 Live from the Sands Convention Center in Las Vegas, Nevada, it's theCUBE at AWS ReInvent 2014. Brought to you by headline sponsors, Amazon and Trend Micro. Okay, welcome back everyone. We are here live in Las Vegas for Amazon ReInvent 2014. This is theCUBE, our flagship program. We go out to the events and extract the signal from the noise. I'm John Furrier. My co-host, Stu Miniman of Wikibon, analyst over there, getting all the data. Our next guest is our keynote whack, manager of technical support and operations of Great Lakes Health Connect, which we found out yesterday was doing a lot of stuff with medical records, and we had Jerry Miller on early with Clouticity. And you guys are a customer of Trend Micro, which is awesome because we're their big sponsor. They sponsor us here, and we really appreciate those guys for doing that. So shout out for Trend Micro. So Barry, I want to get right into it. HIPAA is a big problem, but it's important because it's security. Jerry Miller pointed out that healthcare is not really healthcare. It's the opposite. It should be rewarding people for actually helping people, not procuring illnesses, or just like helping sick people. So this brings up the issue of how do I get the data into the hands of the right people at the right time? I mean, with Clout and big data, it technically is doable. So it sounds easy, is it? It's easier now than it's ever been before. The 24 years I've been actually doing this type of work, health information exchanges, their mandate is to actually go ahead and facilitate what you just described. It's to go ahead and put doctors, hospitals, laboratories, and patients in touch with the continuum of their health record. And that's what we do. So specifically, HIPAA is great. And today we now have the capability of leveraging technologies like AWS, trying to micro-deep security to actually enforce it to a degree that has never been possible before. And we take it very seriously because even one breach can result in us going out of business. So tell us about some facts. What about the business? I'm asking you guys, I have a core service you should explain. What's under the covers? What are you guys doing every day? You're moving files around? Is it an API-based system? Give us a little taste of how things are laid out relative to the service you provide. Okay, so Great Lakes Health Connect has about 95% of all the healthcare organizations integrated into its network today. We provide a broad menu of services to all of those folks. How we started was we asked the organization what their pain point was and then brought that solution in place. So we partnered with vendors to do the community health record, to do some data normalization and transformation. And then we've just developed an intermediate integration architecture that allows us to plug all those people together and then rapidly deliver niche solutions. So for example, we were one of the first HIEs in the country to deliver admits and discharges in real time to physician. So let me give you some numbers about what we're doing right now. Okay, we have 4,000 healthcare organizations integrated through our intermediate integration architecture. Just in health records that we send to the state of Michigan, we average about 1.4 million a day. If you actually put that in volume terms, it's about 3.4 terabytes, which is 6.6 years of music if you were to actually stream it. So in addition to that, we have about 10,000 docs. Yeah, so Barry, I love the story about healthcare. It's really about IT enabling better care and enabling better service rather than just being a cost center for the environment. Talk about how your journey to the cloud started and do you have any in-house IT still or are you mostly in the cloud these days? So that's actually a really interesting question because the reason that I was actually brought in to Great Lakes Health Connect was to actually even validate whether this was possible or not to do what we're doing. So we can actually now deliver custom solutions to our customers in two or three days. While I'm here, we're actually delivering newborn screening registries so to actually improve the outcome for babies, which you got to be all about that. We're also delivering a cancer patient registry. So how we've done it is we've actually taken the infrastructure and moved it out outside of the company and we were able to do that with three IT people and two consultants. Wow. What would that have taken if you were not doing it in the cloud? So the time frame we did, it was a huge factor. We actually did the sort of benchmarking in December and we had our production system up by July 1st of next year, which is pretty damn quick. Still about security because that came up with our past sessions of, okay, I see incidents, I see breaches, there's no perimeter in the cloud. I mean, Trent Mike was your partner here, but I mean, you got to, I mean, it's job one. You got to be critically secure. How do you guys look at that? I mean, what roles do you guys do? What do you outsource with Trent? So we actually use Trent Mike for deep security as well as a number of other systems to go ahead and ensure security. The big things that drive us as a nonprofit is how well we can use each dollar and the integration of Trent Mike into AWS makes that really easy to do things like active intrusion detection, real-time log scraping, malware detection and so on. So we actually have leveraged some third parties to help us actually put the infrastructure in place and we actually believe we lead in security right now for our industry. You feel good about it? I feel great about it. So yeah, okay. What is the biggest trend that you see out there that you guys are excited about that you're riding? You could point to it and say, the folks out there who are looking at