Cloud (22)

Cloud computing seems to have clear priorities for healthcare. A survey by Gatepoint Research, available from Health IT Security, sets out the views of 100 ICT senior decision takers in US healthcare. Supported by Level 3 Communications, Strategies for Next-Gen Healthcare Networks provides Africa’s eHealth leaders with a comparator for their cloud and network investment decisions. The survey shows:

  1. Cloud investment priorities are:
  • Business productivity 54%
  • Business continuity and disaster recovery 41%
  • Telemedicine 25%
  • Big Data and analytics 25%
  • EHRs 22%
  • Data storage 19%
  1. Healthcare network priorities are:
  • Reliability 76%
  • Security 63%
  • Support 47%
  1. Drivers for network investment are:
  • Security 91%
  • Manage application growth 8s%
  • Business productivity 81%
  • Future requirements 815
  • Storage 58%.

Like all eHealth, networks become obsolete. Half the ICT executives said their networks are due for upgrading in the next two years. About 21% said it was needed between one and two years’ time. Some 29% said it was needed within the next year. Taken together, none saw their networks’ current services being appropriate beyond two years.

This may indicate how important investment priority is for Africa’s eHealth leaders to find a slot in their short term eHealth investment plans. As networks are expanded to fill the gaps, short term upgrading’s needed too. 

While using the cloud’s inevitable, it’s harder to work out how to use it. Smart Strategies For Moving Healthcare Workloads to the Cloud, a guide from Connection and Health Data Management, can help Africa’ health systems find some answers.

A trend seems clear. Cloud computing isn’t the answer for all healthcare information workloads for providers and payers. It’s main role is for software, infrastructure, platforms, security, storage and desktops that drive migration of key workloads from in-house legacy systems to third-party managed services and colocation options, each with Service Level Agreements (SLA). These include:

  1. Software as a Service (SaaS)
  2. Infrastructure as a Service (IaaS)
  3. Platform as a Service (PaaS)
  4. Storage as a Service
  5. Security as a Service (SECaaS)
  6. Desktop as a Service (DaaS).

Each of these fits with eHealth that’s appropriate for the cloud, Connection proposes:

  1. Regulatory compliance and mandates
  2. Claims processing
  3. Imaging
  4. eDiscovery, including litigation in healthcare
  5. Telemedicine
  6. Analytics.

Next up’s cloud vendor selection. Choices and requirements are:

  1. Vendor-neutral approach to technologies and supplier brands
  2. Business-centric approach to recommendations instead of an overemphasis on specific technologies
  3. Expertise in security and patient privacy, which’s becoming the most important feature of healthcare organisations’ information activities
  4. Realistic understanding of workloads that should or shouldn’t move to the cloud, and how to move them
  5. How to deploy and manage a broad set of healthcare technology tools.

The guide’s a valuable checklist that Africa’s health systems can follow. The cloud offers some valuable benefits, but using it appropriately’s challenging.

Cloud-based infrastructure services are helping healthcare organisations improve care, patient satisfaction, increase time to innovation and staff productivity and efficiency. A survey of healthcare IT professionals by SADA Systems, a cloud solutions provider, found that Amazon, Google and Microsoft are currently the most popular cloud platforms for more than 300 USA’s healthcare organisations.

An article in HealthcareITNews says all three are market leaders, but Microsoft beat its competitors to take the top spot at 42%. Google scored 29%. Amazon was close at 27%. “Cloud-based IT infrastructure and applications are providing healthcare organizations the opportunity to operate more efficiently, innovate faster and better engage patients,” said Tony Safoian, SDA’s president and CEO,

The study showed that: 

  1. 56% of respondents believe cloud-based apps are improving patient satisfaction
  2. 55% said these tools are leading to better treatment
  3. 54% believe cloud apps and tools used by their organisations are resulting in faster care
  4. 64% said cloud technologies are helping to improve productivity and efficiency for staff and patients.

