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Posts Tagged ‘Cloud’

Healthcare Embraces the Cloud

Liza Sisler, Director at Perficient, recently wrote a blog post about the incredible growth of cloud based services by healthcare organizations:

 “Nearly all cloud adopters plan to expand their cloud services; areas for growth include archived data, disaster recovery and hosting operational applications and data”.   

“The top three reasons for adopting cloud services include lower maintenance costs, speed of deployment and lack of internal staffing resources. The survey shows a positive growth outlook for cloud services as almost all healthcare organizations currently using cloud services plan to expand their use of these tools.”

With healthcare organizations traditionally being slower to adopt cloud based options due to security concerns, this study shows the changing landscape for payers and providers. You can read the full blog post and view an infographic on cloud adoption in healthcare here.

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Posted in Business Intelligence

#TexasHIMSS: MD Anderson’s Consumer Driven Cloud Based Solution

MD Anderson uncovered a potential problem.  Their physicians were using non-approved cloud based storage programs that they “may or may not” have been using to share PHI.  I will note that they use a pretty broad definition for “consumer driven”.  I define consumers as the target market that, in this case, a healthcare provider must engage to generate revenue that impacts the bottom line.  The inside of the organization collaborates with “consumers” outside of the organization.  That’s, perhaps, because I come from the business world where “consumer driven” is defined as “offerings, plans, or strategies motivated by customer demand or expectations.” In this case they were targeting physicians and not patients.  Yes, anyone who consumes a technology is a “consumer” of that technology, but that would basically make the entire technology world as a whole “consumer driven” because every technology is created with someone and their problem in mind.

SBEXRF-00017872-001Now that I have stepped off of my soapbox, below you will see the three steps they used to solve their problem using cloud based technology.

Step 1: Analysis and Planning

Used support of network and desktop teams.  Reached out to a few employees and received positive feedback.  Need to establish an appropriate scope.  Decided it was naïve to say that they couldn’t put the data they use in that system.  They went forward assuming it would include PHI.  Worked with desktop and network teams to identify actual target technology.  Engaged Information Security early.

Step 2: Prototype Pilot Implementation

MD Anderson used the following process to implement their pilot

  • Implement gradually and with care.
  • Evaluate surveys and usage data.
  • Pilot with a mixed user base, prototype with power users and set end user expectations

Pilot program tips were to address security concerns early, take the time to test support and administrative tools, and don’t forget about the support staff.

Step 3: Support and Marketing

Partner with key groups for support.  Advertise that these services are available.  For internal collaboration I often suggest you communicate these new tools “7 different times in 7 different ways”.  In MD Anderson’s case this included advertising the tool on their very own television station and using the help desk to document users that they knew were already using cloud based storage (perhaps inappropriately) and targeting those users.  One of the ways definitely need to be a training program that highlights any self-service functions built into the new program.

Cloud is Driving Scale, Compliance and Growth in Healthcare

Today, a report by market research consulting firm RNCOS released findings that predict the healthcare technology market will grow at a compound annual growth rate of about 10 percent between now and 2018.

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About one-third of healthcare organizations now use cloud technology. 

According to Fierce Health IT:

Continued innovation and government suppport for such tools will factor into the market’s success, according to the report’s authors. The report examines five trends, including an increase in:

  • Wireless and cloud technology
  • Government initiatives
  • Strategic consolidations
  • Reduced operating expenses
  • “Technological upgradation”

The cloud offers the advantages of:

  • Quickly scalable on-demand infrastructure and storage, which clinics, hospitals and provider offices require.
  • Accessibility to healthcare data across multiple settings and geographies, creating a unique opportunity to better serve the patient by sharing information more easily than ever before, and improving operational efficiencies.
  • Vendor technological expertise to support the cloud model.

What about compliance, security, and privacy?

Healthcare organizations must comply with complex medical coding and billing rules, along with HIPAA (Health Insurance Portability and Accountability Act) privacy and security regulations. Healthcare data, including Protected Health Information (PHI), must be kept secure, confidential, available only to authorized users, traceable, reversible and preserved for long periods of time. The right cloud solution for a provider must account for all of these concerns while conforming to HIPAA and Meaningful Use requirements.

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Healthcare CIOs are carefully moving to the cloud

Recently our company has increased our focus on what healthcare organizations are looking for when it comes to cloud computing, in large part due to our acquisition last year of two fantastic Salesforce partners (ClearTask and CoreMatrix). I found this article in Healthcare Informatics to be very interesting. It’s titled “The Many Flavors of the Cloud” and includes interviews with some key CIOs regarding how they view private vs. public cloud solutions and the sensitivity – and often the mandated security requirements – around health data when stored in the cloud.

