HOW TO IMPLEMENT

DEVOPS
IN HEALTHCARE

OSP
Table of Contents

01 Introduction 02 Traditional SDLC 02 What is

Barriers DevOps?

03 Traditional IT 04 Step-by-step 05 Healthcare

vs DevOps DevOps Guide DevOps
Roadmap

06 DevOps Best 08 Benefits of 09 DevOps as a

Practices DevOps Service

10 DevOps Success 12 Use Cases 14 Conclusion

Factors
 Introduction
The healthcare industry has grown by leaps and bounds over the past few
decades. The paper-loaded clinics and hospitals have been replaced by
tech-savvy smart data applications that extend themselves to more agile
hospital management systems. Data lies at the key of the healthcare industry
and is considered the true treasure of the trove. However, this data needs to be
easily accessible and adhere to the relevant security protocols. This is where
DevOps in healthcare weighs in. It is the answer to gaining a competitive edge
through responsive, data-driven, and superior care-giving. 

01
Regulatory
Compliance
& Data Security 02
Automation
of Daily Routine
Tasks

03
Enhanced
04
Patient
Engagement Streamlined
Workflow
Management

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 Traditional SDLC
& Its Barriers Reduced
OPEX

The hindrances with traditional

healthcare software development,
Easy
whether it is the Waterfall, V, or RUP Scalability
model, is lacking with the agility
toward today's business needs.
Higher costs with lower productivity,
lack of flexibility, and accessibility to Increased
Accessibility
data are the common backdrops of
the traditional software delivery
lifecycle method. Implementation of
DevOps is an efficient way to combat High
the inadequacies through custom Availability
healthcare software development. 

What is DevOps? Fast

Deployment

DevOps is expertise of the merger of

agile infrastructure and operational 100%
excellence. Healthcare software Server
Security
developers collaborate to create a
process of operations and
development for better efficiency and
Better
agility into the entire lifecycle to Business
provide integrated care solutions. Agility
DevOps for healthcare is a qualitative
integration of software development
with operational efficiency. It is an
extension of agile technology towards
the overall operations of custom
healthcare solutions. 

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 Dimensions SDLC DevOps

Batch Size Big Micro

Organization Skill Centric Silos Dedicated Cells

Scheduling Centralized Decentralized & Continuous

Release High Risk Event Non Event

Information Disseminated Actionable

Culture Do Not Fail Fail Early

Metric Cost & Capacity Cost, Capacity, and Flow (Time)

Define “Done” “I did my job” Cost, Capacity, and

“Its ready to Flow(Time)
deploy”

Traditional IT and DevOps – Key

Differences
Rigidity Vs. Flexibility: Traditional healthcare IT solutions go through a rigid
lifecycle from the development of the software, testing, Q & A, staging, delivery,
and finally, feedback. DevOps in healthcare focus keenly on the value of
development and delivery for value creation and risk mitigation. 

Macro Vs. Micro: Traditional healthcare software solutions focused on a big

project release that involves high costs and occurs infrequently. In contrast,
DevOps and healthcare adopt a micro approach, avoiding complex releases
and mitigating risk for gradual advancement at regular intervals with lower
risk. 

Data Monitoring Vs. Data Sharing: Traditional healthcare IT solutions have a

cumbersome data sharing process due to management approvals and lengthy
reports. DevOps and healthcare solutions have a dedicated data sharing team
to reduce management time wastage and provides relevant data to the specif-
ic team.
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 Step-by-step Guide for Healthcare
DevOps
Examine and modify development activities

Continuous
Plan financial implications of the relevant custom development
Planning 
Set up a continuous monitoring process

Ensure a version control system to coordinate and control coding

Code Repository
with Version Track your code repository
Control
Streamline version control workflow

Automate the build on a central server

Continuous
Integration Commit or merge to mainline frequently
(CI)
Validate in a production-like environment

