Everyone wants affordable, quality healthcare but not everyone has it. A 2021 report by the Commonwealth Fund ranked the U.S. in last place among 11 high-income countries in healthcare access.1 Carbon Health is working to change that. We are doing so by combining the best of virtual care, in-person visits, and technology to support patients with their everyday physical and mental health needs.

Rethinking how data and analytics are accessed at Carbon Health

Delivering premium healthcare for the masses that’s accessible and affordable is an ambitious undertaking. It requires a commitment to operating the business in an efficient and disciplined way. To meet our goals, our teams across the company require detailed, daily insights into operating results.

In the last year, we realized our existing BI platform was inaccessible to most of our employees outside of R&D. Creating the analytics, dashboards, and reports needed by our clinic leaders and executives required direct help from our data scientists.

However, this has all changed since deploying Looker as our new BI platform. We initially used Looker to build tables, charts, and graphs that improved how people could access and analyze data about our operating efficiency. As we continued to evaluate how our data and analytics should be experienced by our in-clinic staff, we learned about Connected Sheets for Looker, which has unlocked an entirely new way of sharing insights across the company.

A new way to deliver performance reporting and drive results

Connected Sheets for Looker gives Carbon Health employees who work in Google Sheets—practically everyone—a familiar tool for working with Looker data. For instance, one of our first outputs using the Connected Sheets integration has been a daily and weekly performance push-report for the clinic’s operating leaders, including providers.

Essentially a scorecard, the report tracks the most important KPIs for measuring clinics’ successes, including appointment volume, patient satisfaction such as net promoter score (NPS), reviews, phone call answer rates, and even metrics about billing and collections. To provide easy access, we built a workflow through Google App Script that takes our daily performance report and automatically emails a PDF to key clinic leaders each morning.

Within the first 30 days of the report’s creation, clinic leaders were able to drive noticeable improvements in operating results. For instance, actively tracking clinic volume has enabled us to manage our schedules more effectively, which in turn drives more visits and enables us to better communicate expectations with our patients. Other clinics have dramatically improved their call answer rates by tracking inbound call volume, which has also led to better patient satisfaction.

Greater accountability, greater collaboration

As you can imagine, a report that holds people accountable for outcomes in such a visible way can create some anxiety. We’ve eased those concerns by using the information constructively, with the goal to use reporting as a positive feedback mechanism to bolster open collaboration and identify operational processes that need improvement. For example, data about our call answer rates initiated an investigation that led to an operational redesign of how phones are deployed and managed at more than 120 clinics across the U.S.

Looker as a scalable solution with endless applications

We’re now rolling out Connected Sheets for Looker to deliver performance push-reporting across all teams at Carbon Health. Additionally, we continue to find new ways to leverage Connected Sheets for Looker to meet other needs of the business.

For instance, we’ve recently been able to better understand our software costs by analyzing vendor spend from our accounting systems directly in Google Sheets. Going forward, this will allow us to build a basic workflow to monitor subscription spend and employee application usage, which will lead to us saving money on unnecessary licenses and underutilized software.

We’ve come a long way in the last year. Between Looker and its integration with Google Sheets, we can meet the data needs of all our stakeholders at Carbon Health. Connected Sheets for Looker has been an impactful solution that’s going to help us drive measurable results in how we deliver premium healthcare to the masses.

^{1. Mirror, Mirror 2021: Reflecting Poorly
2.  HEALTHCARE EDITORS’ PICK Meet The Immigrant Entrepreneurs Who Raised $350 Million To Rethink U.S. Primary Care}

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&

Millions of people annually view esports, as top players and teams compete in thrilling, fast-paced tests of reflexes, strategy, and teamwork. Fans are a diverse group, sharing a passion for action. A new, revolutionary project we’re working on with Call of Duty League just made that action a lot better.

ActivStat brings fans, players, and commentators the power of competitive statistics in real-time—stats that matter not only to the game at hand, but also for a full roster of competitors globally. Using ActivStat, live broadcasts will soon be enhanced with more depth and color-of-play while they’re happening, building excitement and adding to the overall experience.

