

Orchestration

Monitoring

Billing

Security

Focus on Security & Compliancy

?

?

?

?

?

2. Transparency & Control

Easy Access & Control

?

?

?

?

?

3. Meeting KPIs

Know their Business

?

?

?

?

?

4. Better Tools

Tools that are monetizeable

?

?

?

?

?

5. Strong ROI

Compelling time to Value

?

?

?

?

?

6. Granular/meaningful SLAs

Service-oriented SLAs

?

?

?

?

?

7. Orchestrating Workflows

Holistic & Intuitive Portal

?

?

?

?

?

8. Personalization

Customizable configurations

?

?

?

?

?

9. Scalability & Flexibility

Extensible API

?

?

?

?

?

10. Solutions Oriented

Move away from IaaS selling

?

?

?

?

?

5
Considerations on Day 1
•
•

•
•
•
•

Migration
•

Investment in Provisioning & Orchestration technologies

Security
•

Assurance, IPS, IDS, encryption, etc.

Regulatory (Privacy, Audits)
•

ICD-10, EHR, DR, etc all demand better IT operations

Accessibility
•

Of Data, and differentiated by user.

Governance parameters
52% of Enterprises have no cloud strategy {Logicalis Australia, Aug 2013}
•
•

50% have a private cloud and 46% use cloud in the form of SaaS
72% believe the role of the CIO will change

© 2013 ScienceLogic Inc. All rights reserved

6
Considerations on Day 2
•

•
•
•
•
•

Better Visibility
•
•

Contextual per constituent
Long term verifiability of one’s cloud assets

Meeting KPIs & SLAs
•

Validation

More Control
•

Better tools

Operational Optimization
•

Best execution environment

Cost
•

Chargeback and expenditure

Future-proofing

© 2013 ScienceLogic Inc. All rights reserved

7
So you launch a cloud service…
•

How is your operations team doing?
•
•
•

How is the integration? How long has it been?
Who’s working on it? Why is this so complicated?
Where are my SLAs?

© 2013 ScienceLogic Inc. All rights reserved

8
Traditional IT Management Systems
Traditional IT management systems are threatened…

MSP / “Cloud”
Mainframe

Client / Server

9
So should you
abandon the Cloud?
Bringing Efficiencies to the Architecture

© 2013 ScienceLogic Inc. All rights reserved

11
Bringing Efficiencies to Operations

© 2013 ScienceLogic Inc. All rights reserved

12
What makes us different?
•

Narrow in scope

• Old technology

•

Hard to extend

• Loose integration between

•

Non-integrated

•

Requires manual

• Retrofitted for cloud

correlation

• Retrofitted for multi-tenancy

Point Tools

acquired products

Big 4 Frameworks

• Expensive to maintain

Simple unified product
Fully Multi-Tenant

Extensible and Open

Breadth of Collection

Common Data Model

Highly Customizable

© 2013 ScienceLogic Inc. All rights reserved

Dynamic Dashboards

Rapid Time to Value

13
“Good Enough” not good enough

© 2013 ScienceLogic Inc. All rights reserved

14
Attestation Server Trust Architecture
Policy Engines

GRC

SIEM

(e.g. Hytrust)

(e.g. RSA)

(e.g. ArcSight)

https

Orchestrator/Scheduler
(ex. CloudStack, OpenStack)

Portal

CUSTOMER A
Citrix Xen

Trust Agent

ssl
ESXi Host

VMware
vCenter

ESXi Host

Attestation Server

Linux/KVM

Trust Agent

Citrix Xen

Trust Agent

ESXi Host

VMware
vCenter

Gather platform status
(TCG,XML)

© 2013 ScienceLogic Inc. All rights reserved

Privacy CA

Attestation
Handler/Cache

MLE Whitelist
Management

Provisioning
+ Automation

CUSTOMER B

ESXi Host

https

RESTful API

Credential
Management

Intel TXT Based Attestation Server

Monitor display trust
status (HTML5)

Provide platform trust status for
trusted pools, Compliance, etc
= Attestation Server Components

