Hackensack Meridian Health (HMH) executive Mark Eimer explains how an ambitiously-timed rollout of a comprehensive suite of Google products helped the entire organization—from doctors to IT staff—achieve better security, cultivate a more equitable work environment, and ultimately, improve patient outcomes.

How does a recently merged, 17-hospital healthcare system fast-track a platform migration and hardware rollout securely and in a way that improves work for everyone, regardless of location or role? These are the questions that kept me up at night in early 2020, when the pandemic demanded a “big bang”—something our legacy laptops and operating systems couldn’t handle.

We began our work with Google in 2020 with the adoption of Chrome as our default browser. As we migrated platforms, keeping patient data safe was of the utmost importance to us, along with providing every staff member with the tools they needed to work virtually. Our staff often experienced issues accessing our web-based applications using Internet Explorer or Edge Browser, a problem that went away when we switched to Chrome. Chrome’s versatile compatibility also made it easier for my team to migrate all of our web-based operations, and Chrome’s security and manageability were key components to making this switch a huge win for the organization.

The success of this migration led us to extend our Google partnership to patient care applications—where Google’s expertise in AI and ML helps scale the use of diagnostics tools and improve other aspects of the patient journey.

Achieving security at every step 

Like so many other healthcare organizations, we’ve been concerned about ransomware attacks. This is part of why we moved to Google Workspace and distributed over 3,000 Chrome OS devices in kiosk mode in March of 2020, when many of us went remote due to the pandemic. We were very concerned about team members accessing corporate applications through home devices that were running EOL operating systems (WIN7), as well as a general lack of antivirus and encryption measures.

We were protected by the fact that Google’s software and hardware both had built-in security features that we needed to stave off sophisticated attackers. For example, Chrome OS automatically updates to the latest security update and encrypts data living outside the cloud on the hardware. These features protected us from security-related disruptions, letting us securely move a huge library of file shares and emails across thousands of accounts to Google Chrome OS in just four months.

A year later, in March 2021, we migrated the enterprise over to Google Workspace and saw an immediate reduction in spam by 30% from the inherent built-in AI/ML. This meant staff were less likely to receive (and click through) phishing attempts. My team could connect, create, and collaborate easily and securely—even as more of us were working from home and needed to access sensitive data remotely. 

Leveling the playing field

As an organization, we were surprised by how many team members didn’t have personal computers at home. We quickly decided that if we needed team members to work from home, the health network would have to supply hardware. Chromebooks’ lower price tag compared to PCs—on top of their built-in security controls—allowed us to purchase, deploy, and support that initial distribution of 3,000 Chromebooks to team members in less than three weeks, providing devices to every eligible remote employee instead of just a select few. This was vital to reaching our equitable technology goal as part of our diversity and inclusion initiative: everybody has the same tools to do good work.

When all employees have what they need to do their jobs well, we get better patient outcomes. Before we began this cloud adoption journey, patient and staff experiences were different within the hospitals and outside of them. 

Now it’s the same wherever our staff is, and we’ve seen efficiency and accessibility benefits extend to the patient side. For example, we built a web-based contact center that supports 80 locations that use Workspace and Chrome OS devices. Since customer service, admin, and providers are all on the same system, it has become a one-stop shop for patients.

Furthermore, through the Grow with Google program, we were able to provide another benefit to employees that drove our equity goals. Google trained 50 non-IT staff members—from environmental services, food and nutrition, and other non-tech areas who were interested in making a career change to IT—on the Google products we were using. They may not have thought about switching to a career in IT before the Grow with Google program came to our organization, but through this partnership, they now have that opportunity.

A strategic, long-term partner

With any large-scale rollout, the work doesn’t end once laptops are in employee hands. Google has shown their commitment to long-term collaboration as they continuously optimize their products for the unique needs of healthcare providers and go the extra mile in tailoring tools to our staff’s workflows. 

