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Cloud Computing in Health Care A game changer by Uk Anantapadmanabhan


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Cloud Computing in Health Care A game changer by Uk Anantapadmanabhan, Global Product Director – Hospital Solutions, Telstra Health, India

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Cloud Computing in Health Care A game changer by Uk Anantapadmanabhan

  1. 1. 1 Cloud Computing in Indian Healthcare - A Game Changer U.K. Ananthapadmanabhan
  2. 2. 2 Dichotomy in Indian Healthcare  40% children malnourished / inadequate Public health infrastructure / Acute shortage of medical professionals  Public sector provisioning 20% while private sector is 80%  Overall, good improvement in life expectancy/MMR/IMR/eradication of polio  Corporate hospitals and medical colleges established / Reforms initiated – NEET  Huge Private equity / Venture capital / Foreign / NRI investment in Healthcare  Hitech procedures done at a fraction of US costs – Emergence of medical tourism
  3. 3. 3 Technology Penetration  India leapfrogging in Information Technology and Telecom. India is a IT power house of the world  Enormous support, encouragement and investment by state and central governments under “Digital India“ initiative  Healthcare – a slow adopter of technology, unlike Banking, Manufacturing and Retail  Healthcare organizations are slowly changing focus from automation of back office systems/reimbursement methods/regulatory compliance and accreditation requirements  Major drivers of Healthcare IT - establishment of large hospitals in private sector, insurance penetration, accreditation requirements and emerging disruptive technologies like cloud computing, Robotics, Machine leaning, Big data and BOTs
  4. 4. 4 What is Cloud Computing? Discussion  Hardware, software applications, Network, storage resources are sold and consumed as a service or utility like electricity / air travel  Shared pool of configurable computing resources  Real time, available on demand, rapidly deployable, minimum management effort or service provider interaction  Any time, any device, any place access
  5. 5. 5 Key Characteristics of Cloud Service Measured Service • Pricing for no. of cores, RAM, Storage, Disaster recovery systems, Band width • Annual Maintenance contracts, MC • Escalation Matrix Rapid Elasticity & Homogeneity • Provisioning by day / time for increasing patient loads in existing / new hospitals • Version upgrades • Master data and work flow standardization Multi-tenancy & Resource Pooling • Multiple hospitals / clinics • Operating systems / HIS / SAP / email services / 3rd party software tools Ubiquitous Network Access • Remote / any device / any location (hospital / clinic / home) access
  6. 6. 6 Cloud - Service & Deployment Models Cloud Service Models Deployment Models Infrastructure as a Service For processing, storage, networks, and other computing infrastructure resources Platform as a Service To deploy applications developed using specified programming languages or frameworks and tools onto the cloud infrastructure Software as a Service Private Cloud Public Cloud Hybrid Cloud To access applications from varied end-user devices (generally through a web browser) Operated solely for one organization only or for an individual person Open to the general public or large industrial groups and are owned and are usually managed by a cloud service provider Combining two or more clouds (private or public) that remain unique entities but are bound together with data and application portability.
  7. 7. 7 Why Cloud in Healthcare? Cost Effectiveness Elasticity Rapid Scalability Anytime-Anywhere Access  Move from CPEX to OPEX for new hospitals (Pay as you go)  Long term reduced cost of owernership for existing hospitals  Less IT manpower costs  Computing resources can be configured for varying transaction load patterns peak times in a day / week or Holidays  Ensures optimum untilisation of resouces  Establising servers / networks / airconditioning / power conditioning equipment may take one or two months  Provisioning hardware /software / tools will just take few hours  Clinicians access any data from any place at any time for any patient – improving quality / efficiency and patient experience
  8. 8. 8 Benefits of Cloud Computing
  9. 9. 9 Key Risks & Challenges Data security, Integrity, Privacy and Compliance Latency Risks  Lose contorl over patient data and privacy  May not be certified or compliant for industry standards / regulations - NABH / HIPPA  User request to server response  Time – Ping time  Computational and Network  Bandwidth constrains from network vendors – Fibre optic lines? Few Hospital Information Systems in the Cloud  Most HIS not cloud ready  Hospital Management and IT staff still hesitant to embrace cloud Description  Identify vendors with region specific certifications / compliances  Ensure data security / privacy guarantees  Choosing the right / trusted vendor  Proximity of hospital to data centers locaton  Indian and foreign vendor gearing  Cloud version / localization and customization of software CST / TCS Mitigation
