Since starting in Taiwan, Bionime’s subsidiaries have now spread to Europe, the Americas, Asia, and Africa, and the distribution network has expanded to more than 100 countries worldwide. Bionime has successfully established the “Rightest Precision Health Care Circle” under the brand name “RIGHTEST” to provide accurate blood glucose measurement and personal blood glucose management services, expanding on the possibilities in traditional blood glucose management.

Bionime is committed to developing blood glucose management systems, starting with personal home blood glucose meters and establishing an IOT software department to develop POCT connected blood glucose monitoring systems for use in medical centers, and linking to hospital information systems to integrate blood glucose meters from various hospitals, improving healthcare efficiency. In the past, after a patient’s blood glucose was measured, results had to be transcribed on paper and entered into the medical record system by the medical staff. This process is riddled with the chance of errors occurring, including the patient mistakenly transcribing the data displayed on the machine, or the medical staff making mistakes when entering the patient’s blood glucose data into the system.

Digital blood glucose management reduces human errors

The in-hospital digital glucose management system not only integrates with the hospital’s internal IT system but also provides staff with the ability to confirm the identity of patients by scanning the information displayed on the hospital’s patient bracelet. The system can be customized to meet the requirements of each hospital.

With the expansion of the market, Bionime began to provide personalized products that allow patients to measure blood glucose at home and record it digitally. Later, they also moved the original in-hospital blood glucose system used by medical centers to the cloud and modified it into a blood glucose management system suitable for primary care units, such as clinics, health education centers, and long-term care centers.

Starting in 2017, Bionime started to move to the cloud. Due to the development of the new Bluetooth-enabled blood glucose meter products, using cloud services became a necessity. A Bluetooth-enabled blood glucose meter uploads blood glucose results to the cloud through mobile devices and apps to help users digitally manage their blood glucose. This not only improves the ease of data sharing but also reduces errors that may occur when transcribing data.

Bionime has also modified the original in-hospital closed blood glucose system into a cloud-based version. The connected blood glucose meter can upload the blood glucose values taken by patients in the clinic to the blood glucose management web service in a structured and systematic way for healthcare professionals to manage patient blood glucose more easily. Bionime has obtained ISO 27001, ISO 27701, and HIPPA Compliance certifications to properly integrate user information into the hospital system and provide accurate paperless blood glucose management methods through professional analysis to increase the quality of healthcare.

Bionime now relies on cloud-based products, including Rightest CARE (a personal app) and Rightest Diabetes Management System, which includes a professional blood glucose management app, a connected professional blood glucose meter, a professional blood glucose management web service, and an internal management backend.

By packaging legacy programs into containers for quick access to the cloud, Bionime initially deployed the server-side programs of the hospital system directly to the Amazon Elastic Cloud Computing (Amazon EC2) service to achieve rapid cloud deployment.

Bionime has set up subsidiaries in various continents, using AWS services in Singapore, Tokyo, Ningxia, China, and Frankfurt. Currently, the main markets are Taiwan, China, Malaysia, and the United States. Chi-Lung Yeh stated that because of the container deployment method, Bionime can easily expand its services in various countries, such as the system now operating in Malaysia. The Malaysia system is only slightly modified from Taiwan’s system and directly transplanted over.

However, the process of moving to the cloud was not entirely smooth for Bionime. They learned as they went along, improving the existing system while laying the technical foundation for developing the next generation of products. Chih-Lung Yeh mentioned that the initial system architecture in the hospital was not designed for the cloud, so even though they could quickly move the system to the cloud, the scalability was still limited.

Deconstructing the application to enhance the flexibility of expansion

The original system is based on the improvement of the in-hospital blood glucose management systems for medical centers. Relying only on a single database, even if the system is on the cloud, applications running on Amazon EC2 can be expanded horizontally at a large scale, but eventually still must access the same RDS database to execute. When the traffic suddenly soars the database can be overloaded and may render the overall platform service abnormal. Therefore, the overall service scale is still limited.

Chi-Lung Yeh stated that because of the high cost of modifying the architecture of the old program, at present they are choosing to maintain a single large RDS database executable to cope with peak data connection demand. But traffic is not always at its peak, so Bionime began to try various methods of reducing unnecessary waste of resources, including modifying the architecture to spread the burden of the database executable as much as possible.

In addition, they also began testing the new AWS serverless database service under Amazon RDS called Amazon Aurora  Serverless, a database service that can be automatically started, shut down, expanded, and scaled down according to application needs. 

In the new product, Bionime adopted a modern application design approach, starting with the application architecture, to solve the problem completely, and Mr. Ye mentioned that in the new product, they dismantled the original monolithic application and microserviced the application, making the application architecture truly scalable and flexible.

Solving EC2 deployment pains with AWS Elastic Beanstalk

Another difficulty that Bionime encountered in using cloud services is the complexity of application deployment. The overall deployment process is very troublesome and error-prone.

By using AWS Elastic Beanstalk, an AWS application deployment service, they have completely solved their EC2 deployment pain points. Elastic Beanstalk can automatically handle all the deployment tasks, including capacity deployment, load balancing, scaling, and application status monitoring, effectively reducing the workload of the administrators. In addition, they are gradually switching to AWS-hosted Kubernetes service called Amazon EKS, with Blue-Green deployment and Canary Deployment, to avoid the impact on the service caused by advanced and receding versions.

In terms of the monitoring system, Bionime not only uses AWS monitoring service CloudWatch to monitor important metrics of the system in real-time but also deploys Prometheus and Grafana on EKS to monitor more detailed metrics such as HTTP status codes, machine CPU capacity, network traffic, etc., to fully grasp the status of the platform services.

Video link: https://www.youtube.com/watch?v=-Zqo1jotmDQ

These experiences in using cloud systems help Bionime to build the cloud service of their next-generation product – a Continuous Glucose Monitor (CGM), which requires a subcutaneous biosensor to be installed on the patient’s skin. The amount of information generated by the continuous blood glucose monitor is completely different from that of the traditional blood glucose meter. As Bionime has accumulated experience in cloud development, it has designed a cloud architecture that can support thousands of times the previous amount of data, which will take diabetes self-monitoring to the next level.

Zhilong Ye mentioned that they considered very many factors when they chose to put all the systems on the AWS cloud at the beginning. When they started to move the systems to the cloud in 2017, AWS was the most mature service available, with lots of resources on the network, and it was easy to find answers to problems. There were many kinds of services provided and the speed of service improvement and optimization was also fast. Newly introduced services can also effectively solve their problem areas, such as the potential of the RDS Serverless to solve service scaling problems and Elastic Beanstalk can save the trouble of application deployment.

This article was originally published in Chinese on aws.amazon.com

Media Contact
Company Name: Bionime
Contact Person: Andy
Email: Send Email
Phone: 886 4 2369 2388
Country: Taiwan
Website: https://www.bionime.com/