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What it is – But not how it works!
By Dr. David Edward Marcinko; MBA, CMP™
[Editor-in-Chief]
As commentators, IT pundits, health economists, journalists and so-called experts, we all know that any market is immature when an industry can’t agree on a definition or term-of-art.
Of course, that’s why we just released the Dictionary of Health Information Technology and Security, and several other related works like: Dictionary of Health Insurance and Managed Care – and – Dictionary of Health Economics and Finance.
Of Doctors and Confused Customers and Vendors
The lexicon problem is exacerbated in healthcare IT however, as customers, er-a doctors and medical professionals, still don’t understand what the “computing cloud” or “grid” actually is. This is no doubt important with the recent – and older – governmental pushes toward eHRs, as well as economic bonuses [Medicare 5.1%] for implementation of same.
And, eHR vendors compound the obfuscation when they themselves use the term to describe just about any product they can sell that can be delivered from, or touching a data center. The word “health-cloud” clutters the definitional standardization scene much as the terms “HIPAA”, “HL-7”, and “compliance” did back-in-the day. So, after editing three dictionaries – with a fourth in progress – here goes our modified definition of the “health cloud” with cudos from non-physician colleague Rob Preston of Information Week.
Health-Cloud Defined
The “health-cloud” or “health-cloud computing” refers to:
a highly scaleable health information technology source – hardware, software, CPUs, and storage capacity – that is housed outside of medical data centers, and available on-demand by doctors, patients, payers, government and employers over the Internet, and whose secure variable usage is measured and invoiced incrementally.
Private health clouds mimic those characteristics inside health entity firewalls, but lack the economies-of-scale found in public health clouds.
Assessment
Now that a workable definition has been proposed and we have some definitional clarity, bring on the eHR products and HIT services that physicians can use.
Conclusion
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Filed under: Information Technology, Op-Editorials, Research & Development | Tagged: cloud, grid, PaaS, SaaS |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
Defining the Health Cloud
How about health Platform-as-a-Service [PaaS], as one definition of health cloud or grid computing? And, the leading corporate proponents to provide same would be: EMC, IBM, Oracle, MSFT and Alfresco, etc.
-Stewart
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MSFT and the Cloud
According to the Dow Jones Newswires, 04:12 PM ET 11/12/2008, Microsoft Corp. (MSFT) is staking its place in cloud computing, trying both to grab a share of the fast-growing market for off-premise computing and protect its franchise packaged software products.
Last month, the world’s biggest software company unveiled Windows Azure, a platform that allows developers to write Microsoft-compatible software that is stored on and accessed from its servers. Azure also lets user’s access online versions of Microsoft applications, like databases and email servers. Azure underscores Microsoft’s intention to shake up the world of cloud computing, the growing trend towards hosting applications and data on off-site servers, rather than on individual computers’ hard drives.
The Redmond, Wash. Company is trying to tempt its core customers – the world’s biggest companies and most consumers – to stay with familiar products but access them in a new way, rather than switch to alternative services offered by cloud-computing pioneers like Google Inc.
-Ann
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Cloud computing morphing healthcare in five distinct ways
As its name may suggest from the above ME-P, “the cloud” is a mysterious yet increasingly ubiquitous presence in all parts of life.
Realistically, its definition is simple: cloud computing takes advantage of economies of scale and resource pooling to provide massive amounts of storage and computing power to any users who sign up for the service.
http://www.physbiztech.com/news/cloud-computing-morphing-healthcare-five-distinct-ways
Google’s suite of “apps,” ranging from Gmail to its online document management system is one example.
Dr. Gupta
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So long, cloud
Starting years ago, numerous EDR salespeople painfully discovered on the internet that they can no longer claim that office-based software – such as Schein’s Dentrix and Patterson’s Eaglesoft – is safer and cheaper than paper dental records.
Like so many others who follow HIT in dentistry, I once believed that if interoperable EHRs had a chance of success in dentistry, it would be through encrypted cloud computing. According to advertisements, it appeared that cloud-based EDRs could slow the continuing breach epidemic, as well as reduce skyrocketing HIPAA liability costs. Unfortunately, it’s been recently revealed that the cloud could be even more dangerous for dentists and patients than office-based Dentrix and Eaglesoft systems – which are increasingly more dangerous and expensive than paper dental records.
