Cloud Computing Building the foudation in Healthcare
1. Corporate Marketing Healthcare
White paper
Cloud Computing: Building a
New Foundation for Healthcare
2. 2 Computing: Building a New Foundation for Healthcare
Table of contents A transitioning industry in need
2 A transitioning industry in need of innovation of innovation
3 The potential of cloud The healthcare industry is in a period of accelerating
– What does cloud offer? change that requires continual innovation. The chronic
disease epidemic, changing population demographics and
5 IBM vision for cloud in healthcare
advancements in medical technologies are key contributors
7 Realizing the benefits of cloud computing to escalating costs. All stakeholders expect more value for
– Building your cloud strategy their money. And, patients are beginning to play greater roles
– Data security and confidentiality in managing their care. Driven by economics, emerging
10 Change is possible. The tools exist today care and business models aligned with personal values and
well-being are signaling a major shift in how healthcare
organizations will compete and operate in the years ahead.
A recent CEO Study conducted by IBM revealed that only
34 percent of healthcare provider CEOs are focused on
simplifying operations to manage complexity more effectively.1
Similarly, only 55 percent of healthcare payer CEOs believe
their organizations are ready for the impending complexity.
Yet most recognize that there is a new environment in which
they have to operate.2
Cloud computing is a new IT approach that offers new
economic benefits, rapid deployment of services and tight
IT alignment with business goals. This paper reviews the
potential for cloud computing in the healthcare industry and
makes specific recommendations for how the healthcare
industry can take advantage of this technology to thrive.
3. Healthcare 3
The potential of cloud A flexible and scalable approach to applications and
In healthcare, the pace of change is increasing, along with the infrastructure can help healthcare organizations support
complexity of delivering higher quality care for significantly new business approaches and seamless patient experiences.
fewer dollars per patient. Hospitals and physicians are Emerging care delivery and business processes will drive
looking for strategies to increase business flexibility, while transaction volumes and complex analytics-driven workloads
demonstrating greater healthcare value. To do so, a to new levels never envisioned by healthcare organizations.
transformation from institution-centered, data-poor systems These drivers require a larger IT footprint to enable new
to patient-centered, information-rich health systems is needed. capabilities, yet growing IT complexity threatens to hold
organizations back.
Regardless of segment, the healthcare industry is facing a
multitude of issues (Figure 1). Cloud computing offers new and flexible ways to provision,
manage and pay for technology resources. It is allowing new,
more efficient business models.
Strong need for cost reduction Use data to analyze and improve
clinical and business performance
Strong need for operating efficiencies
Expand access to care What does cloud offer?
and increased productivity
Cloud computing is a general term for anything that involves
Need to automate care delivery Transition from reactive to proactive
processes and systems care the delivery of technology over the Internet. It is a model for
Need to modernize legacy Demonstrate greater healthcare value enabling convenient, on-demand network access to a shared
applications and systems to all stakeholders
pool of configurable computing resources (for example,
Comply with regulations and security Need for business model innovation
mandates to improve sustainability networks, systems, applications and services) that can be
rapidly provisioned and released with minimal management
Figure 1: Healthcare industry issues. effort or service provider interaction.3 It is characterized by:
• On-demand self-service
• Ever-present network access to computing resources
• Rapid and elastic provisioning with minimal management
effort or service provider interaction
• Pay-per-use
4. 4 Computing: Building a New Foundation for Healthcare
Cloud computing changes the delivery of IT services in much Today, organizations and businesses are implementing three
the same way that ATMs changed banking, Amazon.com and primary delivery models for cloud computing (Figure 3).
iTunes have changed the music and entertainment industry Private clouds allow flexible implementation — either in an
and the Internet transformed commerce. The overall goal of enterprise or on a service provider site. Today, we see strong
cloud computing is to manage complexity more effectively, interest in moving many IT activities or workloads to a
using simplification to speed the deployment of new private cloud.
