By Inga Shugalo, healthcare industry analyst, Itransition.
Following the wind of change, we find that healthcare is on the way to transferring most of its processes to the cloud. According to IDC, hospitals now tend to prefer keeping custom medical software from EHRs to AI and data analytics on cloud servers instead of in-house management.
With more providers investing in scalability and cost-efficiency of cloud solutions, the recent research forecasts the global healthcare cloud computing market to reach $35 billion by 2022 at 11.6 percent CAGR.
Currently, the cloudification develops in two complementary directions.
Some providers only test the waters going for a new cloud solution, for example, a mobile app to support chronic disease management. Others consider migrating their already existing architecture elements to the cloud to enable seamless synchronization between different system parts, create new team collaboration practices, or save time and money on the infrastructure maintenance.
Since cloud migration is a complex process requiring substantial planning and good timing, we’ve decided to cover the initial steps of a smooth transition to the cloud.
Assessing the infrastructure
First things first, there is a good chance you don’t need to migrate the full infrastructure and can better manage your investments by injecting them into strategic areas only. Start with considering your as-is situation and pinpointing the architecture components with the potential to impact the business evolution via new or improved services.
Additionally, take into account the possible technology and business constraints, upcoming updates, integration and compatibility requirements for the solutions, as well as the need for a substantial redesign before starting the cloud migration.
It can turn out that some big data archives that aren’t used frequently can stay on-premise, and some applications will serve providers better from the cloud due to increased robustness and security for the regular multi-user access.
In this case, an organization can choose to go for the hybrid environment, decreasing the load on in-house servers and adding up more flexibility to the picked system elements.
Self-check: What are our migration goals?
Answering this question, you will be able to determine the priority elements for migration to the cloud by determining the most pressing needs, such as everyday workflows, equipment management, or disaster recovery.
While thinking about the goals, review all parts of the infrastructure, including business and clinical applications, such as EHR, LIS, PACS, and RIS, assigning them to one of the following categories:
First to be migrated
Future migration projects
Unable/unneeded to migrate
With such a clear prioritization, it will be easier to assemble a migration roadmap that will guide the project scope creation, design, and implementation processes.
Drafting a migration strategy
After your priorities are all set, it is time to create a migration strategy based on applications and data to be transferred to the cloud. You can either pick one of the approaches or mix and match them depending on particular infrastructure elements.
Can you remember how you operated without a cell phone at your disposal 24/7? If you’re like most people today, braving the outside world without a cell in hand probably gives you palpitations. The healthcare industry has seen a comparable shift as a result of technology innovation over the past couple decades. So much so that healthcare practitioners who are somewhat new to the industry may not be accustomed to the manual practices that were in use just a few years ago.
As for today, we know that healthcare companies are using cloud. Perhaps most prominently, electronic health records (EHR) are widely adopted. In fact, the Healthcare Information and Management Systems Society (HIMSS) reports that a majority (83 percent) of healthcare organizations are using cloud services today. With adoption spanning nearly the entire industry, cloud technology has transformed how healthcare is administered.
Given the scale of cloud adoption, a few questions remain. Namely, how is healthcare using cloud today? Now that the industry has adopted the cloud, what does the future hold?
How Is Healthcare Using Cloud?
To start, let’s explore one specific use case. Medicalodges, a post-acute healthcare organization based in Kansas, was looking to get away from managing its own infrastructure. By moving to the cloud, it was able to improve collaboration, security, and set up a business continuity/disaster recovery (BC/DR) solution. Today, the organization has virtualized its servers with dinCloud’s Hosted Virtual Server (dinServer) solution. As a result, Medicalodges reports benefits including: improved collaboration, security, disaster recovery, cost savings, and scalability. Looking ahead, Medicalodges has future plans to run a mix of browser-based thin clients and continue to expand its cloud infrastructure.
In its 2014 Analytics Cloud Survey, HIMSS found that 43.6 percent of surveyed healthcare organizations are currently hosting clinical applications and data. Meanwhile, 35.1 percent are using the cloud for BC/DR, 14.9 percent have virtualized servers, and 8.1 percent are using hosted virtual desktops (HVDs). In another case, a medical organization needed to run several versions of a specific testing application. However, they could not run it on the same computer because of compatibility conflicts of running the same application in multiple instances. They leveraged application publishing from dinCloud to virtualize the application. The application sits in the cloud and can be opened in multiple instances on the same computer now.
Over the past few years, we have seen the healthcare industry shift toward cloud-based services to improve workflow, patient care and access to information. In fact, a 2014 HIMSS Analytics Survey estimates 80 percent of healthcare providers use the cloud to share and store information today. A cloud network allows physicians, referring providers and specialists at many different sites to simultaneously and securely access patient information in real-time on any Internet-connected device to provide urgent care to patients. This technology is changing how information is exchanged to meet the needs of both physicians and patients. Specifically, using cloud-based services for medical image and report sharing can be a game changer when it comes to advancements in quality of care.
Patient care before the cloud
The best way to explain the benefits of cloud-based image and report sharing is to look at life without the cloud. For providers not using this technology, medical images are stored on a physical CD, and the patient is responsible for carrying it from facility to facility – or, even worse, providers rely on couriers and the postal service to ship discs (which takes days and delays patient care). Most physicians will attest that 20 percent of these CDs are lost, forgotten or corrupt. When this is the case, not only is all the information stored on the CD lost, but time and money is wasted having to repeat the imaging procedure.
Josh Pavlovec, PACS administrator at Children’s of Alabama describes the challenges physicians faced to read CDs before the facility moved to a cloud-based image exchange. “In the middle of the night, if a trauma surgeon needed someone to look at a CD that couldn’t be opened properly, that surgeon or a resident, would physically run the patient’s CD down the street, knock on doors and find a radiology resident to view that study; and then run back to their OR and start treating the patient.”
Another challenge arises when a complete profile is not made available to the entire patient care team. For example, if a patient is sent by a primary care physician to a larger hospital for an exam, and the hospital sends the patient to an outside specialist – that specialist will likely not get the patient’s full medical history, and will certainly not receive that information prior to the patient’s arrival. Children’s emergency physician, Dr. Melissa Peters explains, “Having the reading that’s associated with the transferred images is something that’s very helpful to us. When we have a child that’s transferred, our pediatric radiologists interpret the films, and they need the reading from the other facility in order to create a comprehensive report.”
The absence of readily available images and reports creates silos of patient information within healthcare leading to costly delays and repeat testing and, limiting the quality and efficiency of care provided by teams.