Black Knight is a leading provider of technology, data, and analytics to the mortgage industry, catering to both large and mid-tier banks in the United States. Over the past few decades, we tended to manage customer integrations on a case-by-case basis. Whenever a bank needed to connect with a Black Knight app, we’d launch another integration project. Lather, rinse, repeat. Needless to say, this was inefficient; we knew we had to do something to centralize this process.

Building versus buying an API management platform
To start, we created some homegrown API solutions. Despite being largely successful with one of these solutions, we saw that technology advances were outpacing our capacity to update our solutions in-house. We knew we needed to move toward an API platform that would support RESTful architecture and that would fully enable mobile solutions. It also had to be extremely secure. Knowing how complicated such a platform would be to build ourselves, we decided that our developers were better off focusing on providing core solutions to Black Knight clients; engaging with an outside provider was the right way for us to advance our API strategy. 

After a lengthy proof-of-concept process, we went into production with the Apigee API Management Platform from Google Cloud in 2018. In our opinion, Apigee was the most complete, robust, technically sound and full-featured option from among all of the API management tools we evaluated. Its ease of use was the deciding factor for our developers, and the Apigee analytics capabilities provided considerable insight into the anatomy of an API call—something the other platforms we considered didn’t do as well. 

Choosing Apigee meant that we didn’t have to focus on developing and maintaining a tool or spend enormous amounts of money trying to keep up with security patching. For a large company like Black Knight, an API management tool is something we don’t want to spend a lot of time on. We know that Google Cloud devotes tremendous resources to it, and it would be difficult to replicate that in-house. 

Black Knight has more than 150 client-facing applications. Almost half of them now are built with APIs that are externally facing, and many of these apps use APIs that integrated with other Black Knight applications. Add to that the huge number of applications out there that come from clients and third-party vendors, and suddenly, we had a management challenge from an API perspective.

Driving cultural change
We came to Apigee with the goal of containing and empowering our huge ecosystem of APIs, customers, third parties, and internal users.  

Given Black Knight’s size, our developers and customers understandably each have different business goals, so getting everyone to come to a centralized platform is a great opportunity. My role is to help people consider other options so they can be open to the benefits that Apigee brings us.

Now that we’ve engaged with Apigee for over a year, we see two big benefits. First, the huge reduction in point-to-point integrations has produced tremendous efficiencies for us and our customers, who now get instant integration once they’ve been authorized for a particular API. Second, Apigee’s capacity for mobile enablement lets us satisfy our customers’ needs for secure mobile apps.  

Simplifying security
From a technical perspective, security is complicated for mobile apps. We’re often accessing sensitive information on a mobile device that can’t always be trusted. This kind of scenario requires us to implement a number of security precautions to help ensure confidential information remains protected.  

The Apigee API management platform addresses these needs in the simplest way possible. It solves complex problems related to security without having to deploy a new API proxy each time we need to support a particular mobile device upgrade. Our back-end applications remain protected because Apigee helps manage security, requests, access tokens, and authorizations. Today, our back-end applications work with Apigee to communicate with mobile devices or servers coming over the internet. 

Apigee has also enabled us to do a better job sharing a variety of APIs. The developer portal lets us stitch together APIs and get more creative about how we can innovate and build new solutions based on these collections of APIs. At this point, anybody that has a nondisclosure agreement with us can register for the developer portal. The nature of our business is such that we can’t just open up our APIs to anybody, but it’s available to our contracted third parties.

Our Apigee journey has been exciting, and we’re making great progress. I’m looking forward to what innovations we will come up with next, thanks to the way Apigee enables us to create, implement, and deliver.

Lung cancer is the leading cause of cancer death in the United States and like any cancer, early detection is crucial to survival. Screening at-risk populations is an important part of reducing mortality, and if concerning nodules are found on imaging, further testing may be required. Today, we’ll share how Northwell Health uses Google Cloud products such as Cloud Healthcare APIs and BigQuery to increase caregiver productivity and deliver better care for patients with findings that indicate potential development of lung cancer.

Northwell is New York’s largest healthcare provider

Northwell Health is New York’s largest healthcare provider with 23 hospitals and nearly 800 outpatient facilities. Northwell’s nearly 4,000 doctors care for millions of patients each year, and at this scale, there is an immense amount of healthcare data to manage. To better manage and leverage this data, Northwell Health partnered with Google Cloud starting in 2018.

Enabling caregivers to spend more time with patients

Nic Lorenzen, the lead developer of Northwell Emerging Technology and Innovation team, has a mission to put together data for caregivers in a way that makes sense. It is no secret that inefficient electronic health records systems have a negative impact on a physician’s ability to deliver quality care. Traditional EHRs have information distributed across many tabs, which forces caregivers to spend considerable time at the computer trying to find information. Moreover, speed of care matters. If care is delayed, patients may have to spend more time in the hospital and may suffer worse health outcomes.

To solve this problem, Nic’s team focused on giving caregivers the most relevant pieces of data at the right time by developing an intelligent clinician rounding app. The data needed to derive these insights can depend on the caregiver’s role–a nurse cares about different things than a cardiologist. This system aggregates multiple data sources, and provides patient-specific insights to caregivers.

