Amazon S3 is not strictly open source software but may be of interest to
open source 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

<quote>
########################################
Amazon S3 is storage for the Internet. It is designed to make web-scale
computing easier for developers.

Amazon S3 provides a simple web services interface that can be used to
store and retrieve any amount of data, at any time, from anywhere on the
web. It gives any developer access to the same highly scalable,
reliable, fast, inexpensive data storage infrastructure that Amazon uses
to run its own global network of web sites. The service aims to maximize
benefits of scale and to pass those benefits on to developers.

Amazon S3 Functionality
Amazon S3 is intentionally built with a minimal feature set.
    * Write, read, and delete objects containing from 1 byte to 5
gigabytes of data each. The number of objects you can store is unlimited.
    * Each object is stored and retrieved via a unique,
developer-assigned key.
    * Authentication mechanisms are provided to ensure that data is kept
secure from unauthorized access. Objects can be made private or public,
and rights can be granted to specific users.
    * Uses standards-based REST and SOAP interfaces designed to work
with any Internet-development toolkit.
    * Built to be flexible so that protocol or functional layers can
easily be added.  Default download protocol is HTTP.  A BitTorrentâ„¢
protocol interface is provided to lower costs for high-scale
distribution.  Additional interfaces will be added in the future.

Pricing
    * Pay only for what you use. There is no minimum fee, and no
start-up cost.
    * $0.15 per GB-Month of storage used.
    * $0.20 per GB of data transferred.
########################################
</quote>

Amazon provide API libraries or sample code for S3 in most of the
popular programming languages (including C#, Java, Ruby and Python) and
a search of the blogosphere on Google will reveal a lot of activity to
build all sorts of better and more elaborate interfaces to it.

I suspect that Google will follow suit, as they, like Amazon,  already
have the required infrastructure to host this sort of thing, and their
Gmail service is already being used by many as an unofficial Internet
file store (see, for example,
http://richard.jones.name/google-hacks/gmail-filesystem/gmail-filesystem.html

So what could S3 be used for?

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.

2) As a store-and-forward facility for the exchange of lab results or
other health messages (in encrypted form, of course). By using strong
encryption for the data being stored-and-forwarded, the fact that the
"secret" access key for an S3 account would need to be shared between
multiple parties is not an impediment. Billing for the usage of S3 for
such shared data interchange might be an issue, but I think that the S3
billing records are in machine-readable format, so some additional
mechanism for apportioning costs could be built - if the costs warranted
that.

3) As the basis of a shared EHR. As someone commented on a blog
somewhere, what S3 offers is a huge, distributed hashed storage system.
This makes it rather suitable as an object store, particularly good for
things like openEHR data. The really interesting thing is that because
there is no up-front capital cost involved, it means that that
individuals or families could have their *own* EHR stored, in encrypted
form, on S3, and accessible from anywhere with Internet access
(attention: Philippe Ameline). Now, S3 only provides unintelligent, but
cheap and hopefully very reliable, storage, so an EHR application is
still needed, but there are many possible approaches to that - ideally
open source approaches. Here's an idea: start with TiddlyWiki (see
http://www.tiddlywiki.com/ although their Web server seems to be down as
I write this), which is a way-cool non-linear wiki which is written
entirely in Javascript and runs entirely in the user's browser. It
supports facilities for "microformats", which are ways of imposing some
structure on what is stored in each information "snippet". Add some
microformats, some encryption (open source Javascript libraries for this
are available) and an interface to S3 and you have the basis of a
simple, portable individual EHR. The "application" is just the
TiddlyWiki files, which can be carried on a memory stick and used
wherever a Web browser is available. The actual data would all be stored
on S3. There are lots of possible variations on this theme (like
substituting openEHR archetypes for XML microfomats...).

Any other ideas for S3? I am about to take a shower, so it is likely
that a few more will occur to me in the next few minutes... (oh my water
and electricity bills...)

Tim C


 
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