Category: Cloud Management

  • Observability, SRE and Uptime in Telehealth Platforms: A DevOps Playbook

    Virtual care went from nice to have to must have during the COVID-19 pandemic and while in-person visits are starting to pick up again, telemedicine is here to stay. Its growth will continue: health-tech companies are predicting the telemedicine market will be $143.49 billion by 2025 (it will be $167.74 billion in 2025 and $584.99 billion by 2033 at 16.9% growth rate).

    Telehealth platforms handle sensitive health information, manage appointments, stream live video, link to patient EMRs and of course must be fully HIPAA compliant. Anything that goes wrong and we mean anything can harm patient care, erode trust and bring on a whole bunch of regulatory headaches. For DevOps teams who build and run these platforms, having a system that’s rock solid and always available is no longer a nice to have; it’s a patient safety feature.

    This guide is all about where observability, SRE and uptime management come together in telehealth. Based on research, real case studies and hard-won experience of actually managing DevOps teams in healthcare, it outlines a bunch of practical steps you can take to get your production platform ready for production while meeting all the compliance and user experience requirements.

    Why Telehealth Reliability Matters

    Telehealth users expect the same uptime as traditional clinical systems. According to a 2024 survey of healthcare organizations, 93% of patients expect digital health services to be available 24/7 and downtime incidents cost an average of $7,900 per minute. Hospitals and clinics operate on thin margins and outages have a ripple effect: staff have to go back to paper processes, appointment backlogs grow and patient safety declines. The 2024 CrowdStrike-related Microsoft outage cost the healthcare industry about $1.94 billion with individual organizations losing about $64.6 million.

    Regulators are paying attention. North Memorial Health, for example, paid $1.55 million after a HIPAA violation related to inadequate safeguards and lack of business-associate agreements. Downtime during compliance incidents damages not only finances but also patient trust. As Mitesh Rao, former chief patient safety officer at Stanford Health Care, said, telehealth outages “affect every aspect of patient care”. DevOps teams need to engineer telehealth platforms that deliver continuous availability while meeting security and regulatory requirements.

    Beyond Monitoring: Building Observability

    What Is Observability?

    Monitoring checks if specific metrics are within thresholds. Observability goes further; it provides a holistic view of system health by correlating metrics, logs, traces and events. Bri Morgan of Splunk says healthcare observability is “the path to achieving resiliency across mission-critical services”. Observability tools let IT teams see into the system’s internal state based on its external behavior and gather insights into clinical and operational workflows. John Wilson of SolarWinds adds that observability “helps identify security threats and potential breaches” and helps with HIPAA compliance.

    Observability is different from monitoring in its predictive and diagnostic capabilities. It includes distributed tracing, a forensic technique that visualizes the flow of requests across microservices to find bottlenecks and anomalies. Predictive analytics can forecast potential issues so organizations can respond proactively. Patrick Lin, general manager of observability at Splunk, says observability integrates with DevSecOps so teams can catch security issues before they hit production without slowing down the development cycle.

    Telehealth‑Specific Observability

    The unique challenges that come with telehealth platforms. Video streams, asynchronous messaging & all the rest – remote monitoring devices, EHRs, billing systems – observability needs to cover everything from network to application, & that includes video performance & device health too. Take Codebridge’s advice for a moment – setting service level objectives (SLOs) right from the get-go is a good place to start: 99.95% uptime, video join times of 5 seconds or less, & call drop rates under 2%. Those SLOs translate patient expectations into real targets – something to aim for.

    Observability isn’t just about catching errors, though that’s part of it. You need to see the whole picture: all those user journeys & interactions that are happening. For example, if patients are bailing out on authentication all the time, metrics are just the first place to look. You need to dig deeper to find out if it’s the identity provider, network, or the timeouts that are the problem. You should be able to see interactions with all those peripheral devices – digital stethoscopes & blood pressure monitors, that sort of thing. And remote site observability means your telehealth services are running smoothly, patient data & device health are getting checked, & you’re keeping an eye on medical equipment too. DevOps teams want to be able to get that device data, so they can pick up on data quality issues before it’s too late for clinicians.

