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Bhagvan Kommadi [Value Momentum] | TeleHealth Platform: DevOps-Based Progressive Delivery | InfluxDays NA 2021

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Bhagvan Kommadi [Value Momentum] | TeleHealth Platform: DevOps-Based Progressive Delivery | InfluxDays NA 2021

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TeleHealth Platform: DevOps-Based Progressive Delivery
The talk covers a real-life experience related to building a DevOps Delivery-powered AI platform for doctors’ community and telehealth support for patients during COVID-19 lockdown. The doctors’ community interacts related to cases and triage for different patient cases. They can extend telehealth support using medical practice management solutions. Patients can order medicines online through integrated pharmacies on the platform. AI Platform has digital, voice, and knowledge assistants to provide information to the doctor. DevOps is enabled using Jenkins on AWS which helps in continuous integration and progressive delivery of features to Mobile and web apps (Apple & Google app stores). Historical data is used for predictive analytics by the machine learning platform. The platform helps healthcare enterprises: 1. Deploy voice tech to facilitate clinical documentation 2. Reduce physicians’ administrative burden 3. Increase patient volume and billable revenue 4. Eliminate transcription costs 5. Use voice to increase touchpoints and increase patient engagement.

TeleHealth Platform: DevOps-Based Progressive Delivery
The talk covers a real-life experience related to building a DevOps Delivery-powered AI platform for doctors’ community and telehealth support for patients during COVID-19 lockdown. The doctors’ community interacts related to cases and triage for different patient cases. They can extend telehealth support using medical practice management solutions. Patients can order medicines online through integrated pharmacies on the platform. AI Platform has digital, voice, and knowledge assistants to provide information to the doctor. DevOps is enabled using Jenkins on AWS which helps in continuous integration and progressive delivery of features to Mobile and web apps (Apple & Google app stores). Historical data is used for predictive analytics by the machine learning platform. The platform helps healthcare enterprises: 1. Deploy voice tech to facilitate clinical documentation 2. Reduce physicians’ administrative burden 3. Increase patient volume and billable revenue 4. Eliminate transcription costs 5. Use voice to increase touchpoints and increase patient engagement.

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Bhagvan Kommadi [Value Momentum] | TeleHealth Platform: DevOps-Based Progressive Delivery | InfluxDays NA 2021

