Cloud-first strategy or hosting is a frequently used term when discussing digital transformation in healthcare. But building cloud capabilities only makes sense if stakeholders know the purpose behind it.
During a Becker's Healthcare virtual roundtable in October sponsored by Amazon Web Services (AWS), Steven Malme, worldwide principal business development manager at AWS, and more than a dozen chief information officers (CIOs) and implementation leaders discussed the benefits and challenges of migrating electronic health record (EHR) infrastructure to the cloud.
Read on for four key takeaways from the roundtable:
1. Cloud capabilities enable organizations to improve upon traditional ways of doing things.
Cloud-based transformations that roundtable participants look forward to include:
- Transitioning from legacy EHR systems and standardizing them in the cloud. In practice, this means that all members of a health system could have access to the same EHR and generate patient-level data using a universal format. "In our clinically integrated network, we have 4,600 physicians, 80 percent of whom are independent doctors. Each has a different electronic medical record (EMR), and they don't talk to each other," said the president of population health at a healthcare provider network in the northeast.
- Interfacing with payers and patients. For one CIO of a large healthcare system in the southwest, this means reconciling differences within provider directories to improve consumer engagement. For a chief operating officer (COO) of a major city hospital in the southeast, it means enabling simpler interactions between physicians and low-income patients. "I think it's going to take some federal mediation and resources to fully utilize cloud technology," the COO said.
- Freeing enterprise server space by moving disaster recovery sites off premises. "Having the flexibility to support disaster recovery in the cloud is an attractive option," the CIO of a major mid-Atlantic university medical center noted. Another participant suggested that their institution is considering "building our own web" on the cloud so as not to depend on hundreds of servers distributed across member sites.
2. Cloud safety and security are a top concern. Because health data is 8-12 times more valuable than financial data, a data breach can be very costly—both economically and reputationally. Cloud vendors who provide services to a range of industries may not necessarily grasp the importance of this, but as one CIO of a city hospital in the northwest stated: "I can't run a system at 99.9 percent [cybersecurity] and hope for the best."
3. Raising the profile of information technology (IT) is essential. Decision-making around EHR migration to the cloud or other cloud-related initiatives should not be only a question of operational efficiency. IT departments need to make the case that IT is a strategic asset that enables organizational growth and not just supporting other projects. Yet IT professionals are sometimes viewed as a commodity to be tapped when needed rather than as full-fledged collaborators. "IT is where human resources used to be—on the periphery—and we´ve got to make it more mainstream," the southeastern hospital's COO said.
4. Providing a clear-cut problem statement is vital to win over clinicians. Despite the benefits of moving patient records to the cloud, many clinicians have been burned out by the administrative burden that legacy EHRs have imposed on them. They want to understand how a move to the cloud will help them better take care of patients. "We've been implementing [EHRs] but haven’t optimized or leveraged their full functionality," the chief medical officer (CMO) of a major healthcare network in New England said. "Without a clear value proposition to the clinician, this conversation is going to be like an echo chamber, we are going to be divorced from reality, and the downstream consequences can be significant."
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