WASHINGTON, D.C. -- A service-oriented architecture (SOA) could resolve some of hospital IT leaders' reservations about using cloud computing services for data storage and applications, experts said at the SOA in Healthcare Conference cosponsored by the Object Management Group and the standards group Health Level Seven International.
Done right, an SOA model can help mitigate security risks for data in the cloud, provide relief for overflowing data centers and offer business continuity in the event of disasters, David Linthicum, chief technology officer at the St. Louis-based Bick Group, as well as SOA consultant and author, said in Monday's keynote.
Moving a health care network to an SOA model involves decomposing an existing network architecture down to functional processes that cannot be further deconstructed, then addressing them as services, Linthicum said. Such analysis and breakdown can enable CIOs to move operations piecemeal into the cloud, and keep on-site the processes they don't trust to a third-party vendor.
Cloud computing services misunderstood in health care
"I think SOA is the best practice that we have right now, probably the best-understood way to cloud computing," Linthicum said. "Once you're at that point, it's like decks of playing cards. You can figure out which decks need to be dealt out to an Infrastructure as a Service provider, [which pieces need to be dealt out] to a Software as a Service provider and which pieces need to remain on premises. It's really that simple to say it; it's a little harder to execute."
Health care providers are prejudiced against cloud computing services not only because they worry about uptime and access issues, but also because they are burdened with Health Insurance Portability and Accountability Act (HIPAA) compliance, and fear security breaches once data is ported off-site, Linthicum said.
Linthicum can understand that fear, but he has seen health care data centers whose security is inferior to that of many cloud vendors, he said. IT leaders often point to news stories showing an outage at a major vendor, such as Amazon.com Inc., as an indicator of poor performance, he added. When the overall performance of such vendors as Amazon.com is compared to one's own data center's uptime, however, the cloud typically is much more reliable.
Public cloud not for everyone
The public cloud -- in which hosts offer their services to anyone willing to pay the fee -- isn't an answer for everything, Linthicum said. For instance, poorly constructed or poorly functioning processes, as well as legacy applications, probably will not improve when moved to the public cloud.
"You can't take a crappy architecture and put that crappy architecture into the cloud and expect it not to be crappy," Linthicum said. "Crap outsourced to cloud computing is still crap. You've got to get your internal architecture under control. … If you think somehow moving it to Amazon is going to fix it, you are sorely mistaken."
You can't take a crappy architecture and put that crappy architecture into the cloud and expect it not to be crappy.
David Linthicum, chief technology officer, Bick Group
Linthicum envisions many health care providers taking small steps into the cloud at first, he said. One option is to move some pilot projects into private clouds -- hosted services devoted to one client's use only. Community clouds, where a few clients share bandwidth and storage together, are another option. In these cases, the cloud can serve not only as overflow capacity for such files as medical images, but also as a rudimentary backup providing business continuity during disasters.
Once providers see benefits -- or are forced to outsource because of capacity issues -- they will move even more processes to the cloud, Linthicum said. For most health care providers, using cloud computing services will prove to be cost-effective. Being able to pay for just the bandwidth they need costs less than expanding and maintaining a data center, which must grow beyond current network needs -- incurring maintenance costs and powering unused capacity -- until those needs expand to fill it, he said.
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