For example, on the Chrome OS side, the Google team has helped our registration desks and document centers with device integration for hardware like credit card readers and e-signature pads. They’ve also helped us meet security and privacy requirements mandated by state and federal governments around HIPAA, Medicaid, and Medicare reimbursements. Over this next year, we’ll look at a feature roadmap with Google Cloud to deliver further enhancements, iterating on the product itself to meet our needs for the present and the future.

Delivering the future of healthcare

The benefits we’ve seen around security and usability—and the ability to provide all staff with equal access to Google’s technology—are why we’re expanding our partnership with Google to both the administrative and clinical sides of HMH. In addition to further Google rollouts with corporate, next year we’re distributing Chromebooks to all 350 of our ambulatory clinics.

We’re also working with the Google professional services team to create a custom AI model that analyzes 3D mammogram images. This AI model will enable two providers to read mammograms—which adheres to international best practices but is currently rare in the US—without requiring additional time. Conducting double readings of mammograms will yield better health outcomes for our patients, such as a lower patient recall rate and an increased accuracy in detecting breast cancer.

We’re currently building the model using a variety of Google Cloud products, including Cloud Healthcare API. Once complete, this model is expected to be trained, deployed, and maintained in Google’s Vertex AI, allowing our providers to be more productive as they make clinical decisions with AI support. As the model is proven over time, we plan to make the predictive services accessible to other healthcare organizations.

With Google, we’re able to achieve a unified architecture for storing data as well as training and deploying AI models, which enable our staff to work more efficiently and securely from anywhere. While I may not be able to predict the future as accurately as AI can, I foresee our continued partnership with Google as a key part of HMH’s improved provider and patient outcomes.

In the fragmented world of U.S. healthcare, patients often have to wait in line or on hold, navigate multiple patient portals, and fill out numerous request forms—all in pursuit of their own medical history. Healthcare technology startup PicnicHealth is on a mission to put control back with the patient, where it belongs.

PicnicHealth’s growth, from closing successful venture rounds to winning machine learning (ML) competitions, speaks to not only improvements and opportunities in healthcare, but also how startups are leveraging Google Workspace and Google Cloud services to accelerate momentum.

The company does the heavy lifting of collecting records and leverages human-in-the-loop ML to transcribe and validate them with an abstraction team of medical professionals. The records are then structured into a complete medical history that patients can access and share with providers to get better care.

But PicnicHealth helps to improve patient health on more than one front. It allows patients to contribute their data to de-identified medical research, building high-quality, anonymized datasets that researchers and life sciences companies can use to better understand disease progression and treatment in the real world.

Google Workspace has been part of PicnicHealth from day one, helping the founders collaborate and shape the company’s vision using cloud-synced documents and spreadsheets to collaborate and model predictions. “I’ve had a Gmail account since 2006, and in college 100% of people worked out of Google Docs. Workspace continues to be the best choice for online collaboration, and that’s why it’s still the default standard for startups,” said Troy Astorino, CoFounder & CTO of PicnicHealth. “When we started PicnicHealth, my co-founder Noga Leviner was in San Francisco and I was in Southern California, and of course we used Workspace.”

Today, Google Workspace continues to play a central role in the company’s collaboration. “We create design documents in Google Docs, primarily for engineering and product changes, and get really healthy, vibrant discussions through comments,” noted Astorino. “This practice has grown beyond engineering and is used for everything from how the company operates to communication norms.”

Google Workspace offers everything the team needs to collaborate, no matter where employees are. PicnicHealth’s team has spread from San Francisco to being distributed across the country and around the world. Instant collaboration is crucial.

“We work in a complex domain where people need a lot of information to make good decisions,” said Astorino. “Google Workspace allows us to operate in a mode of default transparency, where people can easily get the information they need even if it wasn’t intentionally or directly shared with them. Whether it’s working in Docs or scheduling in Calendar, we can operate much more effectively than we could otherwise.”

