While healthcare has been busy implementing electronic health records (EHRs) and other clinical information systems using traditional infrastructure like privately owned, on-premise data centers, an amazing transformation has been underway as the rest of the IT world has aggressively adopted public cloud-based computing platforms. Understanding the drivers behind this migration and figuring out why and how these apply to health IT is a critical next step in our own evolution.
Not just a hard drive in the sky
Cloud computing started and gained early traction as an alternative to local, on-premise storage. Conceptually, this was “someone else’s hard drive in the sky.” Since they could build or buy storage services, IT leaders were presented with a relatively straightforward cost-benefit analysis: was it better for their organization from a cost, reliability, scalability and security perspective to own and manage data storage, or to outsource this to a proven cloud provider? Interestingly, adoption by healthcare lagged many other industries primarily out of concerns about overall control and ensuring security.
While cloud computing may have started out as a storage solution, it has evolved into a set of powerful computing resources which are increasingly leveraged to create applications. These versatile building blocks are the basis of an emerging set of applications which, in a practical sense, can only be built on a cloud-computing infrastructure.
From a competitive standpoint, the typical organization would be hard -pressed to match the scope of services or the value that Amazon, Google or Microsoft can provide via public cloud services. As a result, use of cloud computing has rapidly grown in many industries. Widespread adoption by healthcare seems inevitable, and this migration has begun and is accelerating.
By way of analogy consider building construction. Traditional “stick built” homes are custom assembled one by one from the foundation to the roof, just like the typical health IT data center or application. In contrast, modular homes and prefabrication of components like foundations, walls and even entire rooms mirrors cloud-based computing in that the “core” of the building has been made by someone else and becomes a constituent building block for a new structure. Assuming it will meet your specific needs, a prefab foundation is likely to be a better value than a localized one-off.
Example: cloud computing sevices
So, what does the cloud offer today? Both the number of services and the complexity of their features continues to evolve for the major cloud computing platform providers. Amazon Web Services (AWS), for example, offers more than 175 services across a global network of data centers. Functionality includes core services for database management, storage and computation and advanced technology for AI, machine learning, high-end analytics and Internet of Things (IoT). Tools to develop applications and to manage development operations are also available with the potential to further streamline and enhance development processes.
From this vantage point, it seems to be increasingly a fool’s errand to compete with the likes of an AWS by continuing to develop and support on-premise approaches. The smart play is to look for ways to co-opt this movement and to plan for a strategic migration that benefits healthcare organizations.
A cloud(y) future: advantages for healthcare
Cloud computing platforms have the potential to be a catalyst for more rapid and robust innovation in health IT for several reasons:
- Focus: Organizations can outsource traditional infrastructure needs and shift more of their internal resources to solving business problems specific to healthcare.
- Scalability and reliability: Cloud-based applications can often be much more easily and reliably deployed, scaled and maintained.
- Power: Evolution of cloud platform computing and storage is driven by multiple industries. The scope and depth of services continues to evolve rapidly. There is immense opportunity to harness and ride this wave of innovation for healthcare to deliver more sophisticated applications at a faster pace.
These advantages go far beyond simple economics. This first wave of digitizing clinical data, primarily through widespread deployment of EHRs, was focused largely on replicating clinical workflows on a computer. More than a decade later, most organizations are looking to leverage this basic digitalization for greater productivity, improved clinical outcomes and to address gaps in patient and provider satisfaction. The approaches that got us to this point will not get us to the next level: innovators need a new generation of computing-resource intensive applications to be reliable, scalable, secure and able to deliver fast responses over large geographic areas.
While there will always be a need for custom development and unique services, increasingly developers and healthcare organizations will be harnessing cloud platforms to provide core infrastructure, jumpstart their efforts and catalyze more rapid and efficient improvements over time. Indeed, the forecast for health IT is inevitably cloud(y) with a chance for greater innovation and value.
Dr. Dave Levin has been a physician executive and entrepreneur for more than 30 years. He is a former chief medical information officer for the Cleveland Clinic and serves in a variety of leadership and advisory roles for health IT companies, health systems and investors. You can follow him @DaveLevinMD or email [email protected].