There are some obvious advantages to providers moving to private cloud storage for all types of data across the organization, but also some critical considerations for any CIO or CMIO. Here are the key takeaways I got from this article.

MedicalImaging_AndroidTabletApp

Medical imaging takes up a lot of storage space in the healthcare space. Imagine a 24 hour study of your heart that takes up a terabyte of space. The cloud can enable better scale for this type of need.

Key insights about cloud computing in healthcare:

  • CIOs interviewed prefer “private cloud” solutions over public cloud solutions like those of Google, Amazon and Microsoft – more control around access & rules
  • CIOs don’t want to deal with power issues, cooling issues, and capitalizing hardware over time – 3 reasons they enjoy Cloud
  • They enjoy reduced costs in scaling a storage room, servers, etc..
  • CIOs take personal ownership over creating their own stringent security requirements for their cloud vendor, making them feel better about storing PHI or other sensitive healthcare data in it.

Read the rest of this post »

Google Decides to Take on Oil of Olay

Calico

 

 

 

 

Google is tackling anti-aging with their new healthcare initiative called Calico.  It remains to be seen if it is a threat to anti-aging creams or will increase their potential customers.  But seriously, Calico is being led by the former Genetech CEO and current Apple Chairman, Arthur D. Levinson and this new healthcare project will leverage Google’s massive cloud and data centers to help facilitate research on disease and aging.  Google already had an investment in 23andMe, and, as a result, has access to a fast growing genomic database that could be used for research into increasing longevity and disease.  Personally, I like these “big bet” investments with a great long term goal by companies like IBM and Google.  Today, we are seeing significant gains in analyzing unstructured information and natural language processing in healthcare, thanks to IBM building Watson to play Jeopardy.  Hopefully, Google’s investment in Calico can bring about innovation in personalized medicine by deep analysis of a person’s genome versus their medical history.  Focusing on an individual’s genetic make-up, it’s impact on aging and the prevention of possible disease is exactly the premise of Eric Topol’s book called The Creative Destruction of Medicine and a bold step in the right direction.

 

Hopefully, Google can use its worldwide reach, like they did with Street Maps, to examine key populations that have longevity today and the combination of their genetics, lifestyles and geography to bring quality of life and wellness to more people.   Google’s investment in Calico could create new “Blue Zones” where a people in demographic or geographic area of the world live measurably longer lives.  Taking guidance from Dan Buettner’s book, “The Blue Zones: Lessons for Living Longer from people who live the longest,” I would suggest that Google begin analyzing the men in Sardinia’s Nuoro province for their genomic lessons.  Studying these centenarians as benchmarks for these rest of us living long lives is a great place for Calico to begin.  Just my two cents worth . . .

 

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Posted in News

Is Cloud Computing the Answer for Healthcare?

It is a much talked about fact that the healthcare industry lags behind other industries in IT adoption. With constantly changing regulations, security concerns, and the pressure to deliver better care at a lower cost, healthcare providers have not implemented the latest technologies to leverage their data. One solution to these issues is cloud computing.

Cloud computing in healthcare holds many advantages, including:

  • Computer closeup detailMobility: Data is stored in the cloud infrastructure, allowing provider staff to access it from anywhere, anytime. 
  • Decreased costs: There is a reduced capital expenditure on hardware and maintenance. Also, hospitals will only pay for the services they use, and challenges can be addressed remotely by IT personnel.
  • Better care: The cloud provides a central platform for EMR data, prescriptions, reports, and patient history. When all of this data is available, the risk for misdiagnosis or conflicting treatments is reduced.
  • Scalability: As the amount of data healthcare provider house grows, cloud server storage can easily be increased, unlike IT infrastructure.
  • Security: Cloud service providers are liable for HIPAA compliance, requiring them to encrypt and securely house data.
  • Speed: Working in the cloud allows for collaborating and sharing data in real time. Data is synchronized as it is processed or updated, allowing staff to work together without being in the same place.

Leveraging the cloud would allow providers to meet regulatory compliance standards at a lower cost than implementing traditional technology. Various forms of data are interoperable, allowing for analysis and reporting. While security concerns remain, cloud computing is becoming a viable answer for healthcare challenges. Read more about cloud capabilities in the article, “Perficient’s cloud prescription for healthcare companies.”

Why is Healthcare lagging in IT adoption?