15
Why are we moving toward Hybrid Cloud?

Your MSP/CSP

© 2013 ScienceLogic Inc. All rights reserved

16
Managing Hybrid IT can be tricky

© 2013 ScienceLogic Inc. All rights reserved

17
Cloud Expectations Changing the Model

© 2013 ScienceLogic Inc. All rights reserved

18
Picking the Right CSP

© 2013 ScienceLogic Inc. All rights reserved
Noisy Neighbor Concerns with the Cloud

© 2013 ScienceLogic Inc. All rights reserved

20
ScienceLogic Today
•

Instant
•
•
•

•

Intelligent
•
•
•

•

Time to value
Visibility
Smart™ Actions & Automation
Discovery
Application Mapping
Contextual Quality of Service
Visualization

Integrated
•
•
•

All-in-One
True™ Multi-Tenancy
Open Architecture

© 2013 ScienceLogic Inc. All rights reserved

21
Next Generation Monitoring Platform
Assets

Automation

Reporting

Performance

Customer Portal

Events

Service Levels

Instant Management
Billing

Orchestration

Via RESTful
API

Integrated
Datastore

CRM

Service Desk

3rd
Party

Provisioning

Intelligent Discovery & Monitoring

Application

Cloud

© 2013 ScienceLogic Inc. All rights reserved

Virtualization

Network

Compute

Storage

Physical
22
Monitoring the Entire Cloud Estate

© 2013 ScienceLogic Inc. All rights reserved

23
Open Extensibility
Technology Extensions

Core Product Extensions

APM / DaaS

Config Management
SERVICE
MANAGEMENT

INTELLIGENT
MONITORING
Unified Communications
Cloud
Application
Virtualization

Performance
Service Levels

Network

Storage / Server Mgt

Multi-tenant
Datastore

© 2013 ScienceLogic Inc. All rights reserved

NetFlow / sFlow

Reporting

Storage

Customer Portal

Physical

Security / Trust

Network Config Mgt

Event

Compute

Big Data

Service Desk

Service Desk

Automation

Notification / Remote

Video Scheduling

24
Anticipate performance issues in your cloud
Antonio Piraino, CTO
ScienceLogic
For more information:
blog.sciencelogic.com
info@sciencelogic.com
www.sciencelogic.com
@antoniopiraino

© 2013 ScienceLogic Inc. All rights reserved

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Should Healthcare abandon the Cloud? Key Considerations