    As the world moves on, more & more of these observability platforms are including AIOps – AI-driven analytics that can spot anomalies & say “here’s how to fix it”. That AI observability stuff can collect & analyze all the data – events, metrics, logs & traces, to name a few – & spot system issues before they become problems, keep downtime to a minimum & make sure services like EHRs, telehealth & imaging are always available. Those AI models can even spot the really subtle stuff, like a slow memory leak or the odd bit of network congestion that you might otherwise miss.

    Implementing Observability:

    • Instrument all your bits and bobs – use open standards like OpenTelemetry to add monitoring to your code, infrastructure, and networks. Get a handle on metrics (latency, throughput, error rates) and logs (the lowdown on what’s happening, in context) – and don’t forget about those cross-service workflows, captured via distributed tracing. For telehealth, pay attention to video streaming (looking at WebRTC metrics), call quality (packet loss and jitter can be a real problem), and device connectivity.

     

    • Gather all your data in one place and get some visibility across the board. Use a unified observability platform to collect telemetry data and spot problems as they appear, across different parts of the system. And make sure distributed tracing ties user actions back to the processes that are actually working on them – that way you can stop teams from bouncing between different dashboards to try and figure things out.

     

    • Set up your alerts and anomaly detection to save you time and stress. Use machine learning to spot when things are behaving strangely, and get real-time alerts when there’s an issue. And make it easy to fix things fast with some run-book automation to help sort out problems as soon as they come up.

     

    • Put data privacy at the top of your list – observability has to comply with HIPAA and GDPR. Make sure any sensitive data stays encrypted while it’s in transit and when it’s stored, limit who can access it with role-based controls, and draw up business associate contracts. And don’t forget that HIPAA needs end-to-end encryption, audit trails, and frameworks like NIST and zero-trust architecture. Your data pipelines have to fit the bill, too.

    Site Reliability Engineering: Turning Metrics into Reliability

    SRE is the application of software engineering to operations. Google made it popular by treating reliability as a product feature and quantifying it through service level indicators (SLIs), SLOs and error budgets. Healthcare can benefit a lot from SRE.

    A 2024 research paper says Google’s SRE team maintains 99.99% uptime for critical services and the Cleveland Clinic reduced critical incidents by 40% and MTTR by 60% after adopting SRE. A HIMSS survey found 70% of healthcare IT professionals believe SRE practices improve system reliability and performance.

    SRE Practices for Telehealth

    Design for graceful degradation, so if the video doesn’t work, for example, the system can fall back to audio or chat. Provide asynchronous options like secure messaging or offline notes so care can continue even when live sessions drop.

    Do chaos engineering: Simulate node failures, network partitioning and API timeouts to see how the system behaves. In telehealth scenarios, testing should include streaming services, device connectivity and EHR integration. Use the results to enhance failover strategies and client-side resiliency.

    Track patient-centric SLIs: CPU and memory metrics are not enough. Monitor metrics like join time, call drop rate, video quality (jitter, packet loss), authentication latency, prescription fulfillment success, and device connectivity. These SLIs are patient-facing. When you put multiple microservices together, use distributed tracing to correlate patient-level transactions across authentication, scheduling, video streaming, EHR integration and billing.

    Automate remediation: Combine observability data with automated runbooks to reduce MTTD and MTTR. According to IRJET, advanced monitoring allowed one hospital to detect and resolve 80% of incidents before they impacted end users; 75% of organizations using advanced monitoring reported improved availability and reduced downtime.

    Prioritize patient data integrity. There’s no use being reliable if the data is wrong. SRE practices should include thorough validation and error handling. The Cleveland Clinic reduced errors in data entry by 80% and increased the accuracy of records to 95% by implementing full data validation.

    DevOps Playbook for Telehealth

    Now that we have the theory, let’s turn it into a playbook for DevOps teams to build telehealth platforms.

