Guidance for Simplifying Virtual Appointments using Salesforce Health Cloud on AWS

Overview

This Guidance deploys Salesforce Health Cloud: Virtual Care on the AWS Cloud.

This deployment integrates Virtual Care with Amazon Chime to offer video conferencing for patients or members using a healthcare platform connected to Health Cloud. Virtual Care sessions provide both video and audio support for patient-to-clinician interactions. Video calls can use Amazon Transcribe or Amazon Transcribe Medical to generate real-time audio transcriptions, which are then used to display text captions directly on the interface for accessibility.

Costs and licenses

This Guidance integrates various AWS services with a Salesforce Health Cloud. For details and costs, refer to Compare AWS Support Plans.

There is no cost to use this Guidance, but you will be billed for any AWS services or resources that this solution deploys.

As of September 2024, the cost for running this Guidance with the default settings in the US East (N. Virginia) is approximately $5.18 per month, for 1000 virtual care minutes-per-attendee and 100 total session-minutes.

Region	Description	Service	Monthly	Assumptions
US East (N. Virginia)	Connect to a standard WebRTC session	Amazon ChimeSDK	$1.70	Standard definition session at 1,000 minutes-per-attendee
US East (N. Virginia)	Capture of 720p composited WebRTC media	Amazon ChimeSDK	$1.00	100 session-minutes
US East (N. Virginia)	Messaging - Message Send+Control+System Message	Amazon ChimeSDK	$0.08	100 messages (Virtual Care waiting room)
US East (N. Virginia)	Standard Live Transcription	Amazon Transcribe	$2.40	100 session-minutes standard live transcriptions

Architecture

Deploying this Guidance with default parameters builds the following Virtual Care environment in the AWS Cloud.

Architecture for Virtual Care on AWS

As shown in Architecture for Virtual Care on AWS, this Guidance sets up the following:

• Amazon Chime SDK control plane for receiving requests from Health Cloud when patients request appointments through their healthcare provider application.
• A default event bus for receiving event notifications from the control plane and delivering them to Amazon EventBridge.
• An Amazon EventBridge rule that filters aws.chime events and a predefined input transformer rule that modifies the event and creates a Salesforce platform event.
• During an active session via a Salesforce-connected app, Amazon Chime SDK to communicate to the Amazon Chime media services endpoint to receive transcription requests.
• Amazon Transcribe or Amazon Transcribe Medical for receiving and processing transcription requests.
• For event delivery failure handling:
  • An Amazon Simple Queue Service (Amazon SQS) queue that serves as a dead-letter queue.
  • AWS Key Management Service (AWS KMS) to encrypt all messages stored in the Amazon SQS queue.
  • An Amazon CloudWatch alarm that monitors the Amazon SQS queue depth and alerts when the configured threshold is exceeded.
  • An Amazon Simple Notification Service (Amazon SNS) topic to send email notifications to interested parties when the CloudWatch alarm is triggered.
• An AWS Secrets Manager secret for securely storing Salesforce credentials and connection secrets.

Deployment options

This Guidance provides the following deployment option for provisioning Virtual Care resources into your new AWS account. Configure Virtual Care settings as needed.

Deploy Virtual Care into a new AWS account

Upgrade an existing deployment of Virtual Care

If you’ve already deployed Virtual Care and just need to upgrade your existing deployment, perform the following steps:

1. Do the following steps to download the latest template file from GitHub:
   1. Navigate to the Github source code for this Guidance to open the GitHub repository.
   2. Open the template folder to access the latest CloudFormation template.
   3. Download the template.
2. In the AWS Management Console, choose Services > CloudFormation.
3. Choose the existing Virtual Care stack.
4. Choose Update to open the Update stack page.
5. Choose Replace current template, and upload the template file. Choose Next.
6. On the Specify stack details page, review the stack settings and update the control Region (for example, us-east-1) and messaging Region (for example, us-east-1). Choose Next.
7. On the Configure stack options page, review the changes and choose Next.
8. On the Review page, review and confirm template settings. Under Capabilities, select all of the check boxes to acknowledge that the template creates AWS Identity and Access Management (IAM) resources that might require the ability to automatically expand macros.
9. Choose Submit. The stack takes about 5 minutes to update.
10. Monitor the stack’s status, and when the status is UPDATE_COMPLETE, the Salesforce Health Cloud: Virtual Care deployment is ready.