  • 1. Should Healthcare abandon the Cloud? Antonio Piraino, CTO, ScienceLogic www.sciencelogic.com @antoniopiraino
  • 2. Should Healthcare Abandon the Cloud? 1. Why consider the cloud? 2. Healthcare Success and Failure – why has this happened? 3. Considerations on day 1 4. Considerations on day 2 5. So do you abandon the cloud? © 2013 ScienceLogic Inc. All rights reserved 2
  • 3. Drivers of Cloud Greater Financial Containment • • • • • • Staffing levels Hosted Apps Reducing TCO • Less Capex • Shrink Opex IT Unit costing, Chargeback IT spend ratios Projections Greater IT Complexity More Regulation • • • • • • • • © 2013 ScienceLogic Inc. All rights reserved HIPAA ICD-10 EHR adoption Accounting of Disclosures FISMA Disaster Recovery HITECH Act Internal Governance • • • • • Auditability Performance and availability demands Hybrid architectures HA and high performance Apps Consumer, OSS, Bus Productivity Apps More Pressure on IT • • • • • Latest Technologies Improved Performance Retain Security and Uptime More data analytics available Fundamental to business operations 3
  • 4. Cloud Failures & Successes © 2013 ScienceLogic Inc. All rights reserved 4
  • 5. What Healthcare Enterprises are Looking for Enterprise Cloud Vendor 1. Trusted Partner Provisioning Orchestration Monitoring Billing Security Focus on Security & Compliancy ? ? ? ? ? 2. Transparency & Control Easy Access & Control ? ? ? ? ? 3. Meeting KPIs Know their Business ? ? ? ? ? 4. Better Tools Tools that are monetizeable ? ? ? ? ? 5. Strong ROI Compelling time to Value ? ? ? ? ? 6. Granular/meaningful SLAs Service-oriented SLAs ? ? ? ? ? 7. Orchestrating Workflows Holistic & Intuitive Portal ? ? ? ? ? 8. Personalization Customizable configurations ? ? ? ? ? 9. Scalability & Flexibility Extensible API ? ? ? ? ? 10. Solutions Oriented Move away from IaaS selling ? ? ? ? ? 5
  • 6. Considerations on Day 1 • • • • • • Migration • Investment in Provisioning & Orchestration technologies Security • Assurance, IPS, IDS, encryption, etc. Regulatory (Privacy, Audits) • ICD-10, EHR, DR, etc all demand better IT operations Accessibility • Of Data, and differentiated by user. Governance parameters 52% of Enterprises have no cloud strategy {Logicalis Australia, Aug 2013} • • 50% have a private cloud and 46% use cloud in the form of SaaS 72% believe the role of the CIO will change © 2013 ScienceLogic Inc. All rights reserved 6
  • 7. Considerations on Day 2 • • • • • • Better Visibility • • Contextual per constituent Long term verifiability of one’s cloud assets Meeting KPIs & SLAs • Validation More Control • Better tools Operational Optimization • Best execution environment Cost • Chargeback and expenditure Future-proofing © 2013 ScienceLogic Inc. All rights reserved 7
  • 8. So you launch a cloud service… • How is your operations team doing? • • • How is the integration? How long has it been? Who’s working on it? Why is this so complicated? Where are my SLAs? © 2013 ScienceLogic Inc. All rights reserved 8
  • 9. Traditional IT Management Systems Traditional IT management systems are threatened… MSP / “Cloud” Mainframe Client / Server 9
  • 10. So should you abandon the Cloud?
  • 11. Bringing Efficiencies to the Architecture © 2013 ScienceLogic Inc. All rights reserved 11
  • 12. Bringing Efficiencies to Operations © 2013 ScienceLogic Inc. All rights reserved 12
