At 340 square miles, the City of Memphis is among the largest in the United States in terms of land area. Memphis has over 6,800 lane-miles of city streets, enough to drive back and forth to Los Angeles four times. Keeping these streets well maintained and safe for citizens and visitors is a major priority for the city.

Lots of traffic, lots of roads, and a four-season climate prone to wintertime freeze-thaw-refreeze cycles means the opportunity for potholes. Although the city aims to fill potholes within five business days of notification, it can take longer, especially during winter and early spring. Last year, the city’s Public Works crews repaired some 63,000 potholes, only 20% of which were reported by residents. Approximately 32,000-man-hours each year are spent repairing potholes, with seasonal fluctuations requiring ten to twelve Street Maintenance crews working steadily during the winter months. Still, many went unreported, leading the city to flag pothole request resolution under “needs improvement” on its open data portal website.

Like many large cities, Memphis also struggles with vacant and blighted properties. Nearly 15,000 properties in Memphis are likely vacant, and city officials contend that many are owned by out-of-town investors who live elsewhere and do not take necessary restoration or maintenance steps. These properties can decrease the value of surrounding real estate and discourage new businesses and other residents from moving to an area. Citizen frustration and concerns over the number of blighted properties has made blight eradication a major focus of the City of Memphis.

Historically, residents reported potholes and blighted properties by calling 311, or more recently by using the Memphis 311 app. However, these reports only covered about 20 percent of the problems — often the worst cases. And by the time residents took the initiative to submit a 311 report, they usually weren’t feeling good about the situation.

Recognizing that potholes and vacant properties are often the most visible indicators of whether a city government is doing its job efficiently, Memphis Mayor Jim Strickland and CIO Mike Rodriguez began looking for ways they could apply technology to fix the problems. Mike approached Google for ideas, and Google recommended conducting a machine learning proof-of-concept (POC) with SpringML, a Google Cloud Partner.

“Memphis is focused on easy living, and we want to do everything we can to keep our citizens happy,” says Mike Rodriguez. “Working with Google and SpringML to reduce potholes and urban blight using machine learning and artificial intelligence was an easy decision.”

Bringing machine learning to city operations and budgets

The city’s goal is to detect potholes and abandoned properties by analyzing video footage of roads and residential properties. It wanted to classify potholes by width and depth, and share the information with workers who can repair them. For abandoned properties, it wanted to enable more strategic deployment of resources for homeowners citywide and take action to hold neglectful property owners accountable.

The POC began by training TensorFlow models for ML object detection using preconfigured AI Platform Deep Learning VM Images on Compute Engine. SpringML helped set up cameras and developed a user interface to collect pothole data and automate the 311 ticketing process.

Together, the teams analyzed 30 days of video from a moving city bus and high-resolution video from 360-degree cameras mounted to a code enforcement vehicle, overlaid with data from 311 reports. As the models were refined, accuracy quickly climbed from 50 percent to over 90 percent as models were taught to differentiate a pothole from a manhole cover or other object.

The city also imported routes, potholes, and paving data along with geolocation data from ArcGIS and Google Maps into BigQuery to better understand street conditions and the proximity of potholes to one another. BigQuery also analyzes city property records, tax records, 311 reports, and third-party survey data on-demand to predict where homes are starting to become run down and where neighborhood decay is most likely to occur. The SpringML team created a pilot analysis to begin vacant property protections and developed a user interface tool to interact with the model’s results.

“Google Cloud Platform made it possible for us to experiment with machine learning and artificial intelligence to help solve our city’s problems while working within the budget constraints of a municipal IT organization,” says Mike. “Google turned a ‘nice to have’ into a ‘let’s do this!'”

Identifying 75 percent more potholes

Memphis expects to substantially reduce the number of potholes on its streets, creating a better driving experience for residents and visitors alike. Because drivers won’t be as likely to swerve to miss a pothole, streets will be safer and friendlier to bicycles and scooters. Fewer potholes will also save the city between $10,000 and $20,000 annually in city claims that it pays out in cases where vehicle damage results from a pothole that was not addressed in a timely manner.

