Over the last couple of years, the cloud (distributed) computing concept has received a lot of traction. It’s ability to leverage virtual, scalable hardware for information systems can alter the costs associated with the high cost of healthcare in the United States today. It has been a source of discussion by many in the mostly technology conservative care delivery industry.
At a recent discussion with a care provider’s IT infrastructure department, I discussed with them, the factors that would influence their adoption (or lack thereof) of cloud based infrastructure. Their first response (to my “What about leveraging the cloud?”) was, “Well, what do you mean when you say “Cloud”? We already have our own private cloud that we manage ourselves”. Further discussion on this yielded the apprehension of the team to adopt the cloud and all that it had to offer. Was it that they did not want to change? Or that change was arriving all too quickly on their doorstep and they did not have the opportunity to test it out to see if what the cloud offered would be beneficial to them?
One of the factors that came out during our discussion was that the cloud is ‘the’ perceived security risk. Your most precious asset, data is now not in your control. Loss of control is the factor there. Reliability and security must be top priorities in the planning and selection of cloud services for the healthcare industry. When building your requirements for the cloud adoption, ensure that your solution obviously meets HIPAA regulations first and foremost. Bandwidth issues will be something that would affect the quality of care you would receive as a patient. During an infrastructure deployment in 2012 for an Ambulatory infrastructure implementation, the team I was part of physically went to several clinics around the city to make sure that the standard two factor authentication tap badges and devices were deployed at all those locations prior to Ambulatory go live. At one clinic, we discovered that the authentication process took a long time to register, but this was due, in part we realized to their bandwidth connection. Where other clinics took less than a second or two, this one took as long as possibly 8-10 seconds, which is a life time when you are focused on many patients each day. If applications are stored in the cloud, IT departments fear that the speed of the “pipe” would slow considerably the further away the application is stored from the actual usage site. Essentially, performance issues are the concern.
Reliability and security are essential factors in building your requirements and with the new HIPAA Omnibus RUle, that gives Cloud Service providers better opportunity to show their customer prospects that they are now better served by it. Healthcare IT departments must carefully plan the deployment of a pilot phase for this initiative with technological champions at clinics where physicians, operational staff and other clinicians are open to new ideas and ways of reducing costs and increasing efficiency for the organization.
The PMO can work with the clinic champions, Network Services, Security, Change Management and EMR analysts to understand what their roles and responsibilities need to be to carefully and successfully roll out this project. After the billions of dollars spent over the last few years to achieve Meaningful Use Stage 1 at many hospitals and the purchase of software and infrastructure to support that software, the sunk cost of implementing those initiatives would deter many provider organizations from moving ahead with cloud based initiatives, unless they have been asked to make steep cuts in their IT budgets by hospital operations. Those cuts could necessitate the IT organization looking at alternative options to manage their budget and the adoption of the cloud has a chance. For systems integrators and cloud services vendors, the opportunity is to have a well thought out solution that you collaborate with your healthcare customers over and have patience, keep educating and collaborating with your provider customers and truly listen to their concerns by demonstrating to them that these concerns, while valid, would be functionally taken into consideration and part of your overall solution.