    1. Know the Domain

    Telehealth is regulated and patient-centric. Know HIPAA, HITECH and regional regulations. Map data flows and ensure PHI is secure. During planning, involve compliance specialists and clinicians to understand functional requirements (e.g. e-prescriptions and remote monitoring) and non-functional requirements (e.g. uptime, latency and security). As an example of how domain expertise drives success, ScienceSoft telemedicine solutions enable audiovisual patient-doctor communication, patient monitoring and remote care delivery while reducing healthcare costs and increasing care accessibility. This shows that telehealth software must balance technical complexity with clinical usability.

    2. Define Reliability Objectives and Architecture

    Set SLOs for each user journey: session setup time, video quality, messaging latency, device connectivity and data synchronization. Document error budgets and attach to business objectives. Build architecture diagrams showing redundancy, failover paths, encryption layers and integration points. Decide to use commercial video SDKs or build a custom WebRTC infrastructure. As an example, Codebridge recommends 99.95% uptime, with call drop rates less than 2%; adjust to your clinical use cases.

    3. Instrument and Automate

    Instrument from day one: OpenTelemetry in microservices; quality metrics in video streaming components and log for EHR integration. Infrastructure as Code (Terraform, Ansible) and CI/CD pipelines for consistent environments and repeatable deployments. SAST and DAST in your pipeline, performance tests. Canary deployments and feature flags to control the blast radius of new features. Strong CI/CD pipeline reduces manual errors: Northwell Health’s 95% error reduction is proof.

    4. Operate with SRE Principles

    Create on-call rotations and incident response playbooks. Use run-books to automate standard remediation tasks – such as scale pods and restart services. Run game days and chaos experiments to validate failover. Track incident metrics: MTTD, MTTR; have blameless postmortems. SRE is not about heroics; it’s about creating systems that self-heal and freeing engineers to focus on automation instead of firefighting.

    5. Continuously Improve Based on Observability Data

    Observability should be the driving force that guides where your development and ops teams focus their efforts. Take a close look at those system traces to figure out where you’re really getting bottlenecked – then use that info to tweak code, snag those pesky database queries & network routing issues. And let’s not forget using predictive analytics to stay one step ahead, so you can spot impending hardware doom before it becomes a disaster.

    Throw those observability dashboards up on the screen for your clinical stakeholders to see, so they can get a handle on how the platform is doing and maybe even make a strong case for some much-needed investments. In the words of LogicMonitor, you can proactively sniff out issues and keep EHR, telehealth & imaging systems always accessible when you use a hybrid observability platform powered by AI.

    6. Prioritize Compliance and Trust

    Reliability and compliance go hand in hand – so don’t forget it. Encrypt that data, set up proper access controls and keep track of all those audit trails. Plus, make sure you’re in compliance with the major security frameworks like NIST CSF & zero-trust network segmentation – that’s a given. Then toss in some regular risk assessments & penetration tests for good measure. Document all those data flows, have all the necessary business associate agreements in place with your vendors and make darn tootin’ sure the customer feels safe knowing their data is protected and their care won’t be put in jeopardy from some avoidable security screw-up.

    Conclusion

    Observability and SRE are key to uptime and reliability in telehealth platforms. By doing proactive monitoring, automated response and DevOps, teams can make every virtual visit seamless, secure and always available when patients need it most.

  • Tools for Sustainability in Cloud Computing

    Tools for Sustainability in Cloud Computing

    Cloud computing is a primary driver of modern technological advancements. However, as cloud services adoption continues to soar, so does a concern for their environmental impact. The further expansion of cloud infrastructure will demand more energy, which means the need for sustainable solutions has never been more acute.

    Due to their scale, cloud vendors operating large data centers have a greater impact on minimizing the IT’s industry overall carbon footprint than do smaller on-premises deployments. In this article, we highlight the main benefits of migrating business operations to the large-scale cloud providers known for their established sustainable practices, and point to useful resources.

    Follow the Leaders

    Major cloud platforms, including Google Cloud Platform, Amazon Web Services and Microsoft Azure, have pledged to achieve net-zero carbon emissions in their data centers by 2030. These platforms are well-positioned to lead the adoption of sustainability principles in cloud engineering due to their reputation and global reach.