By any measure, PicnicHealth’s trajectory is one of record success. The startup is a 2014 alumni of Y Combinator, a program that helped launch household names like Airbnb, DoorDash, and Dropbox. Three years later, the team went on to win the $1 million grand prize at Google’s Machine Learning Competition. And the momentum has continued— PicnicHealth has recently announced a $60 million Series C round, bringing the amount raised to date to over $100 million. With the Series C, PicnicHealth is investing in expanding its reach to more patients across over 30 diseases.

As a healthcare startup, PicnicHealth faced a very particular set of challenges, especially when working with and accessing data. Data fragmentation and interoperability are only some of the challenges of realizing the value of big data in the cloud. The healthcare industry is notoriously difficult to navigate due to sensitive data protection laws and regulations like the Health Insurance Portability and Accountability Act (HIPAA).

PicnicHealth started in the cloud on Amazon Web Services (AWS). However, after migrating over to Kubernetes and facing an expanding list of requirements for HIPAA compliance, the company started to explore alternatives.

“We needed to be HIPAA compliant, which was going to be painful on AWS, and we wanted to get away from managing and operating our own Kubernetes clusters,” recalled Astorino. “We had heard good things about GKE (Google Kubernetes Engine). And particularly valuable for us, — many technical requirements you need for HIPAA compliance are configured by default on Google Cloud.”

PicnicHealth would have had to implement a lot of changes and get specialized instance types to get their existing configuration to work. So, they began experimenting with Google Cloud and discovered a much smoother experience.

“It was a lot easier to manage in terms of product setup and developer experience,” said Astorino. “There is a sane product hierarchy of resources you can access and use through Google Cloud and the relationships between them, from coordinated IAM (identity and access management) to using Google Groups for granting permissions. Overall, it’s cleaner.”

Astorino added that the move has also opened the doors to taking advantage of other services in the Google Cloud ecosystem like Cloud SQL, BigQuery, and Cloud Composer. PicnicHealth also uses Security Command Center because it easily integrates with everything but also helps meet various compliance frameworks’ requirements, providing visibility, near-real-time asset discovery, and security information and event management.

But most importantly, the integrated ecosystem has simplified the work needed for PicnicHealth to create a secure environment for employees to use when working with sensitive medical records while still providing all the tools they need. For example, abstractors not only use Google Workspace but also have Chromebooks because they are easy to manage and secure.

Altogether, Google Cloud helps form a technology stack that has enabled the startup to build a massive labeled dataset containing over 100 million labeled medical data concepts. In turn, it accelerates PicnicHealth’s ability to generate highly-performant AI models and feed other ML pipelines, which has been vital for processing and reviewing data at scale.

To learn more about how Google Workspace and Google Cloud help startups like PicnicHealth accelerate their journey, visit our startups solutions pages for Google Workspace and Google Cloud.

Road construction is booming in India. A recent report prepared by the India Brand Equity Foundation—a trust established by the Department of Commerce—pointed out that in FY 2019 alone, the country added 10,855 kilometers of highways to a road network that spans 5.89 million kilometers. This network is the second largest in the world and transports 90% of passenger traffic and 64.5% of all goods in the country.

The Indian Government has also earmarked road construction as key to plans to increase the nation’s GDP to $5 trillion in coming years, targeting road construction worth $212.8 billion in the two years from April 2020.

G R Infraprojects Limited is well positioned to support the government’s program. The business, which started as a contractor building roads in rural villages in India, now specializes in road engineering, procurement, and construction (EPC), a model whereby private construction firms build roads funded by the government.

The business now undertakes the processing of bitumen, manufacture of thermoplastic road-marking paint and road signage, and fabrication and galvanizing road-crash barriers. Its in-house integration model includes a design and engineering team, as well as manufacturing facilities in Rajasthan, Assam, and Gujarat.

