Beth Israel Deaconess Medical Center in Boston has moved to the cloud.
The move followed a need for a massive data storage location. "We needed to get our electronic medical record system deployed to about 200 physicians in eastern Massachusetts, and we didn't want to store it on a bunch of big servers here," says Bill Gillis, CIO of Beth Israel Deaconess Care Organization (BIDCO), the ACO-focused physician organization associated with the BIDMC group of hospitals. .
So he sent the EMR to the cloud — a custom-built network storage system hosted in a third-party, multi-tenant environment. "We got space at a cloud storage facility and were able to build our own cloud that we now manage and maintain," says Mr. Gillis.
"In 2007, not a lot of organizations were using cloud-based storage," adds Mr. Gillis, "but we were just going with something we thought would work — and it did."
Mr. Gillis and BIDMC/BIDCO have been joined by a growing number of hospitals utilizing cloud storage to accommodate the increasing amount of data for which a modern hospital is responsible.
"We've worked with a number of hospitals to implement cloud-based storage," says Bob Dupuis, practice director for infrastructure and security at Arcadia Solutions. "It has really run the gamut from smaller critical access hospitals to some of the largest systems in the country."
There are several reasons hospitals have been utilizing cloud storage, says Mr. Dupuis, starting with the cost and availability issues that come with storing massive amounts of data on-site. "Building out and maintaining data storage internally is expensive," he says, "and many hospitals have limitations on physical space."
Storing data in the cloud can also safeguard it against internal server failures and can serve as effective data backup, says Mr. Dupuis. Additionally, storing data on physical servers can limit the effectiveness of a hospital's data recovery plan following a disaster. "It would be difficult to have the proper geographical dispersement so that a disaster wouldn't impact both data centers," rendering the backup center moot, he says.
"Of course, there's the obvious concerns of storing data somewhere outside your control," says Mr. Dupuis, where a hospital can't ensure regulations from the Health Insurance Portability and Accountability Act and HITECH Act are being met. "It can be difficult to ensure the compliance of a third-party vendor," he says.
Depending on what the cloud is used for, cloud storage can bring availability concerns as well, says Mr. Dupuis. Hospitals that choose to store email exchange servers on the cloud now have a failure point in their Internet connectivity, he says. These systems now need high-performance Internet, and a redundant connection to take over if the main connection is lost, he says.
Below are four best practices for hospitals ready to make the move to cloud storage.
1. Have a reason. Cloud-based storage is not necessarily the best move for every hospital or health system, says Mr. Dupuis. "Make sure the decision [to move to cloud-based storage] is made on sound business principles," he says. The switch should not be made out of a perceived need to utilize the newest technology but rather as a way to "address a problem or compliment an overall strategy," says Mr. Dupuis.
"Do the due diligence, make sure it's the best choice," he recommends.
2. Move data strategically. "Putting everything into the cloud all at once is not a good strategy," says Mr. Dupuis. Hospital administrators should move data and applications piecemeal into cloud storage, "starting with things that are well-established in the cloud and not directly care-oriented, like Microsoft Word," he says, to test the system and make sure cloud storage meets the hospital's requirements. Then the cloud can be used for data backup and progressively important data.
3. Ensure security. It is up to the hospital to ensure the security of all protected data, even when it is stored offsite in a cloud, says Mr. Dupuis. He recommends a third-party risk assessment of the vendor before any data is moved. Additionally, "make sure to cover yourself contractually [and] that all the right agreements are in place" to protect the hospital in the event of a noncompliance issue or breach, he says.
4. Look to the future. "Gathering information from the EMRs will be the next big challenge," says BIDCO's Mr. Gillis. "We'll need to be able to look at all data sources and be able to provide both patient care and population health management based on all available data."
"Big data is the next big thing," he adds, and data storage systems will need to be able to manage both large amounts of data and new demands for data arrangement and analysis.
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