Patients about to undergo a healthcare procedure understandably want the best medical professionals they can get. But how can they know which doctors have had the most experience and the best outcomes with that particular procedure? How can they make an informed decision about which doctor to select when the information they have is limited to the doctor’s practice area and subjective reviews from other patients?

MD Insider is working to solve that problem using machine learning (ML) to objectively analyze doctor performance. By analyzing data from thousands of institutions and millions of doctor-patient interactions and medical events, MD Insider identifies physician performance insights based on their experience and outcomes. Insights are then integrated into a triage engine, that enables consumers to search for and schedule appointments with providers who meet their clinical criteria and convenience preferences, such as insurances accepted, office hours, locations, and language.

MD Insider also offers robust data APIs to help health systems, health plans, and employers reduce costs and improve quality of care. Payers use the APIs to curate high-quality provider networks and manage provider directories. Examples of MD Insider’s data APIs include Provider Experience and Share of Practice metrics, Provider Quality and Outcomes, Network Modeling, Expert Clinical Search Taxonomy, Find a Provider, Acute-Care Hospital Quality, and Provider and Facility Metadata.

“We use Google Cloud Platform the way the cloud was supposed to be used. By comparison, other cloud providers feel like you’re renting somebody else’s data center.”

—Ed Holsinger, Lead Data Engineer and Head of Data Science, MD Insider

MD Insider is continuously ingesting the latest performance data about physicians and analyzing billions of rows of data. Requiring constant scalability, the company was born in the cloud; however, it had difficulty configuring server instances for the optimal balance of memory and CPU, and its Hadoop cluster had to be kept running 24/7. Network performance was often slow for no apparent reason. As a result, failure rates from node timeouts increased, and costs grew along with the data. MD Insider had to estimate its usage and pay up front, and received little financial benefit from sustained use commitments.

Knowing that data would continue to grow, MD Insider decided to move its data services — the most demanding and complex portion of its infrastructure — to Google Cloud Platform (GCP), and took advantage of GCP managed services for container management and big data analytics.

“One of the reasons we decided to move to Google Cloud Platform is because it feels like a unified, well-designed cloud architecture and pricing model,” says Ed Holsinger, Lead Data Engineer and Head of Data Science at MD Insider. “We use Google Cloud Platform the way the cloud was supposed to be used. By comparison, other cloud providers feel like you’re renting somebody else’s data center.”

“Moving to Google Cloud Platform and using Kubernetes Engine gave us 5x the processing power for analyzing physician performance at 75% less cost. Our data scientists have more power than ever before to generate insights for our customers.”

—Ed Holsinger, Lead Data Engineer and Head of Data Science, MD Insider

5x the performance, 75% less cost

MD Insider now uses Kubernetes Engine to automate container management and deploy clusters in minutes with just a few clicks. When hundreds of machines are required to analyze a large dataset, automation in Kubernetes Engine deploys ML models as containers, each of which manages the full lifecycle of its task, including scaling up resources, deploying results, and scaling back down when the task is finished. It’s easy for MD Insider to specify exactly how much CPU and memory each container needs, helping maximize performance while reducing costs.

“Moving to Google Cloud Platform and Kubernetes Engine gave us 5x the processing power for analyzing physician performance at 75% less cost,” says Ed. “Our data scientists have more power than ever before to generate insights for our customers. Data scoring jobs that used to take three business days now take four hours.”

Adds Galen Meurer, Senior Software Engineer at MD Insider: “Even if all Google Cloud Platform had to offer was Kubernetes Engine, I would still want to use it. Previously we spent up to 30% of our time managing our container infrastructure, which we can now use for product development.”

A foundation for data science

MD Insider was happy to find that GCP offers a wide variety of managed services. For example, the company is supplementing its Kubernetes Engine clusters with BigQuery for its big data masters and selection jobs, enabling scientists to analyze new and different types of data as well as analyze larger datasets in less time. MD Insider also uses Cloud Storage for big data staging and Cloud Dataproc to run managed Apache Spark clusters for data processing.

“Google Cloud Platform gives us an incredibly powerful cloud architecture for data engineering and data science,” says Eric Wilson, CEO of MD Insider. “That gives our scientists independence, they can do what they need to do without waiting and with no contention between them.”