“Historically, Public Works has relied primarily upon Street Maintenance crews to proactively locate and fill potholes. As Memphis has over 6,800 lane-miles of public streets, it is a daunting task to reliably survey the entire system in an efficient and systematic way,” says Robert Knecht, Public Works Director for the City of Memphis. “The outcome of the data collected will be invaluable to Public Works so that it can ensure it is managing the city’s street system in a more proactive manner.”

Memphis will be able to better prioritize road maintenance based on condition and impact, increasing the efficiency of its Public Works road crews. Analyzing video of streets also gave the city visibility into issues it wasn’t previously aware of, such as curbs, gutters, and manhole covers that had been mistakenly paved over and need to be excavated. The ML process is easily transferrable to other concerns as well, helping the city identify illegal signs or spools of cable hanging on light posts that could be potentially unsafe.

Helping communities recover and thrive

Memphis is also having success in analyzing predictive trends to combat high rates of abandoned and blighted properties, surpassing 97.5 percent accuracy. “In the past, Public Works experimented with comprehensive, city-wide blight identification by using approximately 200 volunteers to survey and photograph over 237,000 city parcels. This effort was costly, took a long time to complete, and resulted in inconsistent data collection,” says Robert. “Blighted property conditions can change quickly in a city the size of Memphis. Now, with this new technology, Memphis will be able to make a significant difference in the efforts to proactively and comprehensively identify and manage blighted and substandard properties.”

Code Enforcement with better data-driven detection mechanisms enables the city to also identify cases where homeowners are not physically or financially able to keep up with the challenges of homeownership and make them aware of resources that are available to assist them. Memphis Code Enforcement can do a better job of finding people living in derelict properties that pose hazards to inhabitants’ health and safety, and help them fix those problems or find a new place to live.

“Using SpringML and Google Cloud Platform to detect indicators of vacant or blighted properties will help Memphis create safer neighborhoods that will be more attractive to businesses and home buyers,” says Mike. “Property values and employment will go up, crime will go down, and social services can be more focused and effective.”

Revolutionizing service delivery for citizens

Memphis is proving the viability of a cost-effective, cloud-based machine learning model that other cities can follow. The city is already looking into new applications of AI and ML that will further improve city services and help it build a better future for its 652,000 residents.

As part of his commitment to a transparent government, Memphis Mayor Jim Strickland created an open data policy that commits to releasing raw data and sharing it with citizens in a variety of downloadable formats. Going forward, this transparency will help citizens understand how their needs are being served and uncover new, innovative use cases for AI and ML.

“Our goal is to become a smart city, and technologies such as Google Cloud Platform and SpringML put us ahead of the game,” says Mayor Strickland. “Google understands data, and there isn’t a better company to help us analyze our data resources for actionable insights.”

Every organization has its own unique data culture and capabilities. Yet each is expected to use technology trends and solutions in the same way as everyone else. Your organization may be built on years of legacy applications, you may have developed a considerable amount of expertise and knowledge, yet you may be asked to adopt a new approach based on a technology trend. On the other hand, you may be on the other side of the spectrum, a digitally native organization built with engineering principles from scratch without legacy systems but expected to follow the same principles as process driven, established organizations. The question is, should we treat these organizations in the same way when it comes to data processing? In this series of blogs and papers this is what we are exploring: how to set up an organization from the first principles from data analyst, data engineering and data science point of view. In reality, there is no such organization that is solely driven by one of these but it is likely to be a combination of multiple types. What type of organization you become is then driven by how much you are influenced by each of these principles. 

When you are considering what data processing technology encompasses, take a step back and make a strategic decision based on your key goals. This can be whether you optimize for performance, cost, reduction in operational overhead, increase in operational excellence, integration of new analytical and machine learning approaches. Or perhaps you’re looking to leverage existing employees’ skills while meeting all your data governance and regulatory requirements. We will be exploring these different themes and will focus on how they guide your decision-making process. You may be coming from technologies which are solving some of the past problems and some of the terminologies may be more familiar, however they don’t scale your capabilities. There is also the opportunity cost of prioritizing legacy and new issues that arise from a transformation effort, and as a result your new initiative can set you further behind on your core business while you play catch up to an ever changing technology landscape. 

