My data is, well, it’s in the cloud?

Cloud Technology in Healthcare

Recently, a blog was posted in Diagnostic Imaging entitled Cloud Computing Creates Climate Change in Teleradiology in which the author, Joe Moock, discussed the benefits of cloud computing for teleradiology.  Reading this post led me to ask myself, is this “cloud” thing something new? I have been fascinated recently with the use of the term “cloud” to describe hosted computer services, like it is the greatest technology advancement since, well, sliced bread.  Technology vendors are announcing cloud based services right and left, with Apple recently joining the likes of Salesforce, Google, and Microsoft with their latest announcement of the Apple iCloud.

The “cloud” is really not new technology, but instead is a new marketing concept that answers the question, “How do you explain technology concepts to non-technical people?” In this case, the technology is a combination of software applications and servers designed to serve multiple users and organizations, and the Internet.  Tools like Google mail (GMail) and picture sharing applications like Kodak Gallery, and yes, even Facebook are examples of hosted applications that could be considered “clouds”.  These tools have been called other names before, such as hosted services and Application Service Providers (ASPs).  Telling your CEO that you want to run your email system on someone else’s servers may set a different mind set than saying, we want to move our email to “the cloud”, especially when the gigantic marketing engines of the likes of Apple, Microsoft, and Google are all touting how great this cloud thing really is.

There can be no argument that these “cloud” based solutions can provide a cost savings to many companies that cannot afford large capital investments in their own solutions, are ill-equipped to manage  their own solutions, or who simply do not consider these types of solutions core to their business; there are still trade offs to choosing to run in the cloud.  A few examples of this are: 1) customization of applications through cloud based solutions is possible, but less feasible than it is when a company controls their own applications; 2) there may be a question or insecurity about who actually controls, has access to, or even owns the data that is stored in the cloud; 3) if access to the cloud is lost in any way, then a company may be powerless to access critical data or run critical applications, and has little control over restoring service to those applications.  In considering the above trade offs, companies can make informed decisions about whether it makes sense to run certain applications in the cloud.

Cloud technology is also not new to the Healthcare industry.  Hosted data archiving, PACS, and RIS solutions have been around for some time now.  However, the real issue may have been concern over regulatory compliance and data ownership.  By entrusting a third party as the shepherd of your medical data, are you taking a risk?  In effect, this adds a 4th trade off to the list I suggested above: 4) are there regulatory considerations or restrictions that would stop me from running my solution in the cloud. The real innovation that I expect to see in the months and years ahead are regulatory changes that address the use of third party hosted solutions, and effectively answer this 4th trade off. While efficiency is certainly generated by running in the “cloud”, and in essence, a teleradiology service in itself can really be considered “cloud radiology” (My Radiologist is “in the cloud”), there are always considerations to take.

In the case of radiology, and really healthcare cloud computing in general, the considerations should be: 1) how do I mitigate the risk of loss of access to the “cloud” when my patient’s health depends on it; 2) how do I ensure that the results I get back from the cloud (downloading of images, format of reports, accuracy of radiology interpretations, etc) meet the quality and format standards of my department; 3) by using the cloud, can I lower the cost of providing quality healthcare services to my patients while still adhering to regulatory standards, thus making quality healthcare more accessible to a larger patient population?  These are all questions and considerations that I deal with day-to-day as the CTO of a national radiology services provider.

I look forward to hearing your feedback and having an open discussion with you about how you see the “Cloud” and healthcare interacting in the months and years ahead.  As will be my trend here in this blog post, and my posts to come, I am interested in sharing my opinion with you- the healthcare community.  But, I am also interested in your opinions.  We are all in this together.

-Jesse Salen, CTO, ONRAD, Inc

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