Healthcare IT Solution Delivery and the Cloud

By Arvind N Sivaramakrishnan, CIO, Apollo Hospitals

Healthcare IT is vibrant today and brings to bear an unparalleled potential to be truly transformative in its capability to take healthcare to every citizen of the world at the right time, at the right place, in the right format and at the right cost. Life is precious and with it comes the reality of delivering perfect solutions with absolutely no chance of error or malfunction. The rising cost of infrastructure, enterprise software licenses, talent acquisition and maintenance costs necessitates the need to look at alternative, innovative, viable and sustainable models of Health IT solution delivery.

Delivering solutions using the cloud computing technology is definitely an option that merits serious consideration given its ability to optimize infrastructure standup costs, costs of scalability, deployment costs and the cost associated with resources. At the same stroke of this consideration are serious concerns on ensuring privacy compliance and security which are both paramount.

India is yet to see comprehensive legislation in privacy and security of healthcare transactions as is practiced in the west. Despite the lack of governing legislation, the consumer expectation of privacy and security has not lowered but in contrast become higher or on par with the west. While public cloud comes with several apprehensions on these aspects, hybrid and private cloud models are indeed garnering attention of health IT solution delivery architects.

The balance between the triple constraints of this field - cost, speed to delivery and solution maturity has to be maintained keeping in mind business priorities and other market constraints. Careful consideration may be given in a healthcare enterprise to clinical applications that host patient data, non–clinical business enterprise applications such as communication and collaboration solutions, back-office business productivity solutions such as HCM and Finance, business intelligence and analytics solutions that work on aggregated data with little direct link to the transactional specifics. Each of these provides challenges and options of embracing the cloud. Careful consideration of design balancing business needs clearly provides effective and sustainable solution delivery models that balance cost and customer delight.

A private or hybrid cloud solution in a hub and spoke model for enterprises that span geographies is definitely worth consideration. This helps balance seamless data movement appropriately balancing infrastructure, communication networks and software solution’s design effectiveness and maximizing outcomes. Such design models also help maximize the deployment of enterprise class software licenses.

Healthcare is directly impacted by the consumer industry. The electronics, mobile technology, ecommerce and internet technology have simplified daily chores. The same expectation is laid on Healthcare IT for healthcare delivery. BYOD and mobile technology are a reality. The sooner we embrace and get them aligned to the mainstream health IT solution delivery, the lesser our chances of disintegrated solutions, expectations and the gamut of security leakages and infringements. This again puts pressure on the core backbone of the overall solution delivery and the ability to scale up to disruptive technologies capable of being positively transformative for health delivery.

The cloud thus becomes a valid option still walking a tight rope on balance with growth and security. There is no direct and inheritable solution delivery model in this space. While learning from each experience is invaluable, careful consideration to cost, risks, business agility, realistic solution needs and long term sustenance and maintenance have to be carefully considered and design suitably effected.

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