From The Editor | May 27, 2011

Cloudy Days Ahead For Health IT?


By Ken Congdon, editor in chief, Health IT Outcomes

Cloud computing has received several black eyes over the past few weeks. First, there was the Amazon EC2 (Elastic Cloud) outage April 21-22 that brought down many businesses and websites. Some of the data was unable to be recovered and transactions were lost.

Next, an outage of Microsoft's cloud-based email and Office services occurred May 10-13, upsetting thousands of customers affected by the incident. This event was followed by a Google Blogger outage May 11-13, which brought down editing, commenting, and content for thousands of online blogs. Most recently, Twitter crashed for an extended period of time May 16.

These incidents have many questioning the reliability of cloud computing, particularly for sensitive healthcare applications. Some have even suggested that the industry abandon cloud-computing strategies altogether. However, other health IT leaders have come to the defense of the cloud, stating that cloud computing — just like any other complex technology architecture — is subject to unanticipated consequences and human error. One such industry leader is John Halamka, CIO of Beth Israel Deaconess Medical Center. In his blog, Halamka stresses that despite these recent problems, the healthcare industry should be steadfast in its pursuit of highly reliable, secure, and cost-effective computing via the cloud. He supports his contention with a detailed look into the causes of downtime and a list of the benefits he has personally experienced from using cloud-based services in his own facilities.

Healthcare Embraces Cloud Applications, But Not A Cloud Strategy
If a recent study by CDW is any indication, the healthcare industry isn't quite ready yet to embrace Halamka's advice. CDW's first ever Cloud Computing Tracking Poll indicates that while 84% of healthcare organizations are using at least one cloud-based application, only 30% identify themselves as cloud users who are implementing or maintaining cloud computing. This means that most are making tactical use of one or more cloud applications, but are not yet committed to a full-blown cloud computing strategy.

"Many organizations are moving carefully — and selectively — into cloud computing, as well they should, because it represents a significant shift in how computing resources are provided and managed," says David Cottingham, senior director of managed services at CDW. "In fact, CDW's survey shows that healthcare organizations predict that they will spend just 21% of their IT budgets on cloud computing in two years and 30% in five years."

Vendors See Promise For Cloud Computing
While CDW's study shows an industry still hesitant to embrace cloud computing, vendors I've spoken with indicate that the market appears to be warming up to the cloud concept. For example, Carestream Health, a provider of medical imaging systems, has seen an uptick in U.S. sales of its CARESTREAM Vue eHealth Services — a cloud-based RIS/PACS archiving service.

"The primary concerns surrounding cloud computing in healthcare have always been data security and performance," says Cristine Kao, global HICS marketing manager at Carestream Health. "The technology infrastructure is now in place to provide reliable, secure, and high-performance computing via the cloud. We are proving to clients that they can access medical images on-demand via the cloud quickly and reliably, and we are winning them over on the concept. Administrators and IT personnel like the cloud model because it's a predictable operational cost and it protects them from technology obsolescence. Clinicians still worry about giving up control of the data, but this mindset is even changing as many physicians have already been convinced to give up data control in their EHR and HIE initiatives."

The jury is still out on whether or not the healthcare industry will truly embrace a cloud-computing strategy. More high-profile cloud computing calamities surely won't help the cause. However, documented successes in the area of cloud computing might. What has your experience with cloud computing been to date? I'm interested in learning more about your successes and/or hesitations when it comes to cloud-based services. Send me an email with your feedback.

Ken Congdon is Editor In Chief of Health IT Outcomes. He can be reached at