capabilities that can enable innovation. Although cloud
computing has been associated more with infrastructure,
Private Public
the ability to generate new business value in terms of process IT capabilities are provided “as a IT activities / functions are
service,” over an intranet, within the provided “as a service,”
innovation and significant cost savings is on the horizon. enterprise and behind the firewall over the internet
Cloud computing provides a platform for business-to-business Enterprise Enterprise Users
Enterprise Enterprise
and business-to-consumer collaboration and enables data center data center A B A B
organizations to focus on differentiating activities as distinct
private cloud
from transactional processes (Figure 2). Hosted private cloud Shared cloud services Public cloud services
• Service Provider • SP implements on • SP owned and • SP owned and • Currently not
(SP) implements client/SP premises operated operated offered by IBM
on client premises
• Can be configured • Enterprise-only • Enterprise-only • End-user access
• Can be configured to client specific access access (credit card)
to client specific workflows
Infrastructure Platform as a Software Business Process workflows • Dedicated • Shared resources • Shared resources
as a Service Service as a Service as a Service • SP operated Resources & facilities
(IaaS) (PaaS) (SaaS) (BPaaS) • Client runs/manages
• Shared facility • VPN/VLAN
E.g., optimized E.g., application E.g., EMR, medical E.g., enrollment, claims and cloud isolation
systems, storage servers, middleware, image management, audit and fraud discovery, management
and networking development and analytics, public reimbursement, home care
test environments alerts, collaboration monitoring and alerts
Figure 3: Comparison between private and public clouds.
Figure 2: Cloud computing service models.
5. Healthcare 5
Hybrid clouds combine services from both public and private In a cloud-enabled future (Figure 4), healthcare begins with
clouds. Public cloud providers sell services to anyone on the individual in the center, who receives better, safer, less
the Internet. costly and more convenient care and has better overall health
because of consistent interactions with stakeholders.
IBM supports the creation of private and enterprise shared
service clouds, which enable multiple tenants to share
common resources securely. IBM delivers public cloud
services (for example, IBM LotusLive™ for collaboration) Other patient
Primary Care
and provides services to clients for delivering public cloud Provider-led Specialists
Care Team*
services. However, IBM does not support a pure public
cloud, such as the Amazon credit card model. Life Sciences
and Research
Hospitals
Organizations
IBM vision for cloud in healthcare Medical Device
Companies
Patient
Private and
The healthcare industry is shifting toward an information- Other patient Public Payers
centric care delivery model, enabled in part by open standards Government Support
Networks**
that support cooperation, collaborative workflows and Patient information Other patient
information sharing. Ultimately, an ecosystem will evolve Population-based insights
Clinical knowledge
that continually generates and exchanges insights and brings
relevant insights into health and care decisions. It will be
efficient, with the flexibility to respond dynamically to Figure 4: An example of how cloud could enable healthcare in the future.
changing needs and the latest medical breakthroughs. Cloud
computing, information management and business analytics
will be key enablers of these capabilities. Services delivered
by cloud computing will evolve to support a wide variety
of healthcare processes.
6. 6 Computing: Building a New Foundation for Healthcare
Closest to the patient is the primary care physician, who Public and private insurers strive to improve each individual’s
leads a core team of nurses, physician assistants and care satisfaction, to act as health advocates offering health and
coordinators and an extended team that includes hospitals, wellness products and services and to lower healthcare costs.
specialists, pharmacists and others. Practice and population- They process digital claims and update patient records
scale information and insights are available in near real-time. continuously with current data to improve the timeliness of
This availability ensures that the most current, complete care and insurance processes.
insights and clinical knowledge are available to support
care provider decisions and, most critically, to deliver To optimize the effectiveness of cloud computing and to
comprehensive, integrated and coordinated care focused achieve efficiencies, we expect organizations to adopt
on value creation rather than consumption. Information is standardized processes and focus on achieving differentiation
harvested and repurposed for more appropriate referrals through collaborative partnerships and use of information.
and medical research to support the promise of personalized Common processes, data and standards can improve quality
health and care. and operational effectiveness. Rapid, flexible and scalable
IT can change how information is used and delivered.