Deploy scripting, and automated retrieval of the code

Automated
Compile the recovery into a binary artifact for periodic testing
Build
Follow a consistent and automated pattern format

Automate testing and system rollback

Continuous
Deployment Push your changes to a rush box
(CD)
Automatically deploy to production

Adopt a micro-approach for minute detailing

Constant
Feedback Gather feedback at regular intervals
& Monitoring
Have self-monitoring analytics to get loopholes

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 Healthcare DevOps Roadmap
Node.js Ruby Python Threads and Concurrency
Process Management
Go
01 I/O Managment
Learn a Programming Language Rust Sockets Memory/Storage
C / C++ Virtualization File Systems

02
Doesn’t matter which language you Understand different OS Concepts
pick, key is to get some programming
knowledge

03 Learn about Managing Servers Learn to live in Terminal

Operating System
Get some administration in some OS,
especially any Linux distribution. Pick Ubuntu
if you have little to no experience with Linux. Learn Base Scripting
Linux DSN

Unix OSI Model Text Manipulation Tools Vim/Nana/PowerShell/Emacs

owk, sed, grep, sort , ubiq, cat, cut
Windows echo, fmt, tr,nl,egrep,fgrep.wc
Compiling apps from source
(gcc, make and other related stuff)
04 Networking and Security Process Monitoring
ps, top, htop, atop, isof
HTTP
System Performance
HTTPS Others nmon, iosta, sar, vmstat
strace,dtrace,systemtop
FTP uname, df, history
Network
SSL / TLS 05 nmop, tcpdump,ping, traceroute
What is and how to setup a - airman, airodump, dig, iptables, mtr

IIS
Apache
Reverse Proxy Coching Server Web Server
Nginx
Caddy Tomcat
Forward Proxy Load Balancer
06
Firewall Learn Infrastructure as Code

Infrastructure Provisioning
Containers
07 Cloud Formation
Configuration Management
Learn some CI / CD Tool Docker
Terraform
rkt
Ansuble Salt
LXC
Jenkins Chef Puppet Nagios Icinga
Datadog
Teamcity
08 Learn how to monitor Infrastructure Monitoring
Drone Zobbix
Travis CI software and infrastructure
Google Cloud Monit
Circle CI
Digital Ocean Application Monitoring
Azure ELK Stack New Relic
Heroku
Graylog App Dynamics
Logs Management
Splunk
09 Papertrail
Cloud Providers

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 DevOps in Healthcare Best
Practices
The DevOps team need to be on the same page about development, testing,
and deployment. Implementing common collaboration tools toward healthcare
product development is the must. A collaborative approach to include
processes, communication, development, integration, testing, and operations
towards automation ensures streamlined movement. 

1. Use tools to capture every request   3. Use tools to log metrics on both
Adopt the stringent systems, wherein
the processes of DevOps development
and tooling modification is
automatically captured. Change
requests are automated to adapt to
performance through the entire
spectrum of development and
operations. Ex. Healthcare payer
solutions modification is captured and
adapted throughout the system for
administrative convenience.
2. Use agile Kanban project
management for automation and
DevOps requests
The Kanban framework is an intelligent
tool that undertakes comparative
analytics between the potential require-
ments of the project and the capacity
of the team towards the same. This
allows the development team to plan
more efficiently, provide quicker turn-
around, and overall
transparency through the entire
development cycle.
manual and automated processes:
The selection of tools that will boost
the productivity of the DevOps
process is dependent on the clear
definition of metrics. These tools
offer powerful automation techniques
to correct and modify errors with
minimal to no human involvement. 
4. Implement test automation and
test data provisioning tooling
Test automation is the ability of the
automated system to apply to test on
code and data, at regular intervals, for
qualitative assessment of the overall
operational ability of the software.
The numerous tests that are applied
in this automated fashion to diagnose
the quality of the code and allow the
development team to gauge its
efficiency.
  