  10. 10. 10 Cloud Market in Global Healthcare By Region North America Europe Asia Rest of the World Pricing Model Pay as you go Spot Pricing End-users Healthcare Providers Healthcare Payers Deployment Model Private Cloud Public Cloud Hybrid Cloud Community Cloud Software Clinical Information Systems Non-clinical Information Systems Component Hardware Software Services
  11. 11. 11 Cloud Deployment in Healthcare Hospital Information Systems Network Vendors Disaster Recovery Systems Data Centers Provision VMs / storage Location of data centers Long term contract (5years) Better pricing; Falling Cloud services pricing SLA contracts Escalation Matrix Monitor Resource consumption Primary & Secondary MPLS connectivity Fiber optic Vs RF connectivity SLA - 99.9% up time Take advantage of falling prices Patient Management Op/IP Billing; CPOE Radiology/Laboratory services EMR/PACs and ERP- SAP Third party software – Asset management, canteen billing Claims Management Hot / Cold DR Remote location Expensive
  12. 12. 12 Sl No Name of vendor Healthcare Organization 1 CtrlS Data center, Hyderabad Apollo Hospitals, Rainbow Hospitals, Call Health 2 Ricoh India data center Fortis Hospital, Delhi /Artimis, Gurgaon / Emanuel Hospital 3 Microsoft Azure L V Prasad Eye Institute, Hyderabad / Partners Health, United States / Apollo Hospitals / Fortis Hospitals 4 Amazon Cloud services Cleveland Clinic, Ohio, United States Cloud service providers & Healthcare customers
  13. 13. 13 Case Study: “Rainbow Digital” – Cloud HIS for Rainbow Hospitals (1/2) Context Legacy Systems Key Initiatives Rainbow Children’s hospital is one of India’s largest, foremost and most progressive super-specialty pediatric hospital networks - 800-bed, private, equity-funded group has positioned itself nationally as a center of excellence. Why Cloud? Growth necessitated a complete digital transformation and meeting commitments to ongoing improvements to patient safety, quality of care and efficiencies as more hospitals came online. Decision to comprehensively overhaul all hospital IT systems and replace the old legacy system with a new state-of- the-art integrated solution. 1200 600 1200 # of Total Beds Daily in-patients Daily out-patients Newly procured Arcus hospital information system including electronic medical records SAP and Adrelin (Polaris) ERP systems for materials, HR, and finance management Integrated and hosted on the cloud at the well-established Tier4 cloud service provider, CltrS limited, Hyderabad. CltrS has data centers in Hyderabad, Mumbai and Delhi. Cloud-hosting has enabled Rainbow to scale up or down its infrastructure requirements based on fluctuating and evolving demand with minimal investment. Rainbow ran with two large computer servers - one supporting four hospitals in Hyderabad (the Hyderabad cluster) and another - a stand-alone server at Vijayawada hospital.
  14. 14. 14 Sl No Name of Hospital /Clinic location No of Beds Type of Project Date of Go live 1 Raiinbow ,Vikrampuri, Hyderabad 75 Existing 25/1/15 2 Rainbow ,Kondapur, Hyderabad 70 Existing 22/2/15 3 Rainbow Kukautpalli Hyderabad 100 7/3/15 4 Rainbow Madhapur clinic Hyderabad NA Existing 17/3/15 Rainbow ,Banjara Hills Hyderabad 175 Existing 19/3/15 Rainbow children’s hospitals with cloud enabled Arcus HIS
  15. 15.  Clinicians visiting multiple hospitals - now able to access HIS and order for tests, procedures, view reports and write notes from remote locations  Group purchasing and centralized store management for all hospital units with SAP hosted on the cloud – helped reduce inventory & material purchase costs  Real-time dash board reports on number patient visits, inpatient and outpatient billing, pending laboratory reports, manpower/ material cost greatly improved  Turnaround times in laboratory, radiology, OT & OPD areas down by 40 to 50 percent  Configuring 3rd party software, lab equipment, tariff across all the version upgrades of application software, operating systems and tools became very simple as they could be done centrally on the cloud eliminating the need to perform in each hospital server  Ensuring security, integrity, and privacy of patient data practically shifted to Cloud service provider. Hospital IT department - no longer required to ensure these in each of the hospital units and less dependent on their IT personnel  Legacy software in hospitals replaced by new Telstra Arcus HIS one after another over a period of one year with a time gap of one month. Key Outcomes 60% 50% 60% 50% 50% Improvement in documentation accuracy Increase in patient satisfaction rates Reduction in theatre waiting Time Reduction in laboratory test results turnaround times Improvement in radiology turnaround times Productivity Impact Case Study: “Rainbow Digital” – Cloud HIS for Rainbow Hospitals (2/2)  With Cloud - existing hospital servers became redundant and no infrastructure maintenance required in any hospital
  16. 16. 16 Thank you! Questions?