Shaping the Cloud for the Healthcare Industry

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1 Shaping the Cloud for the Healthcare Industry Louis Caschera Chief Information Officer CareTech Solutions >

2 Information technology (IT) is used by healthcare providers as an important tool and strategic advantage in order to help clinicians and caregivers deliver and improve the quality of patient care. Exceptional care is accomplished by having all the right information about the patient available at all times, particularly at the point of delivering care. IT is continuing to be at the forefront of the healthcare industry, partly driven by healthcare reform and the evolving electronic health record (EHR). As a result, innovative IT solutions for healthcare are developing, such as the cloud. The high cost of clinical software and hardware solutions and system maintenance from healthcare IT vendors has prompted more innovative and cost-effective delivery of IT services. Why are healthcare organizations moving into the cloud? According to recent studies, a majority of healthcare organizations are already using or considering using cloud-based services today. There are many factors that are driving the demand for healthcare IT such as pressures to cut costs, the demand to integrate healthcare systems, incentives and initiatives from the U.S. government, an increasing aging population, and the demand to reduce medication errors through the use of computerized physician order entry (CPOE). However, the high cost of clinical software and hardware solutions and system maintenance from healthcare IT vendors has prompted more innovative and cost-effective delivery of IT services. In part, these factors and challenges are driving the interest and movement to cloud services by healthcare organizations. Healthcare IT organizations and their leaders are now seriously looking at public, private and hybrid cloud services as a viable and cost-effective alternative to their on-premises IT solutions for delivering both clinical and non-clinical application solutions. Cloud-based services give them alternatives as to how they would apply and manage their IT capital and operational expenses. Because the cloud provider would typically provide all the required off-premises IT infrastructure as part of its service, most healthcare organizations would apply this service as an operation expense versus a capital expense. One interesting cloud-based model trending in the industry is a repositioning of products and services utilized by hospitals. Healthcare IT vendors that offer clinical and non-clinical applications are doing so with remote hosting services off-premises, usually from data centers that the vendors own while also running supporting hardware and software application infrastructure. This type of service gives healthcare providers a choice to minimize the need to invest their own capital dollars in the IT hardware required to run and support their clinical and non-clinical applications and ongoing operational maintenance expense for what would have been in their own on-premises data center. Although some healthcare IT vendors may not be calling their remote hosting service a cloud service, it certainly can be perceived as a private or hybrid cloud model and service. Cloud service, cloud computing and other terminology The fast-paced shift of information technology services to the cloud introduces new challenges to healthcare organizations. As IT leaders seek cost-effective solutions, it is important to understand cloud-based offerings in order to determine which technology as a service (TaaS) is right for their organization. Some hospitals and healthcare systems might even be using cloud-based services unknowingly, because the services are being represented under different terminology. 2 CareTech Solutions White Paper

3 Consider this if a hospital is outsourcing its data center to an IT service provider, who is providing data center services, then that service today in cloud terminology is called data center as a service (DCaaS). The term cloud was first introduced several years ago as a service, and it widely became known for its connective availability via the Internet, or worldwide network, in order to utilize data storage. A very simple example of a cloud service is the ability to connect devices, such as mobile phones or tablets, via the Internet. This connection would then allow for automatic storage of personal data, such as pictures or contact information, into the cloud. There is, however, another very important component within cloud services called cloud computing. Cloud computing performs the commands that are required to successfully connect to mobile phones or tablets, and then performs the functions to save personal data or pictures in the cloud. This is accomplished by running an application to perform the service that also uses computing devices such as servers and storage. These computing devices actually reside and run somewhere physically, which more than likely are located in the cloud services provider s data center. Cloud computing is also referred to as on-demand delivery of services, and payment is based on usage. The fast-paced shift of information technology services to the cloud introduces new challenges to healthcare organizations. Another example of a cloud service is Web hosting. Today, most organizations websites are being run and maintained in the cloud by a hosting service provider. Types of TaaS being offered by IT and cloud service providers Public, private and hybrid clouds deliver services in different models: Public clouds deliver their services over the Internet Private and hybrid cloud services ensure the delivery of cloud service and its infrastructure as a dedicated and secured service that is tailored to an organization s requirements. There are different TaaS models being offered in a public, private and hybrid cloud: Infrastructure as a Service (IaaS) The cloud vendor provides and manages your virtualization, servers, networking and storage; you manage your applications, data, operating system, middleware and runtime. Platform as a Service (PaaS) Manage your applications and data, while the cloud vendor manages everything else. Software as a Service (SaaS) Access an application (such as ) without having the responsibility to install or maintain the application software or the hardware it runs on. Cloud Hosting Hosting services for websites on virtual servers which utilize computing resources from underlying networks of physical (Web) servers located in the cloud service provider s data center. This service follows the utility model in that it is available as a service versus a product and is comparable with traditional utilities such as gas and electricity. Examples of cloud hosting also fall under both the IaaS and PaaS models. Backup as a Service (BaaS) - A client s on-premises data is copied over a dedicated or shared (Internet) network to the IT service provider s off-premises data center. >

