Founded in 1907, Huashan Hospital Fudan University (hereafter referred to as “Huashan Hospital”) is an affiliated hospital of National Health and Family Planning Commission of China and a teaching hospital attached to Fudan University, directly under the administration of Red Cross Society of China. The hospital led the pack of domestic medical, teaching and research centers by listing as one of grade A tertiary hospitals in 1992 from the earliest time, keeping a great reputation from home and abroad.
Nowadays, the hospital has entered a fresh new information era with the advancement of cloud technology. Thereupon, the information department is able to focus on the medical exploration and tackle more meaningful problems with the clinical and research departments, without having to waste much efforts in the daily operations.
Director of Information Department in Huashan Hospital
Quantitative medicine analysis jobs usually involve hundreds or thousands of model computing processes. With AWS, we have saved 25% of computing time and greatly improved the productivity.
Deputy Director and Chief Pharmacist of Pharmacy Department in Huashan Hospital
Huashan Hospital has adopted the cloud technology early in 2015. Deputy director and chief pharmacist of Pharmacy Department in Huashan Hospital Jiao Zheng had found that the foreign hospitals had leveraged the substantial cloud computing resources of Amazon Web Services (AWS) for quantitative medicine analysis, which economically and effectively solved the difficult massive computing problems in the supercomputer center.
Jiao Zheng has been devoted to the clinical pharmacy practice, teaching and research work in drug therapy monitoring and individualized drug administration field. He used to study clinical pharmacology and drug discovery in Yale School of Medicine and Celgene in America. Individualized drug administration aims at providing tailored and individualized dosage treatment based on different genetic, physiopathologic and dietetic characteristics of patients. The foundation of individualized drug administration is quantitative pharmacologic analysis, which is a new discipline derived from traditional pharmacodynamics. The first step of quantitative pharmacologic analysis is to build mathematical modeling through calculation and derivation related with huge amounts of data and computing. Jiao Zheng explained, “A complicated modeling calculation usually takes several hours, and sometimes weeks of time, which involves tens, hundreds or even thousands of computing processes. And so we don't have the capacity to attempt it, but only to simplify it. ”
For pharmaceutical research, computing is productivity. In 2010, Jiao Zheng considered using the high-performance computing technology of Shanghai Supercomputer Center, but it was of high cost and low efficiency. When discovering the oversea cloud computing practices, Jiao Zheng was excited and resorted to Information Center at the prospect of achieving success through cloud computing. Director of Information Center Huang Hong and Deputy Director Zhang Qi had also been paying special attention to the cloud computing technology, but AWS was not commercially available at that time, and so they planned to try other clouds first. In 2015, Huashan Hospital officially embarked on the cloud journey, with Pharmacy Department as the starting point. The advantages of cloud computing services were obvious to Jiao Zheng and his team – they were able to launch the computing resources easily, executing multiple tasks simultaneously and viewing the operation states and computed results at any time and any where. But unfortunately, their practices had not attained the expected efficiency described in the foreign scientific literatures. The performance losses across nodes were very huge when using multiple points of presence in the complicated computing jobs.
In 2016, AWS China (Beijing) Region commercially placed in service by Sinnet technology Co., Ltd. (“Sinnet”). From then on, Huashan Hospital transferred to AWS and thus significantly improved the computational efficiency. Take 64-core computing of 4 nodes as an example, the use of AWS could reduce the performance losses by 20%, and remarkably increase the cost performance. As a result, Huashan Hospital decided to give priority to AWS.
Jiao Zheng pointed, “AWS has accumulated many successful use cases in the pharmaceutical analysis field abroad. With AWS, we have reduced the model computation time by 25%, and greatly improved the productivity. We expect AWS would also be widely adopted in China. ”
Jiao Zheng’s research team had successfully completed the pharmacy assistant system “SmartDose” of vancomycin based on AWS. Through collecting and retrieving the large database of Chinese population’s vancomycin pharmacokinetics characteristics, this system could produce individualized vancomycin dosage treatments by maximum a posteriori bayesian algorithm accordingly for common adults, newborns, elders, neurosurgical patients and other special groups. As of May 2019, more than 80 medical institutions had adopted the SmartDose service.
Accelerate application on-boarding and service innovation in the hospital
After the success of Pharmacy Department, Huashan Hospital expanded the adoption of AWS from 2016, increasing App reservation, WeChat reservation, Alipay settlement, single disease database, rational drug use research, initial clinical scientific evaluation, telemedicine, specialist alliance, online revisit and other dozens of application services on AWS.
Zhang Qi, deputy director of Information Center in Huashan Hospital, said, all Internet-based applications would be transferred to the cloud. Traditionally, the hospital had to first deploy the finished applications on the test servers and production servers, and sometimes further pilot plans might be inevitable. However, Internet-based applications will be directly published to all users without allowing for piloting, which demands high stability, reliability and troubleshooting capacity of the servers. With its unparalleled agility and flexibility, AWS comes into play.
