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Options abound for cloud computing in healthcare

There are three main cloud computing implementation options for care facilities. Whether they will increase cloud use remains to be seen.

This is the first in a series of tips exploring cloud computing in healthcare, including cloud services and applications. 

Jon Gaasedelen

Public cloud, private cloud and hybrid cloud: For all the talk around clouds, organizations mostly want to know how this affects their healthcare business. The simple answer is that cloud computing can be relevant to any business in any industry. However, cloud computing in healthcare may be particularly important because of the industry's history with paper-based records and overall poor adoption of computers for anything other than hospital accounting and practice management systems.

Cloud computing in healthcare and other industries might be defined as the externalization of business services or additional computer tasks how and where they are needed.

Think about how computers are used to run an application, such as email. A user runs an email application to review their email. They start the application, they review email and they respond or not. For the computer to run the application it must use its central processing unit (CPU) to load and run the email application. Then it needs to load communications data elements into its memory so that it can talk to the email delivery service. Meanwhile, the email delivery service -- running on a different computer -- must use its CPU and memory to load communications elements that enables it to talk to the user's computer.

Cloud computing in healthcare may be particularly important because of the industry's history with paper-based records and overall poor adoption of computers.

This process permits the emails to be sent to the user for their review. Additionally, the email delivery service must also look for new email and store it in a location that is only available to the original user.

Email is one example of how two computers share data in the cloud and perform a series of tasks to run a simple application. Many such tasks, also called services or applications, exist in the cloud. This also demonstrates another cloud feature which permits apportioning computer hardware like CPU, memory, and storage to different systems or applications as demand requires.

Considering the poor adoption of computers in healthcare, you might be questioning the relevance of the previous statements. Since the introduction of the American Reinvestment and Recovery Act (ARRA) in 2009, Herculean efforts have been made to implement and utilize EHRs, and much has been accomplished. However, the efforts are expensive and have mostly been subsidized through ARRA. These subsidies are already winding down. Hospital and clinic adoption of EHRs is very low due to the complexity of the task and the perceived need for additional computer hardware. What can we do to improve this?

Enter cloud computing, and the relevance of computer systems apportionment. There are many acronyms associated with cloud; the three to focus on are: Infrastructure as a Service (IaaS), Platform as a Service (PaaS) and Software as a Service (SaaS). Collectively, these cloud services can provide any or all of the following.

IaaS: Consists of all the hardware necessary to run an EHR system. This can include servers, storage devices, virtual desktops, load balancers, and so on, and would save on hardware investment costs for providers.

PaaS: This is a ready-made application development environment that provides all the software, tools and utilities to develop and/or tailor an EHR application.

SaaS: Is a software installation and operations service that provides for the running and operations of healthcare applications.

Cloud-based services may not be right for all healthcare providers, but may work for smaller providers who are pooling their resources. Small providers buy one or more of the above services and use them for hospital and/or clinical support. In this situation, the provider benefits from having the services and the healthcare cloud service provider benefits from partnering with more small healthcare providers.

The above examples provide an overview of cloud computing and suggest some ideas for overall cloud implementations. The discussion moving forward will only focus on one example: How storage might fit into a cloud computing model.

In large corporations where shared computing is ingrained in the culture, large storage infrastructures are usually installed and depended upon. A large storage infrastructure consists of two different kinds of storage. The first kind of storage is called network-attached storage (NAS), which is storage attached to servers through the local area network (LAN). It is identical in concept to sharing files from a central repository or from one computer to another.

Network-attached storage devices consist of individual components pieced together and can grow to the size of a large refrigerator. They contain a large number of individual hard disks wired together to provide a large amount of storage and protect saved items from hardware component failures. A best practice for NAS storage is to provide additional storage capacity to desktop users connected to a LAN.

The kind of content stored on NAS devices is most often users' home directories and is less critical to ongoing organizational operations, but it is still frequently backed up and protected from loss. Costs for NAS devices range from $20,000 to $200,000, but this range can be greater depending on other factors.

Continue to the second part of this tip series.

About the author:
Jon Gaasedelen is an independent IT consultant with more than 20 years' experience in information systems infrastructure. He has an undergraduate degree in Economics and a Masters in Health Informatics, both from the University of Minnesota. Let us know what you think about the story; email editor@searchhealthit.com or contact @SearchHealthIT on Twitter. 

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