Health care organizations find themselves with enormous and still-growing datasets to manage, with heavy contributions from computer-based imagery and increased adoption of electronic medical records. Cloud storage would appear to provide a potential remedy, yet security and bandwidth concerns have prevented a headlong rush into the technology. Stricter penalties for exposing protected health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA) also inspire a slow approach to the cloud.
Channel executives, unsurprisingly, aren't experiencing a massive wave of health care cloud storage projects. But they do see some stirrings of activity.
"We are starting to see more interest in the cloud," noted Mike Garzone, solutions director, advanced technology, CTG Health Solutions. "We are seeing caution around security. We are a pretty big proponent that people do proper due diligence around security before making a decision."
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Integrators, resellers and service providers say their work in health care cloud storage covers consulting, security advice and implementation support. Channel players may also resell public or private cloud services or host their own cloud storage solutions. Key applications include backup and disaster recovery.
Cloud storage vendors, meanwhile, aim to build channel relations. But some of their allies aren't traditional value-added resellers VARs. Some vendors now offer cloud storage to hospitals which, in turn, resell the service to medical practices. Cloud providers may also partner with health IT vendors, which bundle cloud storage services into their product offerings.
Storage service lines
Garzone said CTG provides advisory support services to health care clients, helping them weigh cloud deployment options. Another area of steady demand: security consulting. Garzone said CTG, as a matter of course, considers a health care provider's cloud structures as part of a security sweep. The company's security solutions practice provides risk assessment and data loss prevention among other services.
"Customers' use of Software as a Service and externally hosted data in the cloud...is always a factor," Garzone said.
Channel companies also are pursuing hands-on work, stepping beyond the advice-giving role. Indeed, integrators and resellers offer to help health care providers implement cloud storage solutions.
Todd O'Bert, president and chief executive officer of Productive Corp., a specialized software reseller, said his company helps health care customers deploy hybrid storage environments. He said his company's cloud storage work mainly revolves around migrating customers from a traditional back-up solution – CA's ARCserve, for example – to a hybrid environment using the same platform.
The cloud side of the hybrid setting could involve a private in-house cloud or an off-premise cloud-based service.
"It's a horizontal trend across industries," O'Bert said of hybrid environments. He cited HIPAA compliance as the main factor setting health care apart from other vertical markets.
The company equips health care customers with the necessary software and educates them on potential uses. Bandwidth remains an issue in cloud storage, O'Bert noted.
"The pipe always seems to be the limiting factor, internally and externally," O'Bert said.
As a consequence, organizations looking at the cloud for backup and disaster recovery need to determine how quickly they will need to retrieve a given set of data. For instance, an older set of patient records may be better suited for a cloud archive than other types of data.
"How critical is the data and what is my recovery time objective for that?" O'Bert said, framing a pivotal question for customers.
Integrators may also resell a vendor's cloud storage service and, in some cases, may offer their own cloud. Logicalis, an IT solutions and managed services provider, does both. The company offers its Logicalis Enterprise Cloud, a multi-tenant private cloud service that also includes security, managed services and consulting. The company also resells public cloud storage.
What we found is that backup and data disaster recovery are the areas they are venturing into."
Gary Sevounts, vice president of marketing, Zetta
The particular cloud service Logicalis provides depends on the application and the end users' needs, said Karen Burton, Logicalis U.S. health care business development manager. Many customers want encrypted storage, for example, but that feature is not always available through public cloud storage, she explained.
In general, backup and disaster recovery stands out as perhaps the most active cloud storage application in health care.
Gary Sevounts, vice president of marketing at Zetta, an online backup vendor, said health care CIOs are looking for a cloud application that generates immediate benefits, but does not open the organization to new risks. The latter consideration may rule out housing electronic medical records (EMRs) data in the third-party cloud. But backing up accounting and business data to a cloud environment appears less threatening.
