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Tungsten Use Case: Modernizing Medicine, a SaaS solution running on Amazon AWS


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Learn how Modernizing Medicine, an electronic medical records company, serves thousands of customers and leverages Continuent Tungsten to manage databases on Amazon AWS. Modernizing Medicine is a fast-growing SaaS company, offering electronic medical records management solution for thousands of small and medium-sizes dermatology, ophthalmology, optometry, plastic surgery, cosmetic and orthopedics practices.

Continuent Tungsten is a leading database-as-a-service solution for MySQL and Oracle. Continuent Tungsten allows enterprises running business-critical MySQL applications to affordably achieve business and revenue continuity through Tungsten's commercial-grade high availability (HA) and globally redundant disaster recovery (DR) capabilities. Continuent Tungsten makes it simple to create new data services (database-as-a-service) in the cloud or in your private datacenter, and to manage them all from a single point.

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Tungsten Use Case: Modernizing Medicine, a SaaS solution running on Amazon AWS

  1. 1. ©Continuent 2013 Modernizing Medicine a SaaS Solution running on Amazon Web Services Matt Lang, Senior Site Reliability Engineer, Modernizing Medicine Edward Archibald, CTO, Continuent
  2. 2. ©Continuent 2013 2
  3. 3. ©Continuent 2013 3
  4. 4. ©Continuent 2013
  5. 5. ©Continuent 2013 5 With AWS, a complete, affordable LAMP stack, on demand, in minutes - but some assembly is required... apache/php haproxy MyApp Your mobile destination... MySQL AWS is a catalyst for Innovation What happens when your app becomes business critical for your customers?
  6. 6. ©Continuent 2013 Taking a Closer look at Amazon RDS, Amazon’s DBaaS Offering
  7. 7. ©Continuent 2013 What does ‘managed’ mean? • DBMS instance is up and running in minutes, fully integrated with service policies, and bound to a public IP address • Automated backups plus point-in-time recovery • Provision read slaves with a few clicks of a mouse • High-availability options are available • Instances can be easily resized • Software updates can be automated
  8. 8. ©Continuent 2013 How do I use it? • Add hosts to security group • Configure your application to use the ‘endpoint’ provided • Applications that already make a distinction between database connections used for writes versus those used for reads can make easy use of read slaves • Automation of backups, failover, slave provisioning etc. happen behind the scenes
  9. 9. ©Continuent 2013 9 apache/php haproxy MyApp Your mobile destination...Service encapsulation, RDS Style MySQL
  10. 10. ©Continuent 2013 10 apache/php haproxy MyApp Your mobile destination... Multi-AZ Instance Active Multi-AZ Instance Standby Synchronous Block-level Replication Read Slave Service encapsulation RDS Style • Applications reference ‘service’ via ‘endpoint’ • Single endpoint for writes • Zero or more endpoints for reads
  11. 11. ©Continuent 2013 How well does it work? RDS Multi-AZ failover • Failure is detected - can test via reboot • Actual failover appears to be completed within about 20 seconds - depends on size of databases etc. • Some applications may not ‘see’DNS interruption and may not re-connect • DNS Changes need to propagate - can take minutes. In my example, it took about 7 minutes and I needed to restart the app for it to ‘see’ the DNS change
  12. 12. ©Continuent 2013 How well does it work? RDS Multi-AZ failover
  13. 13. ©Continuent 2013 How well does it work? RDS Multi-AZ failover
  14. 14. ©Continuent 2013 App is able to connect at 22:11:45 - about 7 minutes later How well does it work? RDS Multi-AZ failover
  15. 15. ©Continuent 2013 Other RDS Limitations • No cross-region replication • Only runs in AWS • No cross-cloud/multi-data-center operation • Black-box - difficult or impossible to diagnose and correct problems with replication
