P R E PA R E D O N J U LY 3 0 , 2 0 1 3 BY G R O U P 4L AW R E N C E M O R I A R I T Y

J O A N N E PA L L A ST O N Y N G O

CLOUD COMPUTING IN HEALTHCARE

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INTRODUCTION

• Cloud Computing is a big trend in the Information Technology (IT) world.

• Unfortunately the health industry is lagging behind compared to other industries when it comes to adopting cloud technology.

• In a survey conducted by technology vendor CDW, only 35% of health organizations use cloud service, while other major sectors averaged 44% (Narisi, 2013).

• Moving to cloud service would move responsibility of infrastructure management to cloud providers and allow healthcare facilities to focus on patient care.

• There are many challenges to cloud computing such as security risks, compatibility with healthcare IT infrastructure, and training cloud computing skills.

• Healthcare IT professionals must learn that the benefits of cloud-computing outweigh the costs as cloud technology allows not only cost savings, but simplify information infrastructure by creating new innovative health IT systems.

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BACKGROUND

• The healthcare industry is slower than other industries in taking advantage of new technology. • Many hospitals and clinics are still using paper

medical records and hand-written notes.

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WHY CLOUD COMPUTING?

• Health organizations continue to use licensed software, operating hardware that requires significant resources to operate and training on the necessary skill set.

• Millions of dollars are lost each year as redundant waste is created at the consumer expense. In a recent study by Price Waterhouse Coopers Health Research Institute, it was determined that the U.S spends “about $2.2 trillion a year on healthcare and nearly half of that amount is wasted” (Bockrath).

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WHAT IS CLOUD COMPUTING?

• Cloud computing is a form of virtualization that shares IT infrastructures such as data storage and software applications over the internet.

• Cloud computing utilizes 3 types of Service Models; Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS).

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CLOUD COMPUTING MODELS

• There are also 4 different types of clouds:• Private, Public, Community, and Hybrid clouds

• Private clouds centers around a single organization that controls the resources.

• Public clouds are less expensive, open to all customers and operated by cloud providers.

• Community clouds are basically smaller versions of public clouds that support specific users or groups.

• Hybrid clouds integrate important elements from 2 or more of the cloud types allowing for a balance of security and service.

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BENEFITS OF CLOUD COMPUTING

• In a recent report, experts from the College of Healthcare Information Management Executives (CHIME) stated that by using cloud computing, the Health industry could save up to $11 billion in the next 3 years (Narisi, 2013).

• Health organizations can save up to ten times the cost by having a third party host applications and data storage compared to hosting servers and maintenance cost for IT support (Bockrath).

• With cloud computing, organizations can store and share large amounts of data previously not possible with the organizations limited infrastructure capacity.

• For example, the large data sets from DNA sequencing would overload most servers (CSCC, 2012). The cloud platform gives health providers the ability to manage large amounts of data for analyzing and tracking information on patients such as treatments, costs, performance, and studies.

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CHALLENGES

• With cloud computing, the organization is reliant on the internet connection. When the internet is down, the service to the cloud computing service is offline.

• With the ability to access information from anywhere in the world, there are possible security and privacy concerns “which can arise as a problem when users store person data in clouds and lose control of who has which access and usage right” (Timmermans et al, 2010).

• This is also an issue with intellectual property, which can be dispersed among different jurisdictions and lead to a variety of legal and ethical issues.

• While many cloud computer vendors present themselves as utility-based providers, claiming that “you're only charged for what you use”, that is not necessary true. In most cases, an organization must commit to a predetermined contract independent of actual use.

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KAISER PERMANENTE ISSUES

• Kaiser faced budget constraints and economic pressure to dramatically improve Health Care while ensuring IT remained affordable.

• There was political pressure as well as the Obama administration has often referenced Kaiser as a model for health care organizations.

• Kaiser spends millions of dollars per year on lobbying activities, so politics influences IT projects prioritization such as being prepared for the changes mandated by the HITECH Act of 2010.

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KAISER IMPLEMENTATION APPROACH

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KAISER PERMANENTE

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KAISER PERMANENTE IMPACTS

• The decision to use cloud computing was an organizational investment that required creativity and strong commitment to realize the benefits.

• Management started communications early in order to educate the organization on targeted solution.

• Cloud computing has enabled Kaiser to “consumerize business services” by integrating service delivery solutions with elastic support for dynamic business needs and “convergence of SOA and cloud technologies to transform delivery and consumption of IT services” (Nutakki & Matos, 2011).

