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© 2015, Amazon Web Services, Inc. or its Affiliates. All rights reserved. Mark Johnston, Director of Global Business Development, Healthcare and Life Sciences May 3 rd , 2016 AWS Healthcare Days Nashville, TN

2016 AWS Healthcare Days | Nashville, TN – May 3,2016

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Page 1: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

© 2015, Amazon Web Services, Inc. or its Affiliates. All rights reserved.

Mark Johnston, Director of Global Business Development,

Healthcare and Life Sciences

May 3rd, 2016

AWS Healthcare DaysNashville, TN

Page 2: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Payers PatientsProviders

Health Information

Exchanges

Healthcare data

security Precision

medicine

Healthcare

ERPEHR

Revenue Cycle

Management

Connected Health

Page 3: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Ecosystem of established healthcare partners and new

entrants…..

Page 4: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

© 2015, Amazon Web Services, Inc. or its Affiliates. All rights reserved.

Scott Whyte

SVP, Growth & Innovation - ClearDATA

May 3, 2016

Healthcare Cloud: Opening Remarks

AWS Healthcare Days | Nashville

Page 5: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Bad Day at the Datacenter

Page 6: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

What I Hear…Often

“I think in 5 years, all providers will want to get out of the data center

business” - National Provider CIO

“I want my team to focus on innovation, not plumbing” – SaaS CTO

“We need competitive advantage - really fast” – Payer CTO

“We want to help providers take on risk – they need HIE and

analytics.” – Chief Analytics Officer, Payer

Page 7: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Agility

After moving to the cloud, Forbes found 60 per cent of

business leaders say they have reduced their IT

maintenance requirements, allowing them to focus more

on strategy and innovation, with 59 per cent seeing

increased business agility.

Page 8: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Community

Physicians

Participating

Practices and

Physicians

Quality Measures

Population management

Increased care coordination

Business model becomes more

focused on wellness

Financial Alignment

Shared risk/shared rewards

Cost reduction incentives

Shift from encounter-focus to

patient-focus

Clinical Integration Shared Services

Data

AcquisitionClinical Data

Repository

Extract clinical data

Extract claims data

Data

IntegrationPatient EMPI

Provider EMPI

Data Standardization

Quality Metrics

Analytics and

Reports

Health Team

CommunicationsPhysician

communication

Provider-patient

Provider-provider

Technology aspects are critical underpinnings to success

Clinician Knowledge

Find actionable activities (gaps)

Decision support

Enhance communications with

patients and other providers

Clinical

Integration

Solutions

Overview

Hospitals

Inpatient clinical

quality metrics

Payer

s

Physician-Led

Entities

Governing body (Participating

Practices and

Physicians)

Payer

negotiations

Distribute

shared savings

Clinical quality

Reports

Participating

Community

Physician clinical

data

Coordinated

Care

Collaboration

Page 9: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Innovation

Page 10: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Thank You.

Scott Whyte

SVP, Growth & Innovation - ClearDATA

Page 11: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Embracing DevSecOps while improving your

compliance and security agility and postureChris McCurdy

Healthcare and Life Sciences Specialist AWS

Page 12: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Agenda

• DevOps to DevSecOps Primer

• Observed industry cloud techniques with AWS• Tools, processes and frameworks to assist

• Example Compliance Workflows

Page 13: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Big Company, Big Challenges

Thousands of Systems

Complex IT Ops

Limited Financial Impact

Cloud Patterns and Acceleration

Automated IT Cost Transparency

Current State of Enterprise IT Cloud Strategy Offers Agility

Page 14: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

DevOps Level Set

Development

Quality Assurance

Operations

DevOps

Page 15: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

DevOps Toolchain

Plan

Configure

Verify

Preprod

Monitor

Create

Release

Define and plan; business value, application requirements and metrics

Building, coding and configuration

Ensuring quality; acceptance, regression testing

Infrastructure and application

Approval/certification, triggered releases, release staging and holding

Process, application and infrastructure

Release coordination, promotion, scheduling, rollback and recovery

Page 16: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

DevOps Principles

• Collaborate with all stakeholders

• Codify everything

• Test everything

• Automate everything

• Measure and monitor everything

• Deliver business value with continual feedback

Manual Hacking

Page 17: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Drivers for DevSecOps

