ICU EARLY-WARNING VITALS
● STABLE
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These are simulated vital sign readings for 8 oncology critical-care patients, streaming to this browser at 5 updates per second each. In an MSK deployment, Lightstreamer receives these readings from the Epic-sourced ICU vitals and lab feed the moment a bedside monitor reports a new value, and pushes them instantly to any authorized clinical screen across the Manhattan campus or regional network. The MERGE channel ensures that under network pressure, rapid response teams always see the most recent reading, never a backlog of stale values. Sepsis risk scoring recalculates on every new lab or vital and routes threshold crossings to the DISTINCT alert channel below.
REMOTE PATIENT MONITORING · INSIGHT CARE
● STABLE
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These five patients are enrolled in InSight Care / the MSK Remote Monitoring app, reporting symptoms and connected-device readings from home across MSK's regional network: Westchester, Long Island, New Jersey, and Manhattan. Lightstreamer's native MQTT Connector aggregates that device telemetry directly, with no custom broker translation layer, and StreamSense adapts delivery to each patient's actual home network condition. A centralized nursing team monitoring all five patients receives only the latest reading from each, with intermediate values intelligently consolidated when bandwidth is limited, and stateful reconnect ensures no reading is lost during a home internet drop.
AI INFERENCE + RESEARCH COMPUTING
● STABLE
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These scores are produced by MSK's AI research computing environment: AWS Bedrock and SageMaker models for recurrence risk and clinical trial matching, part of the Cancer AI Alliance's operationalized AI work, correlated here with genomics and bioinformatics pipeline telemetry from SAIL, Isabl, and MSK-CHORD. Each score updates at 2 times per second. Lightstreamer delivers each updated score to the researcher's or clinician's screen within milliseconds of computation, using delta delivery: only the value that changed is transmitted. In a full deployment, Lightstreamer's Kafka Connector bridges both the AI inference output topic and the genomics pipeline event topic to live dashboards, one connector serving both use cases, with no custom middleware required. When a recurrence-risk score crosses a threshold, an alert fires automatically through the DISTINCT channel below.
⚡ LIGHTSTREAMER DELIVERY PROOF
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The server publishes clinical and research computing data at a constant rate regardless of any client's network condition. Lightstreamer's MERGE channel tracks the last value delivered to each connected screen and intelligently consolidates intermediate updates when bandwidth is constrained. Each researcher's or clinician's screen always receives the most recent state, never a backlog. The conflation ratio shown here is the ratio of server events to client deliveries: 1 to 1 at full bandwidth, rising as network degrades. Clinical and CDSI alerts on the DISTINCT channel bypass conflation entirely and always deliver in full.
Data Sources to Lightstreamer
MSKCCStreamAdapter publish rate
63
updates/sec (server)
ICU vitals (8 patients)5 Hz ea.
RPM home (5 patients)1 Hz ea.
AI + genomics (8 items)2 Hz ea.
Command center (2 feeds)1 Hz ea.
MSKCC alertsDISTINCT
MERGE Conflation
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Conflation ratio: server publish rate divided by client receive rate. At full bandwidth this is 1 to 1. As network degrades, Lightstreamer consolidates intermediate values so the screen always shows the latest state. MSKCC alerts on the DISTINCT channel bypass conflation and always deliver in full, regardless of bandwidth.
1:1
server events per
client delivery
client delivery
Only the delta is sent.
Unchanged fields transmit 0 bytes.
Unchanged fields transmit 0 bytes.
Lightstreamer to This Screen
This browser's receive rate
63
updates/sec (client)
ICU vitals (8 patients)5 Hz ea.
RPM home (5 patients)1 Hz ea.
AI + genomics (8 items)2 Hz ea.
Command center (2 feeds)1 Hz ea.
MSKCC alertsALL · DISTINCT
📡 NETWORK SIMULATOR
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These buttons simulate network conditions that MSK researchers and clinicians actually encounter: full bandwidth at a Manhattan campus workstation, a clinician's mobile device on cellular during rounds, congested Wi-Fi at a busy regional site, and a link loss simulating a dead zone or home-internet drop for a remote monitoring patient. Lightstreamer adapts automatically to each condition with no configuration required. Use this simulator to observe how the delivery rate and conflation ratio change in the proof panel above, while clinical and CDSI alerts continue to arrive regardless of bandwidth.
