Cloud-based Health IT: Now is the Time

September 26, 2018 Drew Ivan

Managing an information technology infrastructure is a hard job. Consider the variety of hardware, software, and network components that must be procured, secured, kept up-to-date, replaced, managed, inventoried, and retired when they reach the end of their life cycle. For enterprises of even a modest size, this is a full-time job for an entire department. The infrastructural components, not to mention the workforce, represents a huge piece of the organization’s IT budget.

Apart from the financial burden, there’s also the constant headache of training employees, maintaining best practices, and planning for future infrastructural needs. The complexity and constraints can easily become unmanageable for the average CIO.

This is the problem that Amazon was struggling with as they built out their e-commerce platform, and when they solved it they found that they had created a cloud computing solution called Amazon Web Services (AWS) that could help any organization manage its IT infrastructure.

By owning the problem of IT infrastructure management, Amazon provided huge advantages to the market.

  • Elastic scalability eliminated the need to forecast future capacity requirements by making additional processing power and storage available on demand.
  • Security and compliance improved, because Amazon could afford to devote more resources to securing its entire customer base than customers could individually.
  • Software upgrades and patches were simplified by managing them centrally.
  • Subscription models became practical, meaning that a capital budget was not required up-front to procure infrastructure.

Yet, in spite of these advantages, the healthcare industry has been slow to move to cloud computing, and the idea of hosting an organization’s interfaces in the cloud is only now beginning to emerge. If other industries were willing to migrate their systems to the cloud, why did health care take so long?

The answer involves multiple layers of resistance that are only now starting to yield to shifting paradigms.

Layer one: resistance to the idea of cloud services

IT Departments are accustomed to managing their own infrastructure, and the idea of ceding some of this responsibility to an outside party means a loss of control. For small IT departments, that never had much command of their environment in the first place, this is not a big problem, but most healthcare organizations have mature, robust IT departments that have been reluctant to take on the risk and disruption of outsourcing part of their infrastructure management. At the very least, they have been unwilling to become early adopters.

As cloud computing services became more streamlined, reliable and capable, health IT departments have started to become comfortable hosting some solutions outside their own data center. Prudently, they began with non-critical systems that contained no private data, such as web servers and provider directories.

Layer two: HIPAA is a big deal

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is one of the fundamental laws that governs the healthcare industry, and IT departments take it very seriously. Given the dire consequences of leaking patient data, it is not uncommon for IT departments to build all of their policies and procedures around preventing a breach. Needless to say, the idea of allowing patient data to be stored in someone else’s data center is one that took some time to warm up to.

As AWS began adding the capability to satisfy HIPAA and FedRAMP requirements, healthcare organizations — particularly software vendors — became more confident building solutions in the cloud. Today, most software vendors are cloud-only or offer a cloud version of their software, indicating the market’s full acceptance of cloud computing.

Layer three: why integration in the cloud?

For a hospital, an integration engine’s purpose is to serve as a message router to connect systems within the institution’s four walls. Why then, would it make sense to locate the engine in the cloud? Doing so would introduce network latency and the need to encrypt data in transit.

The answer is twofold: first, network technology advances have made it easier and faster to send traffic over a wide area network connection. Second, at least some of the vendor applications that are now being integrated into a hospital’s environment are already located in the cloud, meaning that integration is increasingly happening outside the hospital’s four walls anyway.

Healthcare has lagged behind other industries in moving to the cloud, partly for good reason and partly due to inertia. One by one, over the past several years, the layers of resistance have been overcome and now is the time to seriously consider a strategy that involves integration in the cloud.

Rhapsody’s cloud approach utilizes AWS and is known as Rhapsody as a Service (RaaS). To learn more about RaaS click here.

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