    Microsoft’s study on the carbon benefits of cloud computing showed that an enterprise could reduce its carbon footprint by up to 98% by migrating to Microsoft Cloud, compared to running its IT operations in the on-premises data center.

    As for Google Cloud, all of its cloud products are carbon neutral. Google achieves this by purchasing renewable energy to reduce the carbon footprint from operations performed on its infrastructure, as well as by using high-quality carbon credits to compensate for its remaining carbon emissions.

    By moving your operations to the cloud and focusing on developing cloud-based applications, you can contribute to sustainable business practices and overall carbon footprint reduction.

    Increase Energy Efficiency

    Public cloud platforms rely on large-scale data centers with advanced infrastructure technologies. That allows them to reduce electricity consumption for overhead tasks such as lighting, cooling, and power conditioning. For example, according to Google’s environmental report, its data centers consume half the energy needed to power an average on-site data center.

    Energy efficiency is also driven by higher server utilization rates and the ability to manage workloads flexibly. These are the main factors that allowed AWS to make its data centers 3.6 times more energy efficient than a median data center run by a U.S. company.

    Additionally, the innovative approach applied to server architecture design in large data centers enables cloud service providers to develop custom hardware optimized for their customers’ workloads.

    Big Names are Committed to Sustainable Software Development Practices

    Another environmental benefit of running IT operations in the cloud is that public cloud platforms are committed to sustainable software engineering – and they want to make it feasible for anyone who uses their platforms.

    Green (or sustainable) software starts at the design phase, considering carbon emissions as a project requirement. According to the Green Software Foundation, sustainable software applications are carbon efficient (can run on fewer machines and resources), energy efficient (require less energy to perform the same tasks), carbon aware (prioritize renewable energy sources as a power source) and hardware efficient (use less hardware).

    IT operational efficiency is a fundamental of sustainable software engineering. Since cloud service providers already apply advanced technology to improve the energy and hardware efficiency of their infrastructure, cloud migration is a good start for supporting green coding.

    Microsoft developed eight principles of sustainable software development for engineers to follow when they build, design, and deploy applications. You can apply these principles to all types of applications, whether deployed on-premise or in the cloud.

    Amazon released a sustainable architecture guide with strategies for applying sustainability practices to optimize AWS infrastructure compute, storage and network layers. AWS also provides guidance on applying environmental best practices for designing and operating workloads in the cloud.

    A Tools Roundup for Measuring and Reporting Carbon Emissions

    In addition to implementing sustainability practices in their business operations, cloud platforms offer clients tools to monitor and measure carbon emissions linked to cloud service usage and report their overall carbon footprint following greenhouse gas protocol standards.

    Google Cloud provides users with an emissions calculator. Using Carbon Footprint, you can track the emissions from running your applications. The tool lets you view and analyze data related to gross carbon emissions and use derived insights in emissions reports.

    AWS also offers the Customer Carbon Footprint Tool for emissions tracking. You can calculate their carbon emissions associated with using AWS services, track emissions after migrating to the cloud, and use the data for sustainability reporting purposes.

    Microsoft customers can access the Emissions Impact Dashboard to estimate their carbon footprint related to Microsoft Azure and Microsoft 365 cloud services. Microsoft also offers Cloud for Sustainability for tracking and managing carbon emissions. It gives you visibility into your organization’s environmental impact, aggregates data from various sources, and offers practical recommendations for reducing a carbon footprint.

    Energizing Thoughts

    Achieving “net zero” is not solely the responsibility of large-scale cloud providers. Businesses must also contribute. Itransition’s cloud consultants believe that if more companies move their IT operations from on-premises servers to the public cloud, overall energy consumption and related carbon footprint will decrease.

    By leveraging renewable energy sources, optimizing infrastructure for energy efficiency and employing innovative technologies, these leading cloud platforms can attract a cohort of environmentally conscious clients. Those users may consider switching to the cloud not only for direct business benefits but also to make their operations more sustainable.

