Cloud front breezes along briskly
With its ease of installment, functional versatility, cost effectiveness and seemingly limitless capacity, cloud computing is taking the healthcare IT landscape by storm. There are many different deployments happening at facilities across the industry as providers search for ways to improve their computing power, inject vitality into established systems and utilize the cloud's potential for clinical, financial and administrative purposes.
"Cloud computing is definitely a high growth area," says Paul Burke, director of revenue cycle technology for Chadds Ford, Pa.-based IMA Consulting. "It serves as both a conduit and repository for data. For hospitals that are still using 25-year-old technology, hooking up to the cloud provides a wealth of new functionality and enables them to squeeze more mileage out of those systems."
Migration to the cloud over the past decade initially started slowly, with hospitals typically adopting claims processing applications, Burke said. As PCs became more affordable and Internet access more prevalent, he said, these applications took off.
Perhaps the best performance improvement the cloud provides is speed, Burke said.
"Cloud apps can now sit on top of legacy systems and provide downloadable reports in 30 seconds, compared to days with a mainframe," he said.
As abstract as the cloud concept may seem, it contains a wealth of concrete computing strength for those who can harness it. For instance, computational biologist Victor Ruotti recently plugged into a virtual power source of magnificent proportions.
Ruotti works at the Morgridge Institute for Research in Madison, Wis., as part of the regenerative biology team studying human embryonic stem cells. As the winner of the Cycle Computing (Greenwich, Conn.) Big Science Challenge, Ruotti received the financial means to use the cloud as a supercomputer for constructing a massive knowledge-based indexing system for stem cells and their derivatives. The ambitious project consisted of running more than 1 million computing hours against 78 terabytes of data - a total of 115 years of computer run time - in one week.
The landmark index will allow researchers to quickly classify the cells based on their expression pattern and identify genes and regions of the genome that are critical for establishing and maintaining cell states that have potential for clinical applications.
"This is truly an outside-the-box inventive piece of research," said Cycle CEO Jason Stowe. "Victor wanted to move the needle on this important field of clinical study and hopefully the results he generated will be something that can be put into practice."
The sheer scope of the project - a complex series of stem cell sequencing - needed a cyber-boost that is beyond what most institutions have available to them, Ruotti said.
"It is computational intensive and requires significant memory - it can't be done in a regular cluster," he said. "The emergence of cloud supercomputing as an available and affordable research tool could completely transform the class of problem we can solve, enabling larger breakthroughs than were possible before."
Vernon Hills, Ill.-based CDW Healthcare quantified the cloud's impact on the industry in its 2011 Cloud Computing Tracking Poll. The survey asked 1,200 IT professionals about where their organizations are with cloud adoption, the benefits driving it, the challenges still hindering progress and what ideas could enhance cloud implementation.
Jonathan Karl, director of sales, says respondents' most enlightening feedback centered on aligning cloud computing goals with benefits in four key areas: consolidating IT infrastructure, reducing IT energy and power consumption, enabling and improving "anywhere access" and reducing IT capital requirements.
"The technology you can leverage through the cloud allows you to achieve those goals," Karl said. "Still, the cloud is not a one-size-fits-all solution and each organization has its own unique needs. Everyone needs to look specifically at how the cloud can fix their problems."
Reaching rural hospitals
Small community hospitals in rural areas could benefit greatly from the cloud's potential, but the primary challenge is to get them connected first, said David Ellis, director of development for Houston-based Prognosis Health Information Systems.
"The biggest challenge is Internet connection," he said. "With that will come cloud capabilities."
Prognosis is working to provide an infrastructure and pure cloud model to underserved regions of the country, Ellis said.
"What we bring is data and language to our client base," he said. "This truly helps us get to the same language and bring them up to date."
One solution Prognosis has developed is a product called Cloud in a Box - a virtualization of hardware. Working in basically the same way as the old rural telephone party lines, the box contains five servers that can outfit different providers in the same region.
"It would cost too much to bring in a private cloud," Ellis said, "so this allows us to bring virtualization in-house. It allows us to provide much more capacity than they would have on hardware."
Cloud technology developers are resolute in their trust of the security measures guarding information, though "data privacy and security remain a paramount challenge," concedes Pradep Nair, senior vice president of healthcare for Sunnyvale, Calif.-based HCL Technologies.
Even so, healthcare organizations are not letting those concerns dampen their enthusiasm, he said.
"Healthcare organizations need a technology roadmap that can support emerging end-to-end data across payers, providers, employers and consumers," Nair said. "They are embracing the cloud because of its strong potential to significantly improve how services are delivered."
The cloud environment has some issues that are unique, such as "traffic bleed" between users, said James Brown, chief technology officer for Superior, Colo.-based StillSecure.
"HIPAA auditors have pointed out that if users aren't isolated from one another, there can be 'bleeding' between them," he said. "The only way to be HIPAA compliant is to have a fully isolated environment."
Therefore, StillSecure has come up with a product they call HIPAA Essential that includes a number of different security services and bundles them in a way that ensures compliance, Brown said. The product covers 18 key compliance controls, protects inbound and outbound data streams from eavesdropping or forgery and alerts users when issues arise.
The cloud plays a key role in hosting health savings account transactions, which are steadily growing among young people, said Todd Reynolds, chief technology officer of Fargo, N.D.-based Evolution1.
"Four years ago when we were just getting up and running, there were roughly half a million participants in our system - now it is close to 8 million," he said.
The cloud hosting centers provide reimbursement and account management for consumers and employees with HSA plans, said Reynolds, whose company manages roughly 1,200 plans on its cloud. Because the HSA model is still in its infancy, the main challenge for Evolution1 is a lack of infrastructure to accommodate subscribers.
"This is a generation that does just about everything on iPads and iPhones," he said. "The credit card companies aren't standardized so they can't keep up with demand."