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Thursday, February 01, 2018

Guest Comment - What the cloud holds for healthcare providers

By Andrew Tucker, CEO of ITonCloud

Like many other industries, the health sector is experiencing significant disruption thanks to cloud technology. Cloud was initially adopted in healthcare in the areas of data storage and health information exchange (HIE), but now it is starting to be leveraged across a wider range of areas, like back office functions and patient care.

In fact, according to a study by MarketandMarkets, the global adoption for cloud services in healthcare will grow from $US3.73 billion to nearly $US9.5 billion by 2020. Cloud technology is fuelling advances in growth areas like telemedicine, mobile health apps and remote monitoring tools.

The cloud offers very attractive benefits to healthcare providers, many of which are operating under tightened budgets and resource scarcity, the biggest being agility and mobility as well as cost benefits. Cloud services reduce the need to host, update, maintain or backup IT environments, eliminating the need to invest in on-premise servers, expensive hardware and support costs.

The way organisations use cloud is expanding. Applications like accounting software, file sharing, ERPs, data storage, project management and CRMs, are streamlining operations for healthcare providers, and in some instances are becoming commonplace. The next stage of widespread cloud adoption will see organisations have their entire IT environments in the cloud, including files, email and applications.

For healthcare providers looking at implementing cloud services to improve operations, these are the three things you need to consider.
  • 1.       Data security

This is definitely an area you need to do your due diligence for when choosing a cloud service. You want to ensure your data will be safe from unauthorised access; that it will be backed up regularly and protected from viruses; and the data centres used are secure and well maintained. 
While security was once a major concern for healthcare providers looking to adopt cloud, security measures and technology have improved, and in many cases, having your data in the cloud is more secure than having it stored in an on-premise server.

  • 2.       The type of cloud you choose
There’s more than one type of cloud. When looking to move your IT environment to the cloud, there are a number of cloud options, including public, private and hybrid.

Public clouds, like those offered by Amazon, Google and Microsoft, offer advanced technology. However, they can be expensive, complicated and impersonal. For personalised service you usually have to agree to a hefty upfront maintenance agreement.

Private cloud offerings have benefits from the sharing of IT resources across multiple applications and/or locations, which can help to increase productivity and reduce bottom line costs. However, one trap businesses can fall into is opting for a hosting service rather than a true cloud provider.

As the name implies, hybrid clouds use a combination of on-premise, private and public cloud services. They can expand capacity quickly but can be complicated to set up and run, resulting in a greater potential for things to go wrong, more downtime and more costs. Also, the on-premise equipment required can be expensive, and likewise, the ongoing maintenance.
  • 3.       Migration
When engaging a cloud provider it’s critical to understand their migration methodology. You want to ensure the process is as seamless as possible with no disruption or downtime. Speaking with previous clients can be a good way to ensure the provider’s methodology is tried and tested.

The migration process can represent significant risk if not handled correctly. Before you migrate fully to the new cloud platform, ensure you test before you go live. It’s also important to have safety mechanisms in place so if things go wrong you can correct issues or even revert to the old system if need be.

Cloud adoption will continue to grow in the healthcare sector as providers see the ultimate business benefits. However, before you move to the cloud, do your due diligence. For instance, consider all the costs, including set-up and migration fees. Also, make sure the option you choose offers adequate security measures. If you’ve done your homework, moving to cloud can be one of the best things your organisation has ever done.

About ITonCloud

ITonCloud helps businesses simplify and automate their IT systems by leveraging the cloud. With ITonCloud businesses have their entire IT environment in the cloud, including email, files and business applications, making it easy for your workforce to access anywhere, anytime, on any device with comprehensive security. Using ITonCloud’s proven and state-of-the-art cloud desktop platform eliminates the need for businesses to invest in on-premise servers, expensive hardware and support. www.itoncloud.com

As always - comments welcome!



Anonymous said...

Cloud services reduce the need to host, update, maintain or backup IT environments, eliminating the need to invest in on-premise servers, expensive hardware and support costs.

Never a truer word spoken, in this day and age to be trying to manage your own tin and wires makes no business or logical sense. Anyone replacing on premise servers with on premise servers should be taking a hard look at the IT manager.

Be mindful of the privacy principles, look for a provider that guarantees on shore hosting and backup, there are many.

Another good source of independent advice - http://www.cloud-council.org/

Anonymous said...

What about all the other issues and risks? If you don't know what they are, especially if the customer is the government, you should be careful thinking its only about technology.

And in what sense do you claim http://www.cloud-council.org/ is independent?

It's like going to OPEC and asking for advice about solar panels.

Anonymous said...

What other risks and issues do you refer to? Most are the same for onprem as for cloud. The pricing models can be confusing for cloud but so are maintence and support packages. Cloud providers as with hosting providers manage infrastructure platforms far better the small medium businesses ever can.

As for Government there are a number of ASD certified cloud providers.

Cloud council is independent as they are not pushing a solution just sharing experiences and providing guidance material. Asking Microsoft will result in Microsoft is the answer as would be the same with AWS or Amazon.

Cloud is not a new concept, don’t fear it.

Anonymous said...

I am sure the risks are no more than keeping sensitive information in a filing cabinet

Bernard Robertson-Dunn said...

