Feature | March 14, 2012 | Helen Kuhl

Healthcare Still Slow in Moving to the Cloud

This article appeared as the introduction to a chart on cloud storage in the March 2012 issue.

The term “cloud computing” has been around for almost 10 years, but it only entered the healthcare vocabulary a few years ago. Today, many healthcare providers are confused about what cloud computing is and especially about how it is being used within healthcare and its potential applications for the future.

This is one of the findings that KLAS identified in a study released last November, “Path to Cloud Computing Foggy: Perception Study 2011.” KLAS spoke with 97 providers and found that most define cloud computing as something remotely hosted, where the data is accessible over the Internet. While those attributes are correct, the study noted that few providers understood all the other elements involved, namely, that a cloud should be virtualized, elastic, scalable, metered and residing on pooled or shared resources, to be considered a true cloud.

KLAS identified three basic cloud service models: Software as a service (SaaS), infrastructure as a service (IaaS) and platform as a service (PaaS).

“SaaS allows the user to deploy the software quickly, but restricts the customization of the application,” the report said. “IaaS refers to the provisioning or outsourcing of hardware, servers, storage and networking components, typically via the Web, and allows the user to swiftly allocate computing resources. Finally, PaaS refers to both the infrastructure and sevices to run software or to develop and test software.”

There are three delivery models: Private cloud environment, public cloud environment and a hybrid cloud environment. According to the KLAS research, healthcare providers lean toward a preference for the private cloud.

Cloud for the EMR and PACS
More than half of the respondents are deploying something in the cloud currently; for many, it is their electronic medical records (EMR), and it usually is in a private cloud. Respondents who said they are considering a cloud would follow a similar path, mentioning first deploying their EMR in a private cloud, followed by their picture archiving and communication system (PACS).

Not surprisingly, it is the challenge providers are having with image storage that oftentimes provides a push toward the cloud. Facilities are having to store a massive volume of images from all different departments, and it’s a problem.

“…the ability to put one’s PACS images in a cloud is attractive to providers who struggle to keep up with image storage demands,” the report said.

Respondents who talked about putting their PACS in the cloud said their image storage capacity is filling up much more quickly than they had anticipated, said study author Erik Westerlind, a senior research director with KLAS. “One respondent said they had a three-year plan to upgrade their storage capacity, but found they were already full just 1-1/2 years into it,” Westerlind said. “This is typical. Cloud also is seen as a great solution for offloading older images.”

When it comes to using the cloud for imaging, respondents also mentioned other benefits, such as off-site storage, backup and disaster recovery. “It is perceived as good in terms of business continuity as well,” Westerlind noted. “If something happens and they need to get an image, they know that it’s stored somewhere else.” Providers also like the fact that the cloud provides almost instant availability of images, which enhances collaboration between facilities and physicians.

The providers surveyed see the cloud as offering cost savings that would come from reducing on-site storage and network infrastructure costs, like ongoing maintenance, labor and hardware. But the reality does not always match that perception, Westerlind noted. Some respondents found the cloud is not necessarily cheaper, especially since healthcare providers usually want a private cloud option for security and privacy. But for the price, it can provide access to better equipment and 24/7 technical resources, which is seen as a plus.

Some Uncertainty for the Future
A little more than half of the respondents to the KLAS survey showed interest in using cloud technology, but only about a third plan to do it in the next two years or so. The main concerns providers have are data security and privacy. There is skepticism about whether a public cloud could provide HIPAA compliance, and providers also feel they would lose control with a public cloud. Some providers think the only solution that could ever work in healthcare is a private cloud. Providers really want healthcare-specific solutions, and that goes for everything from EMRs to health information exchanges (HIEs) to analytics to PACS and accountable care organizations (ACOs), the report noted.

“Providers are more confident in complying with privacy and security regulations with images than with EMR data,”  Westerlind said. “But there still is sensitive data attached to that image. There also is a security concern because things are being accessed through the Web.”

Another concern about the Web access component is simply the connectivity issues, Westerlind added, “especially among providers in more remote areas. They don’t have much faith in being able to connect without problems.”

In general, the report concluded that “the fog in the cloud remains,” i.e., healthcare providers are not yet ready to jump into it wholeheartedly. Questions and concerns remain.

KLAS’ mission is to improve the delivery of healthcare technology by independently measuring and reporting on vendor performance. For more information about this and other reports, visit www.KLASresearch.com.

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