Summary

Chikitsa.io is a state-of-the-art cloud-based Health Information ManagementSystem (HIMS) that transforms hospital operations with an integrated ElectronicMedical Record (EMR) and Electronic Health Record (EHR) solution. Itsinnovative e- prescription modules offer flexibility through digital entry,handwritten recognition, and voice command, allowing healthcare providers todigitize prescriptions without altering their current workflows. These featuresenable a smooth transition to digitalization while preserving the familiarityof traditional practices.

Chikitsa.io provides hospitals with real-time data to identifyinefficiencies and optimize resource utilization, leading to faster wait timesand improved patient care. Additionally, the mobile app helps patients manage appointments, access test results, and stay connected with theirhealthcare providers. Fully compliant with Ayushman Bharat Health Account (ABHA) standards, Chikitsa.io ensures secure datamanagement and facilitates seamless insurance claims through the Health Claim Exchange (HCX) platform. This innovative system, leveraging IoT, AI, ML, andBlockchain, is revolutionizing hospital operations and improving patient experiences.

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Challenges:

Despite successfully deployment of their infrastructureon AWS using basic services, the core development team at Chikitsawas encountering several critical challenges in maintaining AWS best practices andensuring the scalability and efficiency of their setup. The increasing demand on their infrastructure has exposed several areas of concern that requireimmediate attention.

• Cost Optimization: Chikitsa’s inhouse team is unsure whether their AWS resources arebeing utilized efficiently, leading to potential cost overruns.
• Scalability: As demand grows, the infrastructure—especially their Kubernetes(K8s) clusters—fails to scale effectively to handle the increased workload.
• Uptime Monitoring: There is a lack of robust monitoring solutions to ensure high availability and quick issue detection across their AWS infrastructure.
• Logging and Observability: Logging mechanisms were insufficient, making itdifficult to gain insight into the performance and health of their AWS services and Kubernetes clusters.
• Lack of AWS Managed Service Support: Chikitsa lacked dedicated support for maintaining and optimizing cloud infrastructure, the team needed expertassistance to optimize their AWS infrastructure, improve scalability, ensure 24/7 monitoring

Chikitsa’s Transformation Journey: Conquering Cloud Challenges

Chikitsa’s team entrusted Velocis Systems with addressing their challenges, leveraging ourextensive expertise as an AWS Advanced Consulting Partner. At VelocisSystems, “we are deeply committed to our clients' success and take immensepride in our ability to deliver innovative solutions that drive businessgrowth”.

After conducting a thorough assessment of Chikitsa'sinfrastructure, Velocis identified several critical business objectives:increasing release frequency, reducing time to market, ensuring zero downtime,optimizing the EKS node group based on application workloads, implementingseamless rollback capabilities in case of failures, optimizing costs, enhancingperformance monitoring, and strengthening security measures.

In response to these challenges, Velocis Systems proposeda holistic solutionfocused on re- architecting Chikitsa’sinfrastructure using a robust AWS technology stack. Below are some of therecommended tools and AWS services:‍