• This has led to interoperable application components for rapid realization and sustained operational management.

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KAISER PERMANENTE RATIONALE

• Kaiser opted for private cloud and internal hosting with the view that it can eventually get to a public or hybrid cloud when factors like security are strengthened. • Nutakki said "From a legal standpoint, none of the

public clouds yet are able to guarantee the data protection that we would require as a health care company".

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FUTURE OF CLOUD COMPUTING

• Cloud computing is in the early stages of adoption by healthcare providers, but its popularity is growing.

• Utilizing cloud computing services is limitless; an organization is only restricted by their imagination on the type of services they want the cloud computing services to provide.

• Markets in these regions are predicted to grow at 34% annually until 2015. “The total public cloud services market size in 2011 was $91.4 billion and it will grow to $206.6 billion in 2016” (Gartner, 2012).

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SUMMARY

• As with all new technology, there are various advantages and disadvantages of implementing cloud computing in a health organization.

• The advantages of using cloud computing in a health organization far outweigh the disadvantages, and have great potential for the future.

• Health care organizations need solutions that can help physicians collect, connect, analyze and act on all the information available to improve a patient's health.

• Cloud computing services can provide in real-time at the point that care is delivered critical health information. As the user base grows and abundance source of new technological capabilities, one can only imagine the potential growth of cloud computing.

• With seemingly endless benefits, cloud computing is changing the landscape of the healthcare industry and allowing providers to focus on their core competency providing top quality medical care.

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ASSESSING YOUR KNOWLEDGE

1. Are health organizations quickly adopting cloud computing technology?

2. How secured is the data stored in the cloud?

3. What type of cloud computing platform did Kaiser implement?

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OPEN DISCUSSION

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REFERENCES

• Bockrath, M. Just What The Doctor Ordered: Cloud Computing For Healthcare. Retrieved July 23, 2013, from http://www.kellyocg.com/uploadedFiles/Content/Knowledge/Ebooks/Just%20What%20the%20Doctor%20Ordered%20-%20Cloud%20Computing%20for%20Healthcare.pdf

• Cloud Standards Customer Council (2012). Impact of Cloud Computing on Healthcare. Retrieved July 23, 2013, from http://www.cloudstandardscustomercouncil.org/cscchealthcare110512.pdf

• Gartner (2012). Gartner Says Worldwide Cloud Services Market to Surpass $109 Billion in 2012. Retrieved on July 24, 2013, from http://www.gartner.com/newsroom/id/2163616

• Narisi, S. (2013). Overcoming the 4 biggest cloud computing challenges in health care. Healthcare Business & Technology. Retrieved July 23, 2013 from http://www.healthcarebusinesstech.com/cloud-computing-challenges/

• Nutakki, M., Matos, C. 2011. Kaiser Permanente Cloud Computing. Retrieved July 29, 2013 from http://www.ibm.com/ibm/cioleadershipexchange/us/en/pdfs/CAEast_2_Cloud_Nutakki_Matos_4-6-11_FINAL.pdf

• Roberts, K. (2013). Top 9 Disadvantages of Cloud Computing. Retrieved from http://www.superb.net/blog/2013/03/04/top-9-disadvantages-of-cloud-computing/

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REFERENCES (CONT)

• Science Applications International Corporation. Cloud Computing in Healthcare Organizations. Retrieved July 23, 2013, from https://www.saic.com/news/resources/CloudComputingHealthcare.pdf

• Techie, C. (2011). Top 5 Disadvantages of Cloud Computing. Retrieved on July 24, 2013, from http://www.cloudcomputingtechie.com/top-5-disadvantages/

• Timmermans, J.; Ikonen, V.; Stahl, B.C.; Bozdag, E., "The Ethics of Cloud Computing: A Conceptual Review," Cloud Computing Technology and Science (CloudCom), 2010 IEEE Second International Conference on , vol., no., pp.614,620, Nov. 30 2010-Dec. 3 2010 doi: 10.1109/CloudCom.2010.59

• Ward, S. (n.d.). 5 Disadvantages of Cloud Computing, Consider These Before You Put Your Small Business In the Cloud. Retrieved on July 24, 2013, from http://sbinfocanada.about.com/od/itmanagement/a/Cloud-Computing-Disadvantages.htm

• Wohlfarth, J. (2013). The Future of Cloud Computing. Retrieved on July 24, 2013, from http://blog.sendgrid.com/the-future-of-cloud-computing/