Earlier this week Phil Fasano, EVP & CIO at Kaiser Permanente, wrote a blog post posing the question: If other industries have proven that IT can improve processes and reduce costs, why has healthcare been so slow to adopt? Phil’s post discusses the current state of healthcare IT as well as what entrepreneurs can focus on in the future. Here are a few key points from the article:

  • If we hope to… improve the quality of care and make it available to more people, while still reducing costs – it is imperative that our health system embraces new and disruptive technologies.
  • According to Insight Research, health care IT spending will grow 9.7 percent annually between 2012 and 2017. That compares to an annual 6.4 percent growth rate in overall healthcare spending.
  • IT systems have…revolutionized financial services, and as a result banks have since saved billions of dollars as consumers first used ATMs for deposits and withdrawals, and then started to pay their bills and make purchases online. According to a Bain & Co. brief, transaction costs have dropped from $4 at the teller window to just 8 cents when paying a bill via a smartphone.
  • EHRs are already proving to save lives and costs, from identifying redundant tests and dangerous drug interactions to revealing trends in treatment outcomes.

The healthcare industry has a great opportunity to employ IT to improve the quality of care and lower spending. But where do we start? Phil suggests that entrepreneurs in the healthcare space being by focusing on: Read the rest of this post »

EHRs: Change is coming in 2013

Sean Brooks, in his article 5 EHR predictions, very astutely anticipates several upcoming changes related to Electronic Health Records:

  1. 2013 will be the year of the replacement EHRs
  2. Many EHR vendors will disappear
  3. The cloud is here to stay

I believe Sean is spot on and I would like to expand on this based on my research and opinions.

Many physicians jumped on the EHR bandwagon to secure Meaningful Use funding for Stage 1.  In fact, some only had to show proof of intentions to collect a check.  Others jumped off the deep end and installed EHR systems only to spend a long time learning the system.  After investing a lot of time in the setup and learning the new system, they realized it doesn’t support their practice.  I’ve spoken to a lot of physicians who feel betrayed and are angry with their EHR vendor.

2013 will be the year these systems with shortcomings get replaced.   Physicians are realizing there are better options on the market and the cost of upgrading is far lower than the cost of continuing to use systems that restrain their business.  There are EHR systems that are designed to adapt to the physician practice instead of forcing the physicians and their staff to change.  Then, there is Meaningful Use Stage 2.  A lot of systems who enabled Stage 1 will not be upgraded to enable Stage 2.  Physicians will be forced to replace their EHR system if they wish to attest for Meaningful Use Stage 2.

EHR vendors will disappear.   The 2014 requirements to certify a system to attest for Meaningful Use Stage 2 are far tougher than the requirements to certify an EHR system in 2011.  Certifying under the 2011 rules was primarily done by sending data that passed a specific set of tests.  In some cases, this was hardcoded for the test and in a production system no longer worked.  The 2014 requirements ensure the EHR vendor’s systems pass legitimate data.  It is no longer possible to pre-pass these tests.  Because of this, I too believe many EHR vendors will leave the business.  Smaller shops that do not have the reach and resources to certify for 2014 will sell out or quit.  Large, inflexible companies will take too long and choose to sunset their EHR products.  Physicians looking for EHR systems this year must be better informed.  They need to exercise care and scrutinize their vendor before jumping into another solution that doesn’t work. Everyone must use a 2014-certified EHR to attest for Stage 2.  One consideration is that those purchasing 2014-certified EHRs can also use them to attest for Stage 1.

Finally, I agree that cloud-based systems are a very smart idea for smaller practices.  It takes a lot of money, staff, and time to build and manage an internal network to host EHR systems.  Independent physician practices should seek out cloud-based EHR offerings so they can focus on what they do best and let the EHR vendors manage the network.   It is smarter to host your EHR in the cloud for several reasons:

  1. Cloud systems are designed for high availability. Independent physicians cannot afford the infrastructure and Information Technology resources to do this themselves.
  2. Cloud systems are expandable.  As data and bandwidth volume grows, cloud-based system can quickly grow (or shrink) to accommodate this.  On-premise solutions are not this nimble.
  3. Cloud is cheaper.  You are sharing systems with other users and can leverage economies of scale.
  4. Cloud is secure.  Although this is a shared service, all competent EHR vendors designed their systems to support the security needed in a shared environment.  This model is also the model supported at most in-house hospitals and larger data centers.
  5. Cloud is interoperable.  As the fog lifts for Meaningful Use stage 3, we can expect more requirements for interoperability.  Hiring an EHR in the cloud is a strong first step.

