A Holistic Cloud Strategy for Healthcare Organizations

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Healthcare IT Continues to Grow.

For hospitals, the electronic medical record (EMR) system sits as the core application that both helps drive patient care and facility operations. But the EMR is really more than one application, because it functions in concert with dozens of others, a growing number of which may not actually sit in hospital datacenters or even be owned by the hospital. To keep these advanced applications running requires advanced infrastructure. As the healthcare IT applications portfolio grows, so, too do the costs to support it. Everything is growing fast and getting faster. As healthcare continues to grow, hospital margins come under assault. CFOs and CIOs must find new, innovative ways to contain costs while still improving IT adaptability.

The Cloud Solves Healthcare IT Scalability and Cost Challenges.

Cloud infrastructure can reduce costs, improve scalability, increase functionality, and more — but only if implemented correctly. Many organizations don’t approach their cloud investment strategically. A cloud implemented without a thoughtful approach can often lead to higher costs, poor interoperability, and end-user frustration. When approaching the cloud, healthcare organizations must take the time to develop a holistic cloud strategy.

Defining the Healthcare Cloud Strategy.

The first goal should be to define the objectives of moving into the cloud. Being cost-effective is almost always on the list, but defining other business objectives are also important:

  • How important is scalability? Does the hospital anticipate broadening services and, therefore, broadening the application portfolio? Adding new service lines and clinical collaborations almost always has an impact in terms of new applications to support.
  • How important is flexibility? Is the current billing system terrible? Are application changes on the horizon? Rarely can clinical applications be ‘hot-swapped’ one for another. How long legacy applications have to operate (and their data stored) become important factors.
  • How important is collaboration? Is the hospital sharing data with a broader, clinically integrated network? Other providers in the region? What applications are these partners using?
  • How important is access? There is always a balance to be struck between security and accessibility. How prevalent are non-employed clinicians accessing applications and to what extent? Are clinicians accessing applications remotely?

Defining what is important to the hospital operationally, besides just cost, will help appropriately define the capabilities needed out of the cloud, or an infrastructure scenario. ▾

Only with a comprehensive cloud strategy, can a CIO be sure they’re doing what it takes to make their hospital successful in their move to the cloud.

Understanding Your Application Portfolio.

Not all application can be easily ported to the cloud. The codebase may have inherent infrastructure dependencies (especially when home-grown). New releases and patches may not be cloud optimized.

When moving an application from on-premises to the cloud, consider facets such as

  • Configurability
  • Disposability
  • Logging capabilities

Understanding the hospital’s strategic plans helps inform the right direction for individual applications. But what becomes important in this scenario is understanding the effort involved in moving given applications and what trade-offs must be made.

Even if an application is cloud native or, as growingly the case, only available in the cloud, understanding its upstream and downstream dependencies is important. It’s great to have EMR in the cloud, but if it can’t communicate back to your on-premises, home-grown Hospital Information System, you may end up building work-arounds that actually increase your infrastructure footprint. Defining the application portfolio, the final resting place for each application, and the plan to minimize issues are key to getting the most out of anything other than a minimal cloud migration.


Understanding the Cloud’s Long-Term Impact.

Moving to the cloud does more than just change the cost model. Understanding what new capabilities (and limitations) the cloud presents helps to redesign IT processes to ensure they’re cloud optimized. Monitoring, provisioning, DRP, and many other areas change when in a cloud environment and often can take advantage of automation.

Along with these process changes, defining how this impacts the IT organization becomes important. Necessary IT roles change as healthcare IT adopts the cloud and becomes more data driven. Defining these changes, how they impact current and future position needs, and what organizational change management efforts are needed to drive the change are all important considerations.

Selecting the Right Cloud.

The cloud strategy takes into account your objectives, application portfolio, processes and organization. Not only does this determine what to move to the cloud, but it also determines how fast to move and, ultimately, which cloud is right for the organization. ▪