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 5. Perform acceptance tests for
each deployment tooling

7
Best in Class
A clear definition of the acceptance
DevOps Tools
tests that need to be undertaken for
each deployment is a critical step
toward success. The details of the
testing include the level of required
efficiency of the software, along with
the parameters of testing.
Evolutionary modification provisions
should be enabled for future Docker
Linux based container engine that enables DevOps
compliance requirements.  teams to pack and move applications
between host and server seamlessly.

6. Ensure continuous feedback

between the teams to spot gaps,
issues, and inefficiencies
Consistent feedback is a crucial
parameter to assess efficiency levels.
Automated communication between
development teams and users,
mechanisms for tracking issues, and
flagging of errors for corrections can
reduce inefficiencies. Finally, a report
on whether the modifications
resolved the error is highly essential.
Jenkins
A Continuous Integration tool for testing
applications, automating code deployment, reporting
build failures, integrating tools, etc.
New Relic
An application performance monitoring and
management tool that provides insights related to
application response time: server, browser, synthetics, etc.
Ansible
A configuration management tool that offers
dexterous controls to define, build and manage
cloud infrastructure

7. Establish a DevOps Community SaltStack

of Practice (CoP)
This is the platform which allows for
consistent contribution and
improvement action to the DevOps
function. It also creates an
environment that promotes Q&As,
increases familiarity with the project
and its workings.
A Python based configuration management tool to
manage distributed infrastructure with the help of
centralised remote engine
Splunk
A powerful tool that collects data from Servers
and Cloud platforms to deliver valuable insights
Kubernetes
Kubernetes is an open source docker orchestration
tool that is lightweight, multi-cloud, extensible and
self-healing platform and helps to scale applications
on the fly.

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 Benefits of Implementing DevOps
in Healthcare
From faster delivery to higher quality, the benefits of DevOps in healthcare are
many. Listed below are the key ones:
Reduced OPEX
Operational expenses are
considerably reduced since there
are no initial investments in
purchases and training, along
with reduced operational
resources.
Increased Patient Engagement
and Satisfaction
The DevOps tools are designed to
minimize time and effort toward
patient engagement, through
check-in systems, etc. It further
increases overall satisfaction
through CI and CD tools for
appointment scheduling, patient
security, etc.  stringent compliance adherence
Enhanced Data Leveraging
The architecture of DevOps
ensures that easy accessibility
through applications is in close
range to patients and
administration. Data is leveraged
across multiple departments and
platforms for multi-purpose
usage to provide integrated
healthcare solutions.
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Automated Daily Routine Tasks
This allows healthcare
organizations to address and
satisfy patient requests and deliv-
er value care through higher busi-
ness agility. 
Superior Regulatory Compliance
and Data Security
When infrastructure is
implemented as code, the level of
security is automatically superior.
Server security and hacker pro-
tection are provided according to
the highest standards, ensuring
the protection of data and
through risk mitigation. 
Improved Infrastructure
Efficiency
The ease of accessibility to
resources and data, along with
automation, improves the overall
efficiency of the infrastructure.
DevOps provides integrated
healthcare solutions through
higher-quality infrastructure.
OSP
 DevOps-as-a-Service
Software Release Automation Infrastructure as a Code (IaC)

DevOps
Microservices Consulting
Cloud Native CI/CD as a
and Architecture Design
Service

Managed Cloud Services Automation Testing

DevOps End-to-End Pipeline

Version Control Tools Build Tools Code Quality Analysis

Check Quality Deploy to Fetch Latest

Build
In-Out code Control Test Environment Build

Continuous Delivery Process

Continuous Integration Continuous Improvement

Deploy to Pre
Deploy to Production Accepting Fetch Release Packaging & Integration
Production
Environment Testing Ready Builds Archiving Testing
Environment

Store valid Binary Packages

Deployment Environments Configuration Management
Testing Framework
(Cloud & On Premises) and Deployment Tools

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 Success Factors of DevOps
Continuous Integration (CI) 