4 Data Center as a Service (DCaaS) - The provisioning of an off-premises physical data center facility and its infrastructure. Clients would lease access to this data center to either house their own servers, storage and networking resources or those owned by the DCaaS provider. Disaster Recovery as a Service (DRaaS) Services which allow clients to replicate and recover critical servers and data center infrastructure. This is typically accomplished by replicating critical servers and data to the off-premises cloud service provider s data center. Cloud service providers are now beginning to offer viable business solutions and alternatives to meet healthcare IT requirements. Benefits of cloud services Cloud service providers are now beginning to offer viable business solutions and alternatives to meet healthcare IT requirements. As a result, a huge shift of IT services and its supporting technologies are being virtually pushed in to the cloud and offered as a service, or more commonly referred to as technology as a service (TaaS), where the word technology is being substituted by the actual cloud service being offered. Cloud services come with many benefits for healthcare organizations: Capital cost reduction Trade capital expense with operational expense. Instead of investing in the purchases of IT infrastructure, such as servers, storage, networking equipment and data centers, you only pay for the IT infrastructure capacity you require and consume. Achieve economies of scale There may be other organizations that are also utilizing a cloud services provider s infrastructure (i.e. data center, recovery center, etc.), which translates into savings. Eliminate maintenance Since the IT infrastructure is being provided as part of your cloud service, you eliminate the direct expenses of maintaining the hardware at your own data center. Improved security This is due to strict security standards that cloud service providers must adhere to in addition to regular security audits. It also includes network infrastructure security, securing active directory, encrypted backups, and encrypting desktops data. Performance, speed, capacity and agility No more guessing on your infrastructure capacity or performance requirements, because with cloud services more can be provisioned quickly. Organization ownership of required hardware and software is minimized. Maintaining or upgrading the infrastructure supporting your cloud is done so by the cloud services provider. You gain operational efficiencies and lower up-front costs. It may provide for easier management of IT staff. Availability of service Establish the required availability you need with your cloud service provider. If you are utilizing DCaaS for your clinical applications and require 100% uptime from an IT infrastructure perspective, then the cloud service provider should have the required IT infrastructure in place to support 100% availability for its data center and wide area network (WAN) connectivity to your users. This is typically handled by an agreedupon service level agreement (SLA) between your organization and the cloud service provider. Enables IT executives to be more strategic The cloud allows you to leverage the latest technology resources thus freeing up your IT executives from overseeing the maintenance of in-house systems. Now your IT executives can spend more time providing the insight to select the right technology and IT services for the business.

5 These benefits should all contribute to total cost of ownership (TCO), return on investment (ROI), and result in a competitive advantage for a healthcare organization. Any consideration to use cloud services must be tightly aligned with meeting an organization s business goals and workload performance requirements. The cloud market is becoming inundated with cloud service providers who may not fully understand the healthcare industry, its applications and required IT infrastructure. Five key factors to consider when determining what services to transition into the cloud The cloud market is becoming inundated with cloud service providers who may not fully understand the healthcare industry, its applications and required IT infrastructure. Because cloud transitioning and its integration to your existing IT infrastructure is key to the success of implementing any cloud service, it would be very beneficial to engage the help of an IT service provider who has the experience and understands healthcare and IT technologies, particularly one that can help decipher the cloud landscape and its services, as well as provide implementation guidance. These services will help establish and confirm a viable roadmap toward pursuing the right cloud services, even starting with one application. The five key factors to understand and help determine if a particular cloud provider s service will meet your IT requirements are: 1. Security Reputable IT Service providers who offer cloud services will be able to explain how they protect personal health information and achieve HIPAA compliance. They should explain how they secure and police their network from attacks, and how they guarantee isolation and security of your data being hosted in their cloud. Ask them about encryption, servers and backups. 2. Availability of Services This is very important in the healthcare industry especially if your IT service provider is hosting your critical clinical applications. We know that no technology is perfect, but you should be demanding close to 100% availability of your applications. Understand how they provide high availability services. Ask them what types of redundancies are built into their cloud infrastructure to eliminate down times. Do they pro-actively monitor their services for problems and uptime? Find out what the protocol is for an outage and the typical response time to get back on line. 3. Performance Understand how vendors provide high-availability services. Ask them what types of redundancies are built into their cloud infrastructure to eliminate down times. Do they pro-actively monitor their services for problems and uptime? Find out what the protocol is for an outage and the typical response time to get back on line. 4. Service Levels Make sure to you consider your service level requirements when evaluating public, private and hybrid clouds. You need the necessary service levels to ensure meeting the required performance, availability, and security of the application and its services being hosted in the cloud and delivered to your organization and its users. 5. References Always ask to speak to current customers with requirements similar to yours. This validation will help you make a final decision when choosing your cloud service provider. As the cloud adapts and matures, healthcare organizations should maintain an open and innovative outlook regarding how cloud services can bring value and drive outcomes for the organization by discussing challenges with an experienced and knowledgeable IT services provider. >

6 Summary Determining an organization s next step toward exploring what cloud service model would be the best fit could present an overwhelming task because of the evolving cloud and its service offerings. To help wade through wealth of information available, I recommend engaging with a knowledgeable and experienced healthcare IT service provider, such as CareTech Solutions, who can assist in developing an organization s roadmap to cloud services. CareTech currently offers TaaS cloud solutions and understands how to help healthcare organizations overcome the challenges and skepticism they face when exploring cloud services. We are subject matter experts about developing and delivering healthcare IT infrastructures because we do it today for over 200 hospitals in the U.S. If you are interested in finding out more about how CareTech Solutions can contribute to cloud services in your organization, call us at or visit our website at CareTech Solutions, Inc.

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