For those who said they plan to increase their organisation’s use of cloud infrastructure in the next two years, 61% mentioned increased confidence in security and reliability of the cloud providers as the primary reason. While 49% said their organisations had experienced some sort of security breach or patient privacy leak, fewer than 10% attributed it to their cloud provider. Employee error or lost device was the primary reason.

The cloud’s also having an impact on healthcare organisations ICT management and innovation. About 35% of healthcare ICT professionals said cloud apps and tools allow them to support patients and staff better. About 23% said cloud enabled greater control over their organisation’s hardware and software. Some 51% said the increased use of cloud apps and tools allow them to be more innovative.

“Cloud apps and tools that connect administrators to suppliers, doctors to patients and hospitals to staff are increasingly important – not only because they improve productivity and enhance patient care and satisfaction, but because they distinguish modern organizations from legacy providers, which is attractive to the younger generation of healthcare users,” Safoian said.

Cloud benefits are clear. It provides African healthcare systems an opportunity to improve productivity and efficiency. From this opportunity, affordability needs assessing and fixing.

Cloud computing offers many benefits, and like all ICT, some risks. While health systems will already be using the cloud for services like Dropbox, Facebook and Twitter, extending it across all eHealth’s a different proposition. A white paper, 5 Risks Hospitals Face When Using The Public Cloud (And How To Overcome Them) from Clear DATA and sponsored by Health IT Outcomes, can help.

eHealth services steadily migrating to the cloud include:

  1. Clinical Research
  2. EHRs and EMRs
  3. Telemedicine
  4. Big Data
  5. Analytics
  6. Health Information Exchange (HIE).

The five risks of becoming cloud casualties are:

  1. Overburdened ICT staff
  2. Security
  3. Compliance
  4. Manual processes
  5. Unexpected costs.

These are leading to a cloud disconnect where results aren’t meeting expectations. A 2014 survey of more than 400 ICT professionals by Enterprise Management Associates (EMA) concluded that large vendors are experiencing failure rates of nearly 60%. What’s the solution?

The white paper proposes that internal, private cloud deployments with a DIY model can succeed if care is taken to manage security and compliance issues. Using the public cloud’s a different matter. For this, the recommendation is always to use a Managed Service Provider (MSP) with extensive experience and understanding of healthcare and eHealth. An MSP can provide guidance, consulting services for reviews, migration roadmaps and suggest ways to improve ICT utilisation and create new efficiencies in ICT departments. MSPs can help reduce their staffing and training costs too.

Taking these together, the value of using an MSP may be to reduce the Total Cost of Ownership (TCO) of using the cloud. Acfee’s approach is that Africa’s health systems need rigorous assessments alongside all the options as part of a business case. It also helps to identify and quantify the risks too.

As the cloud expands, Africa’s health systems need to develop their strategies for using it. This doesn’t mean wholesale transfer, but a cautious, appropriate, affordable plan to transfer data to cloud services.

Why do it? A white paper from Clear Data, a cloud provider, says the cloud has three main benefits: agility, cost savings and focus. Agility’s needed to keep up with changing technology, security and compliance standards. Cost savings may not be immediate, especially when a service transfers in-house. They are significant over time resources shift from capex to opex, and maintenance costs diminish. Focus means resources redeployed for developing software and analytical tools to help

strengthen healthcare delivery, improve performance and reduce costs.

The white paper also provides guidance on switching. First, have a strategic vision. It must address transition cost, so affordability and security concerns.

Second, create a migration road map. Transferring data to the cloud isn’t an all or nothing proposition. A phased, one step at time migration plan makes sense, especially for Africa’s eHealth. Migrating to the cloud means disinvesting from an on-site data centre, eliminating the need to update and maintain in-house resources.

