said Greg Caressi, Senior Vice President, Healthcare and Life Sciences, at Frost & Sullivan. Public cloud solutions are deployed in healthcare, but are more rare, he added.
Infrastructure-as-a-service
(IaaS) technology “will become increasingly important as the data explosion in healthcare continues to stretch the capabilities and budgets of organizations to manage these petabytes of data,” Caressi explained, “and as we need to collaborate and share access to healthcare data among a wider range of stakeholders.” Dennis Schmuland, MD, Chief
Health Strategy Officer at Microsoft’s U.S. Health and Life Sciences division says too many hospitals “sell themselves short by focusing only on the cost- savings” of the cloud. Instead, they should be looking at “how the cloud can focus on what they do best, rather than keeping the lights on.”
3 Opportunities for Innovation That could mean collaborative
analytics for big data, he said—pointing specifically to “3 areas that are exciting.” One is improving patient safety.
“A lot of those data streams can be aggregated and analyzed to signal early warnings from oximeters, ventilators, blood pressure, body temperature, heart rate,” Schmuland explained. “Those early warnings can really predict adverse events well in advance of the condition being serious: detect infections earlier, detect cardiac arrest, or a blood clot before it occurs.” A second area is reducing practice
variability. “Many physicians do not know how their practice compares with others. Big data could quickly enable every physician to see how they compare with best practices—and even help provide them with feedback over time, moving toward best practices and reducing variability and improving their adherence to guidelines,” he said. The third has to do with
comparative effectiveness research. “The challenge with comparative effectiveness research (CER) is that it takes so much time to do comparative studies: You compare one drug to another, and report and publish results, Schmuland said. “Big data could actually do a lot of CER based on data that already exists. A lot of this data is currently lost in the system.”
IMAGES © WOLF JASHA, DENIS_PC / FOTOLIA CONNECTION/HEALTHCARE IT 2013.Q1 17
Three fine examples, sure. But
ultimately there’s not much limit to what can be accomplished with the affordability and collaborative opportunities enabled by the cloud. Indeed, it seems we find ourselves at
a pivotal moment. Taken together, the cloud and big data—those 2 purported buzzwords—are setting the stage for huge changes in the quality and cost- effectiveness of care. Which is precisely the situation in which UPMC finds itself.
How UPMC
Approached the Cloud There are more challenges—albeit
fun and exciting ones—ahead. “Then you hear about things like
‘The Internet of Things’”—discrete physical objects, when represented in a virtual Web-like structure—“where all these different devices will be connecting to the Internet, and we’ll have this additional abundance of data coming in,” UPMC’s Carmody said. “We have a unique opportunity ahead of us as far as how we effectively manage, store, and enable that data to be transformed into information and knowledge for our clinicians.” Eight years ago, even with nearly
one-eighth as many patient records to store as there are now, there was already an “explosion of physical servers just taking over our data center floor space,” he said. “We were looking at having to build or lease floor space at another data center just to deal with that organic growth.” The decision to virtualize UPMC’s infrastructure was appealing, but the process was anything but easy. “It definitely took a lot of effort, a lot of time—3 or 4 years to go through the transformation to where we were fully up and running on our own little private cloud,” Carmody said. The biggest obstacle was
standardization. “We needed to consolidate the varieties of platforms and solutions we’d previously been supporting for all the different application vendors, and really work with them and reach out to them to push us toward where we could reduce the number of operating systems and databases to a manageable few that we could have confidence in as we moved forward to a virtualized environment.” Calling that “a tremendous challenge and a lot of work,” Carmody added that
the benefits “have been overwhelming.” Once threatened with having to spillover into another data center, “We’ve reduced our physical footprint, there’s actually room to grow,” Carmody said, “which positions us well for this next expansion into big data.”
Setting the Stage for Future Growth Today, with the data deluge
gathering strength, “We are well- positioned to be flexible, to be scalable, and to grow with the computing and storage needs that the enterprise analytics program is going to place on the infrastructure,” he said. “As our organization grows and introduces and integrates the genomics data with the electronic health record data with the financial and operational data—and then crank through those different algorithms and infuse that into the clinician’s workflow, the infrastructure is going to be heavily relied-upon. We’ve very confident and feel very capable.” UPMC’s leading-edge data center,
all in the service of a transformative approach to personalized medicine, is a great example of what a world- class institution with huge financial wherewithal can do with the cloud. But providers of every size should be
taking a careful look at cloud technology as data volumes grow inexorably. Indeed, far from being intimidating
to small hospitals, cloud technology should be looked upon as an opportunity as it will “likely be an equalizer between large hospitals with sophisticated IT capabilities and big budgets and smaller facilities that will not be able to keep up without ‘HIT as a service’ solutions,” Frost & Sullivan’s Caressi said. “Both will use cloud solutions, but smaller organizations will be dependent on these solutions for their survival and to keep up with the big hospital systems.”
ABOUT THE AUTHOR Mike Miliard is Managing Editor at Healthcare IT News. Mike covers topics such as health information exchange, privacy and security, analytics, and ICD-10.
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