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Are we ready for a Cloud First hospital?


I will start this article by defining what I mean by the term a Cloud First hospital. The term cloud has been a buzz word in the past decade which led many organizations to declare their support for the cloud, sometime without understanding its true meaning.
For the purpose of this article I am proposing a simple test to decide whether an organization is a cloud first or not. If you are software vendor you must have an IT department which directly in charge of the system up-time at your clients sites. If you are a health organization then you should never have visited the data center where your data resides. A Cloud First hospital is one which more than 50% of its systems reside in data center that none of its staff members ever visited or not even sure where they are.

According to a recent survey by Datica, in the US only 17.7 percent of the respondents say they work with healthcare organizations that have more than 50% of the existing software infrastructure remotely hosted or in the cloud. It is fair to assume that a large chuck of that sum simply have their systems hosted in a remote location which as stated above does not meet the definition of cloud. That survey was conducted in the US were cloud adoption is high. Europe is much more conservative when it comes to cloud adoption, maybe contributing to this fact is that most of the big cloud vendors are US companies.

The big advantage of moving to the cloud is that health organizations can focus on their main mission which is to take care of patients. Dealing with storage boxes and network switches is at the end of the day a distraction.

The costs of cloud computing are falling more rapidly than that of onsite hardware and software, making the cloud a sound and strategic investment if costs are in the same ballpark.
Increasingly, hospital CEOs and their technology lieutenants are realizing that the public cloud platforms are at least as secure as the local option.

For software vendors the shift to being a cloud first company is a major one. Although not always admit it, software vendors don't really care if the health organization host their product on premises or on some AWS VM. If they however need to be in charge of their system up-time, version updates, security and so forth, that will force them to get into the IT business, which pure software vendors are not eager to do.

According to the Datica survey compliance, security and privacy are the three primary concerns for those hospital CIOs who considered moving to the cloud. The common saying is that due to strict regulations and complex, legacy infrastructure, among other reasons, the healthcare industry has been somewhat behind the curve in terms of digital technology adoption.
I am not sure however that this is the true reason for the slow adoption of cloud or simply the story the healthcare IT industry like to tell.
Like many things in life I think the number one barrier for change are the people.
Traditional healthcare IT departments are set up with an IT director and staff, a network infrastructure and local data centers. For many years, the healthcare industry has been exchanging information, such as medical images and more recently electronic medical records, through a local network.
For IT staff who have been trained on legacy data systems, a shift to a cloud includes preparing them for considerable disruptions in their daily work responsibilities.
In order to move to the cloud hospitals will have to stop being control freaks. That is a very hard transformation for organization which their claim to fame is being control freak.

It's worth also to remember that the real benefit for organization comes when all systems are moved to the cloud and the IT department can shrink dramatically, having one or several systems move to the cloud won't have that impact. The healthcare IT people who should lead the transformation are aware of that, and people usually don't rush to cut the branch they are sitting on.

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