postgresql on Digi Hunch

Hosting database on Kubernetes

Sun, 29 May 2022 11:01:00 -0400

Background

“We want to host Postgres database on Kubernetes. Can you help us?”. The client appears assertive and reluctant to resort to managed services. So I did some homework and went through this tutorial. My thought: it’s doable, but don’t do it unless operating database as a service is your main business.

I believed that was the client’s best interest, until I came across this the blog post A Case for Databases on Kubernetes from a Former Skeptic. The author explained his journey from being a skeptic, to grudging acceptance, and eventually to an evangelist on running database on Kubernetes. The same voice came from the author of the upcoming book Managing Cloud Native Data on Kubernetes, who also advocates hosting database on Kubernetes. While the points in the chapters are valid, the book also includes a good amount of technical details which might lead reader to believe the opposite view.

Just a few years back, Kubernetes was not mature to host database. This is changing in 2022. Nowadays, for clients with their own Kubernetes platform, technological maturity is no longer the main reason that keeps them from hosting database on Kubernetes, it is the operational cost. The operational cost has to do with whether the client has in-house expertise in database and Kubernetes. If they do, the hard path makes economical sense.

In this post, we discuss what we need to be aware of in order to host database on Kubernetes.

Benefit with Kubernetes

The first few versions of Kubernetes only supported stateless workload (reference documentary). That is what Kubernetes was born to solve. Built-in objects such as replicaSet, deployment, horizontalPodAutoscaler are abstractions of operations particular to stateless workload. Pods for stateless workload are ephemeral: they crash and get replaced at any time. Because they don’t carry persistent data themselves, they are expendable.

Kubernetes’ orchestration capability are driven by controllers. As discussed, the controller pattern is adopted in all controller implementations. They are the engines of the platform that works tirelessly in a control loop to ensure desired states matches their declared states. This is a key feature of Kubernetes as container platform. Let’s examine a web service that requires 5 instances behind load balancer. With traditional hosting model on Linux servers, you’d have it installed on all five VMs. If the process on one of the VMs dies, the VM has to be removed from the load balancer’s target pool.

One may wrap the process with process monitor and control utility such as supervisord, and re-install the application using automation utility (e.g. Ansible). However, each server is unaware of the status of its peer. Without a central “Control Plane”, there is no coordination between the activities of each VMs. Kubernetes controller solved all these operational problems.

Control Loop

Kubernetes comes with a set of build-in controllers that run inside the kube-controller-manager. Here is a good page about how controllers work. Controller is what is missing in many automation tools other that Kubernetes. Even though Red Hat now brands Ansible as Automation Controller, it does not involve a control loop or controller pattern. If there’s one thing that sets Kubernetes apart from other hosting platforms and automation platforms, it is the implementation of controller pattern.

Stateful workload

Does the controller pattern also benefit stateful workload? Yes. How to orchestrate Pods for stateful workload is usually more tricky. CRD can define a custom object type for controller to consume. In this case, an operator is an implementation of the controller pattern. This pattern is also known as the operator pattern. In a replicaSet, Pod names have extensions of randomly generated numbers. A statefulSet names its the Pods by sequential numbers.

For Postgres database, Bitnami built a good Helm Chart to install the database automatically. However, it does not have a control loop. If someone changes the workload after initial installation, the change is not monitored or controlled by any controller. This is a disadvantage of Helm chart as compared with operators. For PostgreSQL, there are a number of operators, the most notable being PGO (Postgres Operator) from Crunchy Data.

To install an instance of PostgreSQL database, we need to install the operator, and then declare a Custom Resource using the PostgresCluster CRD. The operator will set up the cluster according to the declaration made in the PostgresCluster CR. I used the quick start guide to bring Postgres up real quick on an Azure Kubernetes cluster. The operator (v5) supports common cloud Kubernetes platforms (GKE, EKS, AKS), VMware Tanzu, Openshift, Rancher, Kubernetes. It does not explicitly indicate whether PGO supports Minikube or kind.