2013 is a year for some very good and reasonable changes.  What are you waiting for?

Microsoft steps up to the HIPAA Compliance challenge in the Cloud

Prior to HIMSS 2011, I blogged about the 3 reasons for using a Managed Private Cloud for Interoperability.  In that blog, I noted that in healthcare circles, cloud computing conjures up fears for protecting private healthcare information and security compliance concerns.  In the last few weeks, Microsoft has introduced support for HIPAA compliance in their cloud platform called Windows Azure.  Microsoft will work with healthcare customers to comply with their own specific requirements and put in place a comprehensive compliance framework to meet HIPAA guidelines and secure a BAA for storing healthcare data in the cloud.  Microsoft is committed to providing Windows Azure customers with detailed information about their security compliance programs to help customers make their own regulatory assessments, but they opened the door for building a new class of healthcare applications in the Azure cloud.

HIPAA and the HITECH Act are United States laws that apply to healthcare entities with access to patient information (called Protected Health Information, or PHI). In many circumstances, for a covered healthcare company to use a cloud service like Windows Azure, the service provider must agree in a written agreement to adhere to certain security and privacy provisions set forth in HIPAA and the HITECH Act. To help customers comply with HIPAA and the HITECH Act, Microsoft now offers Enterprise Agreement (volume licensing) customers a BAA as a contract addendum.

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It’s time to stick your head in the cloud

A friend of mine started a business providing a uniquely customizable, cloud-based EMR solution.  His business is growing quickly and enables small physician practices to create a “practicized” EMR that minimizes retraining, lowers overall time to deploy, and is ridiculously inexpensive compared to traditional EMR solutions.  His solution offers these benefits because it is cloud based.

Healthcare IT News forecasts cloud computing in healthcare will have a compound annual growth rate of 20.5 percent from 2010 to 2017.  The estimated market is predicted to hit $5.4 billion in five years.

I think this is a positive trend.  Most hospitals and payors centralize their data storage in some way so the idea of shipping PHI across town or across the country is not new.  What is new is the concept that some other organization is responsible for the functions IT is doing today.  This includes system performance tuning, disaster recovery, high availability, and other back-office tasks that are hygiene factors for better healthcare.

On the positive side, collecting usable data from many organizations has the potential to drastically improve outcomes.  Expanding the scope from one or two local facilities to a nationwide network combined with some creative analytics tools can offer insights and examples that are not available at the local level.

For example, epidemiological trends and outbreaks are far easier to catch when multiple sources of data are viewed as a collection.  With a cloud-based, multi-tenant system, the addition of a few rules to monitor this kind of data and create alerts when the trends change is trivial compared to the infrastructure needed to collect data from many sources.   Other examples include population health, chronic disease management, accountable care, and quality.

For cloud computing, the forecast is bright.

Give me agility or give me death!

Today’s enterprise application ecosystems have evolved over an extended period of time, often resulting in fragmented, disjointed application portfolios and systems. IT is responsible for maintenance of existing business applications, functionality and infrastructure that supports current daily operations while at the same time must address the evolution of future business needs. In order to meet timelines and business initiatives quickly while managing resource contention and financial constraints, solutions may be cobbled together. Delivery managers are under great pressure to deliver on business needs or face becoming irrelevant.

As the velocity of change increases IT organizations must embrace change. To understand this change all one needs to look at is Facebook, Google and Apple. Social media, data and mobile applications are changing the way we develop and maintain relationships in our personal lives and is now driving the way businesses deliver products, services and information. New collaborative ecosystems that drive agility are the norm in modern consumer applications. Applications seamlessly connect to other applications to provide new applications. For example, take Google Maps, a standalone user application that also provides an interface allowing other developers to leverage the platform to create new location-based applications. Applications are built upon other applications creating a web of applications called ‘mashups.’

Key enablers of mashups include infrastructure commoditization, service standardization, service reuse and outsourcing. All of this allows for the efficiencies of scale to be realized and ultimately exploited. At the foundation are cloud infrastructure providers like Amazon and Rackspace. When Amazon first introduced its cloud platform, the Elastic Compute Cloud (EC2), in August of 2006, I immediately realized this was a game changer. While this aspect of the new technology paradigm is not as consumer recognizable as Android or the iPhone, it is one of the key technology enablers of today’s app centric world.