Data value chain

The key for any ingestion and transformation tool is to extract data from a source and start acting on it. The ultimate goal is to reduce the complexity and increase the timeliness of the data. Without data, it is impossible to create a data driven organization and act on the insights. As a result, data needs to be transformed, enriched, joined with other data sources, and aggregated to make better decisions. In other words, insights on good timely data mean good decisions.

While deciding on the data ingestion pipeline, one of the best approaches is to look into the volume of data, the velocity of the data, and type of data that is arriving. Other considerations include the number of different data sources you are managing, whether you need to scale to thousands of sources using generic pipelines, whether you want to create one generic pipeline but then apply data quality rules and governance. ETL tools are ideal for this use case as generic pipelines can be written and then parameterized. 

On the other hand, consider the data source. Can the data be directly ingested without transforming and formatting the data? If the data does not need to be transformed and can be ingested directly into the data warehouse as a managed solution. This not only reduces the operational costs but also allows for more timely data delivery. If the data is coming in through an unstructured format such as XML or in a format such as EBCDIC and needs to be transformed and formatted, then a tool with ETL Capabilities can be used depending on the speed of the data arrival. 

It is also important to understand the speed and time of arrival of the data. Think about your SLAs and time durations/windows that are relevant for your data ingestion plans. This would not only drive the ingestion profiles but would also dictate which framework to use. As discussed above, velocity requirements would drive the decision-making process.

Type of Organization

Different organizations can be successful by employing different strategies based on the talent that they have. Just like in sports, each team plays with a different strategy with the ultimate goal of winning. 

Organizations often need to decide on what’s the best strategy to take in respect to data ingestion and processing – whether you need to hire an expensive group of data engineers, or exploit your data wizards and analysts to enrich and transform data that can be acted on, or whether it would be more realistic to train the current workforce to do more functional/high value work rather than to focus on building generally understood and available foundational pieces.

On the other hand, the transformation part of ETL pipelines as we know it, dictates where the load will be. All of these are made a reality in the cloud native world where data can be enriched, aggregated, and joined. Loading data into a powerful and modern data warehouse means that you can already join and enrich the data using ELT. Consequently, ETL isn’t really needed in its strict terms anymore if the data can be loaded directly into the data warehouse.

All of the above was not possible in the traditional, siloed, and static data warehouses and data ecosystems whereby systems would not talk to each other or there were capacity constraints in respect to both storing and processing the data in the expensive Data Warehouse. This is no longer the case in the BigQuery world as storage is now cheap and transformations are now much more capable without constraints of virtual appliances. 

If your organization is already heavily invested into an ETL tool, one option is to use them to load BigQuery and transform the data initially within the ETL tool. Once the as-is and to-be are verified to be matching, then with the improved knowledge and expertise one can start moving workloads into BigQuery SQL, and effectively do ELT. 

Furthermore, if your organization is coming from a more traditional data warehouse that extensively relies on stored procedures and scripting, then the question that one may ask is, do I continue leveraging these skills and expertise and use these capabilities that are also provided in BigQuery? ELT with BigQuery is more natural, similar to what’s already in Teradata BTEQ, Oracle PL/SQL but migrating from ETL to ELT requires changes. This change then enables exploiting streaming use cases, such as real-time use cases in retail. This is because there is no preceding step before data is loaded and made available.

Organizations can be broadly classified under 3 types as Data Analyst Driven, Data Engineering driven, and Blended organization. We will be covering a Data Science driven organization within the Blended category.   