  • 13. What makes us different? • Narrow in scope • Old technology • Hard to extend • Loose integration between • Non-integrated • Requires manual • Retrofitted for cloud correlation • Retrofitted for multi-tenancy Point Tools acquired products Big 4 Frameworks • Expensive to maintain Simple unified product Fully Multi-Tenant Extensible and Open Breadth of Collection Common Data Model Highly Customizable © 2013 ScienceLogic Inc. All rights reserved Dynamic Dashboards Rapid Time to Value 13
  • 14. “Good Enough” not good enough © 2013 ScienceLogic Inc. All rights reserved 14
  • 15. Attestation Server Trust Architecture Policy Engines GRC SIEM (e.g. Hytrust) (e.g. RSA) (e.g. ArcSight) https Orchestrator/Scheduler (ex. CloudStack, OpenStack) Portal CUSTOMER A Citrix Xen Trust Agent ssl ESXi Host VMware vCenter ESXi Host Attestation Server Linux/KVM Trust Agent Citrix Xen Trust Agent ESXi Host VMware vCenter Gather platform status (TCG,XML) © 2013 ScienceLogic Inc. All rights reserved Privacy CA Attestation Handler/Cache MLE Whitelist Management Provisioning + Automation CUSTOMER B ESXi Host https RESTful API Credential Management Intel TXT Based Attestation Server Monitor display trust status (HTML5) Provide platform trust status for trusted pools, Compliance, etc = Attestation Server Components 15
  • 16. Why are we moving toward Hybrid Cloud? Your MSP/CSP © 2013 ScienceLogic Inc. All rights reserved 16
  • 17. Managing Hybrid IT can be tricky © 2013 ScienceLogic Inc. All rights reserved 17
  • 18. Cloud Expectations Changing the Model © 2013 ScienceLogic Inc. All rights reserved 18
  • 19. Picking the Right CSP © 2013 ScienceLogic Inc. All rights reserved
  • 20. Noisy Neighbor Concerns with the Cloud © 2013 ScienceLogic Inc. All rights reserved 20
  • 21. ScienceLogic Today • Instant • • • • Intelligent • • • • Time to value Visibility Smart™ Actions & Automation Discovery Application Mapping Contextual Quality of Service Visualization Integrated • • • All-in-One True™ Multi-Tenancy Open Architecture © 2013 ScienceLogic Inc. All rights reserved 21
  • 22. Next Generation Monitoring Platform Assets Automation Reporting Performance Customer Portal Events Service Levels Instant Management Billing Orchestration Via RESTful API Integrated Datastore CRM Service Desk 3rd Party Provisioning Intelligent Discovery & Monitoring Application Cloud © 2013 ScienceLogic Inc. All rights reserved Virtualization Network Compute Storage Physical 22
  • 23. Monitoring the Entire Cloud Estate © 2013 ScienceLogic Inc. All rights reserved 23
  • 24. Open Extensibility Technology Extensions Core Product Extensions APM / DaaS Config Management SERVICE MANAGEMENT INTELLIGENT MONITORING Unified Communications Cloud Application Virtualization Performance Service Levels Network Storage / Server Mgt Multi-tenant Datastore © 2013 ScienceLogic Inc. All rights reserved NetFlow / sFlow Reporting Storage Customer Portal Physical Security / Trust Network Config Mgt Event Compute Big Data Service Desk Service Desk Automation Notification / Remote Video Scheduling 24
  • 25. Anticipate performance issues in your cloud Antonio Piraino, CTO ScienceLogic For more information: blog.sciencelogic.com info@sciencelogic.com www.sciencelogic.com @antoniopiraino © 2013 ScienceLogic Inc. All rights reserved

