Cloud-based imaging approaches show promise, but adoption may move gradually

Enterprise imaging is increasingly placing demands on on-premises information technology systems that will be difficult and expensive to meet, making a better case for adoption of cloud solutions.

But impediments and concerns will slow any rapid transition—a lack of widespread Internet capacity, senior level reluctance and consumer concerns about data privacy remain as problems to be surmounted.

However, more hospital executives are understanding the compelling case for cloud-based imaging technology, according to presenters at a roundtable discussion hosted by Change Healthcare Monday, in conjunction with the annual conference of the Radiological Society of North America.

Cloud solutions solve three general concerns—cybersecurity, performance and cost, contends Tomer Levy, general manager of cloud solutions at Change Healthcare, which is rolling out a cloud-native enterprise imaging network that it’s hosting on the Google Cloud.

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Cost constraints are forcing healthcare organizations to think outside the box, contends Ken Buechele, vice president of information technology for Bronson Healthcare Group, an integrated delivery system based in Kalamazoo, Mich.

“We have a multiple best-of-breed type of environment, and we spend a lot of resources to maintain that,” Buechele notes. “We have a petabyte of data to archive, and that solution is at the end of its life, so do we look to do that on premise? I have an aging data center, in a building that was probably built in the 1940s in a flagship hospital that’s on the edge of a flood plain. I don’t want to own a data center any more.

“My budget doesn’t ever go up, so we have to look at investing less or investing differently,” he adds, noting that imaging demands are straining IT capacity, particularly as non-DICOM images are increasingly stored and patient demand for access to data and images is on the rise.

“Bronson is trying to make decisions that keep the patient at the center of what we do,” Buechele adds. “We have a huge ecosystem of patients that use our system” to look at their records, which are on the Epic EHR. “We have 150,000 patient logins to our system every month. They want to have access to their information, and we have to have a cloud presence to enable patients to see their images. There are mid- to long-term opportunities to improve access for our patients and our physicians.”

Imaging data presents a variety of IT challenges for healthcare organizations, contends Arie Meir, product manager for Google Cloud Healthcare. Healthcare providers don’t have imaging data “organized in one place,” he says. “They have PACS, a vendor-neutral archive, a radiology information system; and once you look beyond imaging, there are rising demands for genomics and precision medicine. When data is that unstructured, extracting insights from the data becomes challenging.”

Providers in the short term are running out of storage, which piques interest in the cloud as a solution. Longer term, they are looking to form an artificial intelligence strategy—toward that end, Google Cloud is compiling an ecosystem of solutions that help physicians make the right decisions in patient care.

But the move to the cloud for imaging is likely to be restrained, he adds. “It’s naïve to think that it will be full 100 percent cloud on Day One. We will see hybrid solutions, and on premises approaches will be shrinking over time.”

Questions remain about the privacy of data, as exemplified in the concerns of privacy groups over the recently announced collaboration between the Google Cloud and Ascension Health. Even though that data is encrypted and Google doesn’t have access to it, public perception was that the arrangement poses a risk to patients’ data.

“We have to educate our patients about this,” Buechele concludes. “We have to update our privacy practices and tell them about how their data is being stored and how these arrangements are being used to benefit their care.”

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