Health Gateway: Improving access to health information across B.C. on OpenShift
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Learn how Health Gateway leveraged OpenShift to give people in B.C. access to health information from databases and repositories across the province.
About
Access to your health information and personal records is undergoing a transformation. Since 2019, British Columbians have been able to access their health information online when and where they need it through the Health Gateway service. The open-source online portal was built using Red Hat® OpenShift® on the B.C. Government Private Cloud PaaS. It brings together information from databases and repositories across the province into a self-serve system. The Health Gateway team has been focused on continuous improvement over the last 2 years, and is working to put even more health information into the hands of British Columbians.
Nino Samson is the product owner of B.C.’s Health Gateway, a portal for people who live in B.C. to access their health information online. Prior to its creation, getting access to personal health records could be difficult.
“Getting access to your health information in B.C. can be a fragmented experience. You might need to log on to several different portals with different clinics and organizations to get all the pieces you need.”
Nino’s team is responsible for developing and maintaining Health Gateway. They began the process to bring together information two years ago and released the first iteration of Health Gateway in 2019. Since then, people who live in B.C. have been able to securely log in and access their health information from anywhere in the world at any time using the B.C. Services Card mobile app.
How Health Gateway works
Health Gateway pulls together information from different systems across the province, including clinical repositories from health authorities, LifeLabs, pharmacy databases and immunization registries.
“Our focus has been on provincial repositories, and there are still more we can connect to.”
To date, over 1 million people in B.C have used Health Gateway to access their health information online.
In addition to the everyday health information people need, Health Gateway is a critical resource during the COVID-19 pandemic. In a short period of time, Nino’s team implemented a number of features to help people view their COVID test results and vaccine records. Nino’s team gave people access to their B.C. vaccine card and federal proof of vaccination. So far, 4 million users have accessed their COVID records through the service.
Improving healthcare in the private cloud
Nino’s team decided to build Health Gateway in the private cloud and explore the functionality the new enterprise hosting solution could offer.
“As a ministry, we were looking at ways we could deliver digital solutions differently. The top questions were ‘Can we deliver services in a more Agile way? And can we follow more modern software delivery practices?’ We were interested in seeing what kind of velocity (speed of deployment) we could achieve without having to manage our own servers and infrastructure.”
They considered adopting those practices in their existing traditional infrastructure, but saw the private cloud as an opportunity to work collaboratively across ministries.
“We also wanted to see if we could find a solution that could scale.”
Getting buy-in to work on OpenShift
For Nino’s team, the decision to work in the cloud was easy. Getting approved and resourced was not. Before joining the platform, Nino and his team engaged in over 2 years of discussions with the health sector at all levels to get buy-in for the project.
“There was a lot of back and forth, but the timing was right. We had revamped our strategy around digital health and our goals for citizen access to health information and supporting health sector care delivery.”
To gain knowledge and best practices for working in the private cloud, Nino’s team decided to start their cloud journey through the Exchange Lab. The Exchange Lab brings together Agile methodology and DevOps experts, as well as expertise and shared knowledge from other government teams.
“Community was a big part of why we wanted to have our team at the [Exchange] Lab. Instead of working in a ministry silo, we wanted to work across ministries. The more we work in silos, the more we’re duplicating work, when we could be sharing and reusing the same components.”
Building Health Gateway on OpenShift
Once Nino’s team got the green light to begin, they started working with the Platform Services and Exchange Lab teams, as well as other government product teams developing in OpenShift.
“As soon as we were given OpenShift access, we were up and running within a week or 2, and deployed our first ‘Hello World’ test application.”
To expedite their build, Nino’s team took advantage of the Exchange Lab’s unique environment to benefit from the shared knowledge of other teams.
“Many of the teams on OpenShift were using different setups, stacks and tooling, but there were components we were able to leverage so we didn’t have to start from nothing. We used some DevOps pipeline infrastructure and the database services shared by other teams to get started.”
Nino’s team began work on Health Gateway in July 2019, and released their first iteration in December of that year.
Keeping information secure
Keeping health data safe and secure is a top priority for the Health Gateway team. Their application undergoes regular privacy and security assessments to ensure that any changes to the application don’t put people who live in B.C. or their information at risk.
“Every feature that impacts the use, disclosure or collection of data has to go through a privacy impact assessment or security assessment,” says Nino. “These assessments are completed as iterations of the app are released, which occurs either weekly or bi-weekly.”
Regular assessments are a time-consuming task, but necessary.
“We’re trying to figure out ways to streamline that process, while maintaining the high levels of security and privacy the information requires.”
Results and future plans
Looking back, Nino considers Health Gateway and his ministry’s experiences with the private cloud a success.
“Working in the private cloud has allowed us to focus, adopting and deploying new features very quickly and pivoting as needed.”
His team plans to continue making improvements to Health Gateway by adding new features and incorporating new information and repositories.
“Health information is the focus. We want to give B.C. citizens access to as much health information as possible in one place.”
Part of that plan involves migrating their app from the Silver hosting tier to Gold, to implement additional DevOps best practices including high availability, and the ability to create geographic redundancy. The B.C. Government Private Cloud PaaS Silver tier has an uptime of 99.5%, but since its first release, Health Gateway has become a mission critical application and needs the 99.95% uptime offered in the Gold tier.
“As we add more and more features to Health Gateway, we are positioning ourselves as a critical system. It’s becoming imperative to be highly available and have disaster recovery.”
Looking ahead to the public cloud
As their app continues to grow, Nino’s team is looking at offerings in the B.C. Public Cloud that could meet their growing service and computer needs. The next iteration of the public cloud is a promising candidate.
“We’re thinking about the services we could spin up in the public cloud, like insights that could help with application monitoring and database services. There’s a lot we could do on the public cloud to manage our services.”
For now, Nino and his teams remain focused on the continuous improvement of their application in OpenShift.
“Our main goal is to help citizens be more engaged in their healthcare.”
By empowering people who live in B.C., Nino and his team hope they can help improve health services and outcomes across the province. Looking at their progress so far, they are well on their way to accomplishing their goal.
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