Effective bandwidth
Unthrottled
Protocol (StreamSense)
WebSocket
MERGE conflation
Off
DISTINCT alerts
Unaffected
Manhattan Campus Network: WebSocket delivers all clinical and research computing data at full publish rate. Every vital sign, AI score, and command-center metric arrives the instant it is published.
⚠ DISTINCT CHANNEL: MSKCC ALERT DELIVERY
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Clinical alerts generated by MSK's AI inference pipeline and CDSI case-ready events as the initiative's scope expands into imaging both use Lightstreamer's DISTINCT channel: zero consolidation, every alert delivered exactly once, in sequence, regardless of network conditions. When a clinician's or researcher's device loses connectivity, alerts queue server-side and flush the instant the connection restores. The published and received counts shown here must always converge: that is the DISTINCT guarantee. This is the channel that ensures a sepsis alert or a CDSI case-ready event generated during a dead zone still reaches the right screen the moment connectivity returns.
Published
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Total MSKCC alerts published by the AI inference pipeline and CDSI stream since this session started. This count advances regardless of whether any client is connected.
0
Received
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Total MSKCC alerts received by this browser. During a link loss, this count pauses. On reconnect, queued alerts flush immediately and this count catches up to Published. Published and received must always match.
0
0
alerts queued during last outage
MSKCC alerts bypass all MERGE consolidation. Published and received counts converge after every outage. This is the DISTINCT guarantee: zero missed alerts, zero duplicates, always in order.
🏥 MSKCC COMMAND CENTER
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An aggregate view of CDSI data integration throughput and infusion chair capacity across MSK's regional network, updating once per second from the same Lightstreamer server that powers the clinical and research dashboards above. DigITs staff, CDSI's data engineering team, and infusion scheduling coordinators each subscribe to the metrics relevant to their role. Lightstreamer delivers each metric the moment it changes, from one server push to as many authorized screens as needed. During a link loss, Lightstreamer holds the last known state server-side and delivers the current values instantly on reconnect.
CDSI Data Integration
Records Integrated
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De-identified clinical records integrated into CDSI's near-real-time stream today, against a daily target of 5,000. Updates every second. When integration throughput reaches 90% of target, a DISTINCT alert fires to the CDSI data engineering team automatically.
--
of 5,000 target
Imaging Cases Pending
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Pathology and radiology imaging cases awaiting integration as CDSI's scope expands beyond clinicogenomic data. This figure updates in real time. In a full deployment, Lightstreamer's Kafka Connector bridges CDSI's imaging pipeline events directly to this command center display.
--
in queue
Integration Throughput
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Records integrated today as a percentage of the daily target. At 90% and above, status escalates and a DISTINCT alert notifies the CDSI data engineering team. The bar fills from teal to amber to red as throughput rises toward capacity.
--%
of daily target
Case-Ready Events (1 hr)
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Total CDSI "case ready" / "record ready" events generated in the past hour. Each one corresponds to a DISTINCT channel event guaranteed delivered to every authorized researcher or clinician screen, including those offline when the event was generated.
--
this hour
Infusion Regional Network
Chairs Active
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Infusion chairs currently in use across MSK's Manhattan and regional infusion sites (Westchester, Long Island, New Jersey), out of 120 network-wide. LeanTaaS iQueue-style capacity matching depends on this state staying current across every site.
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of 120 chairs
Avg Utilization
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Average infusion chair utilization across all 4 reporting sites. Lightstreamer's multiplexed MERGE keeps bandwidth flat as more chairs, schedule slots, or sites are added: each display subscribes only to what it needs. At 90% and above, a DISTINCT alert notifies the scheduling team.
--%
4 sites reporting
⚠ MSKCC ALERT LOG: DISTINCT CHANNEL
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Every clinical and CDSI alert appears here in real time. Alerts shown as QUEUED during a link loss will flip to DELIVERED on reconnect. The sequence number confirms no alert was skipped: DISTINCT guarantees ordered, exactly-once delivery. During a link loss, alerts accumulate server-side and flush in order the instant the connection restores.
Awaiting first MSKCC alert...
⚙ LIGHTSTREAMER SESSION LOG
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Live event stream from the Lightstreamer client library: connection status, subscription acknowledgements, and protocol transitions. WebSocket connected means lowest latency delivery. HTTP Streaming is the fallback for networks that block WebSocket. Smart Polling is the last resort for highly constrained environments. StreamSense selects the right protocol automatically with no configuration required.
Connecting...