Medimail aws presentation

base2Services Pty Ltd Commercial in Confidence 2013
Lean start up to mega traffic
and data capture on AWS
Craig Frawley
Managing Director
MediMail
23rd
May 2013
Canberra
AWS Summit Series
Australia & New Zealand

MediMail overview
No matter where you live, what hours you work, how
busy you are or what assistance you require, MediMail
makes Pharmacy easy
 Integrated e-Commerce and e-Prescription platform
 Provides typical eCommerce experience for OTC Pharmacy products
 Provides users with an ‘in-home’ e-Prescription interface
◦ View all prescription and repeat information
◦ Order and organise future dispense events with the click of a
mouse
◦ Choose where and how they receive their medication
 Back-end reporting enables targeting of cognitive and fee-for-
service activities based on disease state metrics of scripts
 The effect… transition Pharmacy further into healthcare

Factors driving an integrated e-approach
 NEHTA has implemented PCEHR as part of e-Health reform
 G.P Practice Incentive Programs will push eScript up-load rate by
G.P’s to ~ 100% nationally by mid 2013
 PBS goes paperless July 1st
, 2013 – this means with ePrescription
services, the traditional paper trail from G.P to Pharmacy is now
optional – patients no longer have to visit a pharmacy
 eScript interface effectively provides every patient with a ‘in home’
dispensing platform
 Pharmacies not offering this service will be at the mercy of
competitors as the traditional retail-patient linkage is broken and be
left with condensing foot traffic
194 Million prescriptions a year = over 3 Billion online transactions a year
and GROWING

- Lean startup
- Quick test to fail
- Quick test to fail
Suck and see approach. We tested the market with little capital spend.
Then we went for it!
 Lean Agile approach
 Tightly scoped iterations to avoid over spending
 Studied the market. We went live for a POC with Australia Post
 Focused on small regional areas
 Measurable results
 Tested the application
 Did not spend capital funds on infrastructure
 Proved the business model
image supplied by http://www.techjini.com
image supplied by http://http://futurestartup.com/

Key technology architecture requirements
 The application has to complete the workflow end-to-end
 Has to integrate with third party services in a repeatable way
 Has to be secure
 Has to report on massive amounts of data in near real time
 Has to notify patients of repeats using multiple channels
 Think big, start small, do it fast
Needs to be convenient, fast and secure

We made Architectural decisions
We selected Amazon Web Services for many reasons
Capacity Planning
Security
Speed
Agility
Availability
Repeatable

We started small...but had to think BIG
We could not even guess how
much infrastructure we needed
... and when we did, we got scared by the numbers
If we bought
Upfront $60,000
Hosting $4,000 p/m
Just to start
No Disaster Recovery
With AWS
Upfront $0
Hosting $600 p/m
We started with
High Availability
AWS gives us the
ability to design
the big picture
but only spend
what we need

We are dealing with very personal and private information
... so it really needs to be secure
we had to come up with some pretty unique security decisions
we did not use RDS to maintain administration control
The data in the database is completely encrypted
the system administrators can not read the data
We introduced two phase authentication for patients
this is the first time we ever saw the value of secret answers
AWS has spent millions on security
we saw them as a security company first
Medicare details had to match 100%
no way to gain access to scripts by intruders
Far more
secure than
what we could
have done

Speed and Agility ... we had to move fast
... we could not wait for infrastructure to be purchased
... and wanted changes to be made instantly
We scripted the environments
and had a production ready environment during the development phase
Procurement
would have taken
at least 1 month
Able to reuse the
same environment
or scripts
Fits perfectly with
our agile
methodology.
Infrastructure
team was part
of Dev team

It never goes down
... and we can launch a whole new environment in minutes if it did
It is also scalable!
as the load increases, so does our environment
Minimum cost based on performance we want to achieve
Load starts to exceed base capacity
We increase AWS instances to handle more load
We scale down when load diminishes
1 5 10 15 20 minutes
online consumers
AWS costs if over 1 month

What does our architecture look like
... enterprise grade that leverages cloud technologies
AWS Big Data Option
Scaled when intense queries
are executed
Scales with demand
We have scaled up to 10 nodes in an hour
Jentrata supports HL/7
Scales rarely
Our Apdex score is 1.0
100% satisfied customers
According to NewRelic

What has Dynamo DB provided
... the ability to store massive amounts of data
... scalable without the upfront costs
when we started
we had 10MB
of data
12 months on
we now have
1GB of data
we expect
over 30GB of
data
In 12 months In 24 months
we expect
over 1TB of
data
Cost: $10 per month
Cost: $20 per month
Cost: $200 per
month
Cost: $1000 per
month
... super fast data querying

We did all this with experts
... We needed a system integrator that worked smart
... We needed a system integrator that worked fast
... that understood cloud technologies & security
... that had experience with health and high volume e-commerce
... that understood high availability
... that understood Big Data was about the mathematics
... that provided ongoing support

Thankyou
Craig Frawley
Managing Director
MediMail
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