The business recently expanded into rail—another area expected to benefit from extensive government investment—with its competencies including earthworks, materials supply, track lining, and bridge construction.

In this environment—and despite the economic impact of the coronavirus pandemic—G R Infraprojects Limited aims to substantially increase turnover and manpower over the next five years.

Best-in-class infrastructure key to success

Digital transformation is key to enabling growth while best-in-class IT infrastructure is one of the foundations on which the business seeks to build success.

G R Infraprojects Limited’s digital initiatives include deployment of a new document management system and corporate systems that enable remote monitoring, live tracking, effective real-time communication, and efficient data management.

Providing a scalable, reliable cost-effective infrastructure

But most important of all is providing a scalable, reliable, and cost-effective infrastructure to support a business-critical SAP enterprise resource planning system. Over the last few years, versions of SAP have enabled the organization to digitize processes and seamlessly run business-critical functions such as inventory management and finance.

G R Infraprojects Limited initially went live with SAP ECC6.0, with a few hundred team members using the system for business-critical tasks such as tracking stock level and movement and generating financial statements and reports for review and action.

“Google Cloud is a very big brand, so we were easily able to secure the trust from our executive and business teams to run an important system such as SAP S/4HANA on the platform.”—Sachin Kumar Agarwal, Head, Transformation, G R Infraprojects Limited

Lowering maintenance costs

However, as G R Infraprojects Limited grew, projects proliferated, and new markets emerged, the business elected to move to the cloud from an on-premises infrastructure. “We wanted to move because there were so many maintenance costs in on-premises solutions and cloud provided convenience to IT and the broader organization,” explains Sachin Kumar Agarwal, Head, Transformation at G R Infraprojects Limited.

The business also wanted to move to SAP S/4HANA to take advantage of features such as AI, advanced analytics, and machine learning to transform business processes. The system runs on the HANA database, an in-memory database with fast processing speeds and a simplified data model.

G R Infraprojects Limited selected Google Cloud to run SAP S/4HANA because, Sachin says, it is “much better than any other platform,” incorporates a wide range of features, and meets uptime requirements. The cloud service could also scale to support forecast growth without a sharp increase in cost.

Furthermore, Sachin adds, “Google Cloud is a very big brand, so we were easily able to secure the trust from our executive and business teams to run an important system such as SAP S/4HANA on the platform.”

“With Google Cloud, our speed and availability are controlled and optimized day by day. With such a scalable and dynamic platform, we are very happy with the performance.”—Sachin Kumar Agarwal, Head, Transformation, G R Infraprojects Limited

Successful transition with Infrabeat

G R Infraprojects Limited completed the project with assistance from partner InfraBeat over three months and SAP S/4HANA on Google Cloud went live mid-2019. “Our dedicated SAP team worked closely with Infrabeat to deliver the project successfully,” says Sachin. “We needed an experienced partner to assist with the implementation process and Infrabeat performed that role admirably. Both teams supported each other and worked to plan to deliver a great result.”

SAP S/4HANA runs on an infrastructure comprising virtual machine instances delivered through Compute Engine, Cloud Storage, and Cloud NAT to enable the secure transmission and receipt of packets to and from the internet.

G R Infraprojects Limited estimates the cost of running SAP S/4 HANA in Google Cloud is significantly lower than on alternative infrastructure options—freeing up budget for other business priorities.

In addition, moving SAP S/4 HANA to infrastructure as a service through Google Cloud has eliminated the need to assign internal team members to infrastructure management, allowing them instead to focus on higher-value activities.

Google Cloud also incorporates the security needed to protect the data and processes of SAP S/4 HANA from intrusion or disruption and ensure the uptime and continuity required of a business-critical system.

Optimized speed and availability

G R Infraprojects Limited’s decision to run SAP S/4 HANA on Google Cloud is delivering benefits on a daily basis. “With Google Cloud, our speed and availability are controlled and optimized day by day,” says Sachin. “We are very happy with the performance.”