Data Analyst Driven

Analysts understand the business and are used to using SQL/spreadsheets. Allowing them to do advanced analytics through interfaces that they are accustomed to enables scaling. As a result, easy to use ETL tooling to bring data quickly into the target system becomes a key driver. Ingesting data directly from a source or staging area then also becomes critical as it allows analysts to exploit their key skills using ELT and increases timeliness of the data. This is commonplace with traditional EDWs and realized by extended capabilities of using Stored Procedures and Scripting. Data is enriched, transformed, and cleansed using SQL and ETL tools act as the orchestration tools. 

The capabilities brought by cloud computing on separation of data and computation changes the face of the EDW as well. Rather than creating complex ingestion pipelines, the role of the ingestion becomes, bringing data close to the cloud, staging on a storage bucket or on a messaging system before being ingested into the cloud EDW. This then releases data analysts to focus on looking into data insights using tools and interfaces that they are accustomed to. 

Data Engineering / Data Science Driven 

Building complex data engineering pipelines is expensive but enables increased capabilities. This allows creating repeatable processes and scaling the number of sources. Once complemented with cloud it enables agile data processing methodologies. On the other hand, data science organizations allow carrying out experiments and producing applications that work for specific use cases but are not often productionised or generalized. 

Real-time analytics enables immediate responses and there are specific use cases where low latency anomaly detection applications are required to run. In other words, business requirements would be such that it has to be acted upon as the data arrives on the fly. Processing this type of data or application requires transformation done outside of the target.

All the above usually requires custom applications or state-of-the-art tooling which is achieved by organizations that excel with their engineering capabilities. In reality, there are very few organizations that can be truly engineering organizations. Many fall into what we call here as the blended organization.  

Blended org

The above classification can be used on tool selection for each project. For example, rather than choosing a single tool, choose the right tool for the right workload, because this would reduce operational cost, license cost and use the best of the tools available. Let the deciding factor be driven by business requirements: each business unit or team would know the applications they need to connect with to get valuable business insights. This coupled with the data maturity of the organization would be the key to making sure the right data processing tool would be the right fit. 

In reality, you are likely to be somewhere on a spectrum. Digital native organizations are likely to be closer to being engineering driven, due to their culture and business that they are in. However, brick and mortar organizations would be closer to being analyst driven due to the significant number of legacy systems and processes they possess. These organizations are either considering or working toward digital transformation with an aspiration of having a data engineering / software engineering culture like Google. 

The blended organization with strong skills around data engineering, would have built the platform and built frameworks, to increase reusable patterns would increase productivity and then reduce costs. Data engineers focus on running Spark on Kubernetes whereas infrastructure engineers focus on container work. This in turn provides unparalleled capabilities as application developers focus on the data pipelines and even the underlying technologies or platforms changes code stays the same. As a result, security issues, latency requirements, cost demands and portability are addressed at multiple layers. 

Conclusion – What type of organization are you?

Often an organization’s infrastructure is not flexible enough to react to a fast changing technological landscape. Whether you are part of an organization which is engineering driven or analyst driven, organizations frequently look at technical requirements that inform which architecture to implement. But a key, and frequently overlooked, component needed to truly become a data-driven organization is the impact of the architecture on your data users. When you take into account the responsibilities, skill sets, and trust of your data users, you can create the right data platform to meet the needs of your IT department as well as your business.

To become a truly data-driven organization, the first step is to design and implement an analytics data platform that meets your technical and business needs. The reality is that each organization is different and has a different culture, different skills, and capabilities. Key is to leverage its strengths to stay competitive while adopting new technologies when it is needed and as it fits to your organization. 

To learn more about the elements of how to build an analytics data platform depending on the organization you are, read our paper here.

Clinical Decision Support System (CDSS) is an important technology for the healthcare industry that analyzes data to help healthcare professionals make decisions related to patient care. The market size for the global clinical decision support system appears poised for expansion, with one study predicting a compound annual growth rate (CAGR) of 10.4%, from 2022 to 2030, to $10.7 billion.

