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AWS re:Invent 2016: Voice-enabling Your Home and Devices with Amazon Alexa and AWS IoT (ALX307)
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AWS re:Invent 2016: Building IoT Applications with AWS and Amazon Alexa (HLC304)

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Alexa, what is the Internet of Things? Now that technology is small enough to be embedded in everyday devices, Healthcare has an opportunity to exploit the extraordinary potential of connecting ordinary devices. In this presentation, we explain how to rapidly build an IoT system and how to drive the Cloud with your voice on an Amazon Echo. In addition to describing how to use Alexa, we explore using AWS IoT, Lambda, Amazon SNS, and DynamoDB.

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AWS re:Invent 2016: Building IoT Applications with AWS and Amazon Alexa (HLC304)

  1. 1. © 2016, Amazon Web Services, Inc. or its Affiliates. All rights reserved. HLC304 Building IoT Applications with AWS and Amazon Echo November 28, 2016 Chris McCurdy - AWS Specialist SA in Healthcare and Life Sciences Nitin Gujral – Directory of Software Engineering and Innovation at Boston Children's
  2. 2. What to Expect from the Session • What is IoT and what are some patterns that are being used in industry? • What are some alternatives if I just want health sensor- related data? • How is KidsMD using Alexa to help improve home care?
  3. 3. What is IoT?
  4. 4. What is IoT?
  5. 5. What is AWS IoT?
  6. 6. What is AWS IoT?
  7. 7. What is AWS IoT?
  8. 8. What does AWS IoT consist of? Security First • All traffic to and from AWS IoT must be encrypted over Transport Layer Security (TLS) • AWS Managed Certificates • Certificate Signing Request (CSR) Certificates • Just-in-time (JIT) Registration • Protect your certificates • chroot • Security Enhanced Linux (SELinux) • One-Time Programmable (OTP) Fuses • Trusted Platform Modules • Smartcards • Locks and Boxes • FIPS-style hardware
  9. 9. What does AWS IoT consist of? Thing Gateway
  10. 10. What does AWS IoT consist of? Thing Gateway Supported Protocols HTTPS, Websockets, Secure MQTT What is MQTT? A lightweight pub/sub protocol, designed to minimize network bandwidth and device resource requirements. MQTT supports TLS for encryption.
  11. 11. What does AWS IoT consist of? Thing Gateway var device = awsIot.device({ keyPath: 'private_key.pem', certPath: 'certificate.pem', caPath: 'root.pem', clientId: clientId, region: 'us-east-1' }); var button = new groveSensor.GroveButton(6); function readButtonSensorValue() { var buttonState = button.value(); if (buttonState == 1) { device.publish(topic, JSON.stringify({ SubmitTime: (new Date()).toJSON()})); } } setInterval(readButtonSensorValue, 100);
  12. 12. What does AWS IoT consist of? IoT Rules Engine Amazon Kinesis Amazon S3 bucket
  13. 13. What does AWS IoT consist of? IoT Rule Engine • Augment or filter data received from a device. • Write data received from a device to an Amazon DynamoDB database. • Save a file to Amazon S3. • Send a push notification to all users using Amazon SNS. • Publish data to an Amazon SQS queue. • Invoke a Lambda function to extract data. • Process messages from a large number of devices using Amazon Kinesis. • Send data to the Amazon Elasticsearch Service. • Capture an Amazon CloudWatch metric. • Change an Amazon CloudWatch alarm. • Send the data to Amazon Machine Learning to make predictions based on an Amazon ML model.
  14. 14. What does AWS IoT consist of? IoT Rule Engine { "sql": "SELECT * FROM 'Sensor/DispensingSensor'", "ruleDisabled": false, "actions": [ { "kinesis": { "roleArn": "arn:aws:iam::XX:role/sensor_status_role", "streamName": "sensor_status_stream", "partitionKey": "${ClientID}" } }] }
  15. 15. What does AWS IoT consist of? Thing Registry • Associate MQTT Client IDs • Associate Certificates • Specify up to 3 custom attributes
  16. 16. What does AWS IoT consist of? Thing Registry { "version": 3, "thingName": "PortableDispenser", "defaultClientId": "abc123", "thingTypeName": "Dispenser", "attributes": { "model": "123", "dispensingVolume": "75" } }
  17. 17. What does AWS IoT consist of? Thing Registry response = client.update_thing( thingName=PortableDispenser', attributePayload={ 'attributes': { 'dispensingVolume': '150' }, }, expectedVersion=2, )
  18. 18. What does AWS IoT consist of? Thing Shadow • Store and retrieve current and future state of the thing • Simple JSON Document • Get and set the state of a thing over MQTT or HTTP • Access the shadow regardless of whether the thing is connected to the Internet
  19. 19. What does AWS IoT consist of? Thing Shadow { "state" : { “desired" : { "sensor" : "ON" }, "reported" : { "sensor" : "OFF" }, "delta" : { "sensor" : "ON" } }, "version" : 10 }