Embedding Security into DevOps was not successful because…

• Compliance checklists didn’t take us far before we stopped scaling…

• We couldn’t keep up with deployments without automation…

• Standard Security Operations did not work…

• And we needed far more data than we expected to help the business make decisions…

Page 18: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

DevSecOps: Security as Code

Establishing these principles…

• Customer focused mindset

• Scale, scale, scale

• Objective criteria

• Proactive hunting

• Continuous detection and response

Page 19: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

DevOps Toolchain

Plan

Configure

Verify

Preprod

Monitor

Create

Release

Define and plan; business value, application requirements, security, compliance

and metrics

Build, code and configuration

Ensuring quality; acceptance, regression, security and compliance testing

Infrastructure and application

Approval/certification, triggered releases, release staging and holding

Process, application, infrastructure, security and compliance

Release coordination, promotion, scheduling, rollback and recovery

Page 20: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Observed industry cloud techniques with AWS

Page 21: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Consult internally before implementing

The following slides are practices we

have seen used in industry. As security

and industry compliance is determined

by the customer before implementing

please:

• Consult with your internal best

practices

• Consult with with your Cloud Center of

Excellence

• Consult with your Information Security

group

• Consult with your Compliance

organization

• Do your due diligence

Page 22: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

AWS Foundation Services

Compute Storage Database Networking

AWS Global Infrastructure Regions

Availability Zones

Edge Locations

Cu

sto

mer

sPlatform, Applications, Identity & Access Management

Operating System, Network & Firewall

Customer content

Client-side encryption implementation, Server-side encryption, Network Traffic Protection

A Word on Security

Security

in the

cloud

Security

of the

cloud

Page 23: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example: Simplified Claims Workflow

Validation

/ Edit

System

(EC2)

Insight

System

(EMR)

Inbound

Claim

Archive

(Glacier)

Inbound

Claim Store

(S3)

Claim History

(Redshift)

1

Claims

Adjudication

System

(EC2)

Data Lake

(S3)6

Insights

2 3 4

55

5

7

HIPAA Eligible

Architecture

Consult with compliance and security organizations before implementing

Page 24: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

AWS Service

Amazon

EC2

Amazon

EMR

Amazon

GlacierAmazon

S3

Amazon

DynamoDB

Amazon

RDS (MySQL

and Oracle)

Amazon

Redshift

Amazon

EBS

Elastic Load

Balancing

Amazon ECS AWS Elastic

Beanstalk

AWS

CodeCommit

AWS

CodeDeploy

AWS

CodePipeline

SQSSNS

AWS Config

AWS

Device Farm

AWS HIPAA Eligible Services (as of 4/21)

AWS Non-HIPAA Eligible Services

Consult with compliance and security organizations before implementing

Page 25: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

General Strategies

AWS

CodeCommit

AWS

CodeDeploy

AWS

CodePipeline

Consult with compliance and security organizations before implementing

• Decouple PHI data from the processing

or orchestration

• Do not check PHI data into your source

or artifact repositories

• Use indirection when orchestrating PHI

flow

• Separate PHI and non-PHI containing

logical boundries

• Monitor the flow of PHI

Page 26: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Separate Virtual Private Cloud (VPC) Strategy

Amazon

EC2Amazon

EMRAmazon

S3

PHI Eligible VPC

Amazon

EC2

Non-PHI VPC

AWS Directory

Service

AWS

Device Farm

PHI

Consult with compliance and security organizations before implementing

Page 27: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Indirection Strategy

Validation

/ Edit

System

(EC2)

Inbound

Claim Store

(S3)

HTTPS

Send

SQS

SNS

Claims

PHI Data

Consult with compliance and security organizations before implementing

Page 28: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example: Simplified Claims Workflow

Validation /

Edit System

(EC2)

Insight

System

(EMR)

Inbound

Claim

Archive

(Glacier)

Inbound

Claim Store

(S3)

Claim

History

(Redshift)

Claims

Adjudication

System

(EC2)

Data

Lake

(S3)

Insights

Consult with compliance and security organizations before implementing

Non-PHI

Insights AWS

LambdaAmazon

SES

Non-PHI

Insights

Email to

Business

Users

SQSSQS

AWS

CodeCommitAWS

CodeDeploy

AWS

CodePipeline

PHI Insights

Non-PHI Insights

Page 29: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Compliance Example Workflow (using DevSecOps)

CloudFormation

templateSecurity /

Compliance Admin

1

Define

AWS Service Catalog

2

Publish

CloudFormation

stack

Healthcare

Developers

4

Browse and Launch

AWS CloudTrail Amazon S3

11

Monitors

Logs all API calls

AWS CloudWatchalarm

8

Monitors

10

Initiates

12

Notifies

AWS Config

Track changes

3

Git push

6

AWS CodeCommit

5

Provisions

9

7

Consult with compliance and security organizations before implementing

Page 30: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example: Fortune 500 Life Science Company

Page 31: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

The Vision

• Self Service

• Rapid Provisioning

• Capacity Management

• Full Stack Availability

Enable Agility

• AD Integration

• Golden AMIs

• Enterprise Logging

• Backup and Retention

• Firewall and Security Rule

Ensure Policy

• Monitoring and Alerts

• VM Scheduling

• Encryption

• Software Configuration Management

Accelerate Best Practices

Page 32: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

What they did…

Assurance Monitors

Compliance Database

Console

Billing Roll up

Administrative

Services

Access Control with

AD Integration

User Help

HPC

Workspaces

Big Data

Page 33: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Consult internally before implementing

The following slides are practices we

have seen used in industry. As security

and industry compliance is determined

by the customer before implementing

please:

• Consult with your internal best

practices

• Consult with with your Cloud Center of

Excellence

• Consult with your Information Security

group

• Consult with your Compliance

organization

• Do your due diligence

Page 34: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Thank You

Page 35: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

and Healthcare Analytics

Ujjwal Ratan

Healthcare and Life Sciences Solutions Architect

Amazon Web Services

Page 36: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Data

Warehousin

g

Databases

Object and

File Storage

Managed Big

Data Platform

AWS Data Pipeline

Data management ecosystem Analytical tooling ecosystem

Machine

Learning

Analysi

s

Data Ingestion

Storag

e

Archiving

Structured Unstructured StreamingData

Visualization

Typical Analytics Workflow

Page 37: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Retrospective Analysis & Reporting

Amazon S3

Amazon

DynamoDB

Amazon RDS

Ingest Store Process Visualize

Amazon Mobile

Analytics

Amazon

EC2

AWS

Import/Export

Amazon EMR

Amazon Redshift

Amazon

Lambda

Amazon

QuickSight

Page 38: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Three Essential Services for Analytics on AWS

Amazon S3 Amazon

Redshift

Amazon

Elastic

MapReduce

(EMR)

All three are HIPAA eligible services

Page 39: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Store anything

Object storage

Scalable

Designed for 99.999999999%

durability

Amazon S3

Page 40: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Transferring data into Amazon S3

AWS Import/ Export

AWS Direct Connect

Internet

Amazon S3

Data Lake

AWS Region

Institutional Data

Center

Amazon

Analytics

Services

Availability Zone

Page 41: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Aggregate all of your data in Amazon S3 Data

Lake

EMR Kinesis

Redshift DynamoDB RDS

Data Pipeline

Spark StreamingCassandraStorm

Amazon S3

Page 42: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Petabyte scale

Massively parallel

Relational data warehouse

Fully managed; zero admin

Amazon

Redshift

a lot faster

a lot cheaper

a whole lot simpler

Page 43: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

When is Amazon Redshift the Right Choice for Healthcare Analytics?

Institutional metrics

Utilize massive datasets with existing SQL skill sets

Queries that involve heavy aggregation such as financial reporting

Clinically actionable gene mutation research

Combine gene variant data with phenotypes and run GWAS/PWAS

analysis using SQL queries

Large population public health studies

Find trends over millions of CMS claims in seconds

Page 44: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon Redshift Architecture

Leader Node

SQL endpoint

Stores metadata

Coordinates query execution

Compute Nodes

Local, columnar storage

Execute queries in parallel

Load, backup, restore via S3

Parallel load from DynamoDB or SSH

HW optimized for data processing DW1: HDD; scale from 2TB to 1.6PB

DW2: SSD; scale from 160GB to 256TB

10 GigE

(HPC)

Ingestion

Backup

Restore

JDBC/ODBC

Page 45: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Copy Data Into Redshift From S3

COPY <table_name> from 's3://<bucket_name>/<file_name>' CREDENTIALS

'aws_access_key_id=<access_key_ID>; aws_secret_access_key=<secret_access_key_id>' DELIMETER ','

IGNOREHEADER 1;

Table_name: Redshift Table Name

Bucket_name: S3 bucket name

File_name: CSV file name in S3 bucket

Access_key_if, secret_access_key_id: AWS security credentials

Page 46: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Hadoop 1.x & 2.x / HDFS clusters

Easy to use; fully managed

Support for EC2 Spot Instances

S3, DynamoDB, Redshift

& Kinesis Integration

Amazon

Elastic

MapReduce

(EMR)

Page 47: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Process – Amazon EMR

• Hadoop - An open-source framework for parallel

processing huge amounts of data on a cluster of

machines

• Amazon EMR - Fully managed Hadoop cluster with

direct integration into Amazon S3 and burstable

capacity

Page 48: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Aggregate the

results from all

nodes and know

what each user did

Process – Amazon EMR Use Case

Large amount of

click logs of user

actions in Amazon

S3 bucket

(e.g TBs)

Amazon EMR cluster

splitting logs into

small pieces working

in parallel

Page 49: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Process – Amazon EMR

• Amazon EMR supports all common Hadoop Frameworks

such as:

• Spark, Pig, Presto, Hive

• etc.

• Decouples storage from compute

• Allows independent scaling

• Direct Integration with DynamoDB and S3

Amazon S3Amazon

DynamoDB

Amazon EMR

Page 50: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon EMR + Hue

Page 51: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

S3, Redshift & EMR forms the backbone of most

analytical workflows on AWS.

When used with other AWS services,

this is how the final architecture would look like …......

Page 52: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

EC2

Amazon EC2

Instances

Amazon

Kinesis

Amazon S3

Amazon

EMR

Amazon

Redshift

BI Tool

Amazon

Machine

Learning

Amazon

DynamoDB

Amazon Mobile

Analytics

Amazon

Lambda

AWS

Import/Export

Page 53: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Security and Compliance

Visibility for HealthcareAWS Nashville Event – May 2016

Adam C. GreenfieldDirector of Engineering

Page 54: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

HEALTHCARE Exclusive

CLOUD

Experts

CERTIFIED

Experience

• BAA with the most coverage of any

leading provider

• Incorporates existing infrastructure

BAAs into a single BAA

THE CLEARDATA DIFFERENCE

ENHANCED

BAA

Page 55: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Deployment Tools

• Configuration Management Tools

• Orchestration Tools

• Auditing and Governance Tools

Page 56: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

57PROPRIETARY & CONFIDENTIAL

Page 57: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

58PROPRIETARY & CONFIDENTIAL

Page 58: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

59PROPRIETARY & CONFIDENTIAL

Objectives

Strong and

Secure Audit

Trail

No tight

coupling to

orchestration

tools

External

Managed

Services

Highly

Automated

Page 59: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

60PROPRIETARY & CONFIDENTIAL

Traditional Platforms

• Platforms normally sit between your

application and tools to translated API

calls into AWS functions.

• This creates vendor lock in, but

obscures AWS value and reduces agility

• Vendors must integrate new services

quickly to give customers access to AWS

features

Customer Applications & Tools

Vendor Platform & Custom API’s

DB on instanceinstance with AMI

Page 60: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Rethinking the model

• Observe

• Orient

• Decide

• Act

Page 61: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

62PROPRIETARY & CONFIDENTIAL

Objectives

Credits: Patrick Edwin Moran https://commons.wikimedia.org/wiki/File:OODA.Boyd.svg

Page 62: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

63PROPRIETARY & CONFIDENTIAL

AWS ConfigAWS CloudTrail

AWS CloudWatch

Customer Account

AWS SNSAmazon API

Gateway

Management Account

AWS

Lambda

Amazon

Kinesis

Page 63: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

64PROPRIETARY & CONFIDENTIAL

Kinesis Streams

SensuCMDB

Backups Vuln Scanning

SlackPagerDuty

Ticketing

CloudTrail / CloudWatch Events EC2 Events Auditing / Governance

AlertingSEIM

Remediation

Amazon

DynamoDB

Amazon

Redshift

Page 64: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Configuration with tags

Page 65: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

66PROPRIETARY & CONFIDENTIAL

Trusted Advisor

• Catches common account misconfigurations

• Suggests cost reductions

• Evaluates fault tolerance

Page 66: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

67PROPRIETARY & CONFIDENTIAL

CloudWatch

• Monitor performance of AWS resources

• Aggregate and process log files (non-PHI)

• Requires instance profile or distributed credentials

Page 67: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

68PROPRIETARY & CONFIDENTIAL

Emerging AWS-native Solutions

AWS Config Rules

https://github.com/awslabs/aws-config-rules/

Community-Based Rules • Constantly watch for account changes

• Remediate in near real-time

• Incredibly flexible and extendable

• Lambda based

Page 68: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

69PROPRIETARY & CONFIDENTIAL

Emerging AWS-native Solutions

Page 69: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Extending OODA inside the instance

• Observe

• Orient

• Decide

• Act

Page 70: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

71PROPRIETARY & CONFIDENTIAL

Objectives

Strong and

Secure Audit

Trail

Unobtrusive

External

Managed

Services

Highly

Automated

Page 71: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

72PROPRIETARY & CONFIDENTIAL

ClearDATA Dynamic Cloud Platform

AWS Environment

• Compute

• Storage

• Network / Cloud

Operating Environment

• Hardened AMIs

• Configuration management engine

• Patch management

• Managed backup

• Monitoring & alerts

• Consolidated account info

• Isolated dev & test environments

Security & Compliance

• Hardened encryption configuration

• Key management

• Intrusion detection system

• Login and access tracking

• Event log management

• File integrity monitoring

• ClearDATA security appliance

• VPNs / Address translation

• Anti-virus

24/7 Managed Services

Delivered by AWS Certified Personnel

Over 30 additional services automatically attached to AWS infrastructure

Page 72: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

73PROPRIETARY & CONFIDENTIAL

• First of it’s kind in the

industry – service based

real-time HIPAA compliance

dashboard

• At a glance system status

plus trending over time

• Detailed history available for

attestation during audits

Continuous security and compliance

monitoring mapped directly to

HIPAA guidelines delivered across

cloud and private environments via

interactive dashboard and individual

asset scorecards.

Security & Compliance Dashboard

Page 73: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

74PROPRIETARY & CONFIDENTIAL

Cloud Platform BAA Coverage

AWS Global

Infrastructure

Availability Zones

Regions

Edge

Locations

AWS Foundation Services

Compute Storage Database Networking

Network Traffic

Protection

Server-Side

Encryption

Client-Side Data

Encryption

Operating Systems, Network & Firewall Configurations

Platform

Customer Data

Applications Identity & Access Management

AWS Global

Infrastructure

Availability Zones

Regions

Edge

Locations

AWS Foundation Services

Compute Storage Database Networking

Network Traffic

Protection

Server-Side

Encryption

Client-Side Data

Encryption

Operating Systems, Network & Firewall Configurations

Customer Data

ClearDATA

PlatformApplications Identity & Access Management

Amazon Web Services Infrastructure ClearDATA Cloud Platform

Page 74: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

HEALTHCARE

Exclusive

CLOUD

Experts

CERTIFIED

Experience

• Current Projects

• Pilots or POCs

• Backup / DR

• Compliance Dashboard

• SRA / SRAaaS

• Cloud Assessment

THANK YOU!

ENHANCED

BAA

LET’S WORK

TOGETHER

Page 75: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Data Storage for the Long Haul

Compliance and Archive

Erik Durand

Amazon Web Services

Page 76: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon EFS

File

Amazon EBSAmazon EC2

Instance Store

Block

Amazon S3 Amazon Glacier

Object

Data Transfer

AWS Direct

Connect

AWS

Snowball

ISV Connectors Amazon

Kinesis

Firehose

S3 Transfer

Acceleration

Storage

Gateway

Storage is a platform

Page 77: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Patient data – Philips Healthcare

• HealthSuite digital platform powered by AWS

• 15 petabytes of patient data

• Archived for decades (beyond the lifetime of patients)

• Uses AWS HIPAA eligible services in the BAA

Page 78: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Public sector – King County

• Most populous county in Washington state

• Replace tape solution for backup from 17 agencies

• Meet compliance requirement

• Saved $1MM in first year, no more tape refresh or

management churn

Page 79: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Archive:

Data retained for the long term,

for compliance or potential

future reference

Data archiving needs are growing everywhere

• Media assets, 4K, 8K

• Health care / life sciences

• Financial services

• Regulated industries

• Oil and gas / geospatial

• Digital preservation

• Long-term backups

• Logs

Page 80: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Traditional archiving approaches

• Storage arrays / disk arrays

• Tape silos / tape libraries

• Tape drives (LTO-X / DLT / etc.)

• Virtual tape libraries (VTLs)

• Tape out / vaulting

• Specialized software and personnel

Page 81: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

How can AWS help with your archival?

Metered usage:

Pay as you go

No capital investment

No commitment

No risky capacity planning

Avoid risks of physical

media handling

Control your

geographic locality for

performance and

compliance

Page 82: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Archive Options – Storage Tiers and Data Lifecycle

Page 83: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Object Storage Options

S3 Standard

Active data Archive dataInfrequently accessed data

S3 Standard - Infrequent

Access

Amazon Glacier

Milliseconds 3-5 hoursMilliseconds

$0.03/GB/mo $0.007/GB/mo$0.0125/GB/mo

Page 84: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

A Closer Look: S3-IA and Amazon Glacier

S3 - IA

• Same durability and throughput as S3 Standard

• Instant access

• $0.01/GB on each data retrieval

Amazon Glacier

• Same 11 9s durability as S3 Standard

• 3-5 hour data retrieval latency

• Suitable for cold archive such as offsite tapes

S3 Standard - Infrequent

Access

Amazon Glacier

Page 85: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

- Transition Standard to Standard-IA

- Transition Standard-IA to Amazon Glacier

- Expiration lifecycle policy

- Versioning support

Data lifecycle management

T T+3 days T+5 days T+ 15 days T + 25 days T + 30 days T + 60 days T + 90 days T + 150 days T + 250 days T + 365 days

Data access frequency over time

Page 86: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Setup lifecycle policy

Page 87: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Transition older records to Standard-IA

Page 88: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Archive to S3-IA after 30 days

Lifecycle policy

Standard Storage -> Standard-IA

<LifecycleConfiguration>

<Rule>

<ID>sample-rule</ID>

<Prefix>documents/</Prefix>

<Status>Enabled</Status>

<Transition>

<Days>30</Days>

<StorageClass>STANDARD-IA</StorageClass>

</Transition>

<Transition>

<Days>365</Days>

<StorageClass>GLACIER</StorageClass>

</Transition>

</Rule>

</LifecycleConfiguration>

Page 89: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Archive to Amazon Glacier after 365 days

Lifecycle policy

Standard Storage -> Standard-IA

<LifecycleConfiguration>

<Rule>

<ID>sample-rule</ID>

<Prefix>documents/</Prefix>

<Status>Enabled</Status>

<Transition>

<Days>30</Days>

<StorageClass>STANDARD-IA</StorageClass>

</Transition>

<Transition>

<Days>365</Days>

<StorageClass>GLACIER</StorageClass>

</Transition>

</Rule>

</LifecycleConfiguration>

Standard-IA Storage -> Amazon Glacier

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Save money on storage

58% saving over S3 Standard

44% saving over S3 Standard-IA

* Assumes the highest public pricing tier

Page 91: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example backup software integration

• CommVault – Native Integration

with Amazon S3 and

Amazon Glacier

• Deduplication and encryption

• Single console management

Amazon S3 Amazon Glacier

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Compliance Use Case 1 – Regulatory Retention

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Amazon Glacier Vault Lock allows you to easily

set compliance controls on individual vaults and enforce them via a

lockable policy

Time-based retention

MFA authentication

Controls govern all

records in a Vault

Immutable policy

Two-step locking

Compliance storage with Vault Lock

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Vault Lock for compliance storage

• Non-overwrite, non-erasable records

• Time-based retention with “ArchiveAgeInDays” control

• Policy lockdown (strong governance)

• Legal hold with vault-level tags

• Configure optional designated third-party access and grant

temporary access

Page 95: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon Glacier received a third-party assessment

from Cohasset Associates on how Amazon Glacier

with Vault Lock can be used to meet the requirements

of SEC Rule 17a-4(f) and CFTC 1.31(b)-(c).

Page 96: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example control: 1 year record retention

• Deny delete archive operation

• From anybody (root, administrators, users, business partners)

• When ArchiveAgeInDays is <= 365 days

Archive age computed from the time an archive lands in a vault

Page 97: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example control: 1 year record retention

Page 98: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Vault Lock: Two-step locking

• InitiateVaultLock

– Effectuates a retention policy for testing (in-progress state)

– Returns a unique lock ID (expires after 24 hours)

• AbortVaultLock

– Deletes an in-progress policy

– Ability to modify a policy before locking it down

• CompleteVaultLock

– Locks down the vault with the appropriate lock ID

– Vault Lock cannot be aborted afterwards

Page 99: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Legal hold with vault-level tags

• Set up a legal hold tag

– Configure a vault-level tag “LegalHold”

– Set initial value to “False”

• Add compliance control for legal hold in a Vault Lock policy

– Deny delete archive operation

– From anybody (root, administrators, users, business partners)

– When LegalHold tag = “True”

• Place/lift legal hold by updating the tag value

Page 100: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Example control: Legal hold

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

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Vault Lock in the Amazon Glacier console

Page 118: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Compliance Use Case 2 – Auditing and Alerts

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Audit logging with AWS CloudTrail

• Amaozn S3 and Amazon Glacier can log

API calls for audit via CloudTrail

• Enable CloudTrail in the AWS console and

designate your log bucket

• S3 logs bucket-level activities; object

activities supported via event notification

• Amazon Glacier logs all APIs calls for

vault and archives

Page 120: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Access policy for a storage container

• Control access to a storage container in a single location

– S3 bucket or Amazon Glacier vault access policy

– Grant/revoke access to internal business units/teams

– “Marketing_Vault” has a distinct access policy from “DevOps_Vault”

• Easily manage cross-account access for your business partner

– Simply add a section for your business partner in the same policy

– Cross-account activities (API calls) also show up in CloudTrail logs

Page 121: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon S3 event notifications

