For many CIOs and other IT executives at hospitals and health systems, planning a storage redesign comes with multiple angles.
For example, health IT professionals must:
- Rationalize what data files and applications will be earmarked for storage in the cloud.
- Determine what data will remain on-premises.
- Figure out if any new technologies will be used to process patient information that must be stored to meet regulatory requirements.
As healthcare organizations embark on new data-driven initiatives -- such as population health, precision medicine and big data analytics -- many medical facilities are focused on remodeling the way they store data and are looking at technologies, including cloud computing, to reduce costs and enhance performance.
Project scope determines cloud use
The decisions around healthcare data storage in the cloud are also being shaped by the size of a hospital and the scope of its work. For instance, a hospital that conducts medical research may find the need to buy more storage technology or may opt to engage cloud services to store older research projects.
What is also evident is that storing data has to be done in a way that meets the needs and regulatory requirements of many stakeholders.
"If you look at storage from a trend point of view, hospitals have multiple different clientele that IT has to satisfy," Marc Staimer, president of Dragon Slayer Consulting in Beaverton, Ore., a company that advises health IT executives, said. On one side are patients, doctors and hospital administrators, and elsewhere "you have the regulators that are looking to make sure that the data is safe and secure under federal rules."
Patient info as part of analytics
Based on a poll of 181 health IT professionals, organizations will increasingly upload more data to the cloud. Research from a 2016 survey conducted by TechTarget in partnership with the College of Healthcare Information Management Executives shows that 32% of survey respondents said their organizations are looking to boost their investments in cloud technology in 2016.The top three areas for cloud adoption are disaster recovery (45%), storage (37%) and mobile health (35%).
An important trend occurring at healthcare organizations is the shift from using electronic health records (EHRs) to simply input and access patient data to instead using patient information for data analytics projects.
"In the past, EHRs were operating just to make sure we collected data from physicians and all of the data is stored in a single repository," Sriram Bharadwaj, director of information services at UC Irvine Health in Orange, Calif., said. "Now hospitals are trying to figure out how the data stored in an EHR can be used to make effective decisions around the planning of care, the quality of care, redesigning care and reducing the cost of care."
As the industry moves toward evidence-based medicine, the requirements for data analytics projects will increase. Healthcare data storage in the cloud will be increasingly prevalent for big data projects that comprise national or regional patient populations, as well as conducting data analytics on a subset of patients within a hospital, Bharadwaj, who is also chair of the Healthcare Information and Management Systems Society's Privacy and Security Committee, said.
"Let's say you want to redesign a care model that applies to a specific patient population, and, for example, you're focused on changes in medication dosage. You might want extra computing power to crunch the numbers from your claims data, which you can get from the cloud," Bharadwaj said. "IT executives are increasingly looking at the cloud for quick projects like this."
Baby steps for storage in the cloud
UC Irvine Health, which operates cancer, trauma and stroke centers, has taken a cautious approach to storing data in the cloud and kept its critical applications, such as its EHR and financial systems, within its data center.
For many healthcare providers, embarking on the shift to host data in the cloud is a slow, deliberate process.
One hospital in the throes of transitioning applications to the Amazon Wed Services (AWS) cloud platform is Beth Israel Deaconess Medical Center in Boston, a major teaching facility of Harvard Medical School that serves approximately 1,250 full-time physicians. The hospital, which also conducts academic research, has 3 petabytes of data and an annual data growth rate ranging from 25% to 100%, depending on the type of data being generated, Manu Tandon, Beth Israel's CIO, said.
Currently, Beth Israel is in the process of identifying which applications to keep at its data center and which ones to move to the cloud -- and in what sequence, Tandon said. While the hospital could very well host critical technology in the cloud one day, that time has not arrived as of yet.
"We are moving to the cloud in a very measured manner," Tandon said. "We think that certain types of storage, such as archived research projects, older patient images and old home directories, are good candidates for storage in the cloud, but we've decided that mission-critical applications, such as our EHRs, as well as our human resource and financial applications, will remain at our data center, for now."
Tandon said that while there are clear advantages to using AWS -- such as avoiding infrastructure investments to store additional data and the reliability, uptime, and general availability of data -- Beth Israel’s approach has been to take full responsibility for the information it uploads to the cloud.
With regard to security in the AWS model, the hospital hired consultants and trained its IT staff to better understand how to design a secure framework on the AWS platform.
“We don’t want to get relaxed with the thought that AWS will just cover us. We have taken the initiative by putting in the hard work to make sure that our data is secure and compliant with HIPAA regulations,” Tandon said.
Beth Israel is focused on building a storage infrastructure that relies on data coexisting on-premises and at AWS. It is investing in a high-bandwidth connection so that data can flow between Beth Israel’s data center and the cloud.
“Storing clinical data is the heart and soul of what physicians need to do their jobs effectively,” Tandon said. “Storage systems are what our EHR runs on, and the storage of our patient data is what our security systems are designed to protect.”
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