Contributed by Michael Ray, Solutions Architect at VAZATA

The Healthcare Industry and Cloud Computing

The healthcare industry generates a tremendous volume of patient information protected by the HIPAA - HITECH Act.

Healthcare providers are being forced to rethink the norm when it comes to the volume of information generated and exchanged, and with the nation’s public healthcare system undergoing an ‘evolution revolution’, as some call it, cloud computing is capturing the attention of the industry and its decision makers.

Cloud offers advantages such as: reduction in IT costs; scalability in performance; customization options; flexibility that embraces change; and interoperability ease.

Presently, the two cloud computing models under consideration for the US public healthcare system include:

• SaaS (Software as a Service): allows for cloud computing to be launched from a service provider (provides more control to end user) or from a remote site owned, managed, and operated by the service provider (provides less control, but is more cost-effective). This platform provides users access to multiple versions of the same software.

• PaaS (Platform as a Service): allows end users full ownership of their environment (the operating system is cloned) where they can share a common library of software programs. A key feature of this platform is customizability where software development and configuration management can occur.

• IaaS (Infrastructure as a Service): IaaS provides the benefits of Software as a Service (SaaS) – managed administration and seamless upgrades – without limitations such as loss of control and the inability to service mission-critical applications.

As the healthcare and social services industry continues to grow, recent healthcare industry research reports support continued growth and development. The healthcare industry is projected to spend $518 million on Infrastructure as a service (IaaS) in 2015. Small businesses with 20 to 99 employees will be the fastest growing size segment in healthcare, growing over 35% from 2010 to 2015. Healthcare public cloud computing spending will surpass $1 billion in 2013.

Regardless of which model is selected and for what reasons, (and it is likely to be a hybrid of these three) there are several key issues on the management of health data that will need resolving.

The Challenges

Some of the challenges contributing to the adoption of cloud computing in the US healthcare system include current policies on security and privacy matters. Presently, patient health information privacy is protected by the Health Insurance Portability and Accountability Act (HIPAA) that was further enhanced by the HITECH Act. The HIPAA-HITECH Act combine has expanded the definition of responsible parties involved in maintaining the privacy of patient health information, included terms for privacy breach notifications, empowered patients with access to health information and an accounting of disclosures, increased enforcement and raised penalties for breaching of privacy.

Beyond healthcare providers and vendors, there is the issue of patient consent. Defining the right to govern who can collect, use and disclose patient health information as part of EHRs will be tricky in a shared public cloud environment. Despite these challenges, a starting point for cloud computing technology in the public healthcare setting will be the creation of private clouds operated by large partner institutes.