Success with SAP S/4HANA has helped the business decide to move its remaining apps and data to the cloud when its on-premises servers and other equipment reach end of life. G R Infraprojects Limited is already running Active Directory in Google Cloud and Sachin says the cloud platform’s “fast and excellent services” made the decision easy.

“There are definitely instances of various upgrades of our systems and within the organization, and as we talk about our application and mobility requirements, we see Google Cloud playing a crucial role.”—Sachin Kumar Agarwal, Head, Transformation, G R Infraprojects Limited

Adding value

As G R Infraprojects Limited grows, Sachin adds, the business expects Google Cloud to continue to add value. “There are definitely instances of various upgrades of our systems and within the organization, and as we talk about our application and mobility requirements, we see Google Cloud playing a crucial role.”

Indonesia is leading the way for digital transformation in Southeast Asia. According to Google’s e-Conomy South East Asia report, the country’s 2030 Gross Merchandise Value – the value of online retailing to consumers –  could be twice the value of the whole of Southeast Asia today.  

This growth means that many companies need more qualified IT graduates and employees with digital skills than they have today. Fast-growing tech companies need more qualified IT graduates, and employees with digital skills. According to the World Bank, Indonesia needs an additional nine million people with digital skills by 2030. The shortage of technical talent reiterates the need to invest in a reliable skills pipeline.

Following years of digital talent developments in Indonesia, Google has become a supporter of Bangkit, an academy designed to produce high-caliber technical talent for Indonesian technology companies and startups. Bangkit has facilitated a multi-stakeholder collaboration between Google, government, industry, and universities across Indonesia. 

Last year, the President of Indonesia and the Ministry of Education and Culture, Research, and Technology, acknowledged Bangkit’s significant impact, with 3,000 students completing nearly 15,000 courses and specialisations. 

Building on last year’s success, Bangkit started its 2022 program in February, offering three learning paths to students:

• Cloud computing with Google Cloud, preparing students for the Google Associate Cloud Engineer certification. Some of the course components are also available online 
• Mobile development with Android, preparing students for the Google Associate Android Developer exam. An online version is available here. 
• Machine learning with Tensorflow, getting students ready to take the Tensorflow Developer certification. Some of the online courses are available here for others.

Bangkit 2022 has enrolled 3,100 university students who will take a five month study course, obtaining university study credit, as well as industry certifications. The program accepts diverse cohorts of people who are passionate about preparing for a tech career in the near future, with support and encouragement for women, people with disabilities, and students from across Indonesia to apply. 

Since its pilot in 2019, Bangkit has been guided by three principles:  

• Industry-led: provides curriculum and instructors from industry experts, including Google, GoTo and Traveloka. Instructors include key figures such as Laurence Moroney (Google, Lead AI Advocate), Google Developer Experts, and other committed professionals. 
• Immersive: combines online learning methods conducted in both individual and group settings.  
• Interdisciplinary: contains knowledge and best practices in tech, soft skills, and English to provide complete career readiness. 

The program runs from February to July 2022, and has a 900-hour curriculum throughout the 18-week learning experience. 

Benefits for students participating in Bangkit include:

• Study credit conversion 
• Job opportunities at our career fair
• Google Cloud, TensorFlow and AAD exam vouchers
• Incubation funds and mentorship support from industry

Towards the end of Bangkit 2022, students will team up for the Capstone Project challenge to propose solutions to some of the nation’s most pressing problems, such as environmentalism, accessibility, and more. The top 15 teams will be selected to receive funding to incubate their capstone projects. These education and career-preparedness offerings are provided at no cost.

Google is partnering with industry, governments, universities, and employers to help meet the skill demands of today. From supporting the State of Ohio to offer tech skills to residents, to working with the University of Minnesota-Rochester to create a customized health sciences degree program, Google is here to help our partners prepare those they serve for a cloud-first world.