So far, I’ve discussed the pros of running PostgreSQL on Kubernetes using Postgres Operator. We can describe the database deployment in a CR and the controller (operator) will monitor the resource incessantly to ensure the actual state matches the state defined in the CR. Not only is it doable to host database in Kubernetes, it makes our lives even easier.

Persistent storage

Database is not only a stateful workload, it also has special requirement on storage. It needs to persist data, support ACID transaction, and make optimal use of disks. When we operate everything on premise, we use fibre cable with a SAN as the storage media for database file. The operating system allows the database process to interact with blocks on the storage volume via device mapper.

In Kubernetes, we need to give Pods persistent volumes. There are a few APIs: Storage Class, Volume Storage Class, Persistent Volume and Persistent Volume Claims. Storage Class represents how Pod can connect to a storage. Pods will need PVCs in order to read and write on PVs. However, since Pods are ephemeral – a Pod may crash any time, even if it is in the middle of writing to a PV, during an ACID transaction. The scheduler may reschedule the crashed Pod to a different node. Then it will need to pick up the PV from where it left off, on the new Node.

Take Azure Kubernetes Service for example, a few storage classes are available by default, backed by Azure managed disk (managed-csi) or Azure file storage (azurefile-csi):

	StorageClass	Azure storage service
in-tree	default	Managed Disk using Azure StandardSSD
	managed-premium	Managed Disk using Azure Premium Storage
	azurefile	Azure File Share using Azure Standard Storage
	azurefile-premium	Azure File Share using Azure Premium Storage
csi	managed-csi	Managed Disk using Azure StandardSSD
	managed-csi-premium	Managed Disk using Azure Premium Storage
	azurefile-csi	Azure File Share using Azure Standard Storage
	azurefile-csi-premium	Azure File Share using Azure Premium Storage

If we use storage class based on Azure disks to create a PV, only one Pod can use the PV. If we use storage class based on Azure files to create a PV, then the storage is mounted as NFS (Linux) or SMB (Windows) share. File storage is not a valid use case for database workload and it can significantly degrade database performance. When I tried to use a file-storage based CSI with PGO, the Pod reports an error and will not start properly. We should use Azure disk based CSI storage classes. That leaves us with two options: managed-csi and managed-csi-premium.

High Availability

Even with these to options left, we still have to investigate how database Pods interact with persistent volume for high availability, in order to determine whether any of the options are suitable. The two storage classes differ by disk performance but both have its own limitation with multi-AZ support on Azure managed disks. When the cluster operates across zones, the Kubernetes scheduler may reschedule a Pod crashed in one zone to a Node in a different availability zone (a different data centre). Even though the managed disks, when attached to VMs, can be configured as zone-redundant, when they are used as Kubernetes volume, they are NOT zone-redundant. So the node in a different zone will not be able to attach PV to the new Pod.

There are SDS (software-defined storage) solution such as Portworx that solves the limitation of Azure disk for cross-region storage volume. The SDS layer brings managed disks from multiple availability zones into a pool. This storage pool acts as a highly available, cross-zone storage tier presented to AKS as persistent volumes. We can install Portworx as the SDS layer using Portworx operator. To do so, we first have to configure grant the cluster the permission to provision resources in Azure, because the Portworx operator will use node’s identity (kubelet identity) to provision Azure resources on behalf of the nodes. Portworx will provision Azure disks and acts as the intermediary layer.

Apart from cross-zone high availability enabled by PX-Store, Portworx can also help with cross-region replication of persistent volumes. The PX-DR component can perform asynchronous replication across Azure regions. The destination region needs to have its own cluster because a single AKS cluster cannot span across regions.

Storage Class

Once we have portworx installed, the following storage classes are available by default:

px-db
px-db-cloud-snapshot
px-db-cloud-snapshot-encrypted
px-db-encrypted
px-db-local-snapshot
px-db-local-snapshot-encrypted
px-replicated
px-replicated-encrypted

The steps for installing porworx on AKS are documented here. This blog post has more details in the installation process on a different platform. We can also built CSI based storage classes with different IO priority and replication factors.

