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2023-07-24

Agenda

  • AWS HealthImaging Series?
    • The journey from day 1
    • Anything medical imaging is interesting
    • How AWS builds services
    • Digital Pathology related
    • What does a CloudNative / Modernized application look like with AHI?
    • What is so wrong with DICOM? How can DICOMweb be improved?
  • How often or if people are dealing with the problems of global latency
    • Centralized server in one location, users accross the globe
    • Are people doing this and is latency an issue?
      • Yes - mostly with pre-fetching and client side rendering
    • AWS Technologies/Services relevant
      • AWS DirectConnect - dedicated network connection from a location to an AWS Region
        • very low latency (<10 ms)
        • High bandwidth = up to 100G
      • AWS Global Accelerator - routing traffic over the AWS internal network around the world
      • CloudFront - CDN with edge compute (Lambda@edge)
      • Edge Technologies
        • LocalZones
        • Snowcone
        • IOT Greengrass
        • Outposts
    • How does client side rendering help with latency?
      • it doesn't change network latency, but it makes the end user experience immune to it (as well as network variability)
    • 10 years from now:
      • Assuming: Redundant, high bandwidth, low latency networks are everywhere
      • Very few rads on premises
      • Don't need any local cache OR prefetching
        • Local Caching
          • Additional hardware $
          • Additional complexity $$ human and software
        • Prefetching
          • doesn't help with ad-hoc (<10%)
          • complex ($$ human it cost)
          • wasteful - prefetch same case to multiple rads just in case
    • Today -
      • First step is hybrid full archive on presmises, partial data in cloud
      • Second step is hybrid full archive in cloud, recent data (and maybe priors) on premises
        • Performance
        • Egress Cost
        • Third Party Applications
      • Third step is full archive in cloud, prefetching to local cache when needed
        • Very few here today (telerad company?)
      • Fourth step is full archvie in cloud, no local cache/prefetching
  • Patient controlled copy of medical records (blockchain based)
    • Would this throw a kink in cloud systems
      • distributed file systems (IPFS/FileCoin/Chia) - these may make sense