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The Value of an EHR Cloud Solution

The term, “The Cloud,” has become so commonplace that one might ask: “What does it mean and what value can it bring to a healthcare organization’s electronic health record (EHR)?”

Without getting too technical, Cloud is a model for delivering IT resources. According to the National Institute of Standards, “Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources … that can be rapidly provisioned and released with minimal management effort or service provider interaction.”

That is a straightforward definition. There are in fact three service layers, five essential characteristics and four deployment models inherent to the definition. Most healthcare organizations would use the “Private” deployment model.

Cloud is a natural evolution in computing brought about by evolving improvement in connectivity and data storage capabilities as a result of improvement in technology. Cloud computing is not new and has existed in many forms over the past 40 years. Remote job entry was the definition in the 1970s and in the 1990s it became “outsourced infrastructure.”

Along with the changing definitions come changing promises. Fortunately, the basic promise of the cloud has changed little and is quite basic. It is one of lower infrastructure and maintenance costs with faster upgrades and data security that surpasses what an individual organization may be able to apply themselves.

There are two models of cloud that a healthcare organization should be familiar with. Deciding between the two forms may be challenging and must be made early as the decision will affect underlying strategic IT initiatives.

The two forms are Cloud-Based (Native) and Cloud-Based (Hosted)

The Native Cloud-based applications are designed for cloud environments and hosted in a true cloud infrastructure. They are delivered as Software-as-a-service (SaaS). In this model, applications are shared amongst resources, upgraded for all users simultaneously, are easily scalable, and are able to share data between implemented customers if desired. Because of this, every customer is on the same instance of the software.

The Hosted Cloud-Based model can be thought of as “on-premise” systems hosted and managed “off-premise” by a vendor. These are generally not designed to house multi-tenant instances of a software solution. Instead of maintaining a server farm, software upgrades and maintenance, physical and cybersecurity at a healthcare facility, a hosted cloud-based model takes that burden off of the organization. Upgrades are a manual process and customer specific. Implementation times may be longer than the native cloud-based model but, since each organization is on their own instance, may be somewhat tailored to the organization, depending on the vendors business model.

Both models may benefit a healthcare organization’s EHR by offloading the server infrastructure, maintenance of infrastructure and software, regulatory (HIPAA) compliance burden at the server level, security (physical and cyber), backups, and disaster recovery to “The Cloud.” The return on investment can be positive but this will vary by organization.

Although lowering of IT expense may be a benefit of cloud computing, the true benefit of cloud computing to healthcare is just now starting to be realized. As edge computing and Cloud 2.0 start to take shape, we are seeing a blurring of the lines between deployment models. The deployment models (Private, Community, Public and Hybrid) will begin to safely and interoperably share data.

This is good for healthcare as a health systems cloud deployment model may be private, but it would be advantageous to enable Internet of Things (IoT) information, from a public or community deployed cloud to be incorporated into the healthcare provider’s decision-making process. Analytics drawing insights using data from multiple cloud sources and deployment models, tailored to a specific patient will be possible, will require blurring of the lines between deployment models.

This holds great promise for the future of improving health outcomes through technology in the cloud.

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