It begins with a checklist that assesses existing infrastructure resources, including hardware, application portfolios and network architecture to establish if and how switching to the cloud will be beneficial. Next, assess short and long-term cost. While the cloud can save money, such as by server virtualisation, there are also significant costs in deploying servers, including licensing, maintenance and obsolescence. Other considerations include:

  1. Energy consumption costs
  2. Hardware scalability, where the cloud can scale up responsively
  3. Application portability to assess if health systems’ applications can run on the cloud, including technical, licensing and legal considerations
  4. Data portability and new ways unlock data’s potential
  5.  of your data and turn it into new
  6. Security and compliance, including the value of offloading risks to healthcare data security and compliance experts.

Three critical susses factors are documentation, communication and coordination. These include plans for:

  1. Dealing explicitly with the specifics and uniqueness of each transition
  2. Connectivity
  3. Data migration, and its sequence and the best
  4. Application migration
  5. Documentation
  6. Security and compliance.

Decisions on relying on the cloud are significant and complex for Africa’s health systems. It’s a clear strategic opportunity, but a constructive feature of Cloud Data’s advice is take one step at a time.

Sasware, the technology investment subsidiary of Signal Alliance, has announced an investment in Medismarts, a health technology company based in Lago, Nigeria. The investment is expected to help to expand its medical cloud platform that integrates healthcare data, says an article in BIZTECH Africa.

Sasware Chief Operating Officer, Mrs Ifeoma Udoh, says the company’s investment allows it to play in the increasingly critical healthcare sector that has seen policy improvements needed to modernise the country’s healthcare. It shows that vendors see the cloud as an important part of eHealth’s future.

Medismart cloud platform unifies data management and aims to transform healthcare management in the country. Its platform is secure, and can connect all major healthcare players. The company’s close to connecting 100 hospitals,free, on their platform. It’ll include information about close to 25,000 patients.

Medismart co founders, Obinna Osuji and Damilola Oni. have extensive healthcare technology experience. It’s helped in developing a solution that takes into account Nigeria’s unique healthcare environment. Speaking on the partnership, Oni said, “We believe Sasware is the right partner for Medismart. Their expertise and experience in technology business will no doubt help us grow the business and become successful.”

Have made a good start, how far will it take cloud? How far can Nigeria’s healthcare benefit from it?

Alcatel-Lucent will soon be providing the government of Burkina Faso with cloud networking technology that will enable it to develop new digital public services, such as eGovernment, eLearning and eHealth. Alcatel-Lucent will supply the West African nation with its Network Functions Virtualisation (NFV), Cloudband and Internt Protocol (IP) platforms, which will be integrated into the ‘G-Cloud’ infrastructure, says an article in BIZTECH Africa.

Approximately 400 buildings in 13 regional urban centres will be connected through a 513Km fibre-optic IP/Multiprotocol Label Switcing (MPLS) wide area network. Backhaul will be provided by an 800 km fibre-optic transmission system that will bepart of Burkina Faso’s National Fibre Optics Backbone. The project is part of an ambitious ICT and telecommunications strategy administered by the country’s Ministry for Digital Development (MDENP). It’ll enable connectivity between public departments and municipalities via an eGovernment platform.

The network will support the increase in future demand for digital services to the health, education, justice, immigration and parliament in the coming years. Under the agreement with MDENP, Alcatel-Lucent will support network and infrastructure operations installed by 2017. Financing is being facilitated by the Danish government through Danida Business Finance, whose contribution to the project amounts to Euro 30 million, with a direct grant subsidy of Euro 15.5 million.

This will be the first Government Cloud in the region and a big milestone for the country. Hopefully, eHealth initiatives will follow soon.

The winners of the second annual South Africa Innovation Awards, in partnership with Business Connexion and Business Day, have been announced at the MyWorld of Tomorrow Gala Dinner held Johannesburg. The awards programme recognizes and celebrates innovative African companies and individuals says an article in IT News Africa.

“All industries should be looking at technology as a mechanism of improving efficiencies, operational effectiveness as well as their competitiveness,” adds Dr Sibongile Gumbi, one of this year’s SA Innovation Awards judges and group executive at the Technology Innovation Agency. “It is important to embrace technology and in the end see these innovations in the market.” 

