Health Care Organizations and the Use of Cloud Computing

Cloud based computing is essentially software offered for use over the internet. In most instances, the software, data, and server elements are all available remotely and do not require client software on any workstations. This is different than the traditional client server architecture, where application processing is done on a local workstation that writes data to a central server⁴.

A cloud solution can be solely a data hosting solution, an arrangement of distributed servers, or a complete application where both the software and data storage is available in an online package³.  Traditionally software had been sold and licensed as a concrete product owned by the buyer, but a newer method of software delivery is where the software is presented and sold as a service provided by the vendor. This is referred to as Software as a Service (SaaS), and provides the model for cloud based software solutions⁴.

Cloud solutions can be completely web based and offer a web interface, such as HealthFusion’s Meditouch EHR. This runs using any available web browser, and is scaled for PC’s, laptops, tablets, and other devices such as I-pads and smart phones².

Benefits to the health organization include reduces IT expenditures as there will not be a need to update or maintain equipment other than that needed to support the environment and maintain network or internet connections.  The amount of storage available is no longer limited by the physical resources on premises, and the vendor will normally handle the application updates and data backups. Another benefit of cloud computing is that the application and data is available at any time, from any location³.

Financial savings include the savings on overall cost of equipment, and the internal IT staff needed to support an application and maintain servers.  Also, since many cloud solutions are subscription based and the health organization can pay as they go, the organization can save by better managing a regular monthly cost. Also, the time to implement or add users and workstations will be less than a client server model and allow for further savings³.
As further noted by Rivers, data covered under HIPAA may be risky to store in a cloud environment.  The HCO should ensure there are proper legal agreements in place with the vendor supplying the data storage or cloud solution to ensure the HCO is not liable for breaches or other threats³.

Other risks include security and data access concerns. Since the data is accessed over the internet, regional service outages may affect data access. Also, a health care organization will still be the need to maintain internal devices and network/internet access to ensure all users can have access to the cloud³.

Security risks inherent to the cloud environment include data access concerns, as well as data integrity issues. In a cloud environment, sensitive data is stored in a remote location and vendor staff can have access to protected data. The vendor may have a business associate agreement, and if so any staff member may be able to view protected health information.  The vendor should be readily available for regular auditing and review. Also, since the data can be stored alongside other client data and may even be stored in different countries, vendors should be willing to ensure data is stored in environments subject to satisfactory regulation and security³.

References:
1 HealthFusion (2013). EHNAC Certification. Retrieved 9/15/13 from: http://www.healthfusion.com/ehr-ehnac-hipaa.asp

2 HealthFusion (2013). Meditouch HER. Retrieved 9/15/13 from http://www.healthfusion.com/ehr-platform.asp
3 Rivers, D (2012) Cloud Computing First Look (Online Video Course/presentation). Retrieved 9/14/13 from http://www.lynda.com/Business-Collaboration-tutorials/Cloud-Computing-First-Look/105390-2.html
4 Shelly, G. B., & Rosenblatt, H. J. (2012). Systems analysis and design, ninth edition (9th ed.) Boston: Course Technology Cengage Learning.