  1. 1. 1 © 2021  InfluxData Inc. All Rights Reserved. DevOps Based Progressive Delivery Telehealth Platform Bhagvan Kommadi Director of Product Engineering, ValueMomentum
  2. 2. 2 © 2021  InfluxData Inc. All Rights Reserved. Mind Map - DevOps Telehealth Solution Architectural Components Deep Learning Solution Implementation What’s Next ? Sneak Preview of Upcoming Features Agenda DevOps Agility Flexibility Quality
  3. 3. 3 © 2021  InfluxData Inc. All Rights Reserved. 3 Mind map No Code Platforms Low Code Platforms Market Requirements Health Insurance Payment Processing AI Digital health Data Sources Knowledg e Resources Legacy Systems & Migration Budget In House Applications Health Care Application Upgrades & Update Training Metadata Customizations Licensing & Subscription Life insurance Tech Stack Wellness Apps Hospital Management Application Scope Neural Sketch Learning AI/ML Devops Containers Cloud CI/CD Version Control Testing GIT IDE Automation Virtualization Network Monitoring System Admin
  4. 4. 4 © 2021  InfluxData Inc. All Rights Reserved. 4 © 2021  InfluxData Inc. All Rights Reserved. Telehealth Solution
  5. 5. 5 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Patient Journey Book an Appointment Appointment Reminder Schedule Tracking Intimate Delays Manage Appointments Post Appointment Engagement
  6. 6. 6 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. What Patients Want & Doctor’s View
  7. 7. 7 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Voice Assistants
  8. 8. 8 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Process Flow Filters NLP API Web Mobile Desktop Queries Registry Data Sources Links Knowledge Base Updates 1) Diseases 2) Data Sources 3) Artifacts Top Down As Knowledge Domain Expert Bottom Up Registry & knowledge updates • Orphanet • Johns Hopkins • WHO • NORD
  9. 9. 9 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Knowledgebase Architecture Service Layer Visualization Layer Data Access Layer Knowledge Updates Internet Data Sources Search Manager Knowledge Base Manager axios cheerios node Disease Registry Disease Knowledge
  10. 10. 10 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Digital Assistants & Video Bots Taking clinical notes Retrieving cases Updating Prescriptions Creating consultation appointments
  11. 11. 11 © 2021  InfluxData Inc. All Rights Reserved. 11 © 2021  InfluxData Inc. All Rights Reserved. Architectural Components
  12. 12. 12 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Bug Tracking Systems Monitoring Systems Configuration Management OS Patching CI/CD Pipelines Containers Source Code Control Systems Collaboration Infrastructure Foundational Tools & Infrastructure
  13. 13. 13 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. DevOps Evolution - Metrics Metric Value Deployment Frequency Monthly Lead Time Between a week and 6months MTTR Less than a week Change Failure Rate Less than 15% Low Mid High Metric Value Deployment Frequency Between Daily and Weekly Lead Time Less than a week MTTR Less than a day Change Failure Rate Less than 15% Metric Value Deployment Frequency On Demand Lead Time Less than an hour MTTR Less than an hour Change Failure Rate Less than 5%
  14. 14. 14 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. DevOps Evolution - Challenges • Resistance to Change • Legacy Architecture • Shortage of Skills • Lack of Automation • Unclear Objectives Low • Resistance to Change • Legacy Architecture • Shortage of Skills • Lack of Automation Mid • Legacy Architecture • Shortage of Skills High
  15. 15. 15 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Flow of Change Business Domain Business Domain Stream Aligned Team Stream Aligned Team Enabling Team Platform Team Complex Subsystem Team Flow of Change Collaboration X as a Service Facilitating
  16. 16. 16 © 2021  InfluxData Inc. All Rights Reserved. Jenkins Devops - Features Authorization Administration Analytics Scalability Availability Distributed Teams Container Support Quality Cost Product Time
  17. 17. 17 © 2021  InfluxData Inc. All Rights Reserved. Jenkins Pipeline – Devops Workflow Code Checkout Build the code Test the code Stage the build Release the build Deploy the build Version Control Continuous Integration Continuous Delivery Continuous Deployment
  18. 18. 18 © 2021  InfluxData Inc. All Rights Reserved. Progressive Delivery of Web Apps Automating the Delivery of Web Apps Jenkins Server GitRepo Update Jenkins Trigger Jenkins Build Process AWS Deployment Live Web App
  19. 19. 19 © 2021  InfluxData Inc. All Rights Reserved. Progressive Delivery of Mobile Apps Automating the Delivery of Mobile and Web Apps Jenkins Server GitRepo Update Jenkins Trigger Jenkins Build Process Google Play Store Apple App Store
  20. 20. 20 © 2021  InfluxData Inc. All Rights Reserved. Jenkins Devops : Benefits Autonomous Teams Simple setup Delivers Release in Time Faster Delivery Higher Productivity Software Predictivity Business Sustainability Autonomous Teams Audit Trails End to End Integration Tests Functional Tests Unit Tests
  21. 21. 21 © 2021  InfluxData Inc. All Rights Reserved. Jenkins – Agent based Architecture Jenkins Server Git Lab Jenkins Agent Jenkins Agent Jenkins Agent
  22. 22. 22 © 2021  InfluxData Inc. All Rights Reserved. Dev Ops Best Practices 22 Automating Software Delivery Treating Release Orchestration as a Business Imperative Adopting Best-of-Breed Solutions but Doing so Judiciously Practicing Value Stream Thinking Using Feature Flags for Safer, Faster Software Delivery