I can't speak for anyone else, but when I worked for the Federal Government on their Cloud Computing strategy in 2012, they had a number of issues, two of which were:

1. Cloud computing uses highly standardised, lowest common denominator technology environments. Converting from an old architecture to a new cloud architecture can be very complex and expensive - it often isn't worth it. It may be worth it for a green fields app. And if your old architecture has OLTP apps using something like CICS/COBOL/DB/2 or model 204, you'll have a very challenging job ahead of you. Likewise if you have a non-relational DBMS.

2. If you put an app into the cloud, you may have an integration problem if you already have apps in your data centre. Most enterprise apps are not stand alone so you have the problem of maintaining two separate environments with extra overheads/duplication or you somehow have to integrate the two, which can become highly complex when you factor in back-ups and disaster recovery over multiple sites. It's also harder to get good throughput performance when there are two linked environments.

New, green field, stand alone apps are not that common in government.

They are only two, there were quite a few others, some technical, some contractual, some about trust.

And the government still has people who have nightmares over the whole of government outsourcing debacle of the 1990s. But you might not have been around then.

Anonymous said...

Having read that document Bernard it is not to shabby. I probably needs a refresh and I am sure the DTA is onto it. Although I do not disagree with you points around apps and one should always assess application for tradition to the cloud. Many Government bodies are adopting cloud and the cloud providers have many tools to assist in transitioning. That to one side the welcomed blog I do not believe was targeting monolithic old mainframes or large Government administration and processing systems.

The cloud xaas offers a lot to healthcare organisations of all sizes. There is not much we don’t use that is not cloud related. The thing to remember cloud is a computing delivery service rather than a new technology. If you move to the cloud make sure your internet is resilient and of a decent bandwidth for your needs.

Bernard Robertson-Dunn said...

IMHO, the biggest technical problem with cloud is the same as with myhr. How do you ensure resilience in times of emergency and/or disaster? A medical facility needs the capability of working autonomously when there are problems with communications, power or an overload of the central system.

A hospital or medical centre should be able to work independently without any reliance on anything outside its own premises.

Anonymous said...

@7:59AM I think your argument here "resilience in times of emergency or disaster" is shallow and somewhat tainted by trying to justify your objection to a cloud based health record, be it myhr or something else.

Power failure, earthquake, volcanoes, massive floods, building collapses, explosions, raging bushfires, do occur but in the main most are not common occurrences. Medical practices may be impacted by power failure but that won't stop a doctor, paramedic or nurse from treating a patient. People can be treated frequently and adequately when a disaster occurs without having to rely on information stored 'somewhere' in a medical record.

Bernard Robertson-Dunn said...

or your argument that "resilience in times of emergency or disaster" is unnecessary is somewhat tainted by trying to justify using a cloud based health record, be it myhr or something else.

I'll leave it to others to decide on the merits of the arguments, but resilience is a non-functional requirement decided by those who need the system, not those who build the system. Neither you nor I should put a value on resilience.

It should be made clear to those who will be using the system of the consequences of the different architectures. AFAIK, this was never done with myhr.

Anonymous said...

@10:08 AM "leave it to others to decide" is fair enough. One can only hope that they have sufficient intellect and understanding of the problems to make a 'wise' decision.

I agree. If "the consequences of different architectures" has never been done then the myhr is being built over a quicksand of vapourised thinking on a wing and a prayer.

Bernard Robertson-Dunn said...

"I agree. If "the consequences of different architectures" has never been done then the myhr is being built over a quicksand of vapourised thinking on a wing and a prayer. "

A truer word has never been said.

The reason I believe that my statement about the architecture is correct is because the base document on which everything else rested was the Concept of Operations - i.e a description of how it works. One of the following documents was the requirements.

IMHO, whoever it was who was working on the PCEHR at that stage knew nothing about architecture. Or if they did, were over-ruled by someone who didn't known, probably some project manager who just wanted to get a tick in the box for all the deliverables without realising that the order matters when making decision.

BTW a Concept of Operations document is most often used when solving well known problems with a known range of solutions and all that matters are the design details. If anyone seriously thinks that describes a health record system, they should taken far away, given a stern talking to and left there.

All the troubles of the PCEHR/myhr can be traced back to this egregious decision. And like most initial decisions, if it's wrong, it can't be fixed with any amount of tinkering or "enhancing".

Andrew McIntyre said...

I have been running my day surgery in the "cloud" for about 15 years, at least the clinical side of the information and I think it is safer overall because of the quality of the server environment with multiple level of redundancy with respect to things like servers, switches and connections to the internet backbone and backup generators.

In that time we have had floods and power/internet/LAN server outages that disrupted access but have always had mobile internet access on laptops when that happened. Overall we would have been more inconvenienced by local on site outages that we have been using cloud based services. You need people with laptops and mobile internet to cover local issues, but overall I feel much safer with the data living in a secure place.

Dr Ian Colclough said...

I agree Andrew. It seems to me that logic suggests the 'cloud' should underpin the architecture for a distributed network of medical (health) records. If that holds true, then today's in-house server-based practice medical record systems are approaching the end of their life-cycle, albeit some years off. Further, design of today's medical records, whilst being reasonably rich in functionality, are also becoming quickly outdated. New record design with increasing functionality accessible in the 'cloud' has much to commend it.