  16. 16. ©Continuent 2013 Introducing Continuent Tungsten Cloud-scale DBaaS • Runs wherever you need your data to be • Fast failover - typically 5-15 seconds - does not rely on DNS • Built-in load balancing - applications connect to a single IP address to access all data resources • Compute/DB resources are ‘open’ - no black boxes here • Full resource utilization - no ‘standby’
  17. 17. ©Continuent 2013 17 apache/php haproxy MyApp Your mobile destination... MySQL Service encapsulation, Tungsten Style
  18. 18. ©Continuent 2013 18 Tungsten Data Service apache/php haproxy MyApp Your mobile destination... Service encapsulation, Tungsten Style • Single endpoint for both writes and reads • Read-only resources visible and load balanced as they appear • Service-oriented connectivity can span sites
  19. 19. ©Continuent 2013 west east usa Service encapsulation, Tungsten Style
  20. 20. ©Continuent 2013 apache/php haproxy MySocialSite apache/php haproxy MySocialSite usa Service encapsulation, Tungsten Style
  21. 21. ©Continuent 2013 Continuent’s SaaS Customers
  22. 22. ©Continuent 2013 Introducing Matt Lang and Modernizing Medicine
  23. 23. ©Continuent 2013 Modernizing Medicine Mission Modernizing Medicine® is transforming how healthcare information is created, consumed and utilized in order to increase efficiency and improve outcomes. Its product, Electronic Medical Assistant® (EMA™),  is  a  cloud-based, specialty-specific electronic medical record (EMR) system with a massive library of built-in medical content, designed to save physicians time. Available as a native iPad application or from any web-enabled Mac or PC, EMA adapts to each provider’s unique style of practice and is designed to interface with hundreds of different practice management systems. Today, Modernizing Medicine provides specialty-specific offerings for the dermatology, ophthalmology, optometry, orthopedics and plastic and cosmetic surgery markets, and to more than 1,100 physician practices across the country. In 2013 Modernizing Medicine was listed on Forbes’ annual ranking of America’s Most Promising Companies.
  24. 24. ©Continuent 2013 Electronic  Medical  Assistant  (EMA™) • Saves doctors' time by eliminating the need to transcribe notes, allowing the Doctor to focus on the patient. • EMA learns preferences and adapts to the doctor which reduces time spent on coding, all with a touchscreen interface on the iPad • EMA grand rounds provides statistical results of treatments across millions of patient encounters
  25. 25. ©Continuent 2013 Database technology pain points • setting up/maintaining replication • need for high-availability • protecting patient data (encryption, data at rest, data in transit) • massive and unpredictable growth • Big data -- we have the data to revolutionize medicine, but how do we do it?
  26. 26. ©Continuent 2013 How we are addressing the issues • Tungsten takes care of replication and high- availability • leveraging AWS, pod design, automatons to deploy new pods • file system encryption, S3 encryption, SSL, Continuent Tungsten for all db traffic • taking small steps. maybe we will replicate data from all pods into central DB, using Tungsten. Then transform data, create datamarts.
  27. 27. ©Continuent 2013 VPC (subnet Deployment Topology
  28. 28. ©Continuent 2013 Quick Demo: Creating and administering a Continuent Tungsten Data Service
  29. 29. ©Continuent 2013 Continuent Tungsten failover
  30. 30. ©Continuent 2013 Continuent Tungsten failover
  31. 31. ©Continuent 2013 Continuent Tungsten failover Failure detected and failover completed within 15 seconds
  32. 32. ©Continuent 2013 Continuent Tungsten failover Failed db instance is isolated from the service
  33. 33. ©Continuent 2013 What else can Tungsten do? • Cross-region fail over with a single command • Multi-site, multi-master architectures supported • Run services cross-cloud i.e. AWS to Rackspace Cloud etc. • Applications can specify ‘read affinity’ in order to read from local resources
  34. 34. ©Continuent 2013 Questions?
  35. 35. ©Continuent 2013 36 560 S. Winchester Blvd., Suite 500 San Jose, CA 95128 Tel +1 (866) 998-3642 Fax +1 (408) 668-1009 e-mail: