In an industry as highly regulated as healthcare, building a single secure and compliant application that tracks patient care and appointments at a clinic requires a great deal of planning from development and security teams. So, imagine what it would be like to build a solution that includes almost everything related to a patient’s healthcare, including insurance and billing. That’s what Highmark Health (Highmark)—a U.S. health and wellness organization that provides millions of customers with health insurance plans, a physician and hospital network, and a diverse portfolio of businesses–decided to do. 

Highmark is developing a solution called Living Health to re-imagine healthcare delivery, and it is using Google Cloud and the Google Cloud Professional Services Organization (PSO) to build and maintain the innovation platform supporting this forward thinking experience. Considering all the personal information that different parties like insurers, specialists, billers and coders, clinics, and hospitals share, Highmark must build security and compliance into every part of the solution. 

In this blog, we look at how Highmark Health and Google are using a technique called “secure-by-design” to address the security, privacy, and compliance aspects of bringing Living Health to life.

Secure-by-design: Preventive care for development

In healthcare, preventing an illness or condition is the ideal outcome. Preventive care often involves early intervention—a course of ideas and actions to ward off illness, permanent injury, and so on. Interestingly, when developing a groundbreaking delivery model like Living Health, it’s a good idea to take the same approach to security, privacy, and compliance. 

That’s why Highmark’s security and technology teams worked with their Google Cloud PSO team to implement secure-by-design for every step of design, development, and operations. Security is built into the entire development process rather than waiting until after implementation to reactively secure the platform or remediate security gaps. 

It’s analogous to choosing the right brakes for a car before it rolls off the assembly line instead of having an inspector shut down production because the car failed its safety tests. The key aspect of secure-by-design is an underlying application architecture created from foundational building blocks that sit on top of a secure cloud infrastructure. Secure-by-design works to ensure that these building blocks are secure and compliant before moving on to development.

The entire approach requires security, development, and cloud teams to work together with other stakeholders. Most importantly, it requires a cloud partner, cloud services, and a cloud infrastructure that can support it. 

Finding the right cloud and services for secure-by-design 

Highmark chose Google Cloud because of its leadership in analytics, infrastructure services, and platform as a service. In addition, Google Cloud has made strategic investments in healthcare interoperability and innovation, which was another key reason Highmark decided to work with Google. As a result, Highmark felt that Google Cloud and the Google Cloud PSO were best suited for delivering on the vision of Living Health—its security and its outcomes. 

“Google takes security more seriously than the other providers we considered, which is very important to an organization like us. Cloud applications and infrastructure for healthcare must be secure and compliant,” explains Highmark Vice President and Chief Information Security Officer, Omar Khawaja. 

Forming a foundation for security and compliance

How does security-by-design with services work? It starts with the creation and securing of the foundational platform, allowing teams to harden and enforce specified security controls. It’s a collaborative process that starts with input from cross-functional teams—not just technology teams—using terms they understand, so that everyone has a stake in the design. 

A strong data governance and protection program classifies and segments workloads based on risk and sensitivity. Teams build multiple layers of defense into the foundational layers to mitigate against key industry risks. Google managed services such as VPC Service Controls help prevent unauthorized access. Automated controls such as those in Data Loss Prevention help teams quickly classify data and identify and respond to potential sources of data risk. Automation capabilities help ensure that security policies are enforced.

After the foundational work is done, it’s time to assess and apply security controls to the different building blocks, which are Google Cloud services such as Google Kubernetes Engine, Google Compute Engine, and Google Cloud Storage. The goal is to make sure that these and similar building blocks, or any combination of them, do not introduce additional risks and to ensure any identified risks are remediated or mitigated. 

Enabling use cases, step by step

After the foundational security is established, the security-by-design program enables the Google Cloud services that developers then use to build use cases that form Living Health. The service enablement approach allows Highmark to address complexity by providing the controls most relevant for each individual service. 

For each service, the teams begin by determining the risks and the controls that can reduce them. The next step is enforcing preventive and detective controls across various tools. After validation, technical teams can be granted an authorization to operate, also called an ATO. An ATO authorizes the service for development in a use case.

For use cases with greater data sensitivity, the Highmark teams validate the recommended security controls with an external trust assessor, who uses the HITRUST Common Security Framework, which maps to certifications and compliance such as HIPAA, NIST, GDPR, and more. A certification process follows that can take anywhere from a few weeks to a few months. In addition to certification, there is ongoing monitoring of the environment for events, behavior, control effectiveness, and control lapses or any deviation from the controls.

The approach simplifies compliance for developers by abstracting compliance requirements away. The process provides developers a set of security requirements written in the language of the cloud, rather than in the language of compliance, providing more prescriptive guidance as they build solutions. Through the secure-by-design program, the Highmark technology and security teams, Google, the business, and the third-party trust assessor all contribute to a secure foundation for any architectural design with enabled Google Cloud services as building blocks. 

Beating the learning curve 

Thanks to the Living Health project, the Highmark technology and security teams are trying new methods. They are exploring new tools for building secure applications in the cloud. They are paying close attention to processes and the use case steps and, when necessary, aligning different teams to execute. Because everyone is working together collaboratively toward a shared goal, teams are delivering more things on time and with predictability, which has reduced volatility and surprises. 

The secrets to success: Bringing everyone to the table early and with humility

Together, Highmark and Google Cloud PSO have created over 24 secure-by-design building blocks by bringing everyone to the table early and relying on thoughtful, honest communication. Input for the architecture design produced for Highmark came from privacy teams, legal teams, security teams, and the teams that are building the applications. And that degree of collaboration ultimately leads to a much better product because everyone has a shared sense of responsibility and ownership of what was built. 

Delivering a highly complex solution like Living Health takes significant, more purposeful communication and execution. It is also important to be honest and humble. The security, technology, and Google teams have learned to admit when something isn’t working and to ask for help or ideas for a solution. The teams are also able to accept that they don’t have all the answers, and that they need to figure out solutions by experimenting. Khawaja puts it simply, “That level of humility has been really important and enabled us to have the successes that we’ve had. And hopefully that’ll be something that we continue to retain in our DNA.”

We opened our Sydney cloud region in 2017 and, since then, we have continued to invest and expand across Australia and New Zealand to support the digital future of organizations of all sizes. In Australia, Google Cloud supports almost A$3.2 billion in annual gross benefits to businesses and consumers. This includes A$686 million to businesses using Google Workspace and Google Cloud Platform, another A$698 million to Google Cloud partners, and A$1.8 billion to consumers.¹ 

For customers in Australia, New Zealand and across Asia Pacific, we’re excited to announce that our new Google Cloud region in Melbourne is now open. Designed to help businesses build highly available applications for their customers, the Melbourne region is our second Google Cloud region in Australia and 11th to open in Asia Pacific. 

We’re celebrating the occasion with a digital event where federal minister for the Digital Economy, Jane Hume, and customers Australia Post, Trade Me, Bendigo and Adelaide Bank, The Australian Football League and Macquarie Bank will share their perspectives. Come join us!

A global network of regions

Melbourne joins the existing 26 Google Cloud regions connected via our high-performance network, helping customers better serve their users and customers throughout the globe. With this our second region in Australia, customers benefit from improved business continuity planning with distributed, secure infrastructure needed to meet IT and business requirements for disaster recovery, all the while maintaining data sovereignty in-country.

With this new region, Google Cloud customers operating in Australia and New Zealand will benefit from low latency and high performance of their cloud-based workloads and data. Designed for high availability, the region opens with three zones to protect against service disruptions, and offers a portfolio of key products, including Compute Engine, Google Kubernetes Engine, Cloud Bigtable, Cloud Spanner, and BigQuery. 

We also continue to invest in expanding connectivity across the Australia and New Zealand region by working with partners to establish subsea cables and new Dedicated Cloud Interconnect locations and points of presence in major cities including Sydney, Melbourne, Perth, Canberra, Brisbane and Auckland.

Collectively, this will deliver geographically distributed and secure infrastructure to customers across Australia and New Zealand – which is especially important for those in regulated industries such as Financial Services and the Public Sector.  

What customers and partners are saying

Navigating this past year has been a challenge for companies as they grapple with changing customers demands and greater economic uncertainty. Technology has played a critical role, and we’ve been fortunate to partner with and serve people, companies, and government institutions around the world to help them adapt. The Google Cloud region in Melbourne will help our customers adapt to new requirements, new opportunities and new ways of working.  

“We moved to Google Cloud to improve the stability and resilience of our infrastructure and become more cloud-native as part of a digital transformation program that keeps the customer at the heart of our business. We welcome Google Cloud’s investment in ANZ and the opportunities the Google Cloud Melbourne region presents to improve Trade Me’s agility and performance. – Paolo Ragone, Chief Technology Officer, Trade Me     

“We initially turned to Google Cloud to help us process parcels faster and gain deeper insights into our business and its processes. The relationship has continued to deliver benefits to our customers and our organization and we welcome Google Cloud’s opening of the Melbourne region as presenting even more opportunities for businesses to innovate and generate efficiencies.” – Munro Farmer, Chief Information Officer, Australia Post.

“We are well progressed with our multi-year strategy to grow and transform our organization to be Australia’s bank of choice. Google Cloud’s advanced data capabilities and renowned culture of innovation are strongly aligned to this strategy and will allow us to become even more innovative and agile in responding to our customers’ ever-changing needs. We were quick to run our workloads out of the Melbourne cloud region and we believe Google Cloud’s expanded investment in local infrastructure will further assist us on our business transformation journey.” – Andrew Cresp, Chief Information Officer, Bendigo and Adelaide Bank.

“We have a clear vision when it comes to innovating to deliver world-class service to our customers, and our partnership with Google Cloud is core to that strategy. The company’s continued investments in local infrastructure and technology present new opportunities for us as we advance our transformation journey in this digital-first era.” – Chris Smith, Vice President, Digital Service, Optus

Our global ecosystem of channel partners has expanded by more than 400% in the last two years, and we look forward to continuing our close relationships with partners  in Australia and New Zealand as we help customers modernize, innovate, scale and grow.

“Australian companies are increasingly realising the benefits of their cloud investments and are now looking to transform their organisations at scale. We are excited about the potential and new value that the Google Melbourne Cloud region will bring to our clients as we continue to work together on delivering intelligent and innovative solutions to Australian organisations.” – Tara Brady, CEO of Accenture Australia and New Zealand

“Google Cloud has always been there for its customers for the long haul and the opening of the new Melbourne Cloud region is great news. This increased resilience and scale will empower companies of all sizes to be bold in accelerating their digital transformation plans.” – Tony Nicol,  CEO of Servian

“We’re excited about the launch of the Melbourne Cloud region. It will cater to the needs of industries we work closely with including healthcare and financial services, and will further enhance how we jointly deliver on the compliance, privacy and security requirements of companies as they advance their digital transformation.” – Simon Poulton, CEO of Kasna

“The opening of the new Google Cloud region in Melbourne is fantastic news as it now enables DXC customers access to enhanced services for their mission critical application and data solutions across two regions within Australia.  As our customers modernise their application estate, many are seeking dual region cloud services, and DXC is excited to partner with Google Cloud to deliver these services to customers in Australia and New Zealand.” – Tim Fraser, Google Practice Lead ANZ at DXC Technology

Helping customers build their transformation clouds

Google Cloud is here to support businesses, helping them get smarter with data, deploy faster, connect more easily with people and customers throughout the globe, and protect everything that matters to their businesses. The cloud region in Melbourne offers new technology and tools that can be a catalyst for this change.  Click here to learn more about all our Google Cloud locations.

^{1. AlphaBeta, The Economic Impact of Google Cloud to Australia, July 2021}

Editor’s note: When Europe’s largest mobile communications company, Vodafone, was asked by the European Commission to help understand population movement across the European Union and the UK to help fight COVID-19, it was able to provide anonymized mobile network-based insights to answer the call. Here’s how Vodafone, with the support of Google Cloud, rapidly mobilized the COVID-19 frontline, while respecting its customers’ privacy.

With the emergence of COVID-19 in early 2020, the European Commission—the executive branch of the European Union (EU)—knew that technology would be instrumental in its fight to control the pandemic. With various lockdowns imposed across its member states, the Commission was keen to predict and prevent the spread of COVID-19 and to manage the related social, political and financial impacts. 

Mobile network data helps track COVID-19 across the EU

Mobile networks produce location data, which can be turned into useful anonymous insights to understand population movement within a geographic area. The European Commission, working with mobile industry association GSMA (Groupe Speciale Mobile Association), asked Europe’s major mobile phone operators for help in producing insights to support the fight against COVID-19. As the largest mobile network operator within the EU, Vodafone saw this as a critical opportunity to participate. 

Vodafone had previous experience of using mobile network data to support pandemic research. For example, in 2019, Vodafone provided mobility pattern analysis to help track the spread of Malaria in Mozambique. And, during the early stages of the COVID-19 pandemic (prior to working with the European Commission), Vodafone assisted the Italian and Spanish governments in understanding their citizens’ mobility patterns. Vodafone had also previously offered anonymized and aggregated population mobility insights to support public transport and tourism authorities and retail organizations in a number of countries. Consequently, Vodafone was perfectly placed to play a greater role in supporting the European Commission’s response to the pandemic. 

When asked to assist the European Commission, Vodafone first considered how it could safely share its data with the governing body without providing details on the individual movements of its customers. It realized it could achieve this through an elaborate set of anonymization and aggregation techniques. Insights are aggregated from a minimum of 50 users and Vodafone only shared these anonymous insights and never the actual raw data with the Commission. As specified by the EU, these insights are then presented onto a large geographical region, typically a city or a county with thousands of people living in that area.

These insights illustrate how people move, helping to determine how lockdowns and self-isolation measures were impacting behaviors.

Using Google Cloud to collate and store population mobility data

In April 2020, Vodafone began migrating its operations, including its mobile data, to Google Cloud on servers in Europe and the UK with elaborate security safeguards, including encryption, building on a previous partnership. 

With the data residing in EU and UK data centers and not the United States, Vodafone could then retrieve anonymous insights from Google Cloud Storage instantaneously. Before supplying any information to the European Commission, however, Vodafone used Dataflow to validate the data and run a series of tests to ensure the database had accurate data, before ingesting and archiving the relevant metrics. For instant access, the data was then made available to the European Commission using a Redis database on Google Kubernetes Engine.

To ensure aggregate Vodafone customer data was always safe, secure, and anonymous, all entry points to the front-end were protected behind Google Cloud Armor, where only specific IP addresses were allowed. Using these tools, seamless data pipelines fed in predefined key performance indicators from each specified European market. While data quality measures ensured the definitions for metrics across markets were consistent and could be accurately compared.

The architecture (pictured below) shows how Vodafone integrated and anonymized its data on Google Cloud.

Live interactive dashboard shows population mobility in real-time

With its data integrated on Google Cloud, Vodafone created a live, interactive dashboard to track mobility patterns and share relevant information with the European Commission in real-time. 

The European Commission Joint Research Center (JRC) was able to gather valuable information from these insights, which enabled them to see where population mobility was aiding the spread of the disease, when cross-referenced with health data. It could also assess the implications of lockdowns on different populations and forecast cross-country spreading.

Mobile data aids disease modeling for multiple stakeholders

The Vodafone data became instrumental in modeling the likely course of the disease too. For example, the University of Southampton in the UK used it to predict the outcome of different coordinated COVID-19 exit strategies across Europe. This research was published in Science Magazine in September 2020. 

The Vodafone data dashboard continues to be used by individual governments, NGOs and organizations to further investigate the impacts of the pandemic and to measure the effectiveness of response strategies alongside the rollout of vaccination programs. The project also helped Vodafone win a DataIQ award for most effective stakeholder engagement. 

Using the learnings from this project, Vodafone has been able to adapt its own B2B solution, called Vodafone Analytics, by adaptIng and migrating the code to work in Google Cloud Platform. This solution has been rolled out across Germany, Greece, Portugal and South Africa, and new countries are being onboarded every day. Vodafone Analytics already has more than 100 customers leveraging it for a variety of use cases—Italian fashion retailer OVS, uses it for its smart retail operation, while global real estate company, JLL, uses it to understand the footfall passing through its properties. 

Working together, Vodafone and Google Cloud continue to help a range of organizations, governments, and NGOs navigate through the ongoing pandemic,  optimize their operations, and help the greater good, without infringing individuals’ fundamental rights to privacy.

To learn more about Google Cloud and Vodafone, watch our full interview here.

As Google Cloud has become a choice for more startups, I’ve experienced an increase in founders asking how they should think about cloud services. Though each startup is different and requirements may vary across industries and regions, I’ve seen a few core best practices that help startups to succeed—as well as several traps to avoid. 

For example, If you go with a public cloud provider, you’re ideally not starting from ground zero like you would running your own data center, but it’s important not to introduce similar complexity in a virtualized environment. Just because you’re using public cloud infrastructure doesn’t mean you want to manage it.

Instead, you want to leverage platforms that abstract away complexity so your team can focus on delivering value to customers. That’s where serverless comes in. Serverless platforms are fully managed by the provider, offering automatic scaling for workloads, as well as provisioning, configuring, patching, and management of servers and clusters. Freed from these resource-intensive tasks, your technical talent can focus on the things that differentiate your business, not on IT curation. 

This applies to not only running stateless applications, but also managing and analyzing data. You should be collecting data points about which features are most popular on your platform, what people are buying, the types of activities that help your customers get their jobs done, and so on. This information is essential to building and executing on a product roadmap that will serve your customers. However, it’s not enough to collect this data, you need to make your data accessible, secure, and easy for your team to analyze—so where do you run and host it? 

On Google Cloud, this is where options like Spanner and Cloud SQL can play a large role, as can BigQuery for analysis. You won’t have to worry about standing up infrastructure or patching servers—you can just stream your data to our data management platforms, where it’s available whenever someone needs to run a query. By leveraging a serverless architecture, your startup can be data-driven without having to invest in the traditional complexity of database administration and management—and that can significantly change your playing field. 

Serverless is just one of the factors you should consider as you build out your tech stack. To hear my thoughts on a range of other topics relevant to startups — such as security, cloud credits, and the differences among managed services — check out the below video or visit our Build and Grow page.

https://www.youtube.com/embed/gn4RjLbs8Hc?enablejsapi=1&

Compute Engine is a customizable compute service that lets you create and run virtual machines on Google’s infrastructure. You can create a Virtual Machine (VM) that fits your needs. Predefined machine types are pre-built and ready-to-go configurations of VMs with specific amounts of vCPU and memory to start running apps quickly. With Custom Machine Types, you can create virtual machines with the optimal amount of CPU and memory for your workloads. This allows you to tailor your infrastructure to your workload. If requirements change, using the stop/start feature you can move your workload to a smaller or larger Custom Machine Type instance, or to a predefined configuration.

Machine types

In Compute Engine, machine types are grouped and curated by families for different workloads. You can choose from general-purpose, memory-optimized, compute-optimized and accelerator-optimized families. 

• General-purpose machines are used for Day-to-day computing at a lower cost and for balanced price/performance across a wide range of VM shapes. The use cases that best fit here are web serving, app serving, back office applications, databases, cache, media-streaming, microservices, virtual desktops, development environments.
• Memory-Optimized machine are recommended for ultra high-memory workloads such as in-memory analytics and large in-memory databases such as SAP HANA 
• Compute-Optimized machines are recommended for ultra high performance workloads such as High Performance Computing (HPC), Electronic Design Automation (EDA), gaming, video transcoding, single-threaded applications.
• Accelerator-Optimized machines are optimized for high performance computing workloads such as Machine learning (ML), Massive parallelized computations and High Performance Computing (HPC)

How does it work?

You can create a VM instance using a boot disk image, a boot disk snapshot, or a container image. The image can be a public operating system (OS) image or a custom one. Depending on where your users are you can define the zone you want the virtual machine to be created in. By default all traffic from the internet is blocked by the firewall and you can enable the HTTP(s) traffic if needed. 

Use snapshot schedules (hourly, daily, or weekly) as a best practice to back up your Compute Engine workloads. Compute Engine offers live migration by default to keep your virtual machine instances running even when software or hardware update occurs. Your running instances are migrated to another host in the same zone instead of requiring your VMs to be rebooted. 

Availability

For High Availability (HA) Compute Engine offers automatic failover to other regions or zones in event of a failure. Managed instance groups (MIGs) help keep the instances running by automatically replicating instances from a predefined image. They also provide application based autohealing health checks. If an application is not responding on a VM, the auto healer automatically recreates that VM for you. Regional MIGs let you spread app load across multiple zones. This replication protects against zonal failures. MIGs work with load balancing services to distribute traffic across all of the instances in the group. 

Compute Engine offers autoscaling to automatically add or remove VM instances from a managed instance group based on increases or decreases in load. Autoscaling lets your apps gracefully handle increases in traffic, and it reduces cost when the need for resources is lower. You define the autoscaling policy for automatic scaling based on the measured load, CPU utilization, requests per second or other metrics.

Active Assist’s new feature, predictive autoscaling, helps improve response times for your applications–When you enable predictive autoscaling, Compute Engine forecasts future load based on your Managed Instance Group’s (MIG) history and scales it out in advance of predicted load, so that new instances are ready to serve when the load arrives. Without predictive autoscaling, an autoscaler can only scale a group reactively, based on observed changes in load in real time. With predictive autoscaling enabled, the autoscaler works with real-time data as well as with historical data to cover both the current and forecasted load. That makes predictive autoscaling ideal for those apps with long initialization times and whose workloads vary predictably with daily or weekly cycles. For more information, see How predictive autoscaling works or check if predictive autoscaling is suitable for your workload, and to learn more about other intelligent features, check out Active Assist.

Pricing

You pay for what you use. But you can save cost by taking advantage of some discounts! Sustained use saving are automatic discounts applied for running instances for a significant portion of the month. If you know your usage upfront, you can take advantage of committed use discounts which can lead up to significant savings without any upfront cost. And by using short lived preemptive instances you can save up to 80%, they are great for batch jobs and fault tolerant workloads. You can also optimize resource utilization with automatic recommendations. For example if you are using a bigger instance for a workload that can run on a smaller instance you can save costs applying these recommendations.

Security

Compute Engine provides you default hardware security. Using Identity and Access Management (IAM) you just have to ensure that proper permissions are given to control access to your VM resources. All the other basic security principles apply, if the resources are not related and don’t require network communication amongst themselves, consider hosting them on different VPC networks. By default, users in a project can create persistent disks or copy images using any of the public images or any images that project members can access through IAM roles. You may want to restrict your project members so that they can create boot disks only from images that contain approved software that meet your policy or security requirements. You can define an organization policy that only allows Compute Engine VMs to be created from approved images. This can be done by using the Trusted Images Policy to enforce images that can be used in your organization. 

By default all VM families are Shielded VMs. Shielded VMs are virtual machine instances that are hardened with a set of easily configurable security features to ensure that when your VM boots, it’s running a verified bootloader and kernel — is the default for everyone using Compute Engine, at no additional charge. For more details on Shielded VMs refer to the documentation here.

For additional security, you also have the option to use Confidential VM to encrypt your data in use, while it’s being processed in Compute Engine. For more details on Confidential VM refer to the documentation here.

Use cases

There are many use cases Compute Engine can serve in addition to running websites and databases. You can also migrate your existing systems onto Google Cloud, with Migrate for Compute Engine, enabling you to run stateful workloads in the cloud within minutes rather than days or weeks. Windows, Oracle or VMware applications have solution sets enabling a smooth transition to Google Cloud. To run windows applications either bring your own license leveraging Sole-tenant nodes or using the included licenced images. 

Conclusion

Whatever your application use case may be, from legacy enterprise applications to digital native applications, Compute Engine’s families will fit it. For a more in-depth look into Compute Engine check out the documentation. 

For more #GCPSketchnote, follow the GitHub repo. For similar cloud content follow me on Twitter @pvergadia and keep an eye out on thecloudgirl.dev