Southern Dental Selects eCloud…for the impossible!

Written by Eric Sanders

December 7, 2018

Executive Summary
Southern Dental Alliance operates over 35+ locations across the southeast under five main practice identities. With a vision to be the best dental supppor organization in the southeast, while also facilitating excellent care for all people.  Southern Dental Alliance creates ongoing partnerships that help dental practices grow by leveraging unique resources and extensive experience to optimize daily operations, enabling dentists and dental professionals to focus on providing excellent care to their patients.

“We set off to do something that nobody has done in the dental industry, which was to build a data warehouse from onsite databases, hosted and SaaS specific dental applications.  We spoke with several AWS Premier Partners and felt that they didn’t understand our requirements and lacked confidence in them being able to pull this off.  We were introduced to eCloud by AWS and felt comfortable right away that they understood our goals and objectives, and their engineering expertise was exceptional.  eCloud developed and pulled in the right partners for our solution, and we pulled something off that nobody has done before.  We couldn’t have done it without them.  We look forward to continuing to work with eCloud on the impossible.”  Phil Socoloff

The Challenge
Southern Dental Alliance had been experiencing challenges in reporting across its 35+ dental offices across the southeast, its SaaS and hosted based applications. Each office has its own server, database, on premise applications and an internet connection to SaaS and hosted based solutions. With data in multiple places, different formats and versions, multiple providers, limited API integrations available, being able to build meaningful reports with a full picture of their patients and payers felt impossible.  This is a common problem which hasn’t been solved in the dental industry.  The second challenge was how do we do this, and with which public cloud provider where this can be easier done with the necessary compliance needed for the dental vertical…AWS or Azure?

High level requirements:

  • Get all this in one place and build a data lake cost effectively
  • Develop and maintain a cost effective data warehouse
  • Develop and maintain a HIPAA compliant environment
  • Ability to display the data and publish scheduled and adhoc reports
  • Increase Scalability and Elasticity of services
  • Fully managed platform
  • Increase Recoverability – Disaster Recovery based solution

Microsoft applications, such as Active Directory, SQL Server, DNS, Dentrix, EagleSoft, Certificate Services and VPN needed to be integrated with AWS.  A total of 35+ on premises sites needed VPN tunnels to AWS.  A SSL VPN solution was needed for employees and customer to connect remotely over the Internet.

The eCloud Solution
Southern Dental Alliance chose eCloud Managed Solutions based on our Advanced Tier Partner status with AWS and our extensive experience performing Microsoft Workload & Application migrations away from legacy infrastructure. We began with a detailed analysis of the client’s requirements, then we began planning the architecture design, automation implementation, while selecting that the deployment would be in AWS, which need to include data migration using real-time file sync and real-time database replication.  We then had to define which ETL (extract, transform, load) would work best and we chose Diyotta due to the out of the box connectors, pricing, speed of building new connectors and flexibility to work with. From there we needed to define what would be the best and most cost effective data warehouse solution, which we chose Snowflake due to their serverless consumption model, scalability and functionality out of the box.

AWS services implemented were; CloudFormation, Amazon Machine Images (AMI),  CloudWatch, CloudTrail, GuardDuty, AWS Config, Identity & Access Management (IAM), Virtual Private Cloud (VPC), Simple Storage Service (S3), Elastic Compute Cloud (EC2), Multi-AZ MySQL RDS, VPN Gateway, AWS Key Management Service (KMS), AWS Shield, Directory Service, Route53, and AWS Certificate Manager.

Implemented Single-sign-on federation between AWS and Active Directory.

Built a hybrid cloud network to connect their 25 on premises sites to AWS, while maintaining encryption and network redundancy.  We implemented an OpenVPN SSL Solution for remote users and customers to connect security and efficieitly to AWS.

Infrastructure Design
Throughout the infrastructure design and implementation, we leveraged PCI compliant AWS services for enhanced security. An important goal of the new architecture was to provide improved scaling for future growth, along with the necessary redundancy to ensure smooth operations.

Instances were deployed in multiple AWS Availability Zones (AZ) to further the goal of constant uptime and redundancy. AWS allows for application resources, such as instances and relevant data, to be placed in multiple AZs. This ensures that if Amazon experiences a failure in one data center, The Caton Companies’ applications will still function.

Because the new infrastructure run on multiple AZs, Amazon RDS for MySQL was incorporated to help ensure that the underlying database could scale to the demands of the application. We implemented Amazon RDS to automatically maintain synchronous copies of the database in each of the AZs in use.

The implementation of VPC VPN Gateways were used to connect 25 on premisie sites to AWS.  This also provided a much more robust path to disaster recovery, as there were multiple network routes to AWS.  In addition, implementing Single Sign On federation between AWS and Active Directory.

AWS Deployment Diagram:

CloudFormation was used to provide developers and admins with an easy way to create, deploy and manage AWS resources. Using stack templates (Master, VPC, Application Level, Database), CloudFormation manages the various dependencies or runtime parameters an application needs to function properly.

AMIs, in turn, contain the information needed to launch an instance or virtual instance on AWS. The instance can include an operating system, application server and the applications to run, along with the various permissions that control access to the applications.

Implementation and Migration
To ensure the smoothest transition possible, eCloud Managed Solutions used a three-step process for implementation.

  1. Application, OS and data migration occurred once the applications were identified, grouped, and prioritized. This involved a thorough application dependency mapping, collaboration with the customer to prioritize each application group and develop AWS target environment.
  2. eCloud provides the toolset and migration expertise to “clone” the customer’s application move group, deploy in AWS target environment and capture differential data prior to final cutover.
  3. The production cutover to the new environment was performed once all applications and data was verified by customer, while the existing system was temporarily left in place while testing and DNS re-routing occurred to AWS and network settings finalized.

The Benefits
Southern Dental Alliance was able to mature their infrastructure capabilities, reduced IT management overhead, and implemented a controlled/automated method for consolidating data from many data sources.  This allows for reporting across multiple practices, see similiarities in business, cross-sell/up-sell opportunities to allow for increased profitability, reduce the effort for healthcare returns, and streamline operations related to running each practice.

All single points of failure have been replaced with HA systems or mitigated with automatic failover configurations. The new environment is elastic, cost effective, highly scalable, and infrastructure automation drives quality and repeatability of reporting for each practice. Southern Dental Alliance chose to leverage managed services, which drastically reduced IT overhead and maintenance costs. Ultimately, their new architecture created a reporting platform that hasn’t been achieved in the dental industry.

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