For any health organization that wants to build a CDSS system, one key block is to locate and extract the medical entities that are present in the clinical notes, medical journals, discharge summaries, etc. Along with entity extraction, the other key components of the CDSS system are capturing the temporal relationships, subjects, and certainty assessments.

At Google Cloud, we know how critical it is for the healthcare industry to build CDSS systems, so we worked with Apollo 24|7, the largest multi-channel digital healthcare platform in India, to build the key blocks of their CDSS solution.

We helped them to parse the discharge summaries and prescriptions to extract the medical entities. These entities can then be used to build a recommendation engine that would help doctors with the “Next Best Action” recommendation for medicines, lab tests, etc.

Let’s take a sneak peek at Apollo 24|7’s entity extraction solutions, and the various Google AI technologies that were tested to form the technology stack.

Datasets Used

To perform our experiments on entity extraction, we used two types of datasets.

1. i2b2 Dataset – i2b2 is an open-source clinical data warehousing and analytics research platform that provides annotated deidentified patient discharge summaries made available to the community for research purposes. This dataset was primarily used for training and validation of the models.
2. Apollo 24|7’s Dataset – De-identified doctor’s notes from Apollo24|7 were used for testing. Doctors annotated them to label the entities and offset values.

Experimentation and choosing the right approach — Four models put to test

For entity extraction, both Google Cloud products and open-source approaches were explored. Below are the details:

1. Healthcare Natural Language API: This is a no-code approach that provides machine learning solutions for deriving insights from medical text. Using this, we parsed unstructured medical text and then generated a structured data representation of the medical knowledge entities stored in the data for downstream analysis and automation. The process includes:

• Extract information about medical concepts like diseases, medications, medical devices, procedures, and their clinically relevant attributes;
• Map medical concepts to standard medical vocabularies such as RxNorm, ICD-10, MeSH, and SNOMED CT (US users only);
• Derive medical insights from text and integrate them with data analytics products in Google Cloud.

The advantage of using this approach is that it not only extracts a wide range of entity types like MED_DOSE, MED_DURATION, LAB_UNIT, LAB_VALUE, etc, but also captures functional features such as temporal relationships, subjects, and certainty assessments, along with the confidence scores. Since it is available on Google Cloud, this offers long-term product support. It is also the only fully-managed NLP service among all the approaches tested and hence, it requires the least effort to implement and manage.

But one thing to keep in mind is that since the Healthcare NL API offers natural language models that are pre-trained, it currently cannot be used for custom entity extraction models trained using custom annotated medical text or to extract custom entities. This has to be done via AutoML Entity Extraction for Healthcare, another Google Cloud service for custom model development. Custom model development is important for adapting the pre-trained models to new languages or region-specific natural language processing, such as medical terms whose use may be more prevalent in India than in other regions

2. Vertex AutoML Entity Extraction for Healthcare: This is a low-code approach that’s already available on Google Cloud. We used AutoML Entity Extraction to build and deploy custom machine learning models that analyzed documents, categorized them, and identified entities within them. This custom machine learning model was trained on the annotated dataset provided by the Apollo 24|7 team.

The advantage of AutoML Entity Extraction is that it gives the option to train on a new dataset. However, one of the prerequisites to keep in mind is that it needs a little pre-processing to capture the input data in the required JSONL format. Since this is an AutoML model just for Entity Extraction, it does not extract relationships, certainty assessments, etc.

3. BERT-based Models on Vertex AI: Vertex AI is Google Cloud’s fully managed unified AI platform to build, deploy, and scale ML models faster, with pre-trained and custom tooling. We experimented with multiple custom approaches based on pre-trained BERT-based models, which have shown state-of-the-art performance in many natural language tasks. To gain better contextual understanding of medical terms and procedures, these BERT-based approaches are explicitly trained on medical domain data. Our experiments were based on BioClinical BERT, BioLink BERT, Blue BERT trained on Pubmed dataset, and Blue BERT trained on Pubmed + MIMIC datasets.

The major advantage of these BERT-based models is that they can be finetuned on any Entity Recognition task with minimal efforts.

