Why the healthcare cloud lacks comprehensive capabilities
There are claims that the healthcare cloud has arrived. Just about any healthcare outlet you can think of has dedicated significant time and effort to explaining what this cloud looks like and that using it is financially beneficial.
However, after you study the contentions and assess where cloud computing is within healthcare, a clearer picture emerges.
Yes, some aspects of healthcare are increasingly relying on the cloud. However, the idea that this is a singular, comprehensive “healthcare cloud” that is here already is not true. What there are, based on all of the claims, is that core components of a healthcare cloud exist, but more needs to be done to realize healthcare’s full cloud potential.
It appears that what healthcare opinion leaders mean when they discuss the healthcare cloud are four types of so-called healthcare clouds that currently exist, none of which are the comprehensive cloud envisioned.
Cloud One: Monoliths—Amazon vs Alibaba
The first group touting the healthcare cloud is the big, monolithic companies that are basically EHR companies selling their services as the comprehensive cloud. Although they have built all the requisite components into their software programs from scheduling to medical records to patient portals, at their core they are still offering a “walled garden” approach to the healthcare cloud.
These providers offer access to their application programming interface (APIs) so that other companies can extend their platform by building applications and extensions. Almost no access is given to the core program.
While these companies say they offer the whole cloud, there are components typically needed for specialized and unique scenarios, such as sleep study centers or skilled nursing facilities. Because these applications are built into the core platform, others are not able to add additional modules for specific specialized features to improve the service. What’s more, even though these companies offer services based in the cloud, they are not true cloud providers because customization and scalability tend to be extremely limited.
An analogy between Amazon and Alibaba explains the point. Alibaba offers digital showroom spaces to companies and their product while providing the infrastructure to market and monetize them—a facilitator—while Amazon’s core business is as a trader. In essence companies fit into their ecosystem only if they are not in competition to their business: a restrictive vs dynamic model.
Cloud Two: Salesforce and the CRM aspect
Salesforce, the 800-pound gorilla in the SaaS market, has entered the healthcare cloud. Given that Salesforce pioneers SaaS offerings, they have chosen to play it safe in the healthcare market and stick to their core competency, which is the CRM aspect of a healthcare provider. No other components—at least until the writing of this blog—have been released by Salesforce. Under their current offerings, e-health applications can link to the Salesforce healthcloud to leverage the power of their CRM platform, but they do not offer a robust, comprehensive healthcare product.
There is no doubt that the CRM aspect of healthcare is only going to continue to gain in importance. As the healthcare marketplace becomes more competitive and the incentives to reduce rehospitilization continues, healthcare providers need to improve their patient touchpoints, and the Salesforce product enables them to do that. It is not, however, a fully integrated, robust, cloud-based healthcare offering.
Cloud Three: Infrastructure as a Service
Some contend that healthcare-specialized Infrastructure as a Service (IaaS) providers are supporting the cloud revolution. They’re not there yet. IaaS providers tout their encryption and security components as capabilities of being the healthcare cloud. They encourage providers to build or host applications on their healthcare cloud, contending that they are safe and secure.
Undoubtedly, security is important to healthcare. If the healthcare cloud is ever going to fully materialize, encryption and secure computing must be bedrock components of developing and putting faith into the cloud. Security alone, though, is not enough. Healthcare is one of the most regulated industries in the country, and the security challenges that healthcare providers face are significantly different than those in other industries. Indeed, security in healthcare—both data security and information security that complies with HIPAA and other regulatory standards—should not only be met, but serve as the basement and not the ceiling for data security.
It’s not helpful to have a company tout security without also being able incorporate regulatory and workflow processes or healthcare ecosystem integration into a platform.
Cloud Four: The unbundling of healthcare components
The last group that is currently considered as the healthcare cloud are not necessarily clouds in any sense. They are individual components or services that essentially can be integrated into healthcare applications.
Areas addressed by these companies include specialized companies in telemedicine patient engagement, regulatory reporting, e-prescriptions, care coordination, messaging and more. Each of these products come with its own pricing.
A comprehensive, secure and dedicated healthcare cloud should include all of the aspects and components that are essential to building a robust, scalable cloud-based solution. Additionally, the healthcare cloud must provide the end user with the customization, scalability and flexibility that they need if it is going to live up to its promised potential.
Some of the most important components include:
- Platform as a Service (PaaS)
- Healthcare ecosystem integrations
- Healthcare specific services
- Regulatory, Benchmarking and Health IT-specific criteria management
Most importantly, affordability must be a consideration so that the healthcare cloud can be available to providers and practices of all sizes and at all different points of care. While some of the previous examples provide some of these elements, we are a long way off from full integration of all of them for any one of the most popular current offerings.
The healthcare industry has come a long way in a very short time with respect to harnessing the potential of the cloud. While there is still a long way to go, determining what a healthcare cloud will look like, how it will operate, function and provide benefits and which components are the most important to the end users are slowly being realized.
Until it is realized, there are some solid components of a healthcare cloud being offered by myriad innovative and disruptive companies. But there’s still a ways to go before a full healthcare cloud can be sold as an actual product that meets all of the unique needs of the healthcare market.