    Photo credit: Aimable Mugabo on Unsplash

  • Survey Sees AI Playing Larger Role in Test Automation

    Survey Sees AI Playing Larger Role in Test Automation

    A survey of 1,028 senior IT professionals and application developers in the United Kingdom, U.S., Germany and Singapore finds nearly half (47%) still use manual testing for mobile applications. More than a third (38%) noted that their organization could save between half and three-quarters (51-75%) of funding allocated to testing per year by fully automating mobile application testing.

    Conducted by the market research firm Censuswide on behalf of Tricentis, a provider of a test automation platform, the survey also found that just under half of respondents (49%) reported their organization is already applying artificial intelligence (AI) to application testing. Another 21% plan to apply AI in the next six months. Almost three-quarters (74%) said their organization’s general sentiment toward AI in mobile software development testing is positive.

    Respondents also expected AI to improve mobile application quality (37%), increase productivity (36%) enhance end-user experience (34%) and to reduce the number of vulnerabilities and/or bugs (32%) in their applications.

    Mav Turner, chief product and strategy officer at Tricentis, said that rather than continuing to rely on expensive testing services, more organizations are looking to reduce costs by automating a wider range of testing workflows within the context of a DevOps workflow. In fact, the survey finds just under a third of respondents (32%) expect their organizations will invest more than $1 million to further automate testing.

    As modernization of testing processes continues, the return on investment in mobile application development will only continue to improve, noted Turner.

    The survey identifies the primary benefits of investing in test automation, which are increased productivity (32%), increased revenue (31%), increased user retention (28%) and increased compatibility across devices (28%).

    The primary obstacles organizations encounter as they strive to achieve that goal are competing priorities (28%), lack of technology and talent (25%), time (25%) and cost (24%), the survey finds.

    A full 87% said the quality of mobile applications is critical to their business, with 90% noting that poor mobile application quality costs their business as much as $2.49 million in lost revenue per year. However, just over a quarter (27%) said they believe their organization’s current mobile application development and testing strategy exceeds expectations.

    As part of efforts to automate testing, it’s not clear just how far responsibility for testing is shifting left toward developers, but there is no doubt many more are being exposed to the results earlier in the software development life cycle. The goal is to provide continuous testing capabilities without overly disrupting code writing. It’s also becoming simpler for developers to leverage generative AI tools to provide summaries of tests along with recommendations to improve code. The end result should be higher-quality applications that require less troubleshooting once deployed in a production environment.

    In the meantime, as organizations continue to become more dependent on mobile applications to drive a wide range of digital transformation initiatives, the cost of testing will continue to pale in comparison to the potential amount of lost revenue that might occur when end users either don’t invoke a specific feature or capability or, more commonly, simply abandon the application altogether.

  • appCD Launches Platform to Securely Provision Cloud Infrastructure

    appCD Launches Platform to Securely Provision Cloud Infrastructure

    appCD this week launched a namesake platform that analyzes an application about to be deployed to automatically generate the code needed to provision the IT infrastructure required.

    Fresh from raising $6 million in seed funding, appCD CEO Sachin Aggarwal said that approach makes it possible to consistently create secure code for provisioning IT infrastructure versus requiring developers with little to no cybersecurity to manually write it.

    Instead, appCD reviews Python or Java code to understand intent, identifies dependencies and then infers application programming interface (API), service configuration, ingress/egress and other environment variables. Terraform code or Helm charts are then automatically generated based on the static analysis of the code that has been reinforced using artificial intelligence (AI) learning techniques.

    That approach also makes it simpler for platform engineering teams to centrally manage the provisioning of IT infrastructure using a set of pre-defined policies that are automatically implemented each time an application is deployed to ensure security by default, he added.

    DevOps teams can also use appCD to visualize the deployment environment before and after an application is deployed, said Aggarwal.

    While infrastructure-as-code (IaC) tools have accelerated the rate at which cloud infrastructure can be provisioned, they are also often the root cause of the security issues that plague cloud computing environments. Developers often misconfigure cloud infrastructure by, for example, inadvertently leaving ports open. The appCD platform reduces the potential such mistakes will be made, noted Aggarwal.

