February 11, 2022

Benefits of AWS Migration Health Cloud — .Net Core Services

How to make the deployment process easier while creating a new infrastructure that can enable automation of CI/CD processes.

If we wonder about the usefulness of cloud migration, it is important to understand what we get by moving away from the on-premises model. The easiest way to try and explain this benefit is to describe an actual project where software engineers successfully completed migration to the Amazon cloud. At completion, we ended up with a new infrastructure that was entirely automated and cost-effective.

Why AWS database migration service was required

The main challenge from the development standpoint was updating the existing concept and creating a new one that was to be a part of the new CI/CD concept. 

The starting point was our client’s system for digital diagnostics that performs eye scanning to detect diabetic retinopathy. The device creates a set of four images that are sent to API for processing after which the system can detect if there is a condition. If it exists, the device shows how severe it is (mild, moderate, or severe).

This is an advanced AI system that consists of a great deal of data. 

Here’s how it works. When a patient’s eyes are scanned, the system then processes the images, and if there is a problem with the scan, it sends emails to clients’ employees in charge of exam review. Before the implementation of the Vicert solution, the deployment process was manual and very slow. Prior to AWS migration, the way that the application was functioning was not practical since there were many steps that employees needed to follow.  They were burdened with:

  • Exporting the CVS file on which the application was based
  • Being notified by email if the app detected unsuccessful images
  • Following a link in the email 
  • Getting to Amazon cloud storage directly 
  • Manipulating the AWS console – S3 bucket download, images review

It was necessary to update the existing project as well as to create a new CI/CD concept. In other words, to automate the new development and deployment process. 

Introducing a new infrastructure – AWS Migration and integration engine

We introduced a new structure with separated projects within the same solution. This enabled an easier development process, maintainability, and testing. 

A Unity of work concept is related to the successful implementation of repository patterns design. This resulted in much easier development since it tracks business transactions and translates them into database transactions, wherein steps are collectively run as a single unit.

The development team created a frontend with backend services. They made the addition with Web API and database storage, which excluded the necessity for digging into S3. The procedure now is to receive an email, follow the link, and get authenticated and authorized by Cognito service (AWS service). Logging in now happens directly with amazon cloud service to a grid with eye scan images. This service communicates with the active directory, validates users, and retrieves a token, which is vital for accessing the data we packed into our database. 

A core part of the client’s app was the integration engine. This is a web API that communicates with most parts of the system and is included in all processing. One of the main challenges while operating with this integration engine was working with DICOM images. DICOM is an international standard for storing, retrieving, printing, and presenting medical image information. 

A part of AWS database migration service required adjustments from our delivery team. In this particular case, we needed to work with DICOM tags that are time-based. When an eye examination is being performed, that DICOM image contains a set of DICOM tags which can be: first name, last name, or image capture daytime.

Another characteristic of DICOM tags was that they were time-based, so it was necessary to present them in local time to those who were using them. This was achieved by embedding a time zone offset with the help of a .NET package called Fo-DICOM. The AWS migration services strategy also needed to include the expansion and update of the current system to support the updated form. The Fo-DICOM package was interesting to use and enabled our team to easily manipulate, extract, and unpack the DICOM tags.

Even more opportunities for advancement with AWS migration

This new approach gave us an opportunity to move other applications such as the CEM (Continuous Efficiency Monitoring). A CEM system enables us to compare AI processing and digital diagnostics to the expertise of a medical doctor. In this way, we can detect if the system is accurate and valid or if it needs updates or bug fixes.  This allows us to implement the existing infrastructure and move it from the exam review to CEM and do it very quickly and successfully. This velocity in updating and changing the infrastructure is actually the main benefit of AWS migration.

Author: Vicert
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