Since its inception many major corporations have developed a ‘Cloud’ for hosting their own and their customers’ data. Some have gone further offering their Cloud infrastructure as a subscription service to individuals and to other organisations. Health Groups, Trusts, clinicians, supply companies and front-line management in Healthcare might consider using these existing Cloud solutions for the following reasons:
- ease of access — patient, system and organisational data sharing with instant access to statistics, reports, services, product information, and any legislative and procedural documentation, available from one central, secure and controllable place
- sharing of information — as soon as information is uploaded, anyone with the right access can see it and use it. This enables a rapid reaction to internal and external events, getting the most up to date information into the right hands for making the right decisions, using the correct medication and learning, striving for the best outcomes
- costs and efficiencies — routine automatic uploads, coupled with built-in algorithms enable regular updates to be made available from a host of measurable data points. Patient vital signs, staffing and resource needs, building environment monitoring, supply of consumables, the list goes on.
Privacy Vs Efficiency
There will naturally be sensitivity in sharing personal data, but there can still be considerable cost savings coupled with greater efficiency, without the need for any personal data being uploaded. If the greatest cost to any organisation is labour, then achieving a more effective and efficient workforce will always be high on the list of priorities. Second to this would be the cost of consumables, medication, infrastructure and utilities. Uploading various data points from dispensaries, nurse call systems, access control, buildings and infrastructure, coupled with bespoke algorithms all in collective, simple to read analysis, available anywhere to management, at the touch of a button.
As services become more widespread and case studies provide the evidence decision makers need, expect to see Cloud services becoming mainstream and essential to delivering effective and efficient health care in the future.
Relying on paper trails has long since been banished to the waste paper bin in the commercial world, but not in hospitals
The use of Cloud services versus more traditional slow and costly paper trails and spreadsheets will be discussed at length by any organisations contemplating change. Listed below are the main areas that should be considered.
1. Cost
When an organisation decides that it and or its customers would benefit from data sharing via a cloud- based solution, the first step will often be to analyse the cost of deployment. Why reinvent the wheel when a subscription model can work for any size organisation from the sole trader to the multi-national retailer. Setting up in-house secure IT infrastructures are not only costly, but leave the organisation with considerable on going costs maintaining and updating software, hardware, logistics and security to avoid all risks associated with cybercrime.
Some organisations share infrastructure and this would be the natural step that NHS Trusts could take. Trying to design and implement a national NHS Cloud would be a massive IT undertaking. History tells us that these sorts of projects often become too costly, too complex and fail to be implemented. By developing services using existing cloud solutions a step by step approach can be developed. Over time removing more and more layers of paper work and inefficiencies.
2. Security
Global organisations with cloud hosting services on offer are not immune to cybercrime, but they will have taken as many necessary steps as possible to both mitigate and then reduce any impact of such attacks.
But network failures might not be limited to attacks conducted over the internet. They could also include malicious attacks on hardware and hosting sites, or even sever weather affecting the building structure or mains power supplies to the site. In all cases backup solutions and shared infrastructure across more than one site, in more than one country are often deployed.
Penetration testing should always be carried out with the level of testing dependent upon the sensitivity of data. For example the banking sector insist on high levels of penetration certification for obvious reasons and this has knock-on effects for all retailers who deploy credit card services. So it’s not simply the banks themselves who need to be vigilant.
Healthcare data can often be very personal, it may be medically sensitive, or need protecting from industrial espionage in the case of new or revolutionary treatments for example. However the majority of data collected daily from every healthcare organisation are both anonymous and unrelated to any person or procedure. It is this data which can often make the biggest impact on the efficient running of wards, departments and trusts, we just need it in one place and make it accessible.
3. Availability
Internet services that fail or become slow due to congestion or are off line due to maintenance cease to be a service. When this happens at regular intervals, organisational processes start to slow down, waiting for information becomes the norm and phrases like “the computer is on a go-slow” are regularly heard. Both Staff and Patients become stressed when they can’t access critical data or complete transactions.
To keep data hosting services running 24/7 is not as simple as it sounds. Being risk aware is one thing, having sufficient capacity for peak traffic whilst maintaining efficiency come at a cost. Often the one compromise that provides a cost-reduction leads to the issue that takes the service down. Once this has happened, budget is always found to prevent it from reoccurring, but by then the damage is done.
4. Scalability
Organisations new to cloud-based services will normally start small, and as their own internal subscribers, data usage and storage grow will require greater bandwidth from their cloud hosting partner. But the security and availability requirements are the same no matter if there are ten users or one thousand. The main concern will be the number of individual users trying to access data at any given time. This will be represented as a ratio of user access points and server speed, it will differ by time of day, day of week and time of year and be dependent upon a host of internal and external influencing factors.
So, are cloud-based services suitable for healthcare?
It is difficult to see how the UK healthcare sector can be expected to deliver increasing medical services, whilst driving up standards and driving down costs without sharing data, best practices and deploying a more open and predictable management structure which can all come from simplifying the production of and sharing of data.
Relying on paper trails has long since been banished to the waste paper bin in the commercial world, yet when we visit hospitals we see mountains of files being passed around as patients move through the system. What we don’t see is the same volume of paperwork required for the running of these massive institutions, for heating, lighting, meals, maintenance, staff rosters and payroll etc. Starting with a small number of paper trails and removing these is the way forward, looking at the whole thing as one massive project is doomed to fail, cost all of us a lot of money and possible cost some of us more in terms of our healthcare provision.