    That capability also eliminates the need to attach cybersecurity specialists to a DevOps team because issues are automatically resolved by the guardrails enforced by appCD, he added.

    In theory, at least, there may soon come a day when AI routinely improves the quality of the code being used to both build and deploy applications. The more the code used to train a large language model (LLM) is vetted, the more reliable the output becomes. In the meantime, platforms such as appCD are combining static analysis with AI reinforcement learning to achieve that same goal in a use case that is specific to generating code to provision IT infrastructure.

    Each DevOps team will naturally need to determine the best path forward, but as regulations pertaining to securing software supply chains become more stringent, it’s only a matter of time before organizations will be required to embrace DevSecOps workflows. In the meantime, DevOps teams should assume that given the probability cloud infrastructure has been misconfigured, it’s all but certain there will be multiple cloud security incidents. In fact, cybercriminals are actively scanning for misconfigurations that they have already created playbooks to specifically exploit in a matter of minutes.

    In the absence of being able to prevent all those issues from arising, the immediate priority becomes remediating as many issues as possible before cybercriminals exploit those vulnerabilities. However, it’s also important to draw a proverbial line in the sand to ensure that all cloud infrastructure being provisioned in the future is much more secure than it has tended to be thus far.

  • Permiso Makes Open Source Tool to Identify Cloud Threats Available

    Permiso Makes Open Source Tool to Identify Cloud Threats Available

    Permiso today launched an open source tool dubbed CloudGrappler that surfaces indicators of compromise in cloud computing environments.

    Based on a cloudgrep project originally created by Cado Security, CloudGrappler detect patterns that Permiso, a provider of an identity threat detection and response platform, associated with tactics and techniques commonly used by various cybercriminal syndicates.

    The tool enables DevSecOps teams to define the data sources they want to scope in a scan of an Amazon Web Services (AWS) or Microsoft Azure cloud. Via a JSON file, DevSecOps teams can access a list of predefined tactics, techniques and procedures (TTPs) that are commonly used to exploit cloud computing environments. DevSecOps teams can also dynamically add queries or a file with multiple queries to scan a specific data set. After scanning, CloudGrappler delivers a JSON report that provides a breakdown of the scan results.

    Ian Ahl, senior vice president for P0 Labs, the research arm of Permiso, said that capability makes it possible for DevSecOps teams to identify issues in cloud computing environments that warrant further investigation before there is a major incident. The primary goal is to make it simpler for DevSecOps teams to determine if they need additional assistance to thwart a potential threat, he added.

    Cybercriminals are, like almost everyone else, creatures of habit and often tend to leverage the same TTPs multiple times simply because they know they’re effective. However, those TTPs also provide clues to their presence in an IT environment. Once discovered, a DevSecOps team can decide if they can remediate the issue themselves or need to tap external cloud security expertise, noted Ahl.

    In general, cloud computing environments may be more secure than most on-premises IT environments. However, the processes used to provision cloud computing environments are often flawed because developers typically don’t have much cybersecurity expertise. Misconfigurations are often rife across cloud computing environments.

    Cybercriminals are also especially adept at stealing credentials to gain initial access to cloud computing environments, which they leverage to escalate privileges in a way that provides them unfettered access to the entire cloud computing environment.

    Adoption of DevSecOps best practices has improved cloud security, but there are still plenty of instances where, for example, a port inadvertently left open has enabled cybercriminals to infest a cloud computing environment with malware that could lie dormant within cloud applications for months before finally being activated.

    There are simply not enough cybersecurity experts available to secure cloud computing environments, so it’s going to be largely up to DevOps teams to secure them. The issue is that in the race to build and deploy applications as quickly as possible, cloud security best practices are either forgotten or simply ignored. Of course, it’s that very carelessness that cybercriminals are counting on to allow them to wreak havoc in an era where the percentage of mission-critical applications running in cloud computing environments will only continue to increase exponentially.