Cloud Computing in Healthcare: The Benefits, Risks & Outlook

Over the last decade, enterprises, SMBs and startups across all industries have adopted cloud for its proven benefits. Organizations within the various industries have chosen different adoption journeys based on which cloud services and capabilities they prefer and benefit from. Some organizations are moving into the cloud with a Cloud-First mentality by migrating out of on-premise data center facilities and quickly adapting their business models and operations to account for this. Other organizations which are more regulated, such as healthcare, utilities, and finance, are focusing on specific types of cloud services that can efficiently drive their business operations forward while staying in compliance with regulatory rules and obligations.

Cloud Benefits for the Healthcare Industry

The advent of Covid-19 has pushed many healthcare providers, payers, and clearing houses to start their adoption of, or increase their rate of, cloud adoption in various ways. Because of the regulated nature of healthcare, many IT services and capabilities they utilize will remain on-premise for some time. But like all industries adopting cloud, the healthcare industry is adopting cloud for its proven benefits including:

  • Lower Costs
  • Flexibility
  • Agility
  • Scalability (up, down, across Cloud Service Providers (CSP), between on-premise and cloud)
  • Collaboration (between providers and between patient-and-providers)
  • Business Continuity (practitioners and staffers can work from home or elsewhere)
  • Security

Even prior to COVID-19 increasing the uptick of cloud adoption in various areas, some organizations in the healthcare industry have been creating cloud strategies and adopting cloud services for some time. Back in 2011, Novant Health started with Epic on-premise to help manage its growing EHR requirements. At the same time, they realized that their existing legacy infrastructure could not keep up with their future EHR growth. Novant Health began their cloud planning and design discussions in mid-2018 and their EHR went live in the cloud early in 2019. 

Meditech, a leading EHR solution provider, announced in 2019 a partnership with Google to offer their EHR solution on the Google Cloud Platform (GCP). Some of the primary reasons why Meditech made this decision is that providing the offering on GCP provides their customers with higher productivity, agility, and interoperability, while enhancing scalability. GCP also allows Meditech customers to expand their security efforts and help combat threats such as ransomware. As quoted by Scott Radner, Vice President of Advanced Technology, MEDITECH, “Whereas many of our customers today have finite resources dedicated to security, the public cloud can facilitate potentially hundreds of additional, deployable resources."

A final example is Providence St. Joseph Health, one of the largest health systems in the country, who in July 2019 announced a partnership with Microsoft to accelerate the digital transformation of healthcare. The partnership is working towards creating integrated solutions designed to improve health outcomes and reduce TCO of care. As stated in the press release in July 2019, "The alliance will accelerate the health care industry’s adoption of cloud and enable data-driven clinical and operational decision-making by leveraging Microsoft Azure, and industry interoperability standards like FHIR, to integrate siloed data sources in a cloud environment that enables security and compliance."

The Outlook and Growth of Cloud Adoption in the Healthcare Market

Given the overall growth rate of public cloud adoption in other industries, how does healthcare compare?

According to a recent Gartner report, global public cloud services were valued at approximately $242.7 billion in 2019. The global public cloud is expected to grow $257.9 billion in 2020 which is about a 6.3% growth. Sig Nag, a research VP at Gartner, stated that when COVID-19 hit, the "cloud ultimately delivered exactly what it was supposed to. It responded to increased demand and catered to customers’ preference of elastic, pay-as-you-go consumption models."

Related to the healthcare cloud computing market, Zion Market Research released a report in January 2019, which focused on the healthcare cloud computing market, its primary drivers and focuses. According to that report, in 2018 the healthcare cloud computing market was valued at approximately $18.9 billion. Zion Market Research reported they expect the healthcare cloud computing market to grow to around $61.8 billion by 2025 which is approximately a 18.7% Compound Average Growth Rate (CAGR) from 2019 through 2025. That is 3x the overall global public cloud growth rate, signifying the healthcare market is poised to begin a heavy adoption phase of cloud services.

Zion Market Research indicates many drivers for healthcare organizations to adopt cloud computing, including:

  • Exponential growth of data storage needs driven by IoT and wearable medical devices (Internet of Medical Things)
  • Big data analytics
  • Expansion of high-speed internet
  • Introduction of novel payment models
  • Increasing demand for rigorous regulatory compliance.

Risks of Cloud Adoption, Despite Growth

There’s gold in them thar hills!!

The healthcare industry generates and maintains enormous amounts of information. In 2018, researchers at IDC expected healthcare data volumes to grow faster than other industries. Healthcare data is expected to experience a CAGR of 36% through 2025. In comparison, the expected CAGR growth for manufacturing data is 30%, financial services is 25%, and media & entertainment is 25%.

Given the projected growth rate of healthcare data, it is not a surprise that those with ill-intent desire access to financially profit from it.  As of Sept 10, 2020, there were 600+ breaches reporting to the U.S. Department of Health and Human Services Office for Civil Rights. This site reports on breaches of unsecured protected health information (PHI) affecting 500 or more individuals. The prominent "Location of Breached Information" (meaning where was it attained from) was "Email" followed by "Network Server". Sadly, this indicates humans are one of the primary attack vectors for attaining healthcare related information as they are for most other industries.

The HHS breach information should not be taken in vein of "cloud is insecure." CSPs like Amazon, Azure, and Google all have services offerings which apply directly to the health sciences market, and others which are complementary to healthcare. The major CSPs are all hyper-focused on security overall for those services, for their own internal resources, and the resources used by their cloud customers. As such, in more cases than not, the CSPs have more resources focused on security of cloud infrastructure (both physical and virtual) and cloud data as compared to a majority of large corporations. In addition, all have focuses on general and industry focused standards (such as the healthcare market) in the United States and internationally for standards such as HIPAA, HITECH, HITRUST, PCI-DSS, ISO/IEC 27001, and many others.

The Outlook

2020 started out as a pivotal year, if not transformational year, for the healthcare market in cloud thanks COVID-19. The growth expectations given previously may not hold as COVID-19 has changed the expectations for the healthcare industry such that it has had to adapt and digitally transform itself rather quickly. Prior to COVID-19, the healthcare market was focused on a strong adoption curve for cloud. COVID-19 has only intensified this focus.

While adoption of cloud for the healthcare market brings numerous benefits, it must be approached with due-diligence and attention to detail. As with any other industry, many use cases in the healthcare market space can and should be migrated to cloud. But other use cases should be approached very carefully especially when they deal with PHI and EMR based data sets. Planning and architecting for strong security at the data and access edge points are paramount to protecting an individual's PHI.

Stay tuned for forthcoming articles focusing on specific challenges in the healthcare space and how use of the cloud can help overcome these challenges providing better efficiency, lower costs, higher patient/provider/payer satisfaction, better patient care from remote locations, and many other quantifiable benefits.

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