This appeared last week:
An idiot's guide: What happens when a GP's patient records are in the cloud?
Is it secure, is it safe, is it worthwhile and what is the cloud anyway?
31st March 2022
By Paul Smith
GP prescribing software is about to go through another revolution in the next few years. It's the shift to the cloud.
One consequence is that patient records won't have to be physically stored on hardware located in the practice, but on servers located in remote data centres.
Given the precious nature of patient information, the very concept can raise big questions in the minds of many GPs.
So, Australian Doctor spoke to Dominique Powis, chief technology officer at MedicalDirector, about what the cloud is, how it works and the future.
Australian Doctor: Could you briefly explain what the 'cloud' is in the context of GP practice software?
Dominique Powis: When practices host their data in the cloud, it means that their email, applications and software are accessible online, using a secure login and available at any time.
Information in the cloud is stored and managed by cloud providers like Microsoft or Amazon, to name a few. These companies provide secure, reliable and available infrastructure. The idea is that you don’t have to.
With respect to a GP practice, hosting your practice data in the cloud means that you have access to the security, availability and reliability that these cloud providers can offer.
It differs from traditional ‘on premises’ applications which are downloaded and stored on servers onsite.
One common misconception you hear is that accessing software via remote desktop counts as ‘the cloud’.
This is not the case. It does not leverage the security, cost benefits and potential scalability and reliability that the cloud provides.
AD: Most GP practices will have their own computer and hardware and store their patient information there.
But when GP practice software uses the cloud, could you explain physically where the patient’s information is stored.
Is there a huge data warehouse somewhere?
Ms Powis: With cloud-based software, you don’t need a physical server at your premises. Your patient information is stored away from your practice, on servers located in data centres.
A data centre is a physical facility that companies like Microsoft, Amazon and Telstra use to house information.
They adhere to strict security standards, and are kept secure with boom gates, screening on entry and constant monitoring of visitors, both physically and by CCTV.
Some data centres use biometric technology to keep intruders out.
When you consider the sensitivity of practice and patient data, alongside the fact that most medical practices are located at retail premises, these security measures can provide great benefit.
Whether data is held at several data centre locations varies between email, software and application provider.
For this reason, it is important to ensure you have read the privacy policy and end user license agreements of the companies providing these services.
MedicalDirector’s Helix cloud-based system, for example, is supported by Microsoft’s infrastructure and is hosted across two Australian-based data centres to ensure availability.
AD: Could you explain what you consider the main benefits of cloud-based systems over existing software packages used in GP practices.
Ms Powis: It’s basically improved efficiency, reduced maintenance costs, faster access to new features and functionality and flexibility.
Because there’s no need for a physical server, there are fewer hardware and infrastructure requirements.
You also don’t have to rely as much on third-party IT providers for server maintenance, upgrades and security as for the most part these are all managed for you.
Another major advantage with cloud clinical software, is that updates are automated so there’s no need to manually download, install and update your software to newer versions.
This means practices should have faster access to new features and functionality — ultimately, it’s about enabling better patient care.
It is also worth mentioning that the cloud is not new in healthcare and that elements of the sector have been using cloud solutions for many years, including the aged and disability sector. Telstra Health has had cloud solutions in the market across these sectors for some time.
AD: GPs are obviously hugely protective of patient information.
Ms Powis: Running your business with your own hardware from your practice comes with a number of physical risks, mostly from having your data all in one place.
We can see with the recent floods in NSW and Queensland. Natural disasters — fire, flood or theft at your premises — could mean a total loss of data, or inability to access records for a period of time.
Obviously, this can be devastating to a practice.
Hardware corruption or vulnerabilities within your system are also common risks when hosting locally.
In addition to this, hosting your applications yourselves means you are solely responsible for the security and protection of your practice and patient data.
Cybercrime is increasing in Australia and moving to the cloud shifts some of that responsibility to world class platforms equipped to handle these threats enabling you to focus on your patients.
Lots more here:
https://www.ausdoc.com.au/practice/idiots-guide-what-happens-when-gps-patient-records-are-cloud
Frankly it seems to me, in the hands of a competent cloud provider – like AWS – there is pretty much no downside in taking the step and there are a huge number of advantages.
Does anyone have a contrary view?
David.
As with any arrangement like this ensure your data is portable and the exit clauses are in your favour. This is fast becoming the norm. Looking at the ADHA plans, they seem headed in the wrong direction. Even NEHTA pre PCEHR was heading in the distributed loosely coupled approach.
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