The security concerns that hinder the adoption of cloud computing in most industries are magnified in healthcare thanks to the sensitive, private nature of patient data — and the heavy fines that healthcare organizations and their business associates face if that data falls into the wrong hands.
However, recent surveys from Imprivata and Porter Research suggest an about-face. Healthcare increasingly trusts the cloud, both surveys conclude, and leaders at the organizations behind the surveys say this progress is just the beginning.
Cloud on Healthcare's Radar As Other Tech Needs Lessen
Imprivata's 2013 Desktop Virtualization Trends in Healthcare report, now in its third year, finds healthcare organizations more willing to store personal health information (PHI) in the cloud than in the past.
In 2012, only 9 percent of respondents used cloud computing. This year, 30 percent of respondents were. What's more, 40 percent of those using the cloud were storing PHI there, compared to 9 percent in 2012.
This didn't necessarily surprise Ed Gaudet, general manager of the Cortext Product Group at single sign-on and identity management system vendor Imprivata. Three years ago, the company's healthcare customers told him cloud computing adoption was three years away. At that time, the industry was busy moving away from paper-based processes and get electronic health records up and running in order to meet federal requirements for the meaningful use of EHR systems.
Now that these organizations (more or less) have meaningful use under their belts, they're beginning to invest in other areas, Gaudet says. This desire to invest has coincided with an increased willingness among cloud service providers — including Amazon, Google and Microsoft — to sign HIPAA business associate agreements. Such an agreement outlines how a business associate will protect an organization's PHI in accordance with HIPAA privacy and security rules.
"We see that as really critical. More and more companies that store PHI in the cloud are starting to do that," Gaudet says.
Cloud Finally Mature Enough for Healthcare
Meanwhile, the Porter Research study — sponsored by Covisint, the SSO and identity management subsidiary of Compuware — suggests that 58 percent of C-level hospital executives "place a high importance in cloud-based technologies." This is quite telling, says Porter Research President Cynthia Porter, since roughly 75 percent of hospital communications occur over fax. "There's still a lot of inefficiencies out there," Porter says.
Healthcare's increasing willingness to use the cloud comes with a decreasing reluctance to see how other industries are solving problems related to data storage, application hosting and the like. Yes, healthcare remains a risk-averse industry, but organizations are starting to realize that it does in fact mean something if a cloud vendor is "proven" in other industries, Porter says. "Healthcare isn't afraid any more to look at how problems are solved outside healthcare."
At the same time, a variety of external factors — meaningful use, the accountable care organization (ACO) model, the ICD-10 switch and the rise of mobile health — push healthcare organizations toward more integrated systems, Porter says.
The maturity of cloud computing makes it the right solution for this type of integration, says Dr. John Haughton, chief medical information officer for Covisint. This maturity comes in three forms, he adds: Technical, in the ability to move information among systems; business, as a means of establishing mire dynamic partnerships with other healthcare facilities, and clinical, in the form of team-based, collaborative care.
Achieving true collaboration, though, means going beyond the "island" EHR systems present at many healthcare organizations and making health IT systems interoperable. Cloud brokerage solutions can help, Haughton says.
The end result, Haughton says, is an ability to drill down into patient registries or outreach lists to better understand how, for example, a care team or even an individual physician is helping a patient who had suffered a heart attack get his or her blood pressure under control. The ensuing performance metrics give an organization insight, he says, into "what makes medical care better."
Future of Healthcare Cloud Mobile, Networked
Over time, Gaudet sees healthcare progressing from cloud infrastructure to cloud-based applications and services. Secure text messaging, in Imprivata's 24-month forecast, is especially poised for growth. "There's a real need for clinicians to leverage technology that they use at home to deliver better patient care," he says. It's much easier to adopt than, say, EHR technology, Gaudet adds, and it has an almost immediate impact on improving the patient experience.
Text messaging — not to mention the use of EHR systems and others clinical apps on a mobile device &mash; presents potential HIPAA privacy concerns. That's why Michael Byrnes, product marketing manager with cloud data security provider Afore Solutions, sees a push toward virtual desktop infrastructure. A mobile device, then, is little more than a "pane of glass" into a hosted virtual desktop running on a server farm and protected with policy-based encryption technology.
As hospitals continue to engage with specialists, home health agencies, acute care facilities and other providers beyond their walls — as meaningful use and healthcare reform mandate — Porter says these individual clouds will be connected. This offers the potential to improve collaboration and interoperability (as Haughton hints) while improving the mobile experience (as Gaudet and Byrnes) and "supercharging innovation," she says.
"[The cloud] could end up mending the healthcare system that has let innovation pass it by," Porter says. "Clouds promise one of the most promising technologies to improve treatment costs."
Brian Eastwood is a senior editor for CIO.com. He primarily covers healthcare IT. You can reach him on Twitter @Brian_Eastwood or via email. Follow everything from CIO.com on Twitter @CIOonline, Facebook, Google + and LinkedIn.