  20. 20. What does AWS IoT consist of? Thing Shadow data = { "state" : { "desired" : { "switch" : "on" } } } response = client.update_thing_shadow( thingName = PortableDispenser', payload = mypayload )
  21. 21. Other services in an scalable IoT architecture Kinesis •Streams are made of Shards •Each Shard ingests data up to 1 MB/sec, and up to 1000 TPS •Each Shard emits up to 2 MB/sec •All data is stored for 24 hours – 7 days •Scale Kinesis streams by splitting or merging Shards •Replay data inside of 24Hr -7days Window
  22. 22. Other services in an scalable IoT architecture Amazon DynamoDB • Provisioned at the table level • Write capacity units (WCUs) are measured in 1 KB per second • Read capacity units (RCUs) are measured in 4 KB per second • RCUs measure strictly consistent reads • Eventually consistent reads cost ½ of constant reads • Read and write throughput limits are independent • Increase as necessary, decrease at most 4 times per UTC day
  23. 23. Other services in an scalable IoT architecture Lambda • AWS Lambda offers 23 "power levels" • Higher levels offer more memory and more CPU power • 128 MB, lowest CPU power • 1.5 GB, highest CPU power • Compute price scales with the power level • Duration ranging from 100 ms to 5 minutes
  24. 24. Example IoT architecture IoT MQTT protocol IoT certificate IoT rule IoT topic Amazon Kinesis AWS Lambda Amazon DynamoDB Amazon SNS Alexa Medication Status monitoring device Medication Status Backend Node.js AWS Lambda AWS Lambda
  25. 25. Elephant in the room http://nos.twnsnd.co/post/104252656546/elephants-tea-party-robur-tea-room-24-march Amazon Kinesis AWS Lambda Amazon DynamoDB Amazon SNS Alexa AWS IoT HIPAA Eligible Not HIPAA Eligible
  26. 26. Example IoT (PHI) Architecture IoT MQTT protocol IoT certificate IoT rule IoT topic Amazon Kinesis Amazon DynamoDB Alexa Medication Status monitoring device Medication Status Backend Node.js AWS Lambda Amazon S3 Amazon EC2 client Amazon EC2 AWS Lambda SQS
  27. 27. Validic Digital Health Platform Clinical, Fitness, Wellness and Nutritional Devices, Wearables, Applications, and Equipment Healthcare Providers, Clinical Research, Wellness Apps, Insurance, Academia
  28. 28. Validic architecture 3rd Party Devices, Apps, and APIs Validic Core Platform VitalSnap™ OCR Image Algorithm Calibration Validic Standardization Services Health Data Retrieval Services Admin Database Primary Database Replica Databases Validic API Healthcare Systems, Clinical Trials Platforms, Wellness Applications Patient / Individual
  29. 29. Alexa Voice Service in Healthcare Nitin Gujral Director of Software Engineering, Innovation and Digital Health
  30. 30. Boston Children’s Hospital #1 ranked pediatric hospital nationwide (8 out of 10 specialties) 400 plus bed; children's hospital affiliated with Harvard Medical School Largest recipient of NIH funds in pediatric-focused research
  31. 31. Innovation and Digital Health Accelerator Shaping the future of health care and extending Boston Children’s pediatric leadership globally BCH DataClinical Expertise HCIT Development Products Platforms Ventures Boston Children’s Expertise & Capabilities: + Industry Partners & Startups, like: = To launch disruptive health care focused: Learn more: bostonchildrens.org/accelerator GE GrandRoundsCerner IBM Watson Health Rock Health
  32. 32. Ask the Internet? – Parents are actively looking for guidance—traditional medical content sites lack the trustworthy and readily accessible health guidance. Although I will ALWAYS go with my gut about my kids being sick, I typically ask the internet to confirm my suspicion about what might be happening with them. – Female, 36, Kids ages 1 & 4 Source: 3rd Party consumer research survey (n=200)
  33. 33. Decision support in consumers’ hands Boston Children’s Data & Expertise Withings Raiing
  34. 34. Kids.MD™ is delivering consumer facing digital health tools to patients and families across digital mediums. Kids.MD™ powered by: Boston Children’s Hospital web mobile voice device research platform
  35. 35. “Alexa, ask Kids.MD”
  36. 36. Kids.MD – Alexa Skill Architecture AVS + Kids.MD “Alexa, ask Kids.MD about fever” Skill identified in Alexa voice service Request sent to Kids.MD clinical decision support Sends ‘recommendations’ back to Alexa voice service Alexa converts ‘text’ to spoken words and streams audio Or access via mobile & web app Kids.MD™ Electronic Health Record Patient Portal
  37. 37. Kids.MD on AWS Kids.MD™ Amazon RDS Amazon S3 AWS Lambda API Gateway Amazon EC2 Amazon Dynamo DB
  38. 38. Kids.MD Skill: Development
  39. 39. Node Module - alexa-sdk Handlers for intents
  40. 40. Node Module - alexa-sdk Custom events