Events

SNS topic

SQS

queue

Lambda

function

• Notification when objects are

created via PUT, POST, Copy, or

Multipart Upload, DELETE

• Filtering on prefixes and suffixes

for all types of notifications

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Request specific notifications

Request notifications on specific

PUT APIs

Request notifications on specific

DELETE APIs

s3:ObjectCreated:*

s3:ObjectCreated:Put

s3:ObjectCreated:Post

s3:ObjectCreated:Copy

s3:ObjectCreated:CompleteMultipartUpload

s3:ObjectRemoved:*

s3:ObjectRemoved:Delete

s3:ObjectRemoved:DeleteMarkerCreated

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Compliance Use Case 3 – Geographic Redundancy

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Remote replicas managed

by separate AWS accounts

Secure

Distribute data to regional

customers

Lower Latency

Store hundreds of

miles apart

Compliance

Amazon S3 cross-region replicationAutomated, fast, and reliable asynchronous replication of data across AWS regions

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• Usual charges for

storage, requests, and

inter-region data transfer

for the replicated copy of

data

• Replicate into Standard-IA

or Amazon Glacier

Cost

HEAD operation on a source

object to determine replication

status

• Replicated objects will not be

re-replicated

• Use Amazon S3 COPY to

replicate existing objects

Replication status

DELETE without object

version ID• Marker replicated

DELETE specific object

version ID• Marker NOT replicated

Delete operation

Cross-region replication: Details

Object ACL updates are

replicated

• Objects with Amazon-

managed encryption key

replicated

• AWS KMS encryption not

replicated

Access control

Page 126: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Versioning with cross-region replication

A

B

Vid1- v2

Vid1- v1

Key: A/vid1 Key: B/vid1

Vid1- v2

Vid1- v1

Vid1- v3Vid1- v3

Vid1- v4Vid1- v4

A

Page 127: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Cross-region replication with lifecycle archiving

S3

Bucket A

Amazon Glacier

S3

Bucket B

Page 128: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

AWS Import/Export Snowball

• Accelerate PBs with AWS-

provided appliances

• 80 TB model, global availability

AWS Storage Gateway

• Instant hybrid cloud

• Up to 120 MB/s cloud upload rate

(4x improvement), and

Data ingestion into AWS storage services

Amazon Kinesis Firehose

• Ingest data streams directly into

AWS data stores

AWS Direct Connect

• COLO to AWS

ISV Connectors

• CommVault

• VERITAS

• etcetera

Amazon S3 Transfer Acceleration

• Move data up to 300% faster

using AWS’s private network

Page 129: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

What is AWS Snowball? Petabyte scale data transport

E-ink shipping

label

Ruggedized

case

“8.5G Impact”

All data encrypted

end-to-end50TB or 80 TB

10G network

Rain & dust

resistant

Tamper-resistant

case & electronics

Page 130: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

How it works

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Introducing Amazon S3 transfer acceleration

S3 BucketAWS Edge

Location

Uploader

Optimized

Throughput!

Typically 50%–400% faster

Change your endpoint, not your code

54 global edge locations

No firewall exceptions

No client software required

Page 132: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Amazon

Route 53

Resolve

b1.s3-accelerate.amazonaws.com

HTTPS PUT/POST

upload_files.zip

HTTP/S PUT/POST

“upload_files.zip”

Service traffic flowClient to S3 Bucket example

S3 Bucket

b1.s3-accelerate.amazonaws.com

EC2 Proxy

AWS Region

AWS Edge Location

Customer Client

1

2

3

4

Page 133: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

AWS Snowball S3 transfer acceleration

When do I use what?

Large, infrequent uploads

Tens of TBs of upload from a

centralized location

7–10 day tolerance

Recurring, frequent uploads

GBs or TBs of upload from distributed

locations

Long geographic distances

Page 134: 2016 AWS Healthcare Days | Nashville, TN – May 3,2016

Q&A

Learn more at: http://aws.amazon.com/s3/

http://aws.amazon.com/glacier/

http://aws.amazon.com/importexport/

[email protected]