A developer-friendly platform

Migrating its data services was such a success that MD Insider decided to move the rest of its infrastructure to GCP, including the front end for its web application. Since the migration, MD Insider has experienced no unplanned downtime on GCP, allowing it to easily meet the 99.5% uptime SLA it promises to customers. It’s also taking advantage of Build Triggers in Kubernetes Engine to automate container builds and reduce build times by more than 40%. Production code can be updated in seconds, with no impact to end users other than making new features available.

“GCP has simplified our workflow in so many ways, from intelligent load balancing to content delivery and automating builds,” says Matthew Frey, Software Engineer. “Everything on GCP is cohesive and developer friendly, with a superior UI and better network performance than other cloud providers.”

Ryan Beaini, Senior Software Engineer at MD Insider, agrees: “Since we moved to GCP, our developers are definitely happier. The pain and the headaches we experienced because of the limitations of our previous toolset all went away.”

“We’re a small company, but what we’re doing is incredibly important. We’re helping people make decisions about healthcare providers that could impact their lives and even be life-saving. Google Cloud Platform is helping us make our mission bigger, better, and brighter.”

—Eric Wilson, CEO, MD Insider

Securing billions of rows of clinical and non-clinical healthcare data

As a healthcare technology company, MD Insider processes billions of rows of clinical and non-clinical healthcare data. To control user access to GCP, it uses Identity & Access Management (IAM) along with Yubico YubiKeys for hardware-based two-factor authentication when logging into Google Workspace. MD Insider takes comfort that GCP encrypts data at rest by default, and encrypts and authenticates data in transit when data moves outside physical boundaries not controlled by Google or on behalf of Google.

“On GCP, everything that we need to be encrypted for compliance purposes is encrypted, which is fantastic,” says Eric. “When I tell our potential clients and partners about the resources that Google has dedicated to security, it gives them the confidence that their data will be protected.”

Transforming how teams work

As a growing company, MD Insider must collaborate seamlessly between offices in California, Colorado, and Illinois. It relies on Google Workspace for communication and productivity, using Docs, Sheets, and Slides to drive the business. Employee and team files are stored in Drive, and meetings are conducted via Google Meet with Chromebox for Meetings videoconferencing hardware kits. Google Workspace also helps MD Insider maintain information security by authenticating email domains with digital signatures in Gmail and scanning outgoing email using Gmail Data Loss Prevention (DLP).

“I use Google Workspace every day, and everyone else here does too,” says Eric. “Team Drives are a big time saver for us. We’ve let our previous office software expire, because there’s no need to pay for those licenses anymore.”

Promoting healthcare transparency

With GCP helping MD Insider increase velocity and momentum, the company is making exciting progress. For example, it has entered into a strategic partnership with Zelis Healthcare, which will use MD Insider’s API to provide insights for a next-gen analytics platform that will give health plans unprecedented transparency around physician performance.

“We’re a small company, but what we’re doing is incredibly important,” says Eric. “We’re helping people make decisions about healthcare providers that could impact their lives and even be life-saving. Google Cloud Platform is helping us make our mission bigger, better, and brighter.”

*Google Workspace was formerly known as G Suite prior to Oct. 6, 2020.

With more than 2.5 million customers, Italian utility company A2A is committed to delivering electricity, gas, clean water, and waste collection every day. More recently, the company made another significant commitment: To incorporate the principles of the “circular economy” into its way of doing business — part of the UN 2030 Agenda’s Sustainable-Development Goals — all while also aiming to double its client base by 2030. Growing rapidly but sustainably requires operating as efficiently as possible at every level of the organization, from operating smart meters to generating accurate demand projections. That’s why A2A chose to deploy its SAP S/4HANA ERP and the SAP BW/4HANA data warehouse on Google Cloud.

Roadblocks to innovation

Instead of a linear consumption model that starts with raw materials and ends with use and disposal, the circular economy is a continuous cycle that emphasizes repair, recycling, and the creation of materials rather than their disposal. To take an example from A2A’s own success story: The company keeps 99.7 percent of collected waste out of landfills.1 Of the UN’s sustainability goals, A2A is committing to the three most relevant to its industries:

• Ensuring availability and sustainable management of water and sanitation for all
• Ensuring sustainable consumption and production patterns
• Protecting, restoring, and promoting sustainable use of terrestrial ecosystems

Achieving A2A’s sustainability and customer-first strategies requires high scalability, rapid data ingestion, and rich, accurate analytics. None of this could be reliably supported with the company’s legacy on-premises SAP and Data Warehouse, especially given A2A’s projected growth and the increasing complexity of the data landscape, including IoT deployments and energy market liberalization.

