Cloud Computing

The application and data storage silos built during the last few years have effectively trapped data in systems so it cannot be of value, says Josh Gluck, VP of Global Healthcare Technology Strategy at Pure Storage.

Cloud-based EHR vendor showing its information search engine, virtual scribe and voice assistant that CEO Girish Navani said are built to help providers save time at the point of care.

New Zealand’s largest primary health organisation (PHO), ProCare, has selected Indici after a year-long practice management system (PMS) review. ProCare chief executive Steve Boomer says, “The ProCare PMS review steering group and ProCare Board have reached agreement that Indici is the system best suited to our needs. “However, we cannot recommend this as a preferred system until we have reached a suitable commercial agreement with Valentia Technologies, Indici’s parent company.” Indici was developed by Valentia in conjunction with Ventures, the commercial and innovation arm of Pinnacle Primary Health Network. The cloud-based mobile PMS supports the Health Care Home model of general practice, which is being adopted by PHOs across the country, and involves improving access to care by offering telehealth options for patients. Seven vendors started in the review process and were narrowed down to Indici and US-based Epic in mid-2018. Tū Ora Compass Health, Te Awakairangi Health Network and Central PHO have also committed to rolling out Indici. Valentia president technical services Ahmed Javad says the review was an extremely thorough and well-managed evaluation process. "We are looking forward to completing contractual arrangements and then embarking upon an exciting transformation journey with ProCare member practices," he says. Boomer says the PHO’s members were updated on progress at the end of last year, and are “encouraged to get in touch with us to discuss any specific needs they may have with their PMS”. “We thank the steering group, made up of GPs, practice nurses and managers from our network, for their dedication to the 12-month review process,” he says. “There were many different perspectives provided by steering group members based on their own PMS experiences, all of which contributed to robust discussion and debate before reaching consensus.” Practices in the region predominantly use Medtech or MyPractice systems currently. An industry expert, who asked not to be named, says the decision is a major accomplishment for Indici. He predicted a steady flow of GPs changing systems.  “Practically the change burden around a practice migrating from one PMS to another is a non-trivial undertaking,” he says. This article first appeared on eHealthNews.nz.

The specialty pavilion is the destination for leading-edge exhibition, education and networking on the show floor.

Organization says 5 will build on FHIR 4 with more normative content, support for apps that use multiple versions of the spec and other advancements.