"What we found is that backup and data disaster recovery are the areas they are venturing into," Sevounts said. Zetta focuses on cloud-based backup, offering snapshot and replication technologies as well as disaster recovery.
For its part, Logicalis offers disaster recovery as a service, among other cloud offerings. With this service, customers replicate their data into Logicalis' cloud. In addition, the company makes virtual servers available for clients in case they need them.
Garzone, meanwhile, cited using cloud storage to house–and provide disaster recovery for–picture archiving and communications system (PACS) images.
"I think that is a very practical application," he said.
In general, infrequently accessed large-content files will inevitably move to the cloud, said Steve Zivanic, vice president of marketing at Nirvanix, a cloud storage service provider. He said organizations seeking to cut costs will move their tier 3 and tier 4 data to the cloud instead of spending money to keep in-house storage systems up to date.
As vendors phase out storage products, customers face purchasing new gear and migrating their data. Zivanic noted the example of NetApp discontinuing its virtual tape library (VTL) product, a move that compelled customers to seek a new vendor. VTLs are typically used in backup and disaster recovery.
"Companies are basically saying, ‘I'm not going to refresh my infrastructure anymore'" when it comes to systems for storing infrequently accessed content, Zivanic explained.
"These systems and new technologies coming out are expensive for hospitals to implement," added Tommy Curb, vice president of business development and legal affairs at Venyu, which offers cloud and data center services.
Accordingly, health care customers are eying cloud services as a way to protect their data.
"Backup is a good fit," said Matt Wallace, vice president of marketing at Venyu. "The cloud is going to be an interesting exploration over the next year or two for our customer base." Venyu partners with resellers, managed services providers and consultants.
Whatever the application, private clouds or hybrid environments mixing private clouds and in-house storage appear to be the models of choice in health care. Health care providers do express some interest in public clouds such as Amazon's Simple Storage Service and Microsoft's Azure, but the applications tend to be fairly narrow.
"The only area we have had an interest in has been for archiving a second copy of medical images," Burton said. Moreover, those second copies are of "healthy studies" as opposed to images depicting health issues, she noted.
Other paths to cloud storage
Channel companies may also help health care customers deploy online EMR systems or host health care-related SaaS applications. Those scenarios, in effect, offer cloud storage, albeit as part of a broader offering that remotely hosts an application.
Garzone said EMR products from vendors such as Practice Fusion and eClinicalWorks are "provisioned from the cloud and most of them are multi-tenant structures to begin with." The channel work here, he said, is on the implementation side.
Similarly, SaaS offerings place data in a cloud setting. Logicalis, with its enterprise cloud, currently hosts payroll, time and attendance, revenue cycle management and analytics among other health care applications, Burton said. Logicalis' cloud software partners include API Health care, which specializes in health care workforce management.
Burton said the SaaS business, thus far, focuses on non-patient-critical applications. In contrast, hospital systems from vendors such as Cerner Corp. and McKesson Corp. are staying in-house.
"We are not seeing an interest in going to the cloud with those core systems," Burton said.
In another twist, health care organizations may obtain cloud storage solutions from non-traditional resellers and service providers. Nirvanix's pact with Cerner is a case in point. In that arrangement, announced in October 2011, Cerner embeds Nirvanix private cloud storage as part of its Cerner Skybox offering. With Skybox, Cerner is deploying 2-plus petabytes of Nivanix cloud storage, which it resells to its hospital clients, Zivanic noted.
"They are basically shifting from an IT consumer to an IT services provider and the cloud is enabling them to do that," he added.
Similarly, health care organizations are thinking about serving up cloud-based storage as a perk for doctors.
"Many hospitals are looking to provide those kinds of services ... to attract doctors to affiliate with them," Sevounts said.
Zivanic said he doesn't believe the non-traditional providers will impact conventional resellers.
John Moore is a Syracuse, N.Y.-based freelance writer covering health IT, managed services and cloud computing. Let us know what you think about the story; email email@example.com or contact @SearchHealthIT on Twitter.
This was first published in July 2012