IT Environment for Medical Community Provides Challenging “Whether”

Determining whether medical providers need cloud computing has become somewhat of an art. Government mandates have blurred the IT playing field, and consumer “cue the cloud” commercials have muddied the water concerning the best solution, with many healthcare providers still trying to comprehend cloud computing. Medical News asked Monty Blight, vice president of product management for Charlotte-based Peak 10 Data Center Solutions, to explain the cloud environment exclusively for our readers.

What exactly is cloud computing? 

Cloud computing is a general term for anything that involves delivering hosted services over the Internet. The goal of cloud computing is to provide easy, scalable access to computing resources and IT services. Cloud computing isn’t a new technology; it’s a philosophy of service delivery. Service models include Software as a Service (SaaS), Infrastructure as a Service (IaaS), and Platform as a Service (PaaS).

Could you give us an analogy?

Sure, let’s use a SaaS example. Ten or 15 years ago, you paid your own taxes by starting at the post office and getting the 1040 form. You brought it home, did your calculations with pen or pencil, and filled in the return. You signed it, put it in an envelope with a stamp, and mailed it to the IRS, along with a check. If you were getting money back, you’d typically have to wait a long time for the refund check to come in the mail.

The next evolution of technology involved getting a CD or floppy disk with a software program to put on the computer. It helped by prompting you with questions and making your calculations. Then you printed the return. You still had to mail it in, but it was a little faster. Plus, the data lived on that disk, or if you left it on the computer, it lived on the computer drive.

Fast forward. That process evolved to the point of going to a website like TurboTax. You log in and if you used the site previously, it remembers you and populates your data.  You add the new information for this year’s return, verify the accuracy and hit send. Your account is debited or money is deposited into your account. You only pay TurboTax upon completion. The information doesn’t live on your computer and you don’t know where it is. It’s in the cloud.

It should be noted that consumers of the cloud are rapidly developing high expectation. I expect any service that I access through the cloud to be ultra secure, always available and very fast.

Do doctors need cloud computing?

Frankly, at the doctor level, doctors don’t need to concern themselves with cloud computing. They need to concern themselves with their unique medical care or business problems and the technology available to solve that problem. If it’s SaaS, then great. If it’s an on-site system supported by local IT staff, that’s fine, too. There’s no one correct answer.  We do see a trend that doctors don’t need servers in their office or files sitting on their personal computer. More and more, they’re able to access whatever they need, whenever they want, as long as they have an Internet connection and a device that connects them to the Internet. That could be a phone or iPad, not necessarily a computer.

Companies that support them are competing to make data more available and easier to use. It’s part of the cloud computing race going on. Obviously, privacy is a huge piece of that equation.

Then who needs cloud computing?

Larger providers, such as hospitals and companies supporting the medical industry, are becoming greater users of cloud computing.

Most often, we see hospitals with such tremendous financial pressure on them, and they’re held accountable for two important points: one, their profit margins are shrinking so they’re trying to figure out how to save money. Two, compliance requirements are increasing. We all know about HIPAA mandates, but the privacy around data and the security steps to secure that privacy are more and more onerous. The penalties are more and more dramatic.

Cloud computing is a great solution for these companies because it allows them to look to a third party to provide computing services, and to pay for it monthly rather than wrap up capital buying hardware and software and paying to maintain it. More companies are going to providers like Peak 10 to provide cloud services for them. They’d rather pay us a monthly operating bill to manage this environment for them on hardware we own rather than go out, buy hardware, refresh it, maintain it, and support it. They’re telling us they want to concentrate on their core business which, in the case of hospitals, is taking care of their patients.

What’s the quantifier?

We typically don’t see a certain size, such as a particular number of doctors or patients supported in a practice or hospital. The primary question has to do with their uptime requirement: If they lost access to their data for a period of time (let’s say 10 minutes), would it be an inconvenience or a significant problem? If it would be a significant problem, those are the folks more inclined to use our services, whether 24/7 support personnel, redundancy through data centers, and/or cloud infrastructure.

What’s the pushback?

We’re seeing the most pushback in the audit environment. HIPAA has certain guidelines from an infrastructure standpoint concerning where the data is located, the physical requirements, and the defined separation of data. While technically, data can be separated, segmented and secured, you’re looking at patients who may have data on the same storage area network as other patients. Auditors are gravitating to it, but it’s a concern because some auditors say cloud computing doesn’t have the necessary compliance factors to support that environment. From a Peak 10 perspective, it doesn’t matter.  We provide services based on the unique requirements of each customer. That can be Enterprise Cloud, Private Cloud, or management of physical devices.

What are other cloud options?

The classic answer is, of course: it depends. A hospital could completely go to the cloud to offload the “compute” layer, use cloud for temporary services, or build a private cloud.

There are two critical concepts in any organization’s IT design. It has to do with resiliency and recovery: Recovery Time Objective (RTO)—if my primary site went down, how quickly could I get up and running with Plan B?—and Recovery Point Objective (RPO)—how far back is data saved? 5 minutes? 24 hours? How much is spent should match the organization’s unique RTO and RPO.

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