Healthcare has previously been one of the industries hesitant to shift to the cloud, but that trend may be changing for the better. Healthcare hesitated on adopting cloud in the past, due to a number of issues, such as interoperability, data security and privacy concerns, infrastructure availability and regulatory compliance worries, amongst others. The sensitive nature of data within the industry – ensuring that health data like medical histories, allergies, blood types and other health records aren’t compromised – means interoperable sharing or keeping biometric data secure is high-stakes. And regulatory compliance can be a difficult space to manage. In 2010 itself, the Australian Centre for Health Research identified more than 22,600 pages of combined state and federal legislation across 305 different Acts of Parliament covering the health sector. These regulations have created disparities between states, sometimes causing confusion and increasing the barriers to cloud. These challenges can’t be overcome immediately, but the industry has shown a surge of interest and more flexibility in cloud adoption. A recent report by GlobalData, Cloud Computing in Healthcare – Thematic Research, has found that in recent years, the global healthcare cloud computing market size is forecast to be almost US$35 billion in 2022. This amounts to an annual growth rate of 21.7 per cent between 2018 and 2022. Findings also identified that the pharmaceutical cloud computing market size is predicted to grow from $4.7 billion in 2017 to $12.1 billion in 2022. INDUSTRY SUPPORT FOR CLOUD Global industry partnerships signify this uptake of cloud. Microsoft and Allscripts subsidiary Veradigm recently announced a deal to develop a new product to help researchers conduct studies via Allscripts cloud-based electronic health record (EHR), aimed at improving time to market for new drug therapies and slashing costs on research and development. One of Australia’s preeminent clinical trials research centres made a move to consolidate electronic data capture systems into a unified cloud platform. The National Health and Medical Research Council Clinical Trial Centre at the University of Sydney has adopted Medidata’s eClinical platform for studies, said to help simplify, improve and accelerate research. In addition, Australian cancer institute Peter Mac has deployed two new cloud-hosted systems to replace a suite of systems and supercharge precision medicine in Australia. This enables the consolidation of multiple sources of information into a single data repository, stored in Microsoft Azure and accessible by multiple concurrent users. MedicalDirector’s Helix solution, built on Microsoft’s Azure cloud service, also aims to improve the delivery of healthcare, increase the efficiency and flexibility of medical organisations and improve evidence-based decision-making. This shows that investing in cloud computing technology has become an increased priority for healthcare organisations and networks. “For healthcare, a prominent shift is expected in cloud systems from simple data storage to using the technology to lower costs and increase efficiencies within the system,” GlobalData Managing Pharma Analyst Alexandra Annis said.    “It is foreseen to lead to a fully integrated platform in pharma that can compute tasks such as personalised patient care and clinical trial optimisation.” Snowflake Healthcare Strategy Vice President Todd Crosslin said there are three types of cloud that has become popular with the healthcare industry – infrastructure-as-a-service (IaaS), platform-as-a-service (PaaS) and software-as-a-service (SaaS). Crosslin explained that these forms of cloud are sought after for their various capabilities. [Read more: What’s needed to drive innovation and improve affordability in healthcare? | Future healthcare tech may be beneficial, but also poses risks: report] “IaaS, PaaS and SaaS are all in demand. IaaS enables the lift and shift of existing technologies, but while not the most efficient, is well-established due to the flexible nature of the cloud and the potential cost savings of having to purchase or maintain infrastructure at various locations,” he said.  “SaaS is for companies that want the business value without the IT overhead and can compromise on customisation. As for PaaS, why build components from scratch when they are available and can be built upon?” WHAT DOES CLOUD OFFER? The majority of healthcare organisations have historically hosted their applications and data on-premises. With the adoption of virtualisation and automation, on-premise infrastructure hosting has transformed. Crosslin said disruptors born in the cloud are forcing incumbents to embrace the cloud so as to achieve speed and agility. With the speed of technological advancement, healthcare too has been under the pump to adopt it.  For GlobalData’s Annis, cloud is the bridge for the healthcare industry to enable their organisations with the latest technologies and innovation. “The industry will be able to drive to the next level of innovation and analytics, for example by using the cloud’s functionality to match data effectively with patients. This personalised approach will provide physicians with the tools to make the best treatment decisions for patients,” she said. “The power of the cloud also offers the potential to speed up the drug development process [in pharmaceuticals], without compromising efficacy or safety. This will draw from its ability to collect data from patients around the world in real-time.” [Read more: How to explain the real cost of cloud computing to your C-suite | What are the barriers to widespread telehealth adoption?] Zscaler ANZ Country Manager Budd Ilic mentioned that cloud also enables organisations to deploy applications to customers faster and provides an easier exchange of information with third parties for access to update healthcare data. “Traditionally, a patient went to a health care provider’s location to receive care or treatment. Now, with the emergence of things like telemedicine, wearable monitoring devices and remote sampling devices, patients and physicians no longer have to be in physical proximity to deliver and receive care,” Ilic said.  “Cloud allows organisations the ability to better and more quickly share information regardless of where the patient is located, while also providing better security for patient records.” CHALLENGES OF CLOUD, AND A DIFFERENT APPROACH NEEDED Ilic said cybersecurity has been done the same way for 30 years or more and the industry needs to think about and implement it in a completely different manner.  “We can no longer secure the network, as evidenced by continual breaches and data loss. We can, however, secure access to cloud applications and data by ensuring that individuals trying to retrieve that data are authorised to do so and then securing that access,” he said.  “This among other things, such as reducing complexity and utilising the cloud to provide traditional security stack services, are the way to mitigate the risks of cloud deployments.” [Read more: Big leap forward as the cloud transforms GP technology | Peter Mac looks to the cloud to supercharge tech help for cancer treatment] Other vendors, like Snowflake, said there is a need for heightened security offerings. “Many vendors, like us, have made security part of their DNA. Security concerns can be addressed with Tri-Secret Secure (three-key) encryption and fine-grained data access controls to securely and performantly store customer data,” Crosslin said. “The current mechanisms of sharing data between customer and client, or partner to partner, is typically done via file transfer protocol (FTP). The drawbacks of this method are widely understood – security, staleness, time, etc.  “But security-focused companies ensure that data sharing is done by allowing accounts to share data by query. The data does not get copied from one account to another. This can be done securely through specifying the method of access and limitations,” he added. THE FUTURE OF CLOUD IN HEALTHCARE Ilic said the next level of innovation and analytics is where healthcare’s move to cloud will have a global effect on care delivery, diagnostics and treatment.  “The ability to use large historical data sets to make preventative health care interventions based on millions of individual datasets will drive our ability to end many diseases that plague mankind today,” he said.  “The ability to draw correlations between epidemics we’ve never seen before will have a large scale impact on global health that we haven’t seen since the discovery of penicillin.”

The companies will use Azure to expand and develop new platforms and networks for digital health, care management and patient engagement – and compete against companies such as Amazon.

Penn Medicine’s John Donohue explains why hyperconverged infrastructure should be part of your strategic plan.  

In specialty forums in Orlando, Healthcare IT News and its sister brands will be co-hosting in-depth sessions on today’s hottest health IT trends and topics.  

The company will be showing an open scalable platform for managing devices, centralizing storage and providing on-demand analytics, among other capabilities at HIMSS19.