“As more IT resources are moved to the cloud, the chance of a major outage for a corporate enterprise – or worse, a major financial entity – becomes exponentially more likely to occur. Unfortunately, the outage itself doesn’t have to be an elaborate one to yield devastating results.” (“Cloud Computing: Four Predictions For The Year Ahead” by Eric Savitz, Forbes, December 17, 2012).
http://www.forbes.com/sites/ciocentral/2012/12/17/cloud-computing-four-predictions-for-the-year-ahead/
“In 2013, we will be seeing more cloud-related breaches until IT departments can get in front of this problem.” (“2013: The Cloud As Savior And Sinner” by Brian Proffitt, December 28, 2012
http://readwrite.com/2012/12/28/2013-the-cloud-as-savior-and-sinner
“Cloud Computing Increases Risk — As enterprise systems move to the cloud, this makes businesses more vulnerable to security breaches – the cloud is much easier for fraudsters to attack than traditional behind-the-firewall systems.” (“Cybersecurity Threats for 2013” by Pat Speer, Insurance Networking News, December 28, 2012).
http://www.insurancenetworking.com/news/cybersecurity-threats-2013-31585-1.html?pg=2
Have I mentioned that de-identifying dental records just might be the ONLY way around this mess?
Darrell
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EDR’s fall from grace
[Social media, transparency and EDRs’ fall]
It occurred to me that it’s been over a year since I’ve been called a Luddite for criticizing the EHR efforts in dentistry (as far as I know). I interpret the lull in public name-calling as evidence that the internet transparency I warned about is finally causing even dental practice management consultants to reconsider their people-skills.
Considering the little resistance I encounter these days, it seems that even the most intransigent of deceptive EDR salespeople finally got the message that openness put an end to their command-and-control habits. I suggest that in the last year, social media made dentalcare stakeholders’ tightly-moderated, 1990s website-based marketing tactics as lame in the dentistry as they have been elsewhere since Jeff Jarvis publicly spanked Dell Computer 6 years ago. He showed us that networked consumers must no longer tolerate vendors who evade complaints, even in the bypassed dental community.
Several months ago, those with interests in dentists’ continued purchases of office-based electronic dental records systems like Dentrix and Eaglesoft, apparently abandoned their long-held but unproven claims that their EDRs are cheaper than paper dental records. Yet until recently, there was still hope in the air that that cloud-based systems, like CurveDental and NextGen, could offer dentists a better return on investment (ROI) than office-based, in part because cloud service includes easy, automatic HIPAA/HITECH upgrades without interruption of service, as well as built-in encryption.
Nevertheless, due to unanticipated, HIPAA Business Associate security concerns (which I also warned about), cloud-based promises in dentalcare are evaporating as quickly as fantasies of ROI from Dentrix and Eaglesoft.
“Cloud Computing: Security a Hurdle – Healthcare CISOs, Privacy Advocate Outline Concerns” by Marianne Kolbasuk McGee was posted today on HealthcareInfoSecurity.
http://www.healthcareinfosecurity.com/cloud-computing-security-hurdle-a-5404?rf=2013-01-04-eh&elq=431acdc69b7c4d1b87a31dca3ab0fd5f&elqCampaignId=5473
Kolbasuk writes: “While cloud computing can often provide cost-effective and convenient ways for healthcare organizations to store and share data and diagnostic images, two CISOs and a privacy advocate caution that security concerns are substantial.”
Patient privacy advocate Deborah Peel, M.D. asked federal regulators to provide specific guidance about data security and privacy in cloud computing for healthcare providers (including dentists).
Kolbasuk continues: “HHS officials did not respond to requests for comment about whether the agency is considering developing cloud computing guidance. But on Jan. 7, Joy Pritts, chief privacy officer for HHS’ Office of the National Coordinator for Health IT [ONC], will participate in a panel discussion in Washington on cloud computing issues with Peel and others. The event is being hosted by Patient Privacy Rights.”
http://patientprivacyrights.org/
Even after ONC hands down what will be even more tedious and expensive HIPAA/HITECH requirements for dentists to perform again and again, there will still be nothing holding down future compliance costs – easily argued as prudently spent dollars in the name of security. After all, without security, EDRs are worse than worthless. They are dangerous. Yet even cloud-based EDRs are already more expensive than paper dental records – the gold standard in dental record safety.
I think one can mark today as the date the EDR industry vanished.
Darrell
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Trends in Cloud Computing in Healthcare
According to a study by Imprivata, the proliferation of desktop virtualization in health care continues to increase, with the use of server-hosted virtual desktops (SHVD) up 39 percent and the use of server-based computing (SBC) up 23 percent from last year’s survey.
The study also indicates that a mixed use of both SBC and SHVD is becoming more commonplace, with 49 percent of respondents indicating that they are using both technologies today (compared with 23 percent from the 2012 survey).
In particular, storing protected health information (PHI) in the cloud is becoming more commonplace, with 40 percent of respondents that use cloud services saying they store PHI in the cloud today (up from nine percent from last year’s survey).
71 percent of organizations currently using cloud computing work with only one or two different vendors. Despite working with a limited number of vendors, 16 percent of healthcare respondents using cloud computing services today do not have HIPAA Business Associate Agreements (BAA) in place with all of their vendors.
For healthcare organizations that have no plans to adopt cloud computing, security remains the top concern (not surprisingly), but 17 percent of survey respondents cite the primary reason why they have no plans to move to the cloud as “vendors do not offer HIPAA Business Associate Agreements”.
Source: Imprivata
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