Cloud Computing in a World without Connectivity

The potential of cloud computing applications to significantly reduce costs and place more power in the hands of the users has grown steadily over the past six years. However, many organizations are struggling to take advantage of cloud computing applications when they have users in areas that are disconnected, or have intermittent and latent (DIL) connectivity. Unfortunately, most solutions for this involve complex, custom developed appliances that utilize caching and/or require a small infrastructure in the remote location. The significant cost and complexity negate many of the benefits these applications offer in well-connected environments.

This is a challenge we at Fusion PPT have seen repeated multiple times. In a recent press release, we announced a solution that solved this issue for one particular organization delivering mental health services in remote areas of Africa. This solution demonstrates that you can leverage cloud computing architecture even in DIL environments and provide technology platforms at incredibly low price points to make them accessible to large consumer populations.

In 2015, we began working with a Non-Governmental Organization (NGO) that was focused on delivering mental health services to rural villages in Uganda. Without available technology, clinicians relied on paper forms to collect data, paper files to review past data and then transcribed data into electronic systems when in a clinic or hospital. This was time-consuming, prone to data-entry errors and clinicians lacked immediate patient history while on-site.

Our challenge was to create a cost-effective solution that allows clinicians to utilize a handheld tablet to deliver care in the field, including the collection of data and querying of patient history records. Given the lack of information technology infrastructure, we decided to leverage a cloud-computing infrastructure and solve the problem of the user in the DIL environment.

We started with a 7-inch, commercial Android-based tablet based on its low price-point and global availability. We ruggedized the tablet, encasing it in low-cost foam to protect it from environmental harm and utilized the native Android encryption and remote wipe feature to protect against loss or theft.

While part of our strategy was to leverage open source tools for data collection when not connected and then synchronize to a cloud environment once connected, we couldn’t find any tools that would also download a cached version of the cloud data – a critical piece to enabling the creation of data, searching data and modifying data without Internet connectivity. So, we developed an Android application that provides this capability and leverages the data collection from the Open Data Kit. We developed a custom XML form for the data collection and an off-line records platform to store the data.

For the server in the cloud, we utilized Amazon Web Services (AWS) European Region located in Dublin Ireland with failover to the U.S. Eastern region. This architecture provides for 100 percent uptime and reliability for the server component of the solution. When the tablets are connected, they synchronize changes and download the data from the cloud. An SSL certificate was installed on the server so that to encrypt the information in transit.

With this solution – leveraging cloud technology -clinicians have the ability to look up and record patient information in a secure platform that does not interfere with the clinician-patient interaction.

Later this week, I’m excited to present this Fusion PPT solution at the Clinton Global Initiative (CGI) Winter Meeting, during the breakout session: “From Telemedicine to Wearables: The Impact of Technological Innovations on Global Health.” This speaks volumes to the potential for this solution to be leveraged by other organizations with similar cloud computing needs and DIL challenges.