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Caring for Your Data in The Cloud

How does cloud storage fit into an overall health IT strategy?

The "cloud," the buzz word for the intricate web of connected servers distributed throughout the world, can have varying benefits for a healthcare organization, depending on the size, type and structure of the business. There are varying types of "cloud computing" as well, each with a different purpose or role in an information technology infrastructure. While it may not be standard practice yet, Electronic Health Record (EHR) adoption and the accelerated use of cloud technology in the consumer space suggests it will eventually be as ubiquitous in the healthcare space.

Usage data from the healthcare IT industry indicates the use of the cloud is trending upward and has grown significantly in the past three to five years. For instance, a survey done by data management provider BridgeHead in 2010 reported just 9% of respondents used the cloud for archived data.1 In 2012, Healthcare IT News reported 33% of its readership used some form of cloud computing,2 and most recently 80% of respondents reported their healthcare organization currently uses cloud services in the 2014 Healthcare Information and Management Systems Society (HIMSS) Analytics Cloud Survey.3 Although these are three small, independent surveys, it shows the writing on the wall.

Cloud Storage
In an overall IT strategy for a healthcare organization and within the cloud computing space, cloud storage is primarily a means of data back-up in case of data loss. In a data recovery situation, it offers the benefit of greater accessibility and rapid deployment capability. Secondarily, it is a replacement for the widely used disk and tape methods of archiving data (both on- and off-site) not immediately needed for the daily functioning of the organization. Additional benefits of cloud storage include greater reliability, increased data protection and lower overall storage costs as a result of not having to purchase, manage and maintain expensive hardware. To the vast majority of users, the space available via the cloud is limitless. Most storage facilities can easily host multiple petabytes of data (1000 terabytes), and even the largest users rarely exceed one terabyte.

Caring for Your Data in The CloudThe Right Storage Option
Taking a strategic approach to cloud storage will be the determinant of success. Understanding the type (e.g., medical imaging, EHR, admin) and quantity of data that needs to be stored, both in the short-term and long-term, is the first consideration. Is your practice or organization growing at a significant rate? Is a merger or acquisition a possibility in the future? That may rapidly affect the quantity of cloud storage needed. A tiered or phased data plan outlining what data you'll need to migrate and when, is a good approach. Another aspect is how the organization accesses archived information. For instance, ask; who needs what, for what reasons and how quickly or frequently?  Finally, think about the broader strategic plan for the whole of the organization as well as budget availability.

The answers to these questions will lead you the right implementation decision. There are two main options for cloud storage:  

  • Private -- Facilities can create their own cloud by purchasing, installing and maintaining their own private equipment, either in-house or at a satellite facility (or ideally both). This might be feasible for some large institutions if they have rather extensive resources and technical know-how. The benefit here is absolute control. However, it takes a great deal of resources at the outset as well as to maintain and upgrade the system in the long-term. Organizations may want to consider whether the benefits are commensurate with the cost or if the resources required could be allocated to an IT project that will add more value in terms of advancing the long-term strategic vision. 
  • Public -- The second option is to use public cloud storage, or space maintained by a third-party. This is a more cost effective approach, particularly for small and mid-size organizations. Choosing this option also has some cautions. Be sure to do your homework on third-party providers. While a cloud storage vendor may think they have the capability to operate in the highly regulated healthcare space, be sure to check credentials and capabilities. For instance, the provider should be willing to offer a Business Associate Agreement to users, which will relieve some of the responsibility of the healthcare providers if there is a data breach on the server side. It is also wise to shop around. Not all providers are created equal and security methods vary. Also be wary of lock-in rates or hidden fees.

Security
Whether large or small, the most important consideration for cloud storage is security. Data breaches can have serious consequences and the threat is very real. This is evidenced by a recent breach involving information on 4.5 million patients reported by Community Health Systems, Inc.4 The Health Insurance Portability and Accountability Act (HIPAA) places the responsibility of patient privacy in the hands of the healthcare provider. Therefore, you must make certain that the processes (whether internal or a service provider's) are HIPAA compliant, or the more stringent, HIPAA certified. Thankfully, there are service partners who have met these criteria. If choosing a service provider, be sure to also understand the following:  

  • Login and authentication processes, including encryption methods
  • Actual location of the data center
  • Type of platform and its functionality, interoperability and performance history
  • Scaling capabilities to accommodate data growth 
  • Access and recovery processes, including downtime procedures

An integral part of an overall IT and cloud computing strategy, cloud storage offers the benefit of greater accessibility and reliability of data, which has an ever-increasing level of importance for individual healthcare organizations and the broader health community. Through assessment of several key factors internally and externally, it will become clear how and where cloud storage will fit in and drive the most value for your business.

Yvonne Li is cofounder and VP of Business Development at SurMD. As a technologist and a business executive, Li's areas of expertise are in cloud, mobile, enterprise and internet business models. She also has authored a number of business patents and developed two mobile engagement platforms for her two previous startups. Li has a bachelor degree in electrical engineering from University of Houston.

References 

  1. 2010 Data Management Healthcheck Survey Results. Availabe at: http://www.bridgeheadsoftware.com
  2. Survey analysis cloud use. Availabe at: www.healthcareitnews.com/survey-analysis-cloud-use-health-it
  3. Healthcare Information and Management Systems Society. 2014 HIMSS Analytics Cloud Survey
  4. Fox News. Community Health Systems hacked, records of nearly 4.5 million patients stolen. Availabe at: www.foxnews.com.

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