• Microservices Architecture: The backend was re-architected using Amazon EKS (Elastic Kubernetes Service) todeploy containerized Node.js services. EKS’s auto- scaling capabilities ensure efficient resource management,dynamically adjusting to fluctuatingworkloads while maintaining consistent performance. The backend services areexposed using AmazonElastic Load Balancer (ELB), managed by the AWS ALB Controller, androuted via AmazonRoute 53 to provide highly available, secure API endpoints. Thisarchitecture handles key aspects like authentication, authorization, andrequest processing.
• Amazon EC2 (Elastic Compute Cloud) was utilized in conjunction with an Auto Scaling Group (ASG) todynamically adjust the number of EC2 instances based on traffic demands. Theapplication traffic was efficiently routed and balanced using AWS ApplicationLoad Balancer (ALB), ensuring high availability and fault tolerance.
• Serverless Execution for Background Tasks:To optimize backendperformance andcost-efficiency, AWS Lambda was utilized for executing event-drivenbackground tasks, reducing the need for manual infrastructure management whileensuring scalability.
• CI/CDPipeline Automation: AWS CodePipeline was implemented for end-to-end CI/CD automation, facilitatingseamless deployment from code commit to production for both frontend andbackend. By leveraging AWS native tools like CodePipeline, CodeBuild,and CodeDeploy,the automated pipeline to ensure a streamlined build, test, and deploymentprocess, allowing for faster release cycles and reduced time to market.
• Security: The infrastructure’s securitywas enhanced using AWS Security Groups and Network ACLs (Access Control Lists),which follow best practices for protectingthe environment from vulnerabilities. Amazon Route 53 was employed for domain andDNS management, ensuring reliable traffic routing, while SSL/TLS certificatesfrom AWS Certificate Manager (ACM) secure the connection between users andbackend services.
• Monitoring and Logging: Comprehensive monitoring is achieved using AmazonCloudWatch, Amazon CloudTrail, Prometheus, Grafana, and Loki for real-time visibility into the performance of AWS infrastructure and Kubernetes clusters. This combination of monitoring toolsoffered real-time insights and proactive issue detection, improving overallsystem reliability

Production Architecture Diagram(HLD)

Solution Description

The re-architected solution for Chikitsa utilizes Amazon EKS to deploy containerized Node.jsbackend services, allowing for dynamic auto-scaling to efficiently managefluctuating workloads. The frontend, built with React.js and Material-UI, isseamlessly integrated with backend services via Amazon Elastic Load Balancer(ELB) and routed through Amazon Route

53for secure, scalable API exposure. Both theKubernetes clusters and databases are configured within private subnets,with a NAT Gatewayin the public subnet providinginternet access to private subnet resources. The entire infrastructureis deployed in the Mumbai region, ensuring optimal performance.

The application was containerized using Docker and orchestrated on Amazon EKS for efficient scaling and management. Tooptimize resource allocation, Kubernetes node groups were established, whileAWS services such as VPC, ALB, and ASG provided secure networking,fault tolerance, and autoscaling based on traffic demands.

AWSLambda is used for event-driven background taskexecution, offering a serverless architecture that minimizes infrastructuremanagement. Developers commit code toGitHub, triggering a CI/CD pipelinethat automates deployment onto the EKS cluster hosted on EC2 instances. Critical data,artifacts, and Docker images are stored securely in Amazon S3 and Amazon ECR.

Security and access control are managed using AWS Identityand Access Management (IAM) and AWS Systems Manager (SSM), ensuring onlyauthorized users have access to AWS resources. Additionally, comprehensivemonitoring and logging are enabled through a combination of AWS CloudWatch,AmazonCloudTrail, and Amazon SNS for alerting, alongside third-partytools like Prometheus, Grafana, Loki, and Alert Manager.This robust monitoring setup offers real-time insights, proactive issue detection, and efficient system health management, allowing for quick responsesto critical events and streamlined communication during troubleshooting.

Results and Benefits

Velocis takes great pride in serving as the trusted cloud managed servicesprovider for Chikitsa.io, and our collaborative partnership has led tosignificant advancements in their application and public cloud environment. TheAWS Cloud architecture solution delivered for the challenges has not onlyhelped Chikitsa.io to overcomeshared challenges but has also contributed to their business growth infollowing areas -

• Enhanced uptime and reliability, with nearly 100% availability, ensuring thatthe platform can handle increased traffic seamlessly,improving user trust and satisfaction.
• Scalability and resource optimization through EKS auto-scaling, allowing Chikitsa to dynamically adjust resources based on demand, reducingoperational overhead while maintaining peak performance.
• Faster innovation and time-to-market, with a 70% reduction in deployment times due to the automated CI/CD pipeline, enabling Chikitsa to roll outnew features and updates rapidly and with minimal risk.
• Improved security posture, thanks to comprehensive AWS security measuressuch as Security Groups, Network ACLs, andadherence to best practices, ensuring the infrastructure is protected fromthreats while maintaining data integrity and privacy.
• Cost optimization, achieved through serverless components like AWS Lambdaand efficient resource management on EKS, significantlylowering infrastructure costs while supporting business growth