When I met with Gartner’s Fabrizio Biscotti earlier this year, he told me that “cloud computing” has been the #1 search term on Gartner.com for the past three years; it was also in the top 3 on the technology priorities list for CIOs in 2010, 2011 and 2012, up from #16 in 2009. Those statistics span multiple industries, but the cloud is certainly a topic of conversation at many of the healthcare industry events I attend. It’s not surprising, given the need for healthcare organizations to create more collaborative networks through which they can coordinate the care of specific populations. Computing and storage technologies delivered in the cloud also help meet two of healthcare’s biggest challenges: the need to deploy new capabilities rapidly without significant capital investments.
What does surprise me is the lack of a consistent understanding of what the "cloud" is, especially given that the concept dates back to the mid-1980s, when IBM realized it could make money by leasing some of the excess computing power of its large mainframe systems. The term “cloud” is also not that mysterious. It stems from the common practice of using a picture of a cloud in diagrams and flowcharts to depict work that is done in cyberspace, as opposed to functions performed by systems at a specific organization’s site (or what the technology folks call "on-premise").
What seems to concern most healthcare provider CIOs is the fact that the data/work is being stored/conducted "out there," as opposed to under their control. Gail Wilensky, an economist who ran the Medicare and Medicaid programs from 1990 to 1992, told me recently that she thinks it is a cultural thing; historically, she says, most providers have considered healthcare data, and in particular medical records, their property. In an age of paper records, that property was best protected by locking it up in a physical cabinet. In an era of electronic medical records, those cabinets are virtual. The good news is that cloud technology has come a long way since the mid-1980s, with perhaps the biggest advancement being the ability to logically and securely partition data and computing capacity to help ensure access only by authorized users. But the question remains – who really owns the data, the provider or the patient? Wilensky says that’s an issue many healthcare providers have still not addressed.
In my opinion, there is one other critical shift we need to make to take full advantage of the cloud. As I discussed in a prior post, we need to view cloud-based technologies more holistically than we traditionally approached on-premise solutions. After all, deploying different systems for different purposes is one of the reasons we have such a data and systems integration problem in healthcare today. I urge technology leaders at healthcare delivery organizations to consider the breadth of potential applications – clinical, financial, supply chain, marketing, etc. – when developing a cloud strategy. Too often, we still think about problems (and solutions) in silos and, in turn, deploy technology in silos. The cloud may be virtual, but the propensity to build walls still exists, whether it’s your place or theirs.
You can read more about the history of the cloud, its potential healthcare applications (including for the supply chain) and the how to develop a cloud strategy in a recent article I wrote for Becker’s Hospital Review.