Cloud services enable small innovative startups access to world-class infrastructure and platform scalability without having to invest in infrastructure. If you have an idea you can build it, deploy it and scale it on demand only paying for what you use. If you have spikes in usage, say, during business hours, you only pay for the resources you actually use. In a typical datacenter maximizing hardware utilization is a difficult challenge. Infrastructure must be in place to handle peak loads but sits underutilized during non-peak hours consuming datacenter power and space. In addition, if you own it you have to maintain it, manage it and eventually replace it at end of life. With cloud service providers you no longer need to maintain a physical data center.

Expectations of agility, flexibility and speed of delivery is driven by how pervasive this new technology has become in our personal lives. These new platforms are fun and cool but most importantly they are productive. We use these new app driven devices in our personal lives and eventually business will demand IT to deliver to the same standards. For example take the RIM Blackberry and Apple iPhone. Five years ago when the first iPhone was rolled out IT was hesitant to support the iPhone and the Blackberry was king.

Similarly look at the new iPad and Android tablets. Microsoft rules the desktop but how much longer will the desktop be the prevailing platform? On a side note, I find it interesting how we have spent the better part of the last 20 years moving off the mainframe and now we are moving back to the client. The backend architectures are not the same but paradigms are similar.

Ultimately, IT must evolve and embrace this new reality because at the end of the day business survival likely is very dependent on delivering technology services to clients, service providers and partners. If in house IT cannot enable business innovation, business will look to external partners that effectively enable business agility.

Why are Cloud Technologies Leaping to the Top?

Providers are increasing their reliance on cloud technology to better address organizational hiccups and bottlenecks.  Why?  Because cloud technology allows resources to be accessed on demand, which results in a more effective and efficient work force, stronger operations and better customer care.    It is a low-cost option that blows the competition out of the water.

Cloud-based EHRs
With the meaningful use mandate and new legislation, many organizations are “improving” operations by implementing new EHR systems.  These systems are costly but provide great value to organizations and patients.  However, cloud- based EHRs are leaps and bounds above the traditional pre-packaged EHRs, because cloud-based EHRs aggregate the data from multiple, disparate, internal and external sources into a single record or view.  This type of EHR is secure and accessible from anywhere, but more importantly – it puts the burden (and possibly liability) of security and maintenance on the vendor instead of the organization.

Consumers
Healthcare, believe it or not, is becoming a “social” business that connects, interacts and collaborates internally and externally to accomplish its goals (i.e. proper diagnosis, high outcomes and low costs).    To better connect and communicate the industry must rely on cloud technology to overcome the “information gap” – that is the gap between the “consumer” or patient and the information they need.

To date there are numerous “widgets” that will accurately capture the number of calories you burn in a day or steps you took.  There are also plenty of devices that will record the necessary indicators for serious health risks.  However, there are few (if any options) for a consumer who is not chronically-ill to get relevant health-related information and make more informed decisions about their healthcare choices.  Cloud-based EHRs could incorporate patient-centered BI solutions to inform and educate patients.  Basically, the suggestion here is that a “patient Watson” could be in the future and could positively impact outcomes more than any other factor.

Providers
Healthcare providers stand to benefit from implementing cloud technology by enabling providers to receive real-time information on patients from afar.  This translates into better care, because providers may be able to immediately respond to changes in conditions that require emergency medical attention.  By integrating cloud-based technologies throughout a healthcare system, the way healthcare is performed is immediately altered.  Important data that impacts care becomes more readily available and patient status becomes constantly traceable.  With this addition to the healthcare industry, communication and care becomes more timely, efficient and affordable over time – all without adding to the already high administration costs.

Coordinated care is a struggle for most organizations, but cloud technology minimizes the limitations of care given by numerous care givers and across multiple facilities.  We know that having a one stop repository for data minimizes unnecessary or duplicative tests.  We also know that portals to facilitate coordinated care are a must and clinical decision making tools that operate off of EHRs can improve disease and medication management as well as preventative care.  And finally, possibly the most important attribute, is cloud technology’s flexibility and adaptability.  As the federal government refines and changes regulatory mandates, cloud technology will be best suited for providers who don’t want to be bothered with updating and changing hardware.

The Future
The lure to the cloud is rightfully gaining momentum.   From a solution perspective it trumps the competition.  Therefore, the future of cloud technology in the in healthcare industry will be its ability to provide the right cloud at the right time.  Secure clouds will undoubtedly be important, but providing  semi-secure “community” clouds that encourage communication will be equally important.  At the same time, connecting and incorporating automation features and intelligence for customers, in addition to providers and payors, will be the distinguishing attribute of cloud technology.