Flatiron Health

Several years ago, Flatiron Health cofounders Nat Turner and Zach Weinberg watched helplessly as some of their family members and friends battled cancer. Although they were inspired by their courage in fighting the disease, they were also frustrated. “We realized there was no easy solution to ensure that researchers and doctors were collaborating by learning from every patient’s experience with cancer,” says Weinberg. “A lot of the data was siloed and difficult to access.”

Motivated to make a difference, Weinberg and Turner founded Flatiron Health in New York City in 2012. The company offers a software platform that seeks to connect cancer centers across the United States so they can share what they have learned. “Our tagline is: ‘Fighting cancer with organized data.’ We want to organize real-world cancer data and derive the right insights from these data sets to inform cancer research,” says Dan Eisenberg, the company’s senior staff software engineering manager.

Flatiron works with more than 265 oncology practices, three large academic research institutions, and other healthcare organizations, which use the company’s software to manage their daily workflows in one central system. The cloud-based system currently analyzes more than 1.6 million cancer patients.

As the company grew, however, it kept running into limitations on its legacy cloud platform. Due to a lack of good automation tools and APIs, Flatiron software developers couldn’t innovate as quickly as they needed to. “As a startup, we want to get our solutions to market as fast as possible, and we also want to update our existing solutions quickly,” Eisenberg says. For instance, getting software to market faster is important for the Flatiron research division, which works with pharmaceutical and other life sciences companies. “The average time to get a new drug to market is 10 years,” says Eisenberg. “If we can more quickly enable researchers to make smarter decisions with good data, they could potentially bring drugs to market faster.”

Flatiron began exploring new cloud technologies to meet its needs, with security and compliance as the primary criteria. “Our applications collect and store a lot of sensitive patient information, and that’s our number one priority—ensuring we’re in compliance with HIPAA and other healthcare regulations,” Eisenberg says.

The Right Cloud Platform for Growth and Compliance

The company chose to move its analytical applications and data-processing backbone—including the OncoCloudTM software suite—to the Amazon Web Services (AWS) Cloud. “We decided AWS was the best cloud provider for our needs, because it offered the best selection of features and would help us scale quickly,” Eisenberg says.

Most importantly, AWS met the organization’s strict compliance requirements by providing features including data encryption and tracking, and detailed security. Flatiron runs its application environment in an Amazon Virtual Private Cloud (Amazon VPC) and uses VPN connections for secure connectivity to outside networks. The company also utilizes AWS Identity and Access Management (AWS IAM) to enable fine-grained security controls, so Flatiron engineers can develop without having full administrative control. Flatiron also relies on services such as AWS Trusted Advisor and Amazon CloudWatch for additional auditing and security capabilities.

The company runs its applications on Amazon Elastic Compute Cloud (Amazon EC2) instances and uses Amazon Simple Storage Service (Amazon S3) buckets to store more than a petabyte of oncology data and other protected health information.

Ensuring the Quality and Security of Cancer Data

Using AWS, Flatiron can better organize cancer data and consequently empower care providers in their treatment of cancer patients. Many of the important data points in the patients’ medical records are embedded deep in “unstructured documents” such as doctors’ notes, radiology reports, or lab results. Across the United States, Flatiron has hired a team of more than 500 abstractors (nurses, certified tumor registrars, and clinical research associates with at least five years of experience) who go through the unstructured documents and enter them into a proprietary portal as structured fields, so researchers can perform queries and analysis on large cohorts. Eisenberg says, “We are analyzing and enriching patient data every day, and that’s giving us more organized and high-quality data—not just big data.”

By making data more organized and accurate, Flatiron hopes to make headway in the fight against cancer. “By running our applications on AWS and enabling more collaboration and communication between different organizations, we’re providing high-quality cancer data for research and analysis in the life sciences field,” says Eisenberg.

Flatiron is also meeting its main priority—ensuring HIPAA compliance—by running its applications on the AWS Cloud. “We can’t succeed in this industry without protecting the data we collect and store, and that’s a big part of what we get by using AWS,” Eisenberg says. “We gain auditability and security, as well as solutions architects who are also experts in deploying HIPAA-compliant applications for healthcare and life sciences. Their guidance has been a huge benefit.”

Accelerating the Fight Against Cancer

Because of the agility of the AWS Cloud, Flatiron development teams can more quickly iterate on the company’s software. “By having our applications on AWS, we can instantly provision compute resources whenever we need them, and that means our developers can move faster,” says Eisenberg. “Also, we are using AWS to experiment on new software, because it’s simple and fast for us to set up a dev environment and shut it down if we’re not satisfied with what was created.”

In the end, by placing its data collection and research applications in the cloud, Flatiron can focus entirely on what is most important to it as a company. “Using AWS, we have more time to concentrate on developing better software for our oncology practices, and get organized oncology data to researchers more quickly,” says Eisenberg. “By doing this, we are able to accelerate the fight against cancer.”