In summary, Kubernetes operator pattern makes it easier to manage stateful workload. However, database performance depends largely on storage. To host database on Kubernetes, one will have to also manage the storage volumes on their own. There has not been a study on the impact to performance by moving database to Kubernetes platform. However, I only expect a degraded performance due to the layers introduced.

Example

In this section we configure a (minimally viable) PostgreSQL cluster using Crunchy Data pgo to demonstrate the idea. The steps are based on its tutorial but it works on a local KinD cluster. As discussed in a previous post, I use KinD for testing workload requiring persistent storage because Minikube has this open issue with permissions on PVs with multiple nodes.

To prepare the cluster, we can use kind-config.yaml file from my real-quicK-cluster repo:

kind create cluster --config=kind-config.yaml
# to delete cluster after testing: kind delete cluster --name kind

We use Helm to install the operator. Since the Helm chart is not hosted in a public repo, we’d have to download the directory of the Helm Chart.

git clone https://github.com/CrunchyData/postgres-operator-examples
cd postgres-operator-examples
helm install -n postgres-operator --create-namespace crunchy-pgo helm/install
kubectl -n postgres-operator get po --watch
kubectl explain postgresclusters

Now we can create a YAML file for the Custom Resource and let’s call it test-cluster.yaml with the following content:

apiVersion: postgres-operator.crunchydata.com/v1beta1
kind: PostgresCluster
metadata:
 name: hippo
 namespace: postgres-operator
spec:
 backups:
 pgbackrest:
 image: registry.developers.crunchydata.com/crunchydata/crunchy-pgbackrest:ubi8-2.38-1
 repos:
 - name: repo1
 volume:
 volumeClaimSpec:
 accessModes:
 - ReadWriteOnce
 resources:
 requests:
 storage: 1Gi
 storageClassName: "standard"
 image: registry.developers.crunchydata.com/crunchydata/crunchy-postgres:ubi8-14.3-0
 instances:
 - dataVolumeClaimSpec:
 accessModes:
 - ReadWriteOnce
 resources:
 requests:
 storage: 1Gi
 storageClassName: "standard"
 name: instance1
 replicas: 3
 minAvailable: 2
 postgresVersion: 14

In the manifest, we specified a cluster, using storageclass named “standard”, with 3 replicas and requiring 2 available. We assume a storage class named “standard” already exists and optimized for database workload. In the manifest, we also configured a backup job. We can apply the manifest and watch for the Pods to come up in a few minutes.

kubectl apply -f test-cluster.yaml
kubectl -n postgres-operator get po --watch
kubectl -n postgres-operator describe postgresclusters hippo

The Pods in the postgres-operator namespace should report something like this:

NAME READY STATUS RESTARTS AGE
hippo-backup-mwpm-ps8wk 0/1 Completed 0 21s
hippo-instance1-6mls-0 4/4 Running 0 3m35s
hippo-instance1-hjp6-0 4/4 Running 0 3m35s
hippo-instance1-k4qf-0 4/4 Running 0 3m35s
hippo-repo-host-0 2/2 Running 0 3m35s
pgo-548d5f48bc-9w4z4 1/1 Running 0 8m41s
pgo-upgrade-566b9cc98f-d7gkr 1/1 Running 0 8m41s

