Richard Hosking <[EMAIL PROTECTED]> wrote:
> 
> Might be a possible architecture for the "web services" NEHTA has in 
> mind
> It would mean that each provider did not have to maintain a web server. 

Yes, that's exactly what I was thinking.

> Still have the problem of keys etc.

You still need an effective PKI to enable it all.

>  I guess it is effectively E mail in 
> another format.

Yes, but one in which each message "attachment" can be up to 5GB in size. 

Tim C

> Tim Churches wrote:
> 
> >Tim Churches wrote:
> >  
> >
> >>Amazon S3 may be of interest to subscribers to this list, both 
> software
> >>developers and end-users.
> >>
> >>Here is the blurb from the S3 Web page at
> >>http://www.amazon.com/gp/browse.html/104-1570532-7764752?node=16427261
> >>    
> >>
> >...
> >  
> >
> >>Lots of things, but a few things spring immediately to mind.
> >>
> >>1) Off-site secondary storage of back-up files for practices or 
> clinics
> >>running their own EMR systems or other clinical applications on
> >>locally-hosted servers. The advantage of the simple API provided by S3
> >>is that the EMR/clinical application for a practice/clinic could
> >>automate the back-up-and-copy-to-S3 cycle, and could even automate
> >>periodic test retrievals and restores (to a separate test database or
> >>file system on the clinic's EMR server). I wouldn't trust the Amazon
> >>assurances of privacy for the data (as Amazon are still subject to US
> >>search warrants and court orders for example, as well as simple 
> security
> >>blunders - so any patient data would need to be strongly encrypted
> >>before sending it to S3 for off-site backup storage - but that should 
> be
> >>routine practice for any off-site back-ups of patient data on 
> removable
> >>or transportable media anyway). The cost structure for the S3 service
> >>would make such use very cheap, since the back-up data are sent once 
> and
> >>would be rarely accessed, so the bandwidth charges should be quite
> >>modest, and the per-month storage charges are very cheap. Cheap enough
> >>for even small clinics in developing and transitional countries to
> >>afford, assuming they have broadband Internet access to enable the
> >>upload of back-ups to S3 in the first place. Certainly cheap enough 
> for
> >>even small practices/clinics in rich countries - no more than $10-$20
> >>per month I would think, maybe much less.
> >>    
> >>
> >
> >I had a play with Amazon S3 over the weekend. Well, I tried to, because
> >it was down for about 22 hours from Sat evening to Sunday evening, 
> which
> > puts their claims of 99.99% uptime in doubt. However, it was only
> >launched two weeks ago so some teething problems might be expected. I
> >expect they will iron out the bugs and achieve their reliability
> >targets, eventually.
> >
> >Anyway, I did manage to store various bits of data and some files on 
> it,
> >and to get them back. Of primary interest is the transfer speed for
> >large files eg encrypted backups. I stored a 15MB encrypted file on S3
> >in 10 minutes. Retrieval took about the same length of time. according
> >to my online S3 account summary, I now owe Amazon US$0.01 - of course,
> >the longer I leave the file there on S3, the more I will be charged -
> >US$0.15 per GB per month for storage - but it is not going to send me 
> to
> >the poorhouse.
> >
> >The primary issue is the transfer speed. I am using Optus cable, which
> >uploads and downloads to local Web servers at over 500 kB (kilobytes,
> >not kilobits) per second - so at full speed, my 15MB upload should have
> >taken just 30 seconds. Thus, the rate-limiting step seems to be
> >elsewhere - perhaps the speed of the link to the US where the Amazon
> >servers are located, or perhaps Amazon is throttling upload and 
> download
> >speeds to and from S3 to preserve their bandwidth. Anyway, the point is
> >that 15MB in 10 minutes is probably what you can expect here in Oz,
> >regardless of what sort of Internet connection you have (as long as it
> >is not a dial-up modem).
> >
> >Is this fast enough to be useful for offsite encrypted back-up copies?
> >Well, its fast enough for our purposes, which is backup storage of
> >encrypted ad hoc public health outbreak data collections which are 
> often
> >collected "on the road". But for a 3 or 4GB practice backup? Let's see,
> >15MB in 10 minutes equates to 3GB in 50 hours.
> >
> >Hmmm, that effectively rules it out for offsite GP encrypted backup
> >copies. Pity. I'll continue to collect data points on transfer speed.
> >Perhaps the forthcoming Google Gdrive and the start-up OmniDrive online
> >data storage services, which are expected to be priced similarly but
> >which may have servers located in Australia, will be much faster.  
> We'll
> >see when they are available. I still think that Amazon S3 might be of
> >interest to radiology practices wishing to provide a cheap
> >store-and-forward facility to clients for their digitised image files,
> >which tend to be rather large and thus not well suited to SMTP-based
> >(email) transport - without either party needing to run 24x7 Web
> >services (Amazon S3 does that for you and both the sender and receiver
> >of an image file would just act as clients to it). It would also work
> >very nicely as a store-and-forward facility for interchange of HL7
> >messages - Amazon S3 would effectively be the unintelligent
> >data-store-and-retrieve middleman - but gee, they don't charge much - I
> >suspect that the bill for even a large path lab might only be a few 
> tens
> >of dollars per month. Some open source code to add the smarts and
> >encryption at the sending and receiving ends and you have the makings 
> of
> >a very cheap but potentially very robust secure health data exchange
> >service with an architecture rather similar to that offered by
> >Healthlink etc, but with negligible per-message costs. Add Google and
> >OmniDrive into the picture as alternative unintelligent
> >data-store-and-retrieve middlemen, which the client software could
> >automatically fall back to and you would really have something. There's
> >a business opportunity there for someone or some group to, um, make
> >almost no money at all, but to receive accolades heaped upon their 
> head(s).
> >
> >Tim C
> >
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> >
> >  
> >
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