Technically, ActivStat is an entirely new capability for esports. It’s a constantly updating catalog of statistics that is sourced, analyzed, updated, and delivered in an easy-to-consume way across global-scale computing systems, with a latency of milliseconds or seconds, rather than minutes or hours. By comparison, many of these stats today are available to fans after a day or more of processing.

Call of Duty League plans to begin rolling out ActivStat during the 2021 season. The initial rollout will include critical information like player and team standings and winning ratios across multiple aspects of virtual combat—including ultimately what these numbers mean for rankings. ActivStats are delivered both in raw statistics and via visualizations and graphics, providing commentators with fast access to the types of insights fans crave. 

For engineers at both companies, building the service has been an epic success all its own. Due to a sponsorship with Call of Duty signed last February, our dedicated game engineering team quickly innovated a new solution incorporating high-speed networking, data pipelines from multiple cloud sources, and data warehousing to create a user-friendly dashboard. Real data was flowing into commentator dashboards by April.

Esports are more complex to cover in many ways than regular sports. Instead of a well-defined physical playing field (often a simple rectangular space), multiplayer games involve complex and sprawling virtual environments that can be the size of a large campus or airport with multiple levels and hidden locations.   

Gameplay between competitors happens across many of these locations simultaneously. In addition, competitors also each choose their own configurations of equipment, known as “loadouts,” which can dramatically affect gameplay and strategy. All of this additional complexity in online gaming involves data that needs to be captured, analyzed, and communicated to the fans in insightful ways.

Two Google Cloud technology capabilities play central roles in the operations of ActivStat. BigQuery—a planet-scale data warehouse that can store and query petabytes of information in real time—is the foundation of the ActivStat platform for gathering and summarizing millisecond-level statistics. Looker, an intuitive analytic dashboard, surfaces those insights to commentators in an easy-to-use, real-time dashboard that enables the commentators to speak to compelling insights and statistics in sync with the gameplay as it is happening in the live broadcast.

While the initial release of ActivStat for this season of Call of Duty League provides compelling and powerful capabilities, it’s only the beginning of this Call of Duty League-Google Cloud co-innovation partnership. Our future vision is mapping gameplay hotspots on the field, and predicting where to place cameras with machine learning as the match evolves–enabling broadcast producers to build excitement for fans by always being in the middle of the best action. Call of Duty League and Google will also look to drive statistics and metrics directly into the broadcast feed.

The implications of the real-time statistical capabilities of ActivStat go beyond gaming and esports. Historically, gaming has been at the leading edge of what computer processing, computer graphics, wide-area networking, data analysis, and insight can do. The real-time data ingestion and output used in ActivStat could one day be useful powering live broadcasts in other types of sporting events, as well as blending live video feeds and data to support use cases in media & entertainment, healthcare, finance, manufacturing, and other verticals. We’re excited about the potential for this bold new solution and partnership between Call of Duty League and Google in esports and beyond.

To learn more about Call of Duty League-Google Cloud partnership, visit our press release.

Spanner uses certain concepts differently from other enterprise database management tools, so you might need to adjust your application to take full advantage of its capabilities. You might also need to supplement Spanner with other services from Google Cloud to meet your needs.

Migration constraints

When you migrate your application to Spanner, you must take into account the different features available. You probably need to redesign your application architecture to fit with Spanner’s feature set and to integrate with additional Google Cloud services.

Stored procedures and triggers

Spanner does not support running user code in the database level, so as part of the migration, you must move business logic implemented by database-level stored procedures and triggers into the application.

Sequences

Spanner does not implement a sequence generator, and as explained below, using monotonically increasing numbers as primary keys is an anti-pattern in Spanner. An alternative way to generate a unique primary key is to use a random UUID.

If sequences are required for external reasons, then you must implement them in the application layer.

Access controls

Spanner supports only database-level access controls using IAM access permissions and roles. Predefined roles can give read-write or read-only access to the database.

If you require finer grained permissions, you must implement them at the application layer. In a normal scenario, only the application should be allowed to read and write to the database.

If you need to expose your database to users for reporting, and want to use fine-grained security permissions (such as table- and view-level permissions), you should export your database to BigQuery.

Read the full article for more, including

• Data validation constraints
• Supported data types
• Migration process
• Transferring your data from Oracle to Spanner
• Maintaining consistency between both databases
• Verifying data consistency
• and more.