Three Pods for PostgreSQL are all up. The first backup run has completed already. We can connect to the cluster using psql following the quick start guide. We can also configure an application. A good example application that uses PostgreSQL database is KeyCloak. We briefly mentioned it in OIDC discussion. Currently the keycloak example on Crunchy pgo’s quick start guide is outdated. Instead, use the following content as keycloak.yaml:

apiVersion: apps/v1
kind: Deployment
metadata:
 name: keycloak
 namespace: postgres-operator
 labels:
 app.kubernetes.io/name: keycloak
spec:
 selector:
 matchLabels:
 app.kubernetes.io/name: keycloak
 template:
 metadata:
 labels:
 app.kubernetes.io/name: keycloak
 spec:
 containers:
 - image: quay.io/keycloak/keycloak:latest
 name: keycloak
 args: ["start-dev"]
 env:
 - name: DB_VENDOR
 value: "postgres"
 - name: DB_ADDR
 valueFrom: { secretKeyRef: { name: hippo-pguser-hippo, key: host } }
 - name: DB_PORT
 valueFrom: { secretKeyRef: { name: hippo-pguser-hippo, key: port } }
 - name: DB_DATABASE
 valueFrom: { secretKeyRef: { name: hippo-pguser-hippo, key: dbname } }
 - name: DB_USER
 valueFrom: { secretKeyRef: { name: hippo-pguser-hippo, key: user } }
 - name: DB_PASSWORD
 valueFrom: { secretKeyRef: { name: hippo-pguser-hippo, key: password } }
 - name: KEYCLOAK_USER
 value: "admin"
 - name: KEYCLOAK_PASSWORD
 value: "admin"
 - name: PROXY_ADDRESS_FORWARDING
 value: "true"
 ports:
 - name: http
 containerPort: 8080
 - name: https
 containerPort: 8443
 readinessProbe:
 httpGet:
 path: /realms/master # https://stackoverflow.com/questions/70577004/keycloak-could-not-find-resource-for-full-path
 port: 8080
 initialDelaySeconds: 30
 restartPolicy: Always

Once we apply keycloak.yaml, in a minute we should see and be able to port-forward web traffic:

$ kubectl apply -f keycloak.yaml
$ kubectl -n postgres-operator get po -l app.kubernetes.io/name=keycloak
NAME READY STATUS RESTARTS AGE
keycloak-7995d78d7c-zjp4d 1/1 Running 0 4m29s
$ kubectl port-forward deploy/keycloak -n postgres-operator 8080:8080

After using the port-forward command, we can browse to web portal on my MacBook by http://localhost:8080 and configure an initial password, as shown here:

In real life system we would need a proper Ingress. After testing, delete the cluster with kind command and specify the cluster name (kind).

Operation Cost

Operation cost is an important consideration. Troubleshooting on Kubernetes platform is in general more complicated than just on a Unix system. Hosting database on Kubernetes requires skills not only on the Kubernetes platform, but also on database. There used to be database administrator positions where someone has to maintain the upgrade, the storage, the replication, the multi-tenancy and the performance optimization of database. With a database hosted on Kubernetes, the database administrator will have to perform all these activities on a containerized platform. This is not an easy undertaking, and in many occasions warrants a full-time position on its own. Therefore, don’t host your database on Kubernetes, unless that is your main business. It is not the technology that shots down this option. It is the operation cost, such as complexity of configuration, and staff skillset, that makes this option not worth it.

AWS CDK example in Typescript – provision an AWX server

Sat, 19 Dec 2020 17:14:00 -0400

This post provides an example of using AWS CDK in Typescript.

Ansible Tower and AWX

We have used open-source Ansible extensively in the past. While the automation is convenient, the lack of UI makes it not as suitable as a team collaboration tool. One way to allow team collaboration with open-source Ansible, is to use Jenkins to glue the components together, as discussed in the Automated Deployment Pipeline series. In this setup, the open-source Ansible remains command-line driven, with Jenkins building up the command, rather than a human user. There are many upsides in this configuration, but it is not built specifically for Ansible. Ansible is agent-less, and can be run from any host. This sounds appealing and can work well in smaller server fleet. However, since it requires some configuration on the controlling host for Ansible to function properly, it become unnecessary to configure Ansible environment on every single host (e.g. production). A typically environment only has Ansible environment configured on the bastion host. This brings the need for a dedicated controller server to drive all Ansible tasks.