Predeployment steps

1. Configure a new AWS account. You can configure either a new standalone AWS account or a new account within an existing AWS organization. For more information, refer to:
   • How do I create and activate a new AWS account?
   • Creating an AWS account that is part of your organization
2. Configure a Salesforce-connected app to integrate the events generated in AWS that are sent via Amazon EventBridge to Salesforce platform events. For instructions, refer to Connect Amazon to Salesforce.

Deployment steps

1. Sign in to your AWS account, and launch this Guidance, as described under Deployment options above. The AWS CloudFormation console opens with a prepopulated template.
2. Choose the correct AWS Region, and then choose Next.
3. On the Create stack page, keep the default setting for the template URL, and then choose Next.
4. On the Specify stack details page, change the stack name if needed. Review the parameters for the template. Provide values for the parameters that require input. For all other parameters, review the default settings and customize them as necessary. When you finish reviewing and customizing the parameters, choose Next.

Caution

Unless you’re customizing the Guidance templates or are instructed otherwise in this guide’s Predeployment section, don’t change the default settings for the following parameters: QSS3BucketName, QSS3BucketRegion, and QSS3KeyPrefix. Changing the values of these parameters will modify code references that point to the Amazon Simple Storage Service (Amazon S3) bucket name and key prefix.

5. On the Configure stack options page, you can specify tags (key-value pairs) for resources in your stack and set advanced options. When you finish, choose Next.
6. On the Review page, review and confirm the template settings. Under Capabilities, select all of the check boxes to acknowledge that the template creates AWS Identity and Access Management (IAM) resources that might require the ability to automatically expand macros.
7. Choose Create stack. The stack takes about 5 minutes to deploy.
8. Monitor the stack’s status, and when the status is CREATE_COMPLETE, the Salesforce Industries: Virtual Calls deployment is ready.
9. To view the created resources, choose the Outputs tab.

Postdeployment steps

Configure a Salesforce Named Credential so that Virtual Care can invoke AWS services.

To use AWS Identity and Access Management (IAM) to retrieve the user’s access key and secret that’s generated by this Guidance, do the following steps:

1. Log in to your AWS account. This account must have sufficient privileges to create an access key for the service account. For more information, refer to CreateAccessKey.
2. In the AWS Management Console, choose Services > Identity Access Management (IAM).
3. Choose Users.
4. Choose the user specified in the AWS CloudFormation template definition.
5. Choose the Security Credentials tab.
6. Under the Access Key section, choose Create access key. This action creates an access key and allows you to copy or download the contents. The access key ID and secret access key is used to configure a Salesforce Named Credential.

Troubleshooting

For troubleshooting issues, refer to the Troubleshooting CloudFormation documentation.

Customer responsibility

After you deploy a Guidance, confirm that your resources and services are updated and configured—including any required patches—to meet your security and other needs. For more information, refer to the Shared Responsibility Model.

October 2022

Harsha Talkad and Vandana Sreenivasa Rao, Salesforce, Inc

Chris Riley, AWS Strategic Accounts team

Troy Lindsay and Dylan Owen, AWS Integration & Automation team

This Guidance was created by Salesforce, Inc. in collaboration with Amazon Web Services (AWS). Guidances are automated reference deployments that help people deploy popular technologies on AWS according to AWS best practices.

Notices

This document is provided for informational purposes only. It represents current AWS product offerings and practices as of the date of issue of this document, which are subject to change without notice. Customers are responsible for making their own independent assessment of the information in this document and any use of AWS products or services, each of which is provided "as is" without warranty of any kind, whether expressed or implied. This document does not create any warranties, representations, contractual commitments, conditions, or assurances from AWS, its affiliates, suppliers, or licensors. The responsibilities and liabilities of AWS to its customers are controlled by AWS agreements, and this document is not part of, nor does it modify, any agreement between AWS and its customers.

The software included with this paper is licensed under the Apache License, version 2.0 (the "License"). You may not use this file except in compliance with the License. A copy of the License is located at https://aws.amazon.com/apache2.0/ or in the accompanying "license" file. This code is distributed on an "as is" basis, without warranties or conditions of any kind, either expressed or implied. Refer to the License for specific language governing permissions and limitations.