Cloud Computing Building the foudation in Healthcare
Corporate Marketing HealthcareWhite paperCloud Computing: Building aNew Foundation for Healthcare
2 Computing: Building a New Foundation for HealthcareTable of contents A transitioning industry in need2 A transitioning industry in need of innovation of innovation3 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 and5 IBM vision for cloud in healthcare advancements in medical technologies are key contributors7 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, emerging10 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.
Healthcare 3The potential of cloud A flexible and scalable approach to applications andIn healthcare, the pace of change is increasing, along with the infrastructure can help healthcare organizations supportcomplexity 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 drivelooking for strategies to increase business flexibility, while transaction volumes and complex analytics-driven workloadsdemonstrating 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 newto 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 amultitude 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 managementFigure 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 Computing: Building a New Foundation for HealthcareCloud computing changes the delivery of IT services in much Today, organizations and businesses are implementing threethe 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 anand the Internet transformed commerce. The overall goal of enterprise or on a service provider site. Today, we see strongcloud computing is to manage complexity more effectively, interest in moving many IT activities or workloads to ausing simplification to speed the deployment of new private cloud.capabilities that can enable innovation. Although cloudcomputing has been associated more with infrastructure, Private Publicthe 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 internetCloud computing provides a platform for business-to-business Enterprise Enterprise Users Enterprise Enterpriseand business-to-consumer collaboration and enables data center data center A B A Borganizations to focus on differentiating activities as distinct private cloudfrom 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.
Healthcare 5Hybrid clouds combine services from both public and private In a cloud-enabled future (Figure 4), healthcare begins withclouds. Public cloud providers sell services to anyone on the individual in the center, who receives better, safer, lessthe 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 sharedservice clouds, which enable multiple tenants to sharecommon resources securely. IBM delivers public cloudservices (for example, IBM LotusLive™ for collaboration) Other patient Primary Careand provides services to clients for delivering public cloud Provider-led Specialists Care Team*services. However, IBM does not support a pure publiccloud, such as the Amazon credit card model. Life Sciences and Research Hospitals OrganizationsIBM vision for cloud in healthcare Medical Device Companies Patient Private andThe healthcare industry is shifting toward an information- Other patient Public Payerscentric care delivery model, enabled in part by open standards Government Support Networks**that support cooperation, collaborative workflows and Patient information Other patientinformation sharing. Ultimately, an ecosystem will evolve Population-based insights Clinical knowledgethat continually generates and exchanges insights and bringsrelevant insights into health and care decisions. It will beefficient, 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. Cloudcomputing, information management and business analyticswill be key enablers of these capabilities. Services deliveredby cloud computing will evolve to support a wide varietyof healthcare processes.
6 Computing: Building a New Foundation for HealthcareClosest to the patient is the primary care physician, who Public and private insurers strive to improve each individual’sleads a core team of nurses, physician assistants and care satisfaction, to act as health advocates offering health andcoordinators 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 recordsscale information and insights are available in near real-time. continuously with current data to improve the timeliness ofThis availability ensures that the most current, complete care and insurance processes.insights and clinical knowledge are available to supportcare provider decisions and, most critically, to deliver To optimize the effectiveness of cloud computing and tocomprehensive, integrated and coordinated care focused achieve efficiencies, we expect organizations to adopton value creation rather than consumption. Information is standardized processes and focus on achieving differentiationharvested 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 qualityhealth 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.
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 initiativeis partnering with IBM Research to develop wellness services.4 Building your cloud strategyParticipants in this cloud-delivered project include hospitals, Cloud computing requires an integrated and orchestrateddoctors, insurance companies, community organizations and strategy. A strategy assessment is fundamental to the thoughtfulcompanies that manufacture devices and instruments. Forexample, remotely monitored blood pressure measurements definition of how you will take advantage of cloud computingare 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 bycloud-based services that involve mobile access, huge data • Understanding the value proposition for cloudvolumes 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 Computing: Building a New Foundation for HealthcareWorkloads vary according to business criticality, protectedhealth information (PHI) involvement, complexity and ITrequirements. Figures 5, 6 and 7 show examples of physician, Care Deliveryhospital and health plan/insurer workloads that can benefit Transformationfrom 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 ServicesFigure 5: Physicians: Examples of workload candidates for cloud computing. Figure 6: Hospitals: Examples of workload candidates for cloud computing.
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 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 fasterIBM: Partnering with clients to understand security and time to market. Our clients are also beginning to see the valuerisk in the cloud of using cloud to move beyond operational cost-cutting toIBM is working with clients to test the limits of security and transforming business processes.risk in a cloud environment. One example is the Europeanconsortium working to prototype an advanced cloud IBM can help you assess and plan cloud adoption, whetherinfrastructure that can deliver a new level of secure, private it is to reduce strain on your clinical, business and technicaland resilient computing and storage that is cost-efficient, infrastructure caused by growing patient data or transformingsimple and scalable.6 This includes a prototype of a the way you deliver care. IBM can help organizations identifypatient-centered home healthcare service to demonstrate and prioritize cloud computing initiatives, includinghow the quality of in-home healthcare can be improved considerations for their strategic use to deliver, consume andcost-efficiently without reducing privacy. The project will also integrate new health services. We can help develop businessstudy the legal, business and social aspects of cross-border and care delivery strategies, extend IT optimization strategiescloud computing, such as country-specific privacy laws. and build a roadmap (Figure 8).
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-goFigure 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 supportswhich cloud strategy meets your needs but also which service is healthcare standards development, working with policybest suited for delivering specific clinical and business use makers, building consensus and delivering unique, innovativecases. 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.