Ansible Tower is Red Hat’s commercial enhancement to the open source Ansible, providing web-based console, REST API and other services such as Role-based Access Control (RBAC). Managing Ansible via REST API is still somewhat involving but this also enables other open-source contributions to simplify the use of API. For example Tower CLI allows you to use Ansible Tower with simplified command. Ansible Tower has an open-source upstream project called AWX, maintained by Red Hat. AWX is essentially a preview release of Ansible Tower without commercial support. AWX can serve as an engine for all Ansible related task. AWX server is essentially an Ansible control server. AWX, or Ansible Tower, also brings several concepts on top of Ansible:

Job template: defines how an Ansible playbook should be executed, including details such as machine credential, project, inventory, and playbook file.
Job: the actual execution of job template
Project: connects Ansible Tower to source control such as BitBucket. It is tied to a Git repository and a branch within that repository

To deploy AWX on EC2 instances, there is a reference deployment by AWS. However, it is provided as CloudFormation template and appears to be outdated (from 2018). In our project (late 2020, named ansible tower lab, or dubbed as “atlab”), we provide the infrastructure in AWS CDK (written in typescript), to provision the AWX environment.

The goal is that once the configuration is completed, you can run ansible ping against a target EC2 instance. The steps are as automated as possible. However, a number of key steps are purposefully left manual for learning purpose, such as the installation of AWX on EC2 instance.

Infrastructure as Code

In previous posting, I created infrastructure as code in AWS CDK with Python, so I decided to change to typescript in this project, with the assumption it is just a matter of syntax mapping. However, I underestimated the transition to a new language I never learned before. A fuzzy understanding of little details such as when to use let a=4 vs this.a=4, may produce elusive errors that takes hours to troubleshoot. I would therefore strongly recommend reading the basic syntax guide for typescript, before getting started.

In typescript, this example project provides an implementation of configuring autoscaling groups, including cloud init, user data, etc on AWS. Other than the language, everything else is very similar to the project in this post, which was developed in Python. Also, note that the project directory structure varies slightly based on the language being used.

If you are absolutely new to AWS cdk, start with this app. It is beyond the scope of this post, to cover extensively the installation and environment configuration of AWS CDK.

In the provision process for Bastion host, the cloudformation init script pulls a specific version from AWX repository, then makes slight modification. User will need to install it manually. Note that AWX can be installed on three types of platforms:

OpenShift
Kubernetes
Docker Compose

All are documented in their README file. For simplicity in this project, the installation is on standalone docker compose. This is the default mode so there is no need to modify the inventory file.

The code repo

The repository is version controlled here. To run the project, you need to have aws cli environment, then install the required packages including node js, and npm packages such as aws cdk. Once configured, validate with command:

cdk ls

This should display the stacks available. Use cdk deploy to deploy each stack.

When BastionStack is deployed, dependent packages should be installed with user data and cloud init. You will just need to SSH on to the server to manually install AWX, as explained in the instruction, to manually install AWX:

ansible-playbook -i inventory install.yml

Then you can browse to the server (at port 80 by default). Before the log-in page for the first time, the AWX will upgrade itself, with the following screen presented:

Now log on with default credential (in README.md), you will have the UI for AWX:

AWX Web Console

From here, you can edit inventory by adding the host. Or use the helper script (~/awxcompose-helper.sh) from bastion host to create a new inventory (named Private Instance Inventory), and populate it with the hosts in the stack. The helper script does so by querying aws resource, and isssue rest API calls to AWX. After executing the script, you can see a new inventory, and the Private instance inventory should contain all hosts in the stack:

Automatically populated inventory

You can then run Ansible ping against the host to validate connectivity. Note that during inventory creation, the ansible_user is already set to ec2-user (by the helper script):

Ping result

Some technical details

The initialization process on Bastion host creates an RSA key pair, stores the public key to AWS, for the upcoming private instances to uses. It keeps the private key locally in order to make outgoing SSH connection to the private instances. To ensure connectivity between AWX and private instances, there are a couple of (bash) helper scripts involved. Both reflects some technical details that I had to work through.