saying, okay, I didn't really know there's that big of a problem there but what's really happening in your business and why is Amazon, why is the technology working for you now and what would have been hard years ago to do? Okay, so how long it takes to actually get a server in place to put a new solution up and be available? The best I've seen it do is two to four weeks with a major infrastructure project, it could be six months. We can do it in hours and minutes. When we have issues with demand and capacity, we actually autoscale our servers. So as we need more servers, we actually spend them up and spend them down in real time. So we just pay for the infrastructure we need. So those are huge things that have never been possible before. So what do you think of the show here? Okay. What's going on with the show? In your mind, you just walk around, see the keynotes, be involved in meetings. What's impressing you? What's the vibe? Share with the folks out there who aren't here. What's it like? So number one, the people are phenomenal. It's been one of the best experiences from a networking standpoint I've had and the keynote absolutely blew me away. The stuff that Amazon Web Service has done has just announced and is continuing to doing is transformational to our industry. The news about Kinesis, about Aurora, and how that's all moving forward and how that's going to allow us to go ahead to the next step in health information exchange into the internet of everything. The small things architecture is huge. Yeah, Barry, I want to ask you. One of the challenges, Amazon announced so many things. How many of those that you saw, do you think that you could rapidly move into your environment? You mentioned Aurora. Moving a database is not a trivial thing to do. What jumped out at you and does being on AWS allow you to take adoption of new services faster than you would have otherwise? So one thing for us is the services have to move from being announced to being covered by a BAA, so they're HIPAA compliant. So accelerating that's important. So seeing Aurora is great. I'd love to see it under the BAA. Some of the other new services. But for me, I think Kinesis is the biggest thing I'm most excited about, because actually, if you think about, I'm the ability to move data that way. Yeah, bring up a great point. How much lag is there, typically, from when a product first comes out to when it's something that meets all the compliances that you need? I'm actually continually surprised. The change and the number of features and services that we actually are being released is phenomenal. So to give you one small example, we actually were using third-party services to encrypt our data at rest. And AWS, while we were in the process of building our infrastructure made it available, it was part of their base service at no cost. And that's happened probably half a dozen times in six months that we've actually had new services. For example, I don't know if you know this, but Glacier just went under the BAA. So actually backing up all of our data just became a lot more economical. Yeah, that's great. Yeah. Is that a long winter to say I don't know? Yeah, no, no, it's really good. So a question I have in healthcare, you obviously have limits on what costs are. Using Amazon, do you understand what your costs are? Are they very predictable? One of the good things is you could be elastic with what you're doing, but there are some that are concerned that I can't go to my CFO and say, oops, we didn't realize what we were going to be getting, and therefore my bill was a lot more. What's your experience been with the pricing? So I know what every message costs. I know how much we're going to spend by day. I know that I can turn off my dev and search servers that I save costs, and part of the reason that we're able to actually successfully sell this for our board is we actually eliminated the initial capital expenditure for half a million dollars and made all of our IT expenses for infrastructure a percent of revenue. That has gone down 20 times over the past two years. So it made it a really easy sell from that perspective and I know a lot about the cost. So Barry, I got to be, I got to ask them to trend micro question. Those guys are awesome and thanks to Trend Micro for sponsoring theCUBE this week. Without their support, we would not be here or pursuing our passion of getting all the data and sharing that with you guys. Great interview so far. Thanks to Trend Micro. Shout out to you, those guys. So you're a big customer. What do you think of those guys? How would you give them a grade working with them? Good, good. Those guys are awesome. Rely on them. What's your experience? We wouldn't be in business if we couldn't assure the security of our data. So they're one of the reasons that we can actually do this as economically and deliver the benefit that we are right now. Are they going to close ties with you guys? They talk to you? They work with you? So we work with a partner. So that's been phenomenal. They've been accessible to us and obviously we reach out to them whenever we have questions and they've been very, very responsive. That's awesome. We've actually met with them I think three or four times since I've been at the show. Well you're doing some really innovative work. Congratulations. And again, you know, big believer in that the healthcare really is about the data and with iPads and with mobile device internet of things, you're starting to see a real movement towards accelerated data and having it protected, secure, and also available. Really a big deal. So congratulations. This is The Cube. We are here live in Las Vegas for Amazon Web Services Re-Invent. It's a caption to see them from the noise. I'm John Furrier with Student Minimand. We'll be right back with our next guest after this short break.