Editor's Notes

  1. Track: Mobile, Telecommunications/Unified Telecommunications Exploiting the cloud through next generation managementAs more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services.  Similarly, ‘Good enough’ and ‘available’ are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations. In this session, organizations will learn how to exploit the opportunities presented by The Cloud by implementing successful Management systems that:Create contextual visualizations that are key to exploiting the depth of cloud resources and assist in Smart IT decision making.Accelerate productivity and business policy implementation though automation of operations and other manual workflows.  Modernize IT operations management for optimized application performance that legacy tools cannot control.Manage IT workloads and applications that reside in Hybrid Cloud environments through a single pain of glass.Associate the cost of cloud use with best application deployment and use of cloud services. 
  2. As far as total cost of ownership and return on investment go, Roy noted a key consideration when his company began looking at alternatives to its Oracle/Java system. The legacy app had a fixed-cost model, whereas Salesforce expenditures would increase as the company added users, customers and so forth. On paper, Salesforce was considerably more expensive than Oracle in AWPRx's cost comparison, largely because the infrastructure was already bought and paid for. Yet by Roy's math, his annualized cost with Salesforce -- including labor, licensing, servers, and such -- is actually less than half (47%) of what it was previously. A big chunk of that savings comes from reduced headcount -- his IT team went from eight people to five after the switch. Roy noted that three people -- expensive ones, at that -- is a "big deal" in a company of his size.A long-overdue omnibus package that includes HIPAA modifications tops the list of regulations dealing with health data privacy and security issues that are pending for 2013.Also pending is an accounting of disclosures rule that, in early draft form, called for providing patients, upon request, with reports listing everyone who accessed their electronic health information. Plus, rules for Stage 3 of the HITECH Act electronic health record incentive program, which begins in 2016, are in development.Another much anticipated regulation is the accounting of disclosures rule. A notice of proposed rulemaking included a controversial requirement to provide patients, upon request, with reports listing everyone who accessed their electronic health information.next year will see continued development of rules spelling out requirements for Stage 3 of the HITECH Act electronic health record incentive program. For Stage 3, ONC will publish an updated meaningful use rule, spelling out requirements for how hospitals and physicians must use EHRs to earn additional incentives, as well as a software certification rule, outlining the required functions of EHR software that qualifies for the program.Some 25 countries use ICD-10 for reimbursement and resource allocation in their health system. All of these require further Digiiziation of records, agility, TCO, virtualziation of apps, greater IT efficiency
  3. We all know about the famous healthcare.gov fiasco. However, what about it’s latest outage? HeathCare.gov is the front door to a system for registering for insurance and shopping for policies under the 2010 health care overhaul. Since launching on Oct. 1, it has been plagued by errors and long waits for service on the user interface side, and problems in delivering information to insurance carriers on the back end. This is the first reported outage related to a failure at a cloud provider. Impacted by Verizon Network componentfailureand Terremarkfaciltities.Healthcare and other sector failures. Too many tactical decisions, based on public clouds that simply will fail as with anyotherdatacenetr and IT group. You get what you pay for.Since Salesforce.com is hosted in the cloud, pharmaceutical reps can use the tool anywhere with Internet, or from their mobile device. Also, managers can instantly monitor activities in the field with robust reporting. The MDPHnet Project is the marriage of two software systems created by Harvard Medical School’s Department of Population Medicine (DPM). The first system, Electronic Support for Public Health System (ESP), is a disease surveillance software application that can extract and analyze data from electronic health record system for events of public health importance. Resides on Lincoln PeakeInfratsructure.Carpathia has a strong track record engineering and hosting healthcare-compliant systems for companies of all sizes and IT complexity, system integrators and small A8 businesses.  Clients such as INRange Systems and Portal|Ascend Group rely on Carpathia’s healthcare compliance experience and expertise to ensure their information systems achieve and maintain healthcare compliance standards throughout the lifecycle of their systems.In Sep 2013 Two of G2's clients in the Boston area, prescription management startup ZappRX Inc. and genome sequencing firm Courtagen Life Sciences, Inc., have signed on to use AWS' Elastic Compute Cloud (EC2) under G2's BAA.AMAG pharmaceuticals: Then they discovered a small startup called CloudLock that proposed to do exactly what AMAG was looking for."We said, 'We'll pay you if you let us beta test your product. We'll give it a full run, and if it works, you will have solved our company's problem.' They came in, met with us, spent whole day talking about all our problems -- a huge development session. A month later, they came back said 'Here you go.' They hand-delivered their product, which we use religiously."McBride continues, "CloudLock gives us full control over every single document -- all 1.5 million documents in our Google Drive space. We use policy engines to report on keywords, who's doing what, who shared what with who. We know everything that happens to every single one of these docs from genesis to deprecation. Once they gave us that, we immediately commenced moving everyone to Google Drive." 
  4. This is generally what the healthcare industry is looking for. Then breakign it down between day1 and day 2 operations comes next.
  5. Not quite as cleanly as you’d hoped it would be..If your constituents have to think about this for longer than a second, you’ve lost your attractionMeans More workload complexityMeans more challenges in meeting SLAsMeans more Cost without proactive management
  6. No – the answer is in Hybrid cloud. Cloud is revolutionary, but you want an eviolutionary move to better, faster and smarter systems.What is better in the cloud vs your own IT systems?
  7. As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services.  Similarly, ‘Good enough’ and ‘available’ are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.
  8. As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services.  Similarly, ‘Good enough’ and ‘available’ are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.Have been told by Enterprise customers – they have to move to Windows 365 – will stop Hosted office solutions. Large enterprise is telling you they have to do it.If you don’t like the cloud – irrespective you desktop will be in the cloud – like it or not. MS will move you to the cloud like it or not. And you will end up in the Hybrid model – and managing complexity is going to become pivotal.But you also have greater options – Google and AWS for example.
  9. As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services.  Similarly, ‘Good enough’ and ‘available’ are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.
  10. How to pick the right vendor, and diminish your concerns?How to map the variety of monitoring and management technologies available, and the context for which they become relevant to various business needs and network architecture.  Optimize your cloud management
  11. The Noisey neighbor issue