• Cloud
  • How can Africa’s eHealth keep up with cloud options?

    Using cloud services offers considerable benefits. It can engender apprehension too, especially as cloud services keep developing. An article in eHNA asked if Hybrid Cloud Hosting (HCH) can be the type that Africa’s eHealth needs. An article in CloudNews describes and explains some essential themes.

    HCH combines private cloud security with public cloud flexibility. It has two components, a private cloud, often designed for a specific function, and a public cloud that uses data storage and processing power of a remote server. Users access data and applications over the Internet instead of from an in-house network. Public clouds are hosted by Cloud Service Providers (CSP). The top three are Amazon Web Services (AWS), Microsoft Azure and Google Cloud Platform (GCP). When workload’s too high in-house networks, traffic switches to a public cloud to increase capacity, a temporary cloud bursting event. Other ICT companies offer cloud services too, such as IBM and its Cloud Computing.

    Cloud bursting’s paid for as the supplementary services are needed. As Africa’s eHealth expands, pay by use may offer a more affordable option than either buying internal ICT power to meet maximum demand peaks or having insufficient capacity for peaks.

    Laws and regulations require effective data protection and geographic limits on data transfers. These frameworks overlay cloud hosting’s three main services:

    Software as a Service (SaaS), where users can install and run applications on suppliers’ computer systems to reduce the costs of buying and maintaining hardwareInfrastructure as a Service (IaaS) provides customers with hardware, storage, networking, utility software and data centre space, only paying for the time they usePlatform as a Service (PaaS) combines IaaS with software development tools for users to write, test and deploy applications from the cloud.

    Benefits of HCH include:

    Compatibility with legacy environmentsNetwork optimisationCapacity expansion, switching capital expenditure into an operational costAccessibilityDisaster recoveryCyber-security, with an option to store sensitive data in-house with several security layers, and less sensitive data stored in a public cloud’s pay-per-use serviceGovernance.

    HCH’s disadvantages include:

    Dependency on one network, which may be risky, having only one way to access applications and dataComplex system infrastructure needed to transfer data between a public cloud and a private networksLatency of time for data to travel to a public cloud and returnCost for users that don’t have fluctuating data volumes and transactions, so a Total Cost of Ownership (TCO) estimate of options over at least a three-year period as part of a rigorous business case will reveal the best optionService migration from one cloud host to another’s hard, but supply-side development may lead to multi-vendor platforms and enable cross-cloud-migration to mix and match cloud services based on cost, performance and functionality.

    Africa’s health systems have options of HCH. It’s important they find the right ones.

  • What’s the business case for health data in the cloud?

    Cloud services are quite common now. Many people and organisations use them with products like dropbox. Many people use it to store their photos from their iPads. Africa’s health systems have been a bit more reluctant to use the cloud. What’s a good business case for it?

    First, a business case analyses all main options, including their socio-economic and financial components. Microsoft’s describes some of the positives in a paper from Insight, a Microsoft partner, available from HIT Infrastructure.

    It sets out the process and benefits as:

    Taking data storage and analytics to the cloudDelivering lower costs, faster setup and more agilityAchieving reliable security in the age of unpredictabilitySeamless improvements in patient careInformed decision-making across the organisationEstablishing strong governance for continued cloud growth.

    Before embarking on cloud, it advises that the last part, the right governance, has to be in place to realise the benefits. Extra management capacity’s a commonly crucial requirement of all business cases.

    The paper doesn’t deal with other aspects of the business case, such as costs of change and longer term costs. It does say that health systems will need an accomplished development partner, so this needs including in cost estimates.

    Without the costs, it’s not possible to say what the socio-economic or financial returns are of health systems using the cloud. The paper does help to identify some high-level benefits that Africa’s health systems can use as a starting point.

  • Health data in a public cloud needs encrypting

    Hospitals are increasingly turning to cloud-based services. The trend’s set to keep growing as healthcare organisations need more robust infrastructure for advanced analytics, population health and precision medicine, says an article in Healthcare IT News. 

    Healthcare entities face unique challenges and risks when they store their data in the cloud. Perhaps the most important is ensuring that their patient data’s safe. 

    About 82% of databases in public cloud computing environments aren’t encrypted. It’s an estimate in a report from Redlock, a cyber-security vendor. Cloud Infrastructure Security Trends Report. Some 31% of databases in public cloud environments are open to the Internet, and 40% of organisations have cloud storage resources exposed to the public. This isn’t good.

    The analysis by the RedLock Cloud Security Intelligence team, included cloud environments in several sectors and reviewed more than a million resources processing 12 petabytes of network traffic. It identified 4.8 million exposed records with sensitive data.

    It also found that few customers are happy with cloud infrastructure security. It explains why nearly 80% of organisations are only in the trial-and-planning stage of cloud computing.


    With constantly increasing cyber-security risks, it’s imperative that African healthcare organisations provide effective cyber-security for their cloud services. Without it, it’s not possible to be confident of protecting their patients’ personal and private data. 

  • Healthcare has several cloud priorities

    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:

    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%Healthcare network priorities are:Reliability 76%Security 63%Support 47%Drivers for network investment are:Security 91%Manage application growth 8s%Business productivity 81%Future requirements 815Storage 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. 

  • How should Africa’s eHealth use the cloud?

    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:

    Software as a Service (SaaS)Infrastructure as a Service (IaaS)Platform as a Service (PaaS)Storage as a ServiceSecurity as a Service (SECaaS)Desktop as a Service (DaaS).

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

    Regulatory compliance and mandatesClaims processingImagingeDiscovery, including litigation in healthcareTelemedicineAnalytics.

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

    Vendor-neutral approach to technologies and supplier brandsBusiness-centric approach to recommendations instead of an overemphasis on specific technologiesExpertise in security and patient privacy, which’s becoming the most important feature of healthcare organisations’ information activitiesRealistic understanding of workloads that should or shouldn’t move to the cloud, and how to move themHow 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.

  • Microsoft cloud services preferred by healthcare providers

    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: 

    56% of respondents believe cloud-based apps are improving patient satisfaction55% said these tools are leading to better treatment54% believe cloud apps and tools used by their organisations are resulting in faster care64% 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.

  • How can Africa’s eHealth use the cloud?

    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:

    Clinical ResearchEHRs and EMRsTelemedicineBig DataAnalyticsHealth Information Exchange (HIE).

    The five risks of becoming cloud casualties are:

    Overburdened ICT staffSecurityComplianceManual processesUnexpected 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.

  • How can Africa’s health systems move their data to the cloud?

    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:

    Energy consumption costsHardware scalability, where the cloud can scale up responsivelyApplication portability to assess if health systems’ applications can run on the cloud, including technical, licensing and legal considerationsData portability and new ways unlock data’s potential of your data and turn it into newSecurity 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:

    Dealing explicitly with the specifics and uniqueness of each transitionConnectivityData migration, and its sequence and the bestApplication migrationDocumentationSecurity 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.

  • Medismarts gets a boost from Sasware investment

    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?

  • Burkina Faso's new digital services will use the cloud

    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.