1. MTBC Cloud EMR

2. Presentation Outline
 Part 1:
Introduction of Cloud Computing
 Part 2:
Amazon Elastic Cloud Compute (EC2)
 Part 3:
Hosted MTBC-EMR
 Part 4:
EC2 Management Console & Hosted EMR Demo

4. Cloud computing:
the latest evolution of hosting

19. Difference b/w W-Azure, A-EC2 & G-Apps
• Early Stage
• Need to provide .Net
code for front end and
back end server
• Storage for applications
and DB Services
• Provide Development
tools for coding
• Good enterprise
integration
• Pricing based on
Database size and API
Size and users
• Commercially Available
• Upload your VM or
install your applications
and share to your clients
• Not applicable
• Simple Volume Storage
Service
• Fully controlled virtual
Machines
• Pricing is based on
Virtual Server
Specifications and Time
• In Public Beta
• Write application with
limitation Pathon and
submit it to Google
• Provide Development
tools for coding
• Database Datastore APIs
• Integrate the application
with Google services
• Pricing is based on Cloud
Application Usage
Windows Azure Amazon EC2 Google Apps

20. Highlights of Amazon Service
• Pay only for the resources that you actually consume
• Amazon Machine Image (AMI)
• Amazon Elastic Block Store (S3)
• Amazon Virtual Private Cloud (VPC)
• Elastic IP Addresses
• Amazon CloudWatch
• Elastic Load Balancing
• Security Groups
• VM Import

21. EC2 Architecture

22. Amazon Pricing Strategy
• Price is based on instance type, its specification
and region were it is running
• Instance Types:
– On Demand Instance
– Reserved Instance
– Spot Instance
• Instance Specification
– Standard Instance
– High Memory Instance
– High CPU Instance
• Instance Regions
– US East (Virginia)
– US West (Northern California)
– EU (Ireland)
– Asia Pacific (Singapore)
– Asia Pacific (Tokyo)

23. How Hosted MTBC-EMR works
Amazon
EC2 Server
Amazon EC2 Console
Client System
Internet
Practice 1
Installed EMR
EMR Documents
EMR Database
Sync Service
Practice 2
Installed EMR
EMR Documents
EMR Database
Sync Service
Practice 3
Installed EMR
EMR Documents
EMR Database
Sync Service
Microsoft
Remote App
-EMR Practice 1
-EMR Practice 2
-EMR Practice 3
Active
Directory
User 1
User 2
…..
……
User N
RD Web Access
& Firewall
 RDWeb Pages
 GPO Settings
 Ports Setting
Security Group Setting EC 2 Instance in Running State
SSL Certificate: Secure and Encrypted Data Flow

24. Our Medical Data Security at Amazon EC2
• Bit locker (Server Drives will be encrypted)
• Group Policy Management of Server Users
• Windows Firewall Setting
• Amazon EC2 Security Groups
• SSL Certificate Installation (Encrypted Secure
Communication between client & Server)
• HIPPA Compliance (Amazon Claims)

25. Benefits to Clients
• No need to buy a Specified Server Machine for MTBC
EMR Server.
• No need to fulfill clients system specification to install
and run MTBC EMR.
• No need to hire and pay an IT guy to maintain Server and
client machines.
• Available EMR to use for practice within one to two hour
after Signup.
• No need to worry about Server crash and it restoration.
• No need to pay for online backup vaults for MTBC-EMR
databases.

26. Benefits to MTBC
• Very easy MTBC-EMR installation process.
• There is no need to take control of Client machines for
EMR installation and issues resolution.
• We can easy create Server Snapshots and restore them
within 5 minutes.
• No need to send EMR Patch updates and run them all the
client machines. We have to replace the updated exes
only on the Hosted Server.
• No need to worry about data synchronization issue, we
can check the issues immediately when we need.

27. Hosted EMR Cost & Price Analysis (Ruff)
• Cost for (~36 Users):
– EC2 Reserved Instance (3y) : $4000
– SSL for Reserved Instance: $90
– Per User RD Web Services License: $84*36
– Total One Time Cost for three Year: $7042
– EC2 Reserved Instance Per Month Cost: $350
• Client Price:
– Initial Sign Up per Practice: $1000
– Per Provider Per Month Charge(1+2 Users): $295
– E.g: 3 provider in each practice (4 practice): $4000
– After One Month 12providers Charges: $3540
$4000 + $3540 = $7540

28. What we have done so for Hosted EMR!!!
Integration with MTBC Website
Online Hosted Demo EMR Package for New Clients

29. Demonstration
 Amazon Web Services Console Demo
 Hosted EMR Demo

30. References
• Amazon Elastic Compute Cloud (Amazon EC2)
– http://aws.amazon.com/ec2/
• What is cloud computing
– http://www.salesforce.com/in/cloudcomputing/
• HIPAA AND EC2
– http://aws.amazon.com/about-aws/whats-new/2009/04/06/whitepaper-hipaa/
– http://www.ehrdoctors.com/hippa-and-ec2/
• Windows Azure (cloud services operating system)
http://www.microsoft.com/windowsazure/windowsazure/
• Google App Engine
– http://code.google.com/appengine/business/
• Amazon EC2 Pricing Strategy
– http://aws.amazon.com/ec2/#pricing
• Amazon Elastic Block Store (EBS)
– http://aws.amazon.com/ebs/
• Amazon CloudFront
– http://aws.amazon.com/cloudfront/
• Hosted EMR
– demo.mtbc.com