Choosing the right Cloud Provider

Typically, the healthcare sector lags behind other industries when it comes to embracing new technologies. Ironically this industry is embracing cloud computing on par with other industries.

Nearly one-third of healthcare sector decision makers said they are using cloud applications, and 73% said they are planning to move more applications to the cloud, according to a recent report by Accenture. Those figures fall in line with findings about cloud adoption plans in other industries, according to the report.

What’s the attraction of cloud computing that has the healthcare industry adopting it at the same pace as other industries? Basically, smaller practices are finding it economical to do away with their own modest IT operations and rely on cloud service providers for electronic health record (EHR) services, while larger institutions are building internal, private health care clouds for easier accessibility.

However, before jumping to the cloud, healthcare providers should consider the following elements before choosing a cloud services provider:

An assessment of the associated risks and benefits should be taken. Evaluate all potential cloud computing service providers to understand key areas from compliance and data location to availability, recovery and viability. Ensure the service provider’s security, access, and control methods surpass, or at least equals, your current security measures. As I stated in a previous blog post (Due Diligene Is In, Google Health Is Out), perform due diligence on the provider. Even if the service provider is a well known multi-national firm don’t assume vendor due diligence isn’t needed.

As healthcare providers rapidly embrace this new technology, it’s important that they assess all of their needs and options so that the right solution and cloud computing partner is chosen.

EHR, Cloud Computing

Cloud computing is becoming a standard method of software and hardware operation for many businesses. SearchHealthIT reported health care cloud adoption is on the rise, thanks in part to EHR systems.

Cloud computing advantages for healthcare are undeniable (especially for smaller providers), faster EHR implementation, low cost of ownership, and system access mobility. However, cloud computing risks should not be ignored when deciding to transition to a cloud-based system. Cloud computing risks include vendor dependency, security, data privacy and confidentially issues.

Because of the substantial cost savings associated with cloud-based systems, cloud computing is here to stay. However like any other IT project, appropriate steps should be taken to reduce and mitigate those risks. Seek out advice and guidance from cloud computing subject matter and legal experts to hammer out contingency plans, service level, data ownership, and security agreements in the event of system down time, security and privacy breaches.

IT Infrastructure for Telehealth

As baby-boomers continue to age, the demand on health services is set to double in the next 10 years. It’s not practical to believe the number of doctors and nurses, hospitals, and other healthcare providers will double also during this time, therefore, the industry will leverage technology to address these growing needs. Telephone and internet consultations will become increasingly more important as a method of providing and receiving healthcare advice.

Technology will be leveraged to provide care beyond the walls of hospitals and doctor’s offices, a routine trip to a doctor’s office could be replaced by a video, telephone, or even an internet consultation. Thereby free up time for the physician to spend with patients whose conditions require their full attention. In addition, healthcare providers will also increasingly need information systems to support non-collocated collaboration between clinicians.

The efficacy of telehealth requires the IT infrastructure to support this emerging remote physician-patient interaction; the infrastructure must connect and consolidate various imagining and clinical databases; and IT organizations must continually evaluate if and when SaaS and cloud computing is appropriate for their organization.

EMR App for the iPhone

In a previous blog entry, “A Gadget Kind of Day” I blogged about Sling Box finally releasing the Sling Player Mobile app for the iPhone and iPod Touch. Because of my excitement to finally get a chance to watch TV on my iPod Touch, I proudly stated the blog entry had nothing do with HIT, other than possibly up selling a techno-geek physician that had to have the latest gadget. Thanks to blogger Fred Pennic of Healthcare IT Consultant Blog for his blog post on an EHR app for the iPhone.



A company in California, Caretools, have developed an award winning app, iChart, specifically designed for the iPhone and iPod Touch platforms. In addition to the charting, iChart also includes prescription, billing and lab report modules. Basically, all patient data is entered on the iPhone app, or from a web based desktop computer. Once new information is added to a patient’s record via the iPhone, the data is first stored on the iPhone and then synchronized to an iChart Web based account.

So in a nutshell, iChart is a SaaS EMR with an iPhone front-end. Therefore, the same risks identified when evaluating a SaaS EMR must be taken into consideration when evaluating this app. Also, because patient data is stored on the iPhone, in order for this app to be HIPAA compliant the dreaded iPhone password must be enabled. Honestly, do you know anyone with an iPhone that has their password enabled? However from a price standpoint, Cartetools have competitively priced the iChart app. The basic product is priced at $139.00 for the first year with an annual renewal subscription fee of $99.

Here again, for the techno-geek type provider, this app can’t miss, its way cool!! For the bread and butter type provider, a desktop anchored down in the examination room or a nice size handheld tablet is more in line.

Click here to visit Caretools' website.

Read Fred Pennic’s complete blog article here.

IT, it rolls Downhill

I was having lunch with one of my more technical savvy, or so she thinks, doctor friends the other day. Just like most physicians, she’s contemplating implementing an EMR application for her family practice. After visiting with several EMR vendors, she decided that she was going to implement an open source EMR solution because of its cost effectiveness, plus she has a longstanding relationship with her current system integrator.

Since our last discussion, someone, another vendor, had convinced her that a software as a service (SaaS) solution was the way to go. It's quite possible that a good financial case can be made for an EMR SaaS solution as opposed to other EMR solutions. But what surprised me was that she was not aware of the inherent risks of implementing this type of solution. I reminded her of when her web site hosting company closed. The frustration it caused and length of time it took to get her site back online. Actually, the bulk of the frustration came from her trying to get the source code for her site (she never had a copy). I warned her that experience would be very similar if her SaaS provider tanked, only it would be MUCH worst. After our discussion, she realized she had more work to do before coming to decision.

I begin to wonder who responsibility is it to outline the risk of the various EMR solutions to a potential customer? Should each vendor outline the inherent risk associated with their solution? Or should a physician research and understand the inherent risk involved for each possible solution? For large clinical practices and hospitals, this is not an issue because this falls squarely on the CIO, IT Director, or to the most senior ranking IT executive. However, an IT executive would be aware of the inherent risk in each solution platform and would carefully and thoroughly explained the risk to all stakeholders ;)

As the healthcare IT reforms begin to be implemented, vendors, software developers, and system integrators will merge, disappear and possibly default. "Things" will begin to roll downhill and IT will be sitting at the bottom of the hill. If the magnitude of this problem is great, that hill will be Capitol Hill. We all saw what happened to the last industry execs that visited there.