Considerations for Healthcare Applications in a Platform as a Service Environment

Abstract

With the introduction of software as a service projects a fundamental change for the world of the IT services and also for the development of software systems goes on. One of the major challenges for today’s companies is to detect and manage this change and business development. This are not only IT provided internal considerations, but must also be considered for business processes. Software as a service and platform as a service seems at first glance to have only advantages. Users do not need to install software anymore and also the maintenance is eliminated. Developers do not have to worry longer about infra-structure, software requirements and distribution of the results. It seems the perfect world for everyone. But special considerations must be taken into account when developing software for health care and medical solutions. Not only must such software meet highest security standards patient data must never be com-promised or altered unobserved. The primary example under discussion consists of a clinic portal with numerous collaboration possibilities for surgeons.

The first question in traditional system development is for the components to be used. This means both hardware and software. This includes for example the question according to the database, the operating system, application server, or also the programming language. All this requires many decisions and a high risk, which affect the development process of the application much later already in advance.

With the introduction of the cloud and service platforms all of these decisions are moved to the operator of the platform. The selection of the appropriate platform remains for us as system architects, and application developers. This means a comfortable situation for the projects decision maker. However, a later change between platforms is not easily possible.

One of the advantages of a service platform is that infrastructure and platform are provided globally for all users. Modifications allow for adaptations to special requirements. Accordingly, a considerable part of software development consists of the definition of required components in the platform metadata.

To develop healthcare applications on a platform, special challenges are faced for the architecture. A big difference is added in the health sector. Here, security issues and the location of the data play a larger role. In the full paper we will discuss this in more detail. A first insight is that it requires not only a single platform. Due to the still existing, identifiable specialization of the platforms we need to connect the strengths from multiple platforms together. In addition, we must comply with common international standards such as HIPAA compliance and FDA compliance.

In the case study we consider, the client is one of the leading companies in the development of integrated medical software systems. The client at its sites already deploys salesforce.com. An exclusive portal for doctors, especially neurosurgeons, should be developed on this basisfor the professional exchange of experience. It should work similar to a social network (see Fig. 1).

Salesforce.com is by default suitable for the management of users and their rights. The platform comes in the handling of large medical image data sets to the borders. For this reason, Amazon’s simple storage services (S3) and Amazon Elastic cloud computing (EC2) for these aspects are involved. The use of a Microsoft Silverlight component in the force.com platform is introduced for the integration of the two platforms in the same project. Silverlight in turn should then communicate by exchanging SOAP messages with S3 and the user interface, as well as processing of image sequences.The architecture of the final system is shown in Fig. 2.