It isn't yet obvious to the IT folks in the trenches, or even to analysts and soothsayers who make their living trendspotting, but 2012 may end up as the year of the health care cloud.
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Providers are increasingly looking for solutions to real-life problems brought on by jammed-full data centers that can't expand one more inch despite increasing data-storage needs fromelectronic health record (EHR) implementation and meaningful use, ICD-10 compliance and record retention rules, as well as accountable care organizations and other quality-based incentive programs that breed more patient care documentation.
In 2010, the general feeling of many health care practitioners -- and the IT folks serving them -- toward cloud computing services was, "over my dead body." In 2011, some practitioners embraced the cloud. Cloud EHRs gained steam in the marketplace, the radiology specialty launched a unique image-sharing platform, and telemedicine initiatives connected in-demand specialists with patients who needed them.
This year, cloud data migration will no doubt be a vendor chant at the Health Information and Management System Society's HIMSS 2012 conference. Attendees, too, might make it a serious topic of discussion.
For the most part, though, health care providers have not embraced cloud storage services, despite expanding needs for data storage from increasing EHR adoption and compliance with state and federal records-retention rules that applied to paper and now also apply to their electronic counterparts.
That is changing, according to radiology CIOs and vendors. SearchHealthIT.com chose to discuss the practical application and economics surrounding the health care cloud with that specialty because imaging makes up the biggest chunk of data stored on many health care provider networks.
As such, it's safe to say that radiologists are likely getting hit hardest by the data tsunami. They aren’t yet ready to port their entire workflows into the cloud. But cloud services lend themselves well to targeted tasks, as such as creating HIPAA-compliant backup schemes, accommodating overflow data storage and creating file repositories that can be shared with other providers and increasingly tech-aware patients.
Changes in HIPAA-related to disaster recovery have certainly helped make cloud storage more attractive to help organizations meet their obligations.
Michael Leonard, senior health care product manager, Iron Mountain Inc.
"Changes in HIPAA-related to disaster recovery have certainly helped make cloud storage more attractive to help organizations meet their obligations," Michael Leonard, Iron Mountain Inc. senior health care product manager, said in an email.
"Customers have spent a couple of years getting better educated about the benefits and risks of cloud-based solutions. We believe there is a much better understanding of the issues and a greater comfort level with security in the cloud….Other industries have moved more quickly towards adoption of cloud services and, with success demonstrated in other industries, health care customers have taken notice."
Iron Mountain is seeing the adoption of cloud storage services growing among health care customers of all sizes. There are different reasons for adopting the technology depending on the size of the organization, Leonard noted.
Smaller organizations are struggling with storage management issues and limited resources; they solve storage management issues by utilizing cloud vendors. Larger organizations may be struggling with similar issues, but they are also looking to consolidate similar information from discrete sources (such as several flavors of PACS), sharing that data across the organization and improving their disaster recovery processes.
With a robust WAN, health care cloud may be unnecessary
If a rural health care setting is already served well by an existing regional wide area network, storing data in a private health care cloud -- essentially, a regional WAN with firewalled virtual storage -- doesn't yet make sense. That's according to Cavett Otis, IT director at Imaging Associates of North Mississippi Magnolia (IANMM), a regional radiology practice headquartered in Tupelo, Miss., and serving northeast Mississippi and south-central Tennessee.
So far, IANMM -- which interprets up to 120 studies a day across six hospitals, two imaging centers and several other locations -- is coping in-house with the rising storage needs new imaging technologies require.
On the other hand, bandwidth is a bigger problem for the radiology practice, Otis said. Speed is critical because it affects turnaround time for radiologists reading images, which in turn affects a hospital's ability to determine whether to treat or transfer a patient.
IANMM solved its bandwidth problems by implementing WAN optimization. In some of the smaller towns the company serves, it's already on the fastest possible DSL throughput speeds. Laying a proprietary T1 line would be the only way to increase bandwidth, and it would be cost-prohibitive, so tuning up existing infrastructure was the only realistic choice.