The winner for community innovation is hearScreen, an mHealth solution. The patented hearScreen smartphone hearing test, developed and validated at the University of Pretoria, is the first solution for hearing tests operated by untrained personnel with cloud based data management and a referral system that links patients to services. It was developed to detect hearing problems in underserved communities.

Is the combination of mHealth and the cloud where the future lies? We might find out soon.

There many virtues and benefits of using cloud. Like all good things, there’s a downside, and in eHealth, it needs rigorous management. Health Data Management has a post on SKYhigh Networksanalysis showing that health workers use cloud in a way that puts their organisations at risk in six ways.

There are too many clouds. In the USA, SKYhigh Networks says an average healthcare organisation uses 928 cloud services, more than fifteen times the number that their IT departments know about.  On average, IT knows about 60 services, 6% of the total. Employees are using their organisations’ approved cloud services and bringing their own. Bring Your Own Cloud’s a new version of BYOD.

An average employee uses 26 cloud services. They include eight collaboration sites, four file sharing services, four social media sites and four content sharing services. Employees are tracked by an average of four marketing analytics and advertising services, and these provide entry points for cyber-criminals who use them to identify sites employees visit, then compromise the sites to ultimately compromise the healthcare organisations.

Collaboration services is the largest cloud category. They include Microsoft Office 365, Gmail and Evernote. An average healthcare organisation uses 188 of them.

Developmental cloud services are the second biggest. An average healthcare organisation has 52. They include SourceForge and GitHub. Content sharing’s third at 37, including YouTube and LiveLeak. Social media’s fourth at 33 services, including Facebook and Twitter. File sharing’s fifth with 32 services, including Dropbox and Google Drive.

Threats can occur in the cloud just as easily as they occur in a physical location. If a rogue employee is intent on accessing and selling healthcare information, the opportunity can be there. SKYhigh’s analysis of client data found that in 2014, a third of healthcare organisations reported an insider threat incident. It might have recently increased to 79%, but not all are malicious activity. It shows that the incidence of potentially destructive behaviour by employees is much higher than most healthcare organisations assume.

SKYhigh says of ten major industry sectors, 15% of employees in finance have had at least one password stolen. Healthcare’s next at 14% percent. It doesn’t help that only 15% of cloud vendors offer multi-factor authentication. Healthcare organisations must use strong, unique passwords for each cloud service and change them frequently and regularly to limit risk.

Cloud offers huge benefits for Africa’s healthcare, but, every silver lining has a cloud, as pessimists say. Africa’s eHealth must deal with both.

In his blog in the CIO Journal, part of the Wall Street Journal (WSJ) John D Hamalka, CIO at Beth Israel Deaconess Medical Center, says that choosing and using a cloud vendor needs a strict assessment. CIOs must be sure that the service is updated frequently, updates are relevant and important and that security is rigorous but doesn’t limit functionality.

CIOs mustn’t transfer their data problems to the cloud. They should fix them first. The cloud doesn’t provide automatic solutions to internal problems and challenges of the combination of business processes, people, and technology. He sees the objective here as Outcomes as a Service (OaaS), an initiative as a variation to Software as a Service (SaaS).

SaaS is a software licensing and delivery model where software is hosted centrally and licensed to users for subscription. Hamalka sees procuring cloud services as similar. It’s widely used for management and specialised information.

It’s part of the cloud offering alongside similar concepts, such as infrastructure as a service (IaaS), platform as a service (PaaS), desktop as a service (DaaS), backend as a service (BaaS), and information technology management as a service (ITMaaS). These tend to describe resources. With Hamalka’s OaaS concept, it helps focus on the benefits and performance of the cloud.

As Africa’s healthcare looks increasingly to the cloud for some of its ICT investment, performance is a vital criterion. Ministries of health could develop and expand their own OaaS version.