  23. 23. 23 © 2021  InfluxData Inc. All Rights Reserved. 23 © 2021  InfluxData Inc. All Rights Reserved. Demo
  24. 24. 24 © 2021  InfluxData Inc. All Rights Reserved. 24 © 2021  InfluxData Inc. All Rights Reserved. Deep Learning Solution HealthCare Data Analysis
  25. 25. 25 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Input Layer Hidden Layer Hidden Layer Output Layer Hidden Layer Hidden Layer Convolutional Neural Network
  26. 26. 26 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Image Pixels Pixel Value Color Depth Grey Scale Intensity CNN Layers Convolution Rectified linear unit (ReLu) Pooling Fully Connected Features Extraction Image Recognition
  27. 27. 27 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. CNN Models Keras pre-trained CNNs Xception VGG16 VGG19 ResNet5 0 Inception V3 Inception ResNetV2 Mobile Net Dense Net NASNet MobileNet V2
  28. 28. 28 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Atelectasis 192 Cardiomegaly 50 Consolidation 72 Edema 41 Effusion 203 Emphysema42 Fibrosis 38 Hernia 5 Infiltration 503 Mass 99 No Finding 3044 Nodule 144 Pleural_Thickening 65 Pneumonia 14 Pneumothorax 114 Total Result 5606 Atelectasis Pneumothorax Gender : Male, Female Xray Position: Frontal , Back, Side Lung Disease Analysis
  29. 29. 29 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Training Testing Validation Normal Infection by Virus Infection by Bacteria True Positive False Positive False Negative False Positive Actual P r e d i c t e d Precision = True Positive/Actual Results Recall = True Positive/Predicted Results Accuracy = (True Positive + True Negative)/Total Actual Results = True Positive + False Positive Predicted Results = True Positive + False Negative CNN Scale Shift Rotate Salt and Pepper noise Flip Lung Disease – Deep Learning
  30. 30. 30 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Total params: 12,167,424 Trainable params: 12,167,424 Non-trainable params: 0 Precision: 0.734694 % Recall: 0.073022 % Fscore: 0.261248 % Training Data Bias = Average Predicted Value - Average Actual Value Convolutional Neural Network Results
  31. 31. 31 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Convolutional Neural Network - Basic
  32. 32. 32 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Convolutional Neural Network – Complete Dataset
  33. 33. 33 © 2021  InfluxData Inc. All Rights Reserved. 33 © 2021  InfluxData Inc. All Rights Reserved. Implementatio n
  34. 34. 34 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. White Coats Platform Network App Practice Plus Clinic Plus StaffPlus Patient Plus Registered Doctors* 3,00,000 + Locations 3,000 + Onboarded Doctors (App) 50,000 + Doctors from Metro/Tier 1 & 2 ~68 % Doctors from Tier 3 & 4 ~32 % # of Specialties 125+ General Practitioners ~35 % % of Drs : Specialists ~65 % • App & Web Views Q1- 2.05L ; Q2- 2.8L (Growth 36%) • Social Interactions (APP) Q1- 1.27L ; Q2- 1.58L (Growth 25%) • Network Cases Q1- 800 ; Q2- 1000 (Growth 25%) White Coats Platform
  35. 35. 35 © 2021  InfluxData Inc. All Rights Reserved. What’s Next ? Relation of programming paradigms to CD and deployment experience Differences between prevalence and effects of intentional vs. unintentional violations of SOLID OO design principles Count of manual interventions required to go from dev to production and relation to software architecture and testing strategy Relation of database normalization to deployment and incident/rollback frequency Complexity of DevOps pipeline in terms of tool count Overall effect of CD on application quality and security Prevalence of version control for various definable (source, build scripts, infrastructure configuration, etc.) SRE
  36. 36. 36 © 2021  InfluxData Inc. All Rights Reserved. Moving From DevOps to -> DevOps Data Ops Dev SecOps AI Ops MLOps Development Operatio ns Security Data DevOps DevSecOps DataOps
  37. 37. 37 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. DevOps - Tools Plan • Clickup • JIRA Code • JIRA • Clickup • GitLab • Confluenc e Build • Maven • Gradle • Sbt • Ant Test • Selenium • Junit • Watir Release • Jenkins • CodeShip Deploy • Docker • Clouds Monitor • Nagios • DataDog • Splunk
  38. 38. 38 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Ops Roles - Future Vendor Engg Product Engg SocioTechnical Systems Engg Portfolio Management
  39. 39. 39 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. SAFE - CALMR Culture, Automation, Lean flow, Measurement, and Sharing Increased frequency, quality, and security of product innovation Decreased deployment risk with accelerated learning cycles Accelerated solution time-to-market Improved solution quality and shortened lead time for fixes Reduced severity and frequency of failures and defects Improved Mean Time to Recover (MTTR) from production incidents
  40. 40. 40 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Site Reliability Engineering DevOps SRE Waste Reduction Automation Scale Systematic Perspective Delivery Release Automation Infrastructure as Code Config Management Reliability Performance Monitoring Efficiency Improvement
  41. 41. 41 © 2021  InfluxData Inc. All Rights Reserved. © 2021  InfluxData Inc. All Rights Reserved. Clinical Knowledge - EBM 41 • Guidelines • Decisions • Study Results • Observations Data Evidence Guidance Action Omni Channel Telehealth Platform Genomic Applications Personalized Medicine Evidence Based Medicine Predictive Toxicology QSAR Chemo-Informatics
  42. 42. 42 © 2021  InfluxData Inc. All Rights Reserved. Questions?

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