This document outlines a presentation on hosting MTBC's EMR software on Amazon EC2. It introduces cloud computing concepts and Amazon EC2. It then describes how MTBC's EMR would be installed on an EC2 server and made available to clients remotely via Microsoft RemoteApp. The benefits to clients and MTBC are outlined, including reduced costs and maintenance compared to clients hosting EMR locally. It concludes with a demonstration of the AWS management console and hosted EMR solution.

1. MTBC Cloud EMR

2. Presentation Outline
 Part 1:
Introduction of Cloud Computing
 Part 2:
Amazon Elastic Cloud Compute (EC2)
 Part 3:
Hosted MTBC-EMR
 Part 4:
EC2 Management Console & Hosted EMR Demo

4. Cloud computing:
the latest evolution of hosting

19. Difference b/w W-Azure, A-EC2 & G-Apps
• Early Stage
• Need to provide .Net
code for front end and
back end server
• Storage for applications
and DB Services
• Provide Development
tools for coding
• Good enterprise
integration
• Pricing based on
Database size and API
Size and users
• Commercially Available
• Upload your VM or
install your applications
and share to your clients
• Not applicable
• Simple Volume Storage
Service
• Fully controlled virtual
Machines
• Pricing is based on
Virtual Server
Specifications and Time
• In Public Beta
• Write application with
limitation Pathon and
submit it to Google
• Provide Development
tools for coding
• Database Datastore APIs
• Integrate the application
with Google services
• Pricing is based on Cloud
Application Usage
Windows Azure Amazon EC2 Google Apps

20. Highlights of Amazon Service
• Pay only for the resources that you actually consume
• Amazon Machine Image (AMI)
• Amazon Elastic Block Store (S3)
• Amazon Virtual Private Cloud (VPC)
• Elastic IP Addresses
• Amazon CloudWatch
• Elastic Load Balancing
• Security Groups
• VM Import

21. EC2 Architecture

22. Amazon Pricing Strategy
• Price is based on instance type, its specification
and region were it is running
• Instance Types:
– On Demand Instance
– Reserved Instance
– Spot Instance
• Instance Specification
– Standard Instance
– High Memory Instance
– High CPU Instance
• Instance Regions
– US East (Virginia)
– US West (Northern California)
– EU (Ireland)
– Asia Pacific (Singapore)
– Asia Pacific (Tokyo)

23. How Hosted MTBC-EMR works
Amazon
EC2 Server
Amazon EC2 Console
Client System
Internet
Practice 1
Installed EMR
EMR Documents
EMR Database
Sync Service
Practice 2
Installed EMR
EMR Documents
EMR Database
Sync Service
Practice 3
Installed EMR
EMR Documents
EMR Database
Sync Service
Microsoft
Remote App
-EMR Practice 1
-EMR Practice 2
-EMR Practice 3
Active
Directory
User 1
User 2
…..
……
User N
RD Web Access
& Firewall
 RDWeb Pages
 GPO Settings
 Ports Setting
Security Group Setting EC 2 Instance in Running State
SSL Certificate: Secure and Encrypted Data Flow

24. Our Medical Data Security at Amazon EC2
• Bit locker (Server Drives will be encrypted)
• Group Policy Management of Server Users
• Windows Firewall Setting
• Amazon EC2 Security Groups
• SSL Certificate Installation (Encrypted Secure
Communication between client & Server)
• HIPPA Compliance (Amazon Claims)

25. Benefits to Clients
• No need to buy a Specified Server Machine for MTBC
EMR Server.
• No need to fulfill clients system specification to install
and run MTBC EMR.
• No need to hire and pay an IT guy to maintain Server and
client machines.
• Available EMR to use for practice within one to two hour
after Signup.
• No need to worry about Server crash and it restoration.
• No need to pay for online backup vaults for MTBC-EMR
databases.

26. Benefits to MTBC
• Very easy MTBC-EMR installation process.
• There is no need to take control of Client machines for
EMR installation and issues resolution.
• We can easy create Server Snapshots and restore them
within 5 minutes.
• No need to send EMR Patch updates and run them all the
client machines. We have to replace the updated exes
only on the Hosted Server.
• No need to worry about data synchronization issue, we
can check the issues immediately when we need.

27. Hosted EMR Cost & Price Analysis (Ruff)
• Cost for (~36 Users):
– EC2 Reserved Instance (3y) : $4000
– SSL for Reserved Instance: $90
– Per User RD Web Services License: $84*36
– Total One Time Cost for three Year: $7042
– EC2 Reserved Instance Per Month Cost: $350
• Client Price:
– Initial Sign Up per Practice: $1000
– Per Provider Per Month Charge(1+2 Users): $295
– E.g: 3 provider in each practice (4 practice): $4000
– After One Month 12providers Charges: $3540
$4000 + $3540 = $7540

28. What we have done so for Hosted EMR!!!
Integration with MTBC Website
Online Hosted Demo EMR Package for New Clients

29. Demonstration
 Amazon Web Services Console Demo
 Hosted EMR Demo

30. References
• Amazon Elastic Compute Cloud (Amazon EC2)
– http://aws.amazon.com/ec2/
• What is cloud computing
– http://www.salesforce.com/in/cloudcomputing/
• HIPAA AND EC2
– http://aws.amazon.com/about-aws/whats-new/2009/04/06/whitepaper-hipaa/
– http://www.ehrdoctors.com/hippa-and-ec2/
• Windows Azure (cloud services operating system)
http://www.microsoft.com/windowsazure/windowsazure/
• Google App Engine
– http://code.google.com/appengine/business/
• Amazon EC2 Pricing Strategy
– http://aws.amazon.com/ec2/#pricing
• Amazon Elastic Block Store (EBS)
– http://aws.amazon.com/ebs/
• Amazon CloudFront
– http://aws.amazon.com/cloudfront/
• Hosted EMR
– demo.mtbc.com