awxcompose-helper.sh: the initialization process pulls AWX installation file from git repo. The installation process will build a docker-compose file in ~/.awx/awxcompose, based on a template (~/awx-*/installer/roles/local_docker/templates/docker-compose.yml.j2). When user tells AWX to connect to private instance, the connection was made out of a docker container (instead of from the OS of bastion host), we need this script to map SSH key file from host to container, by modifying the template file. Without this helper, outgoing SSH connection will fail with error (Permission denied (publickey,gssapi-keyex,gssapi-with-mic)). This script is invoked in the cloud init process without requiring manual execution.
awxinvt-helper.sh: once the private stack is up and the installation has completed, we need to add the hosts to AWX inventory. This script gets the instance ID and IP addresses of the private instances, and uses Rest API calls to create inventory and populate it with hosts. Ansible has multiple ways of authentication. This script uses the non-stateful basic authentication with each curl command requiring credential. Ansible Rest API guide is provided here and be wary of the convention where URI must end with a slash.

This project is just a start of AWX on AWS CDK project using Typescript. In real life scenarios, there are some work to do to make this even more automated. For example, use cfn-hup service to monitor changes of private stack, and therefore update inventories accordingly.

Automatic deployment of Orthanc on AWS

Sun, 08 Nov 2020 00:54:06 -0400

[Update] I changed reverse proxy from Nginx to Envoy. Here‘s the detail.

[Update] Some security improvement was introduced in may 2021. Here‘s detail.

[Update] Here’s the link to the orthweb repository.

In this project we introduce a medical imaging web service based on Orthanc, an open-source project of DICOM server, and a pipeline to deploy such server automatically and consistently. We deploy Orthanc on AWS automatically. This little project involves a number of technical deets in DevOps, to deliver a web application prototype with an automated deployment pipeline.

A brief on imaging

In medical imaging, scanning devices are the data collectors. It consists of various categories of scanners, such as Computed Tomography (CT), and Ultrasound (US). They are collectively referred to as modality, but vary significantly in terms of image generation and hardware manufacturing. The challenges to exchange data between these heterogeneous scanning devices and centralized computers came around as early as the 1980s, which brought about ACR-NEMA standard in 1985, under the initiative between American College Radiology (ACR) and National Electrical Manufacturers Association (NEMA). The standard lately evolved into DICOM (Digital Imaging Communication in Medicine), a comprehensive set of standard in the ISO framework that governs modern imaging data storage and exchange across several disciplines (radiology, cardiology, pathology, etc) that operate around images in medicine.

In addition to defining a file format to store imaging data, DICOM also includes an upper layer protocol that dictates how two compliant devices (referred as application entity, each identified by AE title) can negotiate a common syntax to transfer objects (e.g. an image, a report or a discovery). Upper layer refers to layer 5-7 in OSI model, or application layer in TCP/IP model.

Imaging server

Once scanner acquires images from patient, they stores the exams to imaging server for persistent storage. The functionalities of such server expands overtime since 1990s and hence go by different names in different eras, such as PACS (Picture Archive and Communication Systems), VNA (Vendor Neutral Archive) and EI (enterprise imaging) archive. Regardless of naming, they can be generally seen as a highly specialized variation of enterprise content management system. They are usually hosted with a centralized database to index clinical information at patient, exam and image levels. The other key component is the persistent storage devices, usually in the form of a NAS.

Orthanc is an open-source initiative for such imaging servers. It provides a DICOM endpoint, allowing scanning devices to store medical images. It also provides a web viewer allowing users to see the images stored. It is released for many platforms, including Docker images.

