Commentary: Vendor, Know Thy Cloud

Frankly, I think there is too much going on in health care to even keep track of, and I salute my peers who cover it exclusively. Health care IT is a bird of many colors and HIMSS was chaos, with 30,000-plus attendees and 1,000 booths full of products of every imaginable type. There was buzz about all the big information management buzzwords at the show: big data, mobile, cloud and even social. Health care has always been very mobile, with all kinds of reporting and data entry devices, mostly of the LAN variety, connected to hardware displays of clinical and diagnostic tools that are very impressive for their human flesh and blood applications.

Data management on the other hand has always lagged across big and small chunks of health IT, notwithstanding a lot of platform installs in recent years. Nowhere else do so many value-add providers and billers hand around the "product," (the patient) and interpret its meaning and qualities. Much of the work is transaction oriented, roping together clinical, research, financial and operational information across a wide variety of affiliated hospitals, clinics, labs and other facilities. It feels a little out of date to hear a lot of folks in health care are just getting into big monolithic repositories and integration projects, and I wish them well for all the work they have ahead of them.

And now, new Meaningful Use rules and Accountable Care Organizations are based on standards of performance tied to federal dollars and performance metrics, and that opens the door to a lot of analytic work. Also under mandate, a lot of information has to flow through custodial walls also, which is where cloud computing might have a good entry back in to the discussion. I heard a health network CIO talking about the benefits of "buying by the drink," reaching out to the customer’s customer and having a storefront approach to service deployments, all naturals for the cloud.

One area of cloud interest is in radiology, where cloud providers and interchanges could act like clearinghouses for shared diagnostic imaging in picture archiving and communication systems(PACs).  It would be cost efficient and worthy for a third party or non-profit to set this up on leased infrastructure.

I was curious how these clearinghouses would work, and what kinds of businesses or organizations would run them. This is where the information glut resurfaced, in this case when I met with a multinational vendor too busy to know its own portfolios.

I'd wandered up to the pavilion of a huge technology provider who is purporting to do this PACS kind of work. I have to call it a pavilion, for the structure I confronted on the convention floor was at least three times the size of my house.

I'm sparing them the mention of their name just in case it was an off day, but I could count 40 to 50 of their people working the crowd. At the radiology section, I started asking about PACS and what the company meant by cloud, was it a hosted thing, regional, proprietary, simple infrastructure on demand or something else?

"Hmmm, that's a very good question," I heard, but nobody had a clue and I was redirected to the front desk. Another marketing spokesperson was equally nonplussed, and directed me to a third. Fifteen minutes of people running around later I was told they'd need to summon up the very chief technology officer of this global conglomerate to explain what they meant by cloud computing.

They never did locate him. “We’re doing a lot of different things,” my last contact apologized and promised to follow up.

I did find some marketing materials and an explanation online, and I was glad to know I'd get an interview with a global CTO from a company in the top half of the Fortune 500.

But you know, there really is too much going on in health care IT.