However, since this is a custom approach, it requires some technical expertise. Additionally, it does not extract relationships, certainty assessments, etc. This is one of the main limitations of using BERT-based models.

4. ScispaCy on Vertex AI: We used Vertex AI to perform experiments based on ScispaCy, which is a Python package containing spaCy models for processing biomedical, scientific or clinical text.

Along with Entity Extraction, Scispacy on Vertex AI provides additional components like Abbreviation Detector, Entity Linking, etc. However, when compared to other models, it was less precise, with too many junk phrases, like “Admission Date,” captured as entities.

“Exploring multiple approaches and understanding the pros/cons of each approach helped us to decide the one that would fit our business requirements.” according to Abdussamad M, Engineering Lead at Apollo 24|7.

Evaluation Strategy

In order to match the parsed entity with the test data labels, we used extensive matching logic that comprised of the below four methods:

1. Exact Match – Exact match captures entities where the model output and the entities in the test dataset match. Here, the offset values of the entities have also been considered. For example, the entity “gastrointestinal infection” that is present as-is in both the model output and the test label will be considered an “Exact Match.”
2. Match-Score Logic – We used a scoring logic for matching the entities. For each word in the test data labels, every word in the model output is matched along with the offset. A score is calculated between the entities and based on the threshold, it is considered as a match.
3. Partial Match – In this matching logic, entities like “hypertension” and “hypertensive” are matched based on the Fuzzy logic.
4. UMLS Abbreviation Lookup – We also observed that the medical text had some abbreviations, like AP meaning abdominal pain. These were first expanded by doing a lookup on the respective UMLS (Unified Medical Language System) tables and then passed to the individual entity extraction models.

Performance Metrics

We used precision and recall metrics to compare the outcomes of different models/experiments.

Precision (also called positive predictive value) is the fraction of relevant instances among the retrieved instances, while recall (also known as sensitivity) is the fraction of relevant instances that were retrieved.

The below example shows how to calculate these metrics for a given sample.

Example sample: “Krish has fever, headache and feels uncomfortable”

Expected Entities: [“fever”, “headache”]

Model Output: [“fever”, “feels”, “uncomfortable”]

Thus,

Experimentation Results
The following table captures the results of the above experiments on Apollo24|7’s internal datasets.

Finally, the Blue BERT model trained on the Pubmed dataset had the best performance metrics with a 81% improvement on Apollo 24|7’s baseline mode with the Healthcare Natural Language API providing the context, relationships, and codes. This performance could be further improved by implementing an ensemble of these two models.

“With the Blue BERT model giving the best performance for entity extraction on Vertex AI and the Healthcare NL API being able to extract the relationships, certainty assessments etc, we finally decided to go with an ensemble of these 2 approaches,“ Abdussamad added.

Fast track end-to-end deployment with Google Cloud AI Services (AIS)

Google AIS (Professional Services Organization) helped Apollo24|7 to build the key blocks of the CDSS system.

The partnership between Google Cloud and Apollo 24|7 is just one of the latest examples of how we’re providing AI-powered solutions to solve complex problems to help organizations drive the desired outcomes. To learn more about Google Cloud’s AI services, visit our AI & ML Products page, and to learn more about Google Cloud solutions for health care, explore our Google Cloud Healthcare Data Engine page.

Acknowledgements

We’d like to give special thanks to Nitin Aggarwal, Gopala Dhar and Kartik Chaudhary for their support and guidance throughout the project. We are also thankful to Manisha Yadav, Santosh Gadgei and Vasantha Kumar for implementing the GCP infrastructure. We are grateful to the Apollo team (Chaitanya Bharadwaj, Abdussamad GM, Lavish M, Dinesh Singamsetty, Anmol Singh and Prithwiraj) and our partner team from HCL/Wipro (Durga Tulluru and Praful Turanur) who partnered with us in delivering this successful project. Special thanks to the Cloud Healthcare NLP API team (Donny Cheung, Amirhossein Simjour, and Kalyan Pamarthy).

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.