Non-italicised points represent notes taken from Google’s official case study documentation, with keywords highlighted in bold. Points in italics represent additional insights and possible solutions.

Overview

  • Leading provider of electronic health record software:
    • Large company
    • Many customers
    • Compliance important
  • Provide SaaS to multinational medical offices, hospitals, and insurance providers:
    • Regulations:
      • Google Cloud is HIPAA compliant
      • Need to protect PII data
    • Multi-national:
      • Even more compliance
      • Multi-regional deployments
  • Growing rapidly:
    • Need to scale
    • Autoscaling Groups
    • Kubernetes autoscaling (pods, node pools)
  • DR plan required
  • Need to update continuous deployment processes:
    • Update software faster
    • CI/CD
  • Google Cloud to replace existing colocation facilities

Existing Environment

  • Lease on DC about to expire
  • Web-based customer-facing applications
    • Many already containerized to run on Kubernetes:
      • Kubernetes Engine
      • Anthos for hybrid-cloud use cases, and to manage multiple clusters centrally
      • Google Container Registry
  • SQL and noSQL DBs:
    • MySQL
    • MS SQL Server
      • Lift/shift to Cloud SQL
      • Provision specific version in Compute Engine (if not available in Cloud SQL)
    • Redis
      • Lift/shift to Memorystore
      • Deploy Redis Enterprise from marketplace
    • MongoDB
      • ETL to Cloud Firestore
      • Deploy MongoDB Atlas from marketplace
      • Manual build on GCE/GKE
  • Legacy file and API integrations with insurance providers on-prem:
    • Scheduled to be replaced, but no immediate plans to move or upgrade
      • Requires secure connectivity between cloud and on-prem
      • VPN, Partner/Dedicated Interconnect
  • Users managed in MS Active Directory:
    • Google Cloud Directory Sync (GCDS)
      • One-way sync of users and groups
  • Monitoring:
    • Currently using open source tools
      • Move to Google Cloud Operations Suite
    • Alerts via email often ignored
      • Reduce frequency
      • Move from email to SMS, Slack, PagerDuty, Pub/Sub etc.
      • Alerting policies

Business Requirements

  • Onboard new insurance providers as quickly as possible:
    • Common APIs
    • API management - Apigee
    • SaaS admin portal
  • 99.9% availability for customer-facing applications:
    • Multi-zonal / regional resources
  • Centralized visibility of applications, with proactive monitoring and alerting:
    • Google Cloud Operations
    • Central logging/monitoring project for all subprojects
  • Gain insights into healthcare trends:
  • Reduce latency to end users:
  • Ensure compliance:
    • HIPAA
    • Audit logging
  • Decrease infrastructure admin costs:
    • Use managed services wherever possible
    • Automate using IaC
  • Predictions and reports on industry trends:

Technical Requirements

  • Maintain legacy interfaces to existing insurance providers
    • VPN or Partner/Dedicated interconnect
  • Consistent way to manage containerized apps
    • Anthos
    • Cloud Run and Cloud Run for Anthos
    • Google Container Registry
  • Secure and high performance interface between Google Cloud and on-prem
    • VPN or Partner/Dedicated interconnect
  • Logging, log retention, monitoring, alerting
    • Cloud Operations
    • Long term retention, use GCS or BigQuery as a sink
  • Manage multiple container-based environments
    • Anthos
    • Centralized DevOps project
      • Host GCR and Cloud Build
    • Same container image for each environment
  • Create interfaces to ingest and process data from new providers

Executive Statement

  • Currently, expensive (time, money):
    • Training team to manage disparate systems
    • Multiple environments
      • CapEx and OpEx too high
      • Consolidate to common platform e.g. Anthos
      • Use managed services where possible
  • Outages caused by:
    • Misconfigurations
      • Automate where possible—CI/CD
      • Infrastructure as code e.g. Terraform
      • Kubernetes—roll-back unstable releases
      • Anthos Config Management for guardrails and best practice policies across all clusters
    • Inadequate capacity
    • Inconsistent monitoring
      • Consolidate onto Google Cloud Operations

Potential Solution Design

EHR Healthcare design

References


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