  41. 41. Node Module - alexa-sdk State Machine Context persistence using DynamoDB
  42. 42. Node Module - alexa-sdk Setting context Response
  43. 43. Project structure • Structure backend code; e.g., handlers, model and other assets - including tests • Organize Alexa Skills Kit speech assets
  44. 44. Debugging Locally debug AWS Lambda code Reference: Blog by Nathan Grice (https://developer.amazon.com/public/community/post/Tx24Z2QZP5RRTG1/New-Alexa- Technical-Tutorial-Debugging-AWS-Lambda-Code-Locally • within any IDE supporting Node.JS • simulate AVS request / response
  45. 45. Unit testing Javascript testing with Jasmine (a behavior driven framework) https://jasmine.github.io/ NPM module - jasmine or jasmine-node Ability to mock requests and responses Reference: Article by Jeremy Bohrer: https://medium.com/@jjbskir/unit-testing-an-amazon-alexa-skill-with-node-js-and- jasmine-98982544471f
  46. 46. Integration testing – developer tools
  47. 47. Lambda deployment • NPM package • Leverages AWS SDK • Packaging for Lambda • Upload to Lambda • Supports unit testing as well https://github.com/Tim-B/grunt-aws-lambda
  48. 48. Kids.MD Skill: technical considerations
  49. 49. States and decision trees
  50. 50. Managing context in an Alexa skill • short time frame for the duration of skill invocation • access to user and application info • persistent context for a user
  51. 51. Intent Schema Slot types • better voice recognition • more accuracy with user response • supports free form responses Custom Slot Types Built-in Slot Types • e.g. AMAZON.NUMBER, AMAZON.DATE, AMAZON.DURATION
  52. 52. Speech Synthesis Markup Language (SSML) • for more natural speech • pauses and predefined formats (characters, digits, date, telephone, address, etc.) <s>Let us start again.</s> <p>Would you like to hear this information again?</p> <break strength='weak'/> <say-as interpret-as="digits">101.4</say-as>
  53. 53. Speech Synthesis Markup Language (SSML) • improved pronunciation using “phoneme” • specifically for medical terminology <phoneme alphabet="ipa" ph="sɪmp.təms">symptoms</phoneme> <phoneme alphabet="ipa" ph="moətrɪŋ">Motrin</phoneme>
  54. 54. Logging, auditing, and monitoring • AWS Lambda CloudWatch logs and metrics • Custom error logs • Custom auditing of user interactions • Monitoring of various service components
  55. 55. Account linking • Link an Alexa user to the user of your system • Enables contextual interactions based on user’s preferences • Performed at the time of skill installation • Using OAuth authorization flow Reference: https://developer.amazon.com/public/community/post/Tx3CX1ETRZZ2NPC/Alexa-Account-Linking-5- Steps-to-Seamlessly-Link-Your-Alexa-Skill-with-Login-wit
  56. 56. Images and audio in Alexa Skills • Display images in Cards • JPG or PNG (less than 2 MB) Need CORS support for image URLS • SSML Audio Tags <audio> • MP3 support • 90 sec limit • Audio Streaming • Leverage built-in intents for playback Reference: https://developer.amazon.com/public/community/post/Tx1DSINBM8LUNHY/New-Alexa-Skills-Kit-ASK- Feature-Audio-Streaming-in-Alexa-Skills
  57. 57. Voice design – lessons learned • Maintain intuitive conversation • provide guidance via prompts • Balance the amount of verbal responses • Effectively utilize Companion App(s) • with images, audio and streaming sound
  58. 58. Some enterprise deployment challenges Security Connectivity
  59. 59. Voice in healthcare A new way for patients and clinicians to access health information and personalized care in various settings @ home @ inpatient @ outpatient by patients & families by clinicians Context: Users:
  60. 60. Photo by John Blanding for The Boston Globe Example usage: • Home Health Hubs • At the Bedside for Patient Care • Virtual Assistant for Clinicians Voice in healthcare – a new medium Streamline and ease delivery of health care services
  61. 61. “Alexa, ask Children’s Hospital”
  62. 62. Growth of “Internet of Healthcare”
  63. 63. Promise of connected healthcare Portable Proactive Patient Centric
  64. 64. Thank you!
  65. 65. Remember to complete your evaluations!
  • sumeetambi1

    Jun. 15, 2018
  • juny3

    May. 20, 2017
  • ras101

    Dec. 13, 2016
  • unicluster

    Dec. 11, 2016
  • MichaelMarx16

    Dec. 4, 2016

Alexa, what is the Internet of Things? Now that technology is small enough to be embedded in everyday devices, Healthcare has an opportunity to exploit the extraordinary potential of connecting ordinary devices. In this presentation, we explain how to rapidly build an IoT system and how to drive the Cloud with your voice on an Amazon Echo. In addition to describing how to use Alexa, we explore using AWS IoT, Lambda, Amazon SNS, and DynamoDB.

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