Today cloud-delivered pilot programs are helping
organizations support wellness programs and make medical
information available to individuals.
7. Healthcare 7
Realizing the benefits of cloud computing
Cloud computing can help transform healthcare. Cloud
technology supports collaboration and team-based care
delivery and the ability to use applications based on business
model requirements and a common set of clinical information.
It can be done on a platform that allows healthcare
organizations to deliver, use and integrate new services
based on a comprehensive and longitudinal view of patients
irrespective of where or by whom the care was delivered.
Using the cloud for wellness services This will require maintaining a level of security and privacy
equal to or greater than what traditional IT provides.
In Taiwan, a government-run national health insurance initiative
is partnering with IBM Research to develop wellness services.4
Building your cloud strategy
Participants in this cloud-delivered project include hospitals,
Cloud computing requires an integrated and orchestrated
doctors, insurance companies, community organizations and
strategy. A strategy assessment is fundamental to the thoughtful
companies that manufacture devices and instruments. For
example, remotely monitored blood pressure measurements definition of how you will take advantage of cloud computing
are uploaded to a cloud for analysis, record-keeping and doctor and the value it will create for your healthcare organization.
review. New device-related solutions deliver new services; This will include:
device manufacturers can expand their offerings, enabled by
cloud-based services that involve mobile access, huge data • Understanding the value proposition for cloud
volumes and analytics. • Exploring cloud workloads and deployment models
• Developing a cloud solution based on the value proposition,
workload and deployment model
• Developing a plan to monitor key performance indicators
to validate business benefits
8. 8 Computing: Building a New Foundation for Healthcare
Workloads vary according to business criticality, protected
health information (PHI) involvement, complexity and IT
requirements. Figures 5, 6 and 7 show examples of physician, Care Delivery
hospital and health plan/insurer workloads that can benefit Transformation
from a cloud approach. Readmission
Reduction
Critical Care Alert
Correlation
Credentialing Point-of-care
Patient Home Care
Decisions Monitoring and
Empowerment
Referral Alerts
Consumerology Development and
Management Readmission
Test Environments Public Reporting
Reduction
Patient Services Rx Therapy Compliance Patient
Management Patient Services Satisfaction
Patient Treatment Plans
Capacity for Medical Image
Communications Compute-intensive
Referral Selections Medical Research Management
Secure Mobile research
Desktop and Device EMR / PMS
EMR / PMS Compute and Secure Mobile
IT Simplification Strategy Storage for Peak Desktop and Device Legacy
Demands Strategy Modernization
Information Collaboration, Mobility Care Delivery
Technology and Business Services Core Systems Collaboration, Mobility Care Delivery
and Business Services
Figure 5: Physicians: Examples of workload candidates for cloud computing. Figure 6: Hospitals: Examples of workload candidates for cloud computing.
9. Healthcare 9
Member Health Healthcare organizations are currently drawn to cloud
Advocacy computing because it helps reduce IT costs and speeds service
Customer and Patients Like Me and infrastructure availability. Cloud computing can reduce
Partner Self-Service Cohorts
capital expenditures and the need to replicate hardware
Customer Provider
Relationship Performance
environments at each facility. It also makes it possible to
Compliance Management
Management Claim Audit and add capacity rapidly when it is needed.
Marketing Fraud Discovery
Development and Execution and
Test Environment Campaign Single Customer
for ICD-10 Migration Management Therefore, part of a cloud strategy should include forecasting
View
Legacy Secure Mobile Cost Management
potential savings from a cloud-delivered approach, just as an
Modernization Desktop and Device (Medical Loss organization would do for other initiatives in an enterprise
Strategy ratio Rule)
Compute and data center strategy.