Infrastructure as code

We use Amazon Web Service (AWS) for infrastructure as service, and Terraform as the tool to provision resources off AWS, in a reliable and consistent mechanism, known as Infrastructure-as-Code. Terraform is an alternative to CloudFormation, AWS’s proprietary infrastructure-as-code technology. Terraform is developed by Hashicorp as an open-source project, and therefore is vendor neutral. It supports multiple public cloud vendor through different providers. Each provider accesses the vendor specific SDK. For example, the AWS provider integrates with AWS SDK. As a result, the code used in one vendor cannot just be applied to a different vendor without a major overhaul. Terraform’s current version is 0.13 as of Oct 2020, and has gone through some syntax changes since version 0.11. Terraform also produces files for state management locally in the working directory.

When executing, Terraform combines all files in the working directory to assess variables, and create required resources. It is compatible with the most of AWS resources. For example, you can specify user data with templates when creating EC2 instances. You can also create managed service instance as long as it is supported by the provider.

Architecture

Orthanc web server stores data in sqlite by default, but also has a plugin to support PostgreSQL, an open-source relational database. AWS has managed service (RDS) based on PostgreSQL. In this project, we create an RDS instance that span across two availability zones for minimum high availability. Orthanc also supports storing imaging data including pixels in PostgreSQL, which obviates the need for a dedicated file storage system.

We deploy the application in Docker’s containers for compatibility and portability. The Orthanc server is shipped in Docker images, available in Docker hub registry. The docker environment is configured as part of EC2 instance bootstrapping, including installing packages with YUM, initializing and customizing environment variables. The docker-compose file, and the auxiliary configuration files are provided in the repo. The bootstrapping script installs git and pulls required files from this GitHub repo.

This demo project does not include load balancing, DNS management, or container orchestration.

Security

Orthanc’s web browser natively supports HTTPS. However, the DICOM port does not support TLS natively, as their development has made clear in the FAQ. This leaves a severe security vulnerability because all patient data (protected health information in HIPPA context) would be sent across the Internet in the clear, visible to every network interface along the route. To address this issue we brought in Nginx as a reverse proxy to work at TCP layer to terminate encrypted traffic for Orthanc’s DICOM end point. DICOM upper layer works on top of TCP layer.

In Nginx literature, this use case is referred to as SSL Termination for TCP Upstream Servers. Note that Nginx is providing layer 4 capability in this use case so the certificate and key configuration should not be placed under http section of the configuration file. This layer 4 capability in fact enables security configurations of all protocol that operates in upper layers and can be used in a broad range of situations. It is also noteworthy that Nginx can re-encrypt the traffic on the way out to upstream, for even tighter security control measure as outlined in this use case.

user nginx;
worker_processes 1;

error_log /var/log/nginx/error.log warn;
pid /var/run/nginx.pid;

events {
 worker_connections 1024;
}

stream {
 upstream dicom_backend {
 server orthanc-backend:4242;
 }

 server {
 listen 11112 ssl;
 proxy_pass dicom_backend;

 ssl_certificate conf.d/site.pem;
 ssl_certificate_key conf.d/site.pem;
 ssl_protocols SSLv3 TLSv1 TLSv1.2 TLSv1.3;
 ssl_ciphers HIGH:!aNULL:!MD5:ECDH+AESGCM;
 ssl_session_cache shared:SSL:20m;
 ssl_session_timeout 4h;
 ssl_handshake_timeout 30s;
 }
}

It is also helpful to use Nginx to terminate HTTPS traffic, using a pair of certificate and key. When testing with self-signed certificate I realized that Chrome browser has specific requirement on self-signed certificate, or it won’t load the page. So the certificate has to be created as instructed here.

For better security, it is advisable that the RDS instance is provisioned in private subnet, with its data encrypted both in-transit and at-rest. Docker service should also manage sensitive information as secrets.

Summary

The deliverable is stored in this Github repo. The docker part of it can be executed on MacBook with PostgreSQL. The entire hardware stack represented by terraform code, can be executed against AWS to create required resources. Checkout README for further instruction. To emulate a modality, one will need a TLS supported DICOM application entity, Horos is a great project on MacOS to serve this purpose, both as DICOM-compliant sender and a viewer. Alternatively, consider some command-line based DICOM toolkit such as dcmtk, or grassroot dicom.