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If consumers can't do it, health IT cloud far away

For me, today’s technical travails started with morning coffee. As in, a piping-hot pint of it dumped on my work laptop keyboard. The nightmare came with the realization that dependency on desktop-based applications almost deep-sixed a high-priority piece of content for SearchHealthIT: a podcast recorded with a National Health IT Week participant who had taken time out of his packed schedule to chat with us from his hotel room in D.C.

With TechTarget’s virtualization efforts and other available tools, it would seem to be pretty straightforward to find alternate paths to accomplishing a podcast. After all, it’s just recording a phone conversation and routing a 70MB audio file to the proper colleagues not even 40 miles away. Piece of cake, right?

Yet, there was no way around connecting that laptop to our VPN because part of the process required to move the audio file from my machine to the network used desktop-based applications tied to the intermittently failing laptop. The only way out of the problem was through that laptop, whose “u” key was stuck down most of the time, as was “page up.” The USB ports would work — but for only a little while at a time.

Some of the podcast-making aspects were cloud-based; for example, I accessed the conference dial-in number and passcode via smartphone. Both email and instant messaging collaboration could be done from other laptops or even my iPad via the Web. Even this blog post was composed in WordPress on a different computer than the one we shall refer to as “the barista.”

In the end, if I couldn’t find a working USB port on the coffee-soaked lapper, it was doomsday for today’s podcast. No way around the bottleneck. All’s well that ends well — the barista held together for four consecutive minutes to upload the audio over the VPN, and coworkers covered a couple Microsoft Word-related processes the cloud alternatives couldn’t.

The talk at the instant-messenger water cooler after the ordeal was mostly over was: if we can’t figure out pure cloud-based workflows for journalism, how can it possibly happen in health care?

From a technology-requirements point of view, journalism is child’s play compared to the heavy lifting of bits and bytes health care practitioners do with their volumes of text and image data and even, for some, video studies. Add to that the fact that many of these data sources are created in proprietary applications that don’t necessarily offer Web-based access, let alone iOS or Android apps. They’re grounded on the desktop. Let’s not mention the proprietary systems that record data from medical devices such as wireless patient monitors into databases, not all of which are cloud-friendly.

Lastly, let’s say I actually could figure out how to port all my journalism-related processes to the cloud. That’d require me clicking “OK” an awful lot along the way, probably giving a bunch of third parties permissions to basically do what they wish with my data — and if I don’t like it, too bad. Eventually, I’d probably indemnify them against data breaches — who reads all the fine print, anyway, at least on deadline? In the HIPAA era, physicians and their CIOs just can’t afford to take such wanton risks.

For all the insanely great iPad advertisements and IBM’s wondrous cloud commercials on network television telling us how smart our planet is, the world still belongs to desktop-based computers. Even if there are many opportunities to port some processes to the cloud, what good is an iPad or thin client if your team falls short of the goal line? Not much. That’s why I refuse to call my iPad an iPad, but rather a “10-inch iPod,” much to the delight of the Apple-haters around me.

Until the iPad can truly replace my work laptop as a terminal to my data in the cloud — and close my personal loop by providing the ability to generate and upload complex documents, created in templates that would make Apple Pages cry, as well as open and upload podcast recordings, interview transcription files, and Livescribe pencasts — it shall remain a 10″ iPod, an expensive Web browser that also can play songs wirelessly over my stereo. Stuff my iPod Touch already does.

Some forward-thinking technologists might suggest I look into Wi-Fi versions of my recording hardware or perhaps an iPhone call-recorder app; those indeed might all but close the loop in my personal workflow. But thinking about the infinitely more complex data workflow that health care practitioners employ with their own kit of proprietary devices, their cloud nirvana would appear to be years away.

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If consumers can't do it, health IT cloud far away
Water cooler talk via @DonFluckinger: If consumers can't do it, the #healthIT cloud is far away: #HITsm
Water cooler talk via @DonFluckinger: If consumers can't do it, the #healthIT cloud is far away: #HITsm
I’d start by asking, how closely tied are your journalists to your IT folks? For healthcare, it’s important for hospitals to align people, processes, and technology. So if clinicians and IT are working together and IT understands how technology affects the clinical workflow, then the Healthcare cloud may not be that far away after all. There’s a whitepaper on the topic actually, here:   And the cloud doesn’t mean you have to give permissions to third parties. Because privacy and security are so important in healthcare, a healthcare cloud must have several key features to meet the rigorous needs for security, privacy, reliability and compliance of healthcare standards like HIPAA, i.e. administrative, physical and technical controls. It should be proactively monitored and protected 24x7 to prevent against intrusion and unauthorized access, to avoid embarrassing medical data breeches, expensive penalties and ensure compliance. So basically, the cloud and/or VDI can actually enhance security with the data not residing on the end device (think stolen laptop) as long as it is properly protected, and at the same time, reclaim thousands of hours a year back for clinicians to spend on patient care, time they previously spent searching for records and test results, searching the right workstationr with the right applications, logging in (or worse forgetting a password), etc.   Regarding our comment on proprietary, you’re right, is not good for healthcare. Interoperability and open, standards-based is the way to go for true collaboration, integration and cross-enterprise sharing. In fact, we have a vendor-neutral clinical image archive for that exact reason.   In the end, as you mention, the clinical workflow is the key. Technology is the easy part, it’s how it’s used. That’s really the key to any IT implementation that will drive better clinician satisfaction and productivity and ultimately better patient care.
Hmm... RT @searchhealthit: If consumers can’t do it, #healthIT #cloud far away: #HITsm #hcsm