AWS results in gigantic advantages for Huashan Hospital:
Firstly, it accelerates the system on-boarding pace. When using traditional IT model, it usually takes 1-3 months of time to build servers, deploy applications and complete tests. With AWS, all of these processes will be finished within one day. Meanwhile, the hospital usually adopts annual IT budgeting plan, so if receiving new temporary application requests, they have to abolish existing IT budgets or refuse the incoming ones for the lack of resources.
Secondly, it saves the IT budgets. For the traditional IT model, the infrastructure costs normally account for 40% of total budgets. With AWS, these costs are to be reduced to less than 20%. It is also more convenient for budget approval since the available business budgets increase.
Thirdly, it reduces the O&M burden. Previously, Both of the two operation personnel in Huashan Hospital had to take trouble in coping with the management of servers, databases, storages and other platforms, but the cloud has eliminated all of these affairs. Now the hospital increases dozens of applications, the amount of which is twice than before, but no extra O&M personnel are needed.
Fourthly, it improves their collaboration ability with application providers. The information system of the hospital is particularly complicated, which is supported by tens of IT application providers, where various applications have different software and hardware requirements. AWS Cloud allows the Information Center of Huashan Hospital to easily respond to all kinds of demands from application providers. For example, when deploying the online revisit platform, the hospital was asked to prepare a server to set up the block chains. For improper communication, they hadn’t discovered the server configuration provided by the application provider was not compliant until the three-party joint debugging phase, but the time slot was very urgent. After all, they quickly opened another server in the cloud and solved this problem satisfactorily.
Fifthly, it improves the data management of the hospital through a unified big data platform. Previously, a huge number of data were distributed everywhere as separate silos in all units of the hospital, and they hadn’t concern much on refined management of increasing data. Now, the cloud enables the information department to spare more efforts and money to build unified big data management platform, and take full advantages of the value of data through deep analysis and research work.
Huang Hong, Director of Information Center, said, “Nowadays, the hospital has entered a fresh new information era with the advancement of cloud technology. In the past 20 years, the information department had been busying with technical problems, wasting time on selecting hardware, on-boarding system and purchasing software. Now, all of these tasks have been undertaken by the cloud service provider, and so the information department is able to focus on the medical exploration and tackle more meaningful problems with the clinical and research departments. Correspondingly, the information department should take a shift from the old staff structure, work pattern and mindset. They need to have a clear clue of business operation, learning how to integrate the information technology into the business processes in a new way. ”
Patients benefit from cloud computing
With a vision of “Providing better accessibility for patients through enhanced information system”, Huashan Hospital has been devoting to strengthen the development of “Internet plus” path, create complete intelligent medical treatment system and raise the bar of service and management efficiency by leveraging the emerging cloud computing technology.
The hospital has offered the electronic medical card service to account for the increasing non-local patients. What is therefore needed for visitors is to submit and authenticate their personal information on the mobile devices ahead of time, and a medical card will be issued to them for information exchange in the hospital. “Huashan Hospital Outpatient Service” WeChat platform combines the consultation, electronic medical card and examination reservation services together.
The hospital actively promotes accurate reservation services based on AWS multi-channel functions, and conducts an AI screening process for the online uploaded examination and test results of patients to recognize the eligible reservations. Until now, the WeChat outpatient service account has received 470 thousand user subscriptions, and in 2018, the number of patient reservations reached 1.139 million, up 54% compared to the same period last year.
Furthermore, the hospital has built a rich and prompt “Online Hospital” platform for telemedicine services, which has become a brand card of Huashan Hospital. With high quality expert resources of state-level key disciplines and specialties, the support of “Online Hospital” dedicates to providing remote consultation, medical training, surgery demonstration, pathological analysis and difficult disease diagnosis services for patients anywhere. Since the launch of this platform, 85% of telemedicine services have been instructed by national renowned neurology, neurosurgery, infection, dermatology and other discipline experts, and the monthly difficult disease consultation cases reaches totally over 120. The hospital has established telemedicine networks with 20 provinces in Middle and West China, which cover 24 provinces in total. It also participates in the Belt and Road Initiative with Pakistan's Gwadar Port, Morocco and other regions, providing advanced complicated illness diagnosis services for local patients. The “Online Hospital” has passed the on-premise site pilot experiment. Huashan Hospital is currently studying the suitable AWS compliant deployment solution, and plans to migrate this platform to the cloud.
Fig 1 shows the system structure of Huashan Hospital. Applications using AWS Cloud services include Amazon Elastic Compute Cloud (Amazon EC2), Amazon Simple Storage Service (S3), Amazon Virtual Private Cloud (Amazon VPC), AWS CloudFormation, Amazon CloudWatch, etc.
The demands of high-quality medical resources are increasing day by day. As a well-known hospital for more than one hundred years, Huashan Hospital has pioneered the adoption of new cloud computing technology, and broken the temporal and spatial constraints of high-quality medical resources, which contributes to the health and well-being of more patients and sets a benchmark for the whole hospital informalisation industry.