Storage for Peak Health Benefit
Demands (e.g., open Efficient PC
Information
enrollment periods) Refresh Cycle Exchange
Data security and confidentiality
Core Systems Collaboration, Mobility Healthcare While organizations can see value in real cloud-delivered
and Business Services Applications applications today, challenges remain. Security is one of the
more significant concerns.
Figure 7: Health plans/insurers: Examples of workload candidates for
cloud computing. Organizations need to manage the security of their
infrastructure carefully, taking into consideration everything
that could happen throughout the life cycle of PHI. The
US HIPAA HITECH Act presents one of the better ways
to support the exchange of PHI, built on a HIPAA baseline.
At the same time, the epSOS European eHealth project is
on a path to create a Europe-wide system for patient data
exchange between member states.5
10. 10 Computing: Building a New Foundation for Healthcare
IBM is working to implement secure delivery models,
deploying platforms for industry clouds that are “secure
by design.” With these secure models, when healthcare
organizations or communications services providers
deliver services, they can trust that their services are not
compromised.
Change is possible. The tools exist today
IBM is working with clients to help them use cloud to reduce
operational costs, increase business flexibility and realize faster
IBM: Partnering with clients to understand security and time to market. Our clients are also beginning to see the value
risk in the cloud of using cloud to move beyond operational cost-cutting to
IBM is working with clients to test the limits of security and transforming business processes.
risk in a cloud environment. One example is the European
consortium working to prototype an advanced cloud IBM can help you assess and plan cloud adoption, whether
infrastructure that can deliver a new level of secure, private it is to reduce strain on your clinical, business and technical
and resilient computing and storage that is cost-efficient, infrastructure caused by growing patient data or transforming
simple and scalable.6 This includes a prototype of a the way you deliver care. IBM can help organizations identify
patient-centered home healthcare service to demonstrate and prioritize cloud computing initiatives, including
how the quality of in-home healthcare can be improved considerations for their strategic use to deliver, consume and
cost-efficiently without reducing privacy. The project will also integrate new health services. We can help develop business
study the legal, business and social aspects of cross-border and care delivery strategies, extend IT optimization strategies
cloud computing, such as country-specific privacy laws.
and build a roadmap (Figure 8).
11. Healthcare 11
What IBM offers healthcare organizations
• Clear economic value. IBM helps you work through the
right mix of delivery models and choices to reap the
maximum benefit. An innovative healthcare client shared
lessons gained from a IBM CloudBurst™ (infrastructure as
a service) implementation that introduced a pay-as-you-go
Figure 8: IBM offers six proven steps to help you get started with
cloud computing. model to increase project flexibility and allocate freed up
resources to other high value activities. The investment in
cloud computing required creativity and a strong commitment
to realize benefits.
Our roadmap methodology can help you understand not only • Integrated and open solutions. IBM actively supports
which cloud strategy meets your needs but also which service is healthcare standards development, working with policy
best suited for delivering specific clinical and business use makers, building consensus and delivering unique, innovative
cases. new technologies. IBM initiated a community-based effort
to drive new standards for cloud computing. Our open
standards approach encourages a broader ecosystem,
including developers, independent software vendors and
resellers, which leads to collaborative partnerships that will
be critical to the deployment and success of healthcare
cloud platforms.
• Secure solutions that are ready for business. The IBM
Security Framework and Blueprint provide a comprehensive
method for addressing all aspects of security and an equally
comprehensive portfolio of security offerings and services.
In addition, IBM Research is helping clients to navigate and
manage the cloud security landscape.
• Designing for simplicity. From sourcing to usage to
maintenance, IBM cloud solutions are simple, intuitive and
designed for how healthcare organizations actually work.
• Globally relevant. We’ve established 11 global cloud
computing laboratories to help local organizations,
governments and research institutions design, adopt and
reap the benefits of cloud technologies. Each lab serves
as a gateway for local clients to tap into the knowledge of
IBM software, services and research labs around the world.
