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Clout in the 'Cloud'

Cloud computing prompts healthcare efficiency, cost reductions and improved patient care

By Valerie Neff Newitt

Posted on: February 25, 2013

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Cirrus, nimbus and cotton-ball cumulous clouds make for nice sky gazing, but it's the virtual variety that is raining down changes on the way business is being done. By all indications, this cloud is not likely to float past. "It's not a fad. It's not a bubble. It's not a buzzword. The technology industry is going through a major transformation," said a 2011 online report from Barron's. Indeed, now in 2013 the cloud is gathering in intensity.

So What Is 'the Cloud'?
"It all began in the '70s and '80s with the idea of computer networks," explained David Miller, chief security officer of Covisint, a cloud-engagement company with an identity management specialization. "Each hospital department had a computer and these were linked together into a network. In the 80s and 90s, the internet took hold, and that was really a 'network of networks.'" Indeed, you could type in www-dot-something, and you could connect to other systems - even a hospital network. Suddenly radiologists could even do reads remotely and revue images from home.

It was revolutionary at the time, but "CIOs started to realize they had a big problem," said Henri "Rik" Primo, director of marketing and strategic relationships for Image and Knowledge Management Division, Siemens Healthcare Solutions USA. "With all of these computers located throughout a hospital, IT folks had to know where each one was physically located in each department, be sure that each one had the proper applications, and that each one was running the correct up-to-date versions. In other words, they continually had to check, update, purchase, expand. And as data volume continued to grow, the computer network storage ability had to increase. It started to get out of hand."

Enter virtualization software, allowing all of the computers in a facility to not only talk to each other, but to link all of their resources. "Now all the applications - like the lab system, imaging, EMR, billing, etc. - had been 'virtualized,' and could run on what was needed from any part of those network computers," explained Primo. "They didn't know exactly which resources they were running off, and they didn't care. That was a cloud."

But such private clouds were just the beginning. The cloud concept really took hold when cloud enablement platform Google taught the world that we really didn't need those "www" addresses to access information. "A cloud is amorphous - it obfuscates you from where things are," explained Miller. "We have moved from data-centric systems - where you have to know where data is - to a system that is user-centric. Cloud services like Google go out and find the information you need. All you have to do is tell it what you are looking for, and a long list of information 'destinations' pop up on your screen."

Anywhere/Anytime Information
"The cloud is a way of accessing services or information anywhere, anytime on any device," further explained Michael Sherling, MD, MBA, co-founder of Modernizing Medicine, a cloud-based healthcare software company. "Data stored in the cloud really isn't 'in the cloud' --- it sits on computer servers in a data warehouse that are backed up, secured and monitored."

In healthcare, the implications are far-reaching. For example, it is reasonable that a clinician could log into a single healthcare cloud enablement platform and be able to find information on patient John Doe: a link to his last blood draw and what the test results were, a link to imaging and his latest X-ray, a link to his allergies, a link to his medications list and more.

"Yet while meaningful use stimulus money has increased the adoption of EMRs for physicians, most EMRs still cannot talk to each other in a meaningful way," Sherling suggested. "Many tests are ordered and reordered because providers don't have access to medical information when they need it. To reduce the cost of healthcare and improve practice, it will be imperative for these EMR systems, image management systems and lab systems to talk to each other in real time. Cloud-based technologies can integrate with each other. and the more healthcare professionals can communicate with each other and the more data is available to make the best medical decisions, the more patients will benefit."

Miller agreed. He used the example of an ED doctor who is confronted with a sick patient unable to give a health history. Being able to pull that information from a cloud in an instant could be life-saving. "Imagine the time savings. Imagine the improved outcomes. This is already starting to happen. It's getting easier and easier to aggregate information," said Miller. "I would argue that all of the technology is available. It's just a matter of implementation --- getting EMRs to expose more to enablement systems. Information to be shared is not something easily given up."

Primo concurred that divulging information has caused many a healthcare system to tread softly into the cloud. Some healthcare facilities have found a sense of security in hybrid clouds, wherein a facility hosts an internal private cloud to run applications, but then expands to a hybrid cloud, provided by a secured, HIPAA compliant outside source, for backup services in case their system were to go down.

The Cloud Imperative
David Byrd, vice president of radiology market development at XIFIN, suggested that there is a real imperative for healthcare providers to make peace with the growing pains of cloud adoption as healthcare moves into the digital age.

"There are already over 800 accountable care organizations within the country," Byrd pointed out, "and in order for accountable care to take place and be effective, you have to be able to share information. And the only way you can do that is through the cloud."

He also noted that healthcare is not strictly the domain of providers; the "new" participants are likely to demand cloud access. "Patients are no longer just patients. They are consumers of healthcare," said Byrd. "They want to know what's going on, they want to know what kind of treatment they are receiving, they want to see images on their mobile devices. Patients are becoming more proactive in their care due to electronic medical records." He made the point that this new cloud-enabled awareness may help people become more responsible about safeguarding their health.

While that is conjecture, one thing is certain. Real-time patient information available through the cloud can have a huge financial impact on facilities. "Consider all of the patients coming into an ED," said Byrd. "An automatic eligibility check to verify that a patient has insurance will substantially reduce revenue risks within hospitals."

It has been estimated that the overall cloud computing market will grow to $5.4 billion industry by 2017, and that 71 percent of current healthcare providers are deploying, or plan to deploy, cloud technology. And while some clinicians still cling to the security of a closed system, the advantages of cloud adoption may be too great to resist.

"You have to draw the big picture to someone who is resistant due to security issues," recommended Byrd. "Do you really think the alarm you have in your office or a deadbolt on your closet is going to keep someone from getting patient information? It's ridiculous."

Data-hosting companies "go well beyond HIPAA compliance," said Byrd. "They have a façade building so that you can't identify what it is, they often have armed guards, scanning abilities, backup generators, dry fire suppression systems. They are very well-secured."

And so, it would seem, there is not only information in the cloud --- there is safety, too.

Valerie Newitt is on staff at ADVANCE. Contact: vnewitt@advanceweb.com

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