Granular Performance Metrics While Protecting Sensitive Data Records For Over Five Million Patients

“Our product helps the National Health Services’ Improving Access to Psychological Therapy services” explained Chris Eldridge, Director of Operations at Mayden. The company’s main product, iaptus, is the leading digital care record system for primary care mental health services in the United Kingdom.

iaptus enables mental health providers to keep track of patient histories, including when they were referred for treatment, the treatment they receive and how they respond to it. On a broader level, it helps providers see how effective the treatments are and where additional resources are needed to get patients access to treatment as quickly as possible.

“Services rely on iaptus to manage and track patient referrals, waiting times and outcomes, as well as to monitor their performance against KPIs such as waiting time targets and to submit the required data for reporting,” explains Chris Eldridge. Mayden’s data services team monitors the system’s performance day and night, and when incidents do occur, they need to quickly understand exactly what is going wrong. Mayden works proactively on improving the application’s reliability by integrating more performance monitoring throughout the development process. That’s especially important because…

…while many healthcare IT providers update software once every three to six months, iaptus is updated as frequently as four times per week.

The Cloud Journey

iaptus has been a web-based solution since 2008 (the same year as Airbnb and Spotify, and 2 years before Instagram). Mayden started its journey to a private cloud in 2018, and as a result of the move, the team has made substantial changes to the system’s architecture as well as to the solutions it relies on.

Previously, their performance monitoring solution did a good job of looking at the underlying hardware infrastructure, memory, CPU and disk usage, for example. But Mayden needed increased visibility into how the software itself was performing. Mayden wanted that information to be accessible throughout the development process, so they could ensure the software stayed secure, reliable and efficient throughout the frequent release cycles.

“We were looking for something that would help us understand, at very high resolution, the performance of our solution,” Eldridge said. “We wanted to be able to see, on a second by second basis, the peaks and troughs that can exist for a variety of reasons.” Minute by minute sampling of key information was not good enough, Eldridge stressed.

Instana was the only solution that gave the granularity and precision Mayden needed.

There was a second very important criteria: data privacy. “We are trusted with a large quantity of very sensitive mental health data,” Eldridge said. Mayden wanted a cloud-based monitoring solution deliberately external to their infrastructure. This required detailed control of the data that the logging system monitored.

Ease of use was also an important factor. Eldridge said that the team tried out a couple of vendors such as New Relic before settling on Instana, and some of them provided an enormous amount of data — but analysing that data presented its own challenge. “We were particularly interested in the AI technology built into Instana that helps us better interpret the information and guide us to the areas that were most likely to be of interest.”

Working with Instana

“Providing outstanding customer service is really important to us,” Eldridge said. “We expect the same level of service from our suppliers. When we first started working with Instana we were really encouraged by the level of support we got.”

At the beginning of the install process, Mayden had to ensure that no patient data would be collected and sent to the monitoring system inadvertently. Other providers made Mayden feel less important than Instana did. “We got some really important support from Instana,” Eldridge said. “Not just the help desk, but phone calls and Slack conversations. with Instana’s technical team, which we just weren’t seeing with other providers. As a result,

…Mayden could feel confident that Instana has a strong technical support team who worked with us closely and understood our requirements.”

Understanding Our App

“As iaptus has grown, we’ve changed the architecture and it’s become a complex piece of software,” Eldridge said. “Instana visually displays the network back to you,” Eldridge said. “I think everyone was very pleasantly surprised to see that…

…with just a couple of clicks Instana has this picture of the physical and logical environment it was running on, without any input from the systems team or developers.”

The Rollout

Once the team understood how Instana would work with Mayden’s architecture and infrastructure, the installation process was quick. “We were expecting it to take a good few weeks to get any data out of it,” Eldridge said. “In reality, we were able to show data and usage information within days.”

The protected environment also means that getting software updates can be a challenge. “Once we understood the process for rolling out into new clusters as our cloud hosting scales,

…it has been, and continues to be a really easy process.” – Eldridge said.

Going Forward

“We’ve been able to uncover much more about how our software performs in certain scenarios, and which bits of the software need to be looked at again,” Eldridge said. “Our teams are able to access it whenever they need it, so if any problems arise they can query the area that might need investigation.”

Nonetheless, Mayden is still at the beginning of a journey with Instana. The plan for the next six to twelve months, he said, is to expand both use of Instana as well as team members’ skills around application performance monitoring in general. The goal is to integrate performance monitoring throughout the development process and work on continually increasing the application’s reliability.