8/23/2020 MD Insider Case Study | Cloud

MD Insider: Matching patients with physicians for better

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Patients about to undergo a healthcare procedure understandably want the best medical professionals they can get. But how can they know which doctors

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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 (https://mdinsider.com/) 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 identies 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, oce 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.

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“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 .”

—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 diculty conguring 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,

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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 nancial benet 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 (https://cloud.google.com/) (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 unied, 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

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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 (https://cloud.google.com/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

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scaling back down when the task is nished. 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 nd that GCP offers a wide variety of managed services. For example, the company is supplementing its Kubernetes Engine clusters with BigQuery (https://cloud.google.com/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 (https://cloud.google.com/storage/) for big data staging and Cloud Dataproc

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(https://cloud.google.com/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 . 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 simplied our workow 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.”

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Ryan Beaini, Senior Software Engineer at MD Insider, agrees: “Since we moved to GCP, our developers are denitely 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.”

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—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 (https://cloud.google.com/iam/) (IAM) along with Yubico YubiKeys for hardware-based two-factor authentication when logging into G Suite. 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 condence that their data will be protected.”

Transforming how teams work

As a growing company, MD Insider must collaborate seamlessly between oces in California, Colorado, and Illinois. It relies on G Suite

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(https://gsuite.google.com/) for communication and productivity, using Docs (https://gsuite.google.com/products/docs/), Sheets (https://gsuite.google.com/products/sheets/), and Slides (https://gsuite.google.com/products/slides/) to drive the business. Employee and team les are stored in Drive (https://gsuite.google.com/products/drive/), and meetings are conducted via (https://gsuite.google.com/products/meet/) with for Meetings (https://enterprise.google.com/chrome/video-conferencing/) videoconferencing hardware kits. G Suite also helps MD Insider maintain information security by authenticating email domains with digital signatures in (https://gsuite.google.com/products/gmail/) and scanning outgoing email using Gmail Data Loss Prevention (DLP).

“I use G Suite every day, and everyone else here does too,” says Eric. “Team Drives are a big time saver for us. We’ve let our previous oce 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 (https://www.businesswire.com/news/home/201805100058 98/en/Zelis%C2%AE-Healthcare-MD-Insider-Announce- Partnership-Power) with Zelis Healthcare, which will use MD Insider’s API

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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.”

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