While there is no doubt cloud adoption has become commonplace among many industries today, healthcare IT has lagged behind for a number of reasons. All of this was made clear last week at the 2019 Defense Health Information Technology Symposium (DHITS) which took place in Orlando, Florida. The event brought together government, military, and industry IT leaders to discuss the latest trends and best practices that are powering the continued success of the Military Health Service, and if there’s one thing that was made clear, it’s that the adoption of cloud for the healthcare industry has evolved in recent years. What once was a security concern has now become a question of having the right architecture in place and the budget to support it.
In an article previously published on GovDataDownload, the editors sat down with Spencer Hamons, former COO and CIO for Taos Health System, to get his take on how cloud and emerging technologies are shaping the future of health IT.
Hamons, now an Executive Architect at NetApp, has been in healthcare for over 20 years and was named to the “Top Nine IT Innovators in the U.S.” by Healthcare Informatics Magazine. He also was previously NetApp’s Healthcare CIO for several years before moving over to the Executive Architect Team, so he had a fair amount of light to shed on the matter.
Here’s what he had to share when asked about the evolving challenges with cloud adoption in health IT and how cloud technology is modernizing the industry in new ways:
Spencer Hamons, Executive Architect at NetApp
Public cloud adoption in healthcare has been much slower than other industries. Several years ago, reluctance was due to security and privacy concerns, as well as difficulty in obtaining the required Business Associate Agreements that all covered entities were required to obtain. However, those concerns have faded significantly as public cloud providers have taken marked efforts to resolve their shortcomings in these areas. Concerns now seem to be more architectural and cost-related.
Architecturally, some of the primary off-the-shelf software providers in the healthcare space still require the use of technologies not readily available in the public cloud, such as AIX and Fibre Channel. Other architectural concerns relate to connectivity to the cloud, both from a bandwidth consideration and from a resiliency perspective. Moving enterprise-class services to the cloud means they must always be connected and must always deliver the right end-user experience, and it becomes more difficult to assure these factors when the focus shifts from on-premises resources you can explicitly control to reliance on third-party, purchased services.
Cost is also a major factor in determining how healthcare entities embrace the idea of the public cloud. In the United States, most healthcare providers participate in both the Medicare and Medicaid programs, both of which require very specific reporting to the federal government. Under government reimbursement models, hospitals and health systems that spend more capital dollars and “reinvest” into their infrastructure (physical facilities, biomedical devices, technology, etc.) are rewarded with increased reimbursement over the next year. Because of this nuance of healthcare finance, many hospitals and health systems continue to embrace traditional capital expenditures (CAPEX) rather than shifting to operational expenses (OPEX).
Public cloud resources are nimble and lend themselves to fast-changing, rapid implementation organizations, where agility is a competitive advantage. Healthcare, for the most part, tends to rely on off-the-shelf software packages and the critical technology factor is reliability and resiliency, not agility. Because of this, the price premium paid for public cloud resources is often viewed as irrational for healthcare organizations when the agility aspect is negligible to daily operations.
There are areas where healthcare organizations are embracing the public cloud, primarily around the archival of stale data and disaster recovery/business continuity. Healthcare is notorious for having poor retention policies, and therefore these organizations hold data much longer than they really should. But this is often a factor of interstate operations with different state and federal rules for data retention for specific use cases, creating a situation too difficult to navigate and remain compliant, so everyone just keeps everything.
This is where moving stale data to cheap public cloud object storage makes a lot of sense. Disaster recovery and business continuity is also an area where the public cloud is receiving significant interest from healthcare entities, although many are embracing their software vendors to provide these capabilities as-a-service.
As daunting as cloud migration and adoption can be for the health IT community, industry IT leaders are addressing the current challenges. A recent eBook from NetApp and Amazon Web Services (AWS) titled 5 Phases for Migrating Healthcare Workloads to Amazon Web Services breaks down the migration process into phases and outlines the most effective ways for health IT professionals to approach each phase.
Embracing the cloud fully across the health IT landscape isn’t something that will happen overnight, but it’s certainly something that experts are working to simplify and expedite, given the invaluable benefits cloud technologies bring to the table for public healthcare.
To learn more, visit www.netapp.com/healthcare.