This system would not have been possible before with traditional EHRs and data warehouses that have proprietary data models and rarely sync data in real time. Now with data easily accessible through Google Cloud’s Healthcare solutions, Nic’s team can deliver the right clinical information to the right people instantly. These days, Nic says, “instead of spending 75% of our time dealing with architecting the underlying platforms, we spend 75% of our time focused on  higher value use cases for clinicians and patients. Google Cloud’s Healthcare solutions have greatly improved our developer productivity and time to value.”

Caregivers have found this new system to be a game changer.Before the implementation of this system, caregivers would spend, on average, seven to nine minutes finding the data needed to make medical decisions for one patient. Now, that aggregated information is delivered to a caregiver’s mobile device in less than a second.

Ensuring patients get the right care with the power of AI

There are a number of reasons why patients might not get the care that they need. For example, patients today can go to multiple hospitals and clinics settings, and coordinating care across multiple facilities is complex. Regional hospitals and clinics have their own siloed view of their data, so pertinent information gathered by one clinic might not be seen by another. These gaps in clinical data lead to gaps in patient care.

When a patient gets radiologic imaging, they may have findings unrelated to the reason they initially got the imaging. For example, a chest CT for a car accident might reveal an incidental lung nodule that could be cancerous. Unfortunately, research shows that a large portion of patients do not get follow up for these incidental findings because it isn’t the primary reason why the patient is seeing a doctor. Moreover, social determinants of health are a factor that affects which patients receive follow-up care. Identifying these patients and providing the necessary follow up care prevents adverse events related to delayed detection of cancer.

With Cloud Healthcare solutions, Northwell built an AI model to identify these patients so that oncologists can appropriately follow up with patients who have findings suspicious for lung cancer. The AI model detects incidental pulmonary nodules in radiology reports so that doctors can then contact the patients that need follow-up care. Nic says his team was able to build this system in a week: “Google Cloud did a lot of heavy-lifting for us and allowed us to get to the AI applications much faster. It allowed us to build a platform that just works.” 

Healthcare systems can now rapidly generate healthcare insights with one end-to-end solution, Google Cloud Healthcare Data Engine. It builds on and extends the core capabilities of the Google Cloud Healthcare API to make healthcare data more immediately useful by enabling an interoperable, longitudinal record of patient data. Northwell Health uses Google Cloud as the core of their platform, enabling their developers to create solutions to the most pressing healthcare problems.

Special thanks to Kalyan Pamarthy, Product Management Lead on Cloud Healthcare and Natural Language APIs for contributing to this blog post.

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.

If you build apps and services that your customers consume, two things are certain: 

1. You’re exposing APIs in some form or the other. 
2. Your apps are made by multiple functions working together to deliver products and services. 

As you scale up and grow, your enterprise architecture can benefit from a sound strategy for both API management and service management, both of which impact your customer and developer experience. In this article, we’ll explore how these two technologies fit into your application modernization strategy, including how we’re seeing our customers use Anthos Service Mesh and Apigee API Management together. 

How APIs, microservices, and a service mesh are related

APIs accelerate your modernization journey by unlocking and allowing legacy data and applications to be consumed by new cloud services. As a result, organizations can launch new mobile, web, and voice experiences for customers. 

The API layer acts as a buffer between legacy services and front-end systems and keeps the front-end systems up and running by routing requests as the legacy services are migrated or transformed into modern architectures.  In addition, an API management platform, like Apigee, manages the lifecycle of those APIs with design, publish, analyze, and governance capabilities.

Once microservices architectures become prevalent in an organization, technical complexity increases and organizations find a need for deeper and more granular visibility into their applications and services. This is where a service mesh comes into play. 

A service mesh is not only an architecture that empowers managed, observable, and secure communication across an organization’s services, but also the tool that enables it. Anthos Service Mesh lets organizations build platform-scale microservices with requirements around standardized security, policies, and controls, and it provides teams with in-depth telemetry, consistent monitoring, and policies for properly setting and adhering to SLOs. 

How API management and a service mesh compliment one another

Many organizations ask themselves, “Do I really need both an API management platform and a service mesh? How do I manage them together?” 

The answer to the first question is yes. These two technologies focus on different aspects of the technology stack and are complementary to each other. A service mesh modernizes your application networking stack by standardizing how you deal with network security, observability, and traffic management. An API management layer focuses on managing the lifecycle of APIs, including publishing, governance, and usage analytics. 

Most organizations draw a logical boundary at business units or technology groups. Sharing these microservices outside that boundary with other business units or with partners is where Apigee plays a significant role. You can drive and manage the consumption of those services through developer portals, monitoring API usage, providing authentication, and more, with Apigee. 

Google Cloud offers Anthos Service Mesh for service management and Apigee for API management. These two products work together to provide IT teams with a seamless experience throughout the application modernization journey. The Apigee Adapter for Envoy enables organizations that use Anthos Service Mesh to reap the benefits of Apigee by enforcing API management policies within a service mesh. 

Accelerate your application modernization journey

Though the journey to application modernization doesn’t always follow a clear-cut path, by adopting API management and a service mesh as part of a modernization journey, your organization can be better equipped to rapidly respond to changing markets securely and at scale. 

Wherever you are on your application modernization journey, Google Cloud can help. To learn more about how service management and API management can be part of your application modernization journey, read this whitepaper.