• Continually collate and incorporate source code updates &

modifications onto a common platform
• Avoiding conflicts and disruptions
• Mitigate the possibility of failures to code changes through
constant merging and monitoring

Infrastructure-as-a-Code

Managing infrastructure is a model that uses code at the

base of the infrastructure and is an evolved strategy that
eradicates the issues of an environment drift in the
release pipeline 

Continuous Delivery

Code changes are automatically pushed for release into

production. Automate testing procedures to verify
updates across various platforms before its release 

Configuration Management

• Creating and maintaining consistency across the product

and its functionality to meet operational requirements
throughout the product lifecycle
• Automation of complex tasks to permit healthcare
organizations to enhance agility 

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 Success Factors of DevOps
Microservices

• Service-oriented Architecture (SOA)

• Analyze smaller pieces of functionality 
• Offers higher productivity and efficiency through the micro
organization. Decreasing the complexity of creating, testing,
and understanding applications 

Policy-as-Code

Writing code in a superior level language to manage and

automate policies through the representation of codes in
text files through version control, automated testing, and
deployment

Thanks to practices such as continuous

integration, continuous delivery and DevOps, high
performers are often now doing thousands
of production deployments daily!
- Gene Kim
Author, Researcher at
IT Revoluation Press

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 Use Case 1
Case 1: Elevating onto AWS for a High-end Healthcare
Platform

A multi-national US-based corporation churning an annual revenue of $30B

was offering 2 wide-ranged SaaS applications to their customers through
their individualized platform. With an employee volume of over 80,000, the
infrastructure consisted of dedicated data centers to carry on the load of
the platform.

The potential of the current system wasn't

scalable to introduce an ML solution toward
data analytics
Challenge

Transition toward DevOps-as-a-service through an

external Managed Service Provider
Gaining a deep analysis in the current infrastructure
and raise input on the workings of the system via
the stakeholders
Proposed Gain the capability to process Big Data to
Solution augment the value delivery and increase product
evolution

The aplications were moved onto AWS

Applying advanced DevOps strategies solve
challenges
Solution

Reduced OPEX by over 45%

No compromization on product availability,
compliance, or operational abilities
Scalability toward AWS ML and Big Data analysis
Result Embedded with high-end security

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 Use Case 2
Case 2: Escalating Performance of Hospital Management
through Microservices

A US-based hospital was using a SaaS solution to integrate multiple EHR

systems in the hospital for optimization of operational functions through
resource requirement predictions that will decrease patient waiting duration.

To improvise the platform to perform the above

through resource optimization
Challenge

To classify the solution into microservices and

containerization with the use of Docker
Proposed Solution

Improved planning efficiency considerably, allowing

highly efficient application speed and real-time
updates
Leveraged Docker group quotas for memory and
CPU usage to create a dynamic resource
partitioning system
Solution Deployed the smart monitoring and alerting system
using Zabbix and Prometheus + Grafana for
monitoring and ELK stack (ElasticSearch, Logstash,
Kibana) for logging

Hospital performance optimization

Simplified the hospital resource optimization
Result

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 Conclusion
DevOps in the healthcare industry is really as advantageous as it seems.
This software engineering strategy has a definitive approach towards processes
and practices, along with highly functional tools to promote overall collaboration
between developers and operations. The outcome is a highly efficient operating
system and increased business profitability. The trend is catching on fast, and
your healthcare organization stands to gain accelerated efficiency through the
infrastructure provisioning and application deployment provided by DevOps. 

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 We are a leading software development company aiming to empower, and
inspire the world with next-gen solutions. We help in simplifing every step of
the development process, from system architecture design to quality
delivery. Our intelligent processes enable quick deployment of
enterprise-grade solutions against the toughest, and most complex
challenges.

We are re-imagining how technology can empower

Healthcare, AI, Analytics, and Financial organizations to build solutions for
every day use in business applications.

With 10+ years of experience, and 200+ customers worldwide, we're

leveraging technology to build the future today.

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