Provisioning data infrastructure was also slow and complex. Simply adding a new metric could require increasing capacity by an order of magnitude. And analytical and transactional data lived in siloes, which created a fragmented and out-of-date view of each customer across sales and customer support teams. A2A’s fragmented data also made it difficult to take proactive action when changing priorities or processes required shifting focus from one data source to another.

With a data warehouse that refreshed only once every 24 hours, simple processes such as responding to a customer calling because their power has been cut off due to an unpaid bill became cumbersome.

Scalability was also a concern. With the on-premises solution, A2A needed to define the budget for its data warehouse over a two-year timeframe, but the rollout of new electricity meters — each sending data every 10 minutes — across Italy made those data requirements hard to predict.

The move to the cloud: From monolith to microservices

The move has been a giant step forward in A2A’s goal of meeting its data-driven, customer-centric strategy. In deploying its SAP systems to Google Cloud, A2A can take advantage of a highly flexible hybrid environment and powerful data management and analytics. It can replicate data from Salesforce, SAP, and other systems in BigQuery, which operates as a data lake with Google Cloud SQL, connected directly to Google Analytics and Google Ads for data-driven customer service, decision-making, and marketing.

“From BigQuery we can feed relevant information directly to the people who need it. Our customer operators work on Salesforce, so we use an OData protocol to embed real-time data in that platform. Elsewhere, we present the information through a dashboard, or with a BI component delivering one-page reports.” —Vito Martino, Head of CRM, Marketing and Sales B2C & B2B, A2A

By running SAP on Google Cloud, A2A can also count on an infrastructure platform that provides:

• Scalability. The robust data architecture on Google Cloud adapts to shifting and increasing demands without compromising on speed or availability, so A2A doesn’t have to worry about over- or under-provisioning as the rollout of smart meters proceeds.
• Speed. The new A2A data solution refreshes every five minutes instead of 24 hours, so the company can respond to its customers’ needs without delays. Customer operators working in Salesforce now receive real-time data from Google BigQuery so that, when a customer calls, operators can see accurate information in seconds. They can now offer value-added services and sustainable options tailored to the customer’s needs, from energy consumption to their preferred method of communication.
• Availability. With microservices orchestrated by Google Kubernetes Engine, the team can update the solution through continuous integration and delivery (CI/CD), eliminating the need for downtime when changes are required.
• Security and control. The A2A IT team uses Google Kubernetes Engine to orchestrate clusters of instances on Google Compute Engine, with Google Cloud Load Balancing and backups on Google Cloud Persistent Disk. Google Cloud Anthos ensures operational consistency across on-premises and cloud platforms.

Ready to grow the sustainable way

By moving to Google Cloud — the industry’s cleanest cloud, with zero net emissions — A2A is ready to grow quickly while locking down the efficiency it will need to meet its ambitious sustainability goals. “To bring sustainable utilities to market, we need to be both responsive to our customers and responsive to the internal needs of A2A,” explains Davide Rizzo, Head of IT Governance and Strategy at A2A. “Understanding what customers need in detail means we can improve their services and reduce their environmental impact at the same time.”

Learn more about the ways Google Cloud can transform your organization’s SAP solutions with scalability, speed, and advanced analytics capabilities.

^{1.  Circular Economy: one of the four founding pillars of A2A’s 2030 sustainability policy | Drupal}

Wipro has partnered with Google for migration of its enterprise-wide SAP footprint to the Cloud platform. The engagement will bring SAP applications and workloads to the cloud to support the country’s fourth-largest software services firm’s 180,000-plus employees.

Bhanumurthy B.M, President and Chief Operating Officer, Wipro said that as a provider of digital transformation services to some of the world’s most impactful businesses, it is critical that the company’s own core systems and technologies are running on intelligent and modern platforms that encompass the needs of the future.

“The technology that we’re getting into right now, and the kind of design led approach that we are taking, I think customers will benefit significantly from this,” he told ET.

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