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NIH STRIDES Toward the Commercial Cloud

August 29, 2018
by David Raths, Contributing Editor
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Initial agreement will allow NIH researchers to make use of Google Cloud’s storage, computing and machine learning technologies

The National Institutes of Health has launched an initiative to give NIH biomedical researchers access to the most advanced commercial cloud computing resources.

The STRIDES (Science and Technology Research Infrastructure for Discovery, Experimentation, and Sustainability) Initiative launches with Google Cloud as its first industry partner and aims to reduce economic and technological barriers to accessing and computing on large biomedical data sets to accelerate biomedical advances.

The NHI said the initial agreement with Google Cloud creates a cost-efficient framework for its researchers, as well as researchers at more than 2,500 academic institutions across the nation receiving NIH support, to make use of Google Cloud’s storage, computing, and machine learning technologies.

In addition, the partnership will involve collaborations with NIH’s Data Commons pilot — a group of projects testing new tools and methods for working with and sharing data in the cloud — and enable the establishment of training programs for researchers at NIH-funded institutions on how to use Google Cloud Platform.

In line with NIH’s first-ever Data Science Strategic Plan, released in June, STRIDES will establish additional partnerships to broaden access to services and tools, including training for researchers to learn about the latest cloud tools and technologies. Services are expected to become available to the NIH-supported community after a series of pilot activities to refine policies and test and assess implementation approaches.

A central tenet of STRIDES is that data made available through these partnerships will incorporate standards endorsed by the biomedical research community to make data Findable, Accessible, Interoperable, and Reusable (FAIR). NIH’s initial efforts will focus on making NIH high-value data sets more accessible through the cloud, leveraging partnerships to take advantage of data-related innovations such as machine learning and artificial intelligence, and experimenting with new ways to optimize technology-intensive research.

“By launching STRIDES, we clearly show our strong commitment to putting the most advanced cloud computing tools in the hands of scientists,” said Andrea T. Norris, NIH Chief Information Officer and director of NIH’s Center for Information Technology, in a prepared statement. “Beyond our partnership with Google Cloud, we will seek to add more industry partners to assure that NIH continues to be well poised to support the future of biomedical research.”


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CIO Survey: Slow Migration to the Cloud Due to Ongoing Security, Privacy Concerns

May 30, 2018
by Heather Landi
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Hospital information executives cite cloud hosting as one of their organizations’ top priorities, yet the transition to the cloud is happening slowly as many chief information officers (CIOs) continue to have concerns about compliance as well as data security and privacy, according to a new survey from Datica, a company that provides a cloud-based digital health platform.

The 2018 CIO Cloud Perspective Survey, titled “Healthcare Cloud Take-off: Waiting for the Fog to Clear,” sought to take an in-depth look at the current state of the cloud from the seat of the CIO of leading hospital organizations. The report examines why CIOs mark cloud migration as a pressing priority and provides details on why shifts to the cloud are happening slowly.

Datica’s Hospital CIO Survey was conducted around the 2018 Healthcare Information and Management Systems Society (HIMSS) annual conference in Las Vegas, and with the College of Healthcare Information Management Executives (CHIME) CIO members. CIO leaders from 175 leading healthcare organizations participated in the survey.

Among the respondents, 17.7 percent work with healthcare organizations that have more than 50 percent of the existing software infrastructure remotely hosted or in the cloud. Nearly 15 percent of those who took the survey say 25 to 50 percent of their infrastructure is cloud-based.

About 55 percent of respondents reported that they do not host their primary electronic health record (EHR) system outside of their data center; about 35 percent said they are using the EHR vendor’s hosted offering and about 10 percent are using a third-party hosting solution.

Even though new tools and changes in the regulatory environment have made cloud a safe option for storing sensitive information, including Protected Health Information (PHI), the survey shows that the majority of survey respondents do not have a strategy for moving their data centers to the cloud.

Nearly 60 percent of those who took the survey place cloud hosting in their organizations’ Top 10 priorities and 30 percent list cloud hosting as one of their organizations’ Top 5 priorities, however, only about 30 percent have a strategy in place. Twenty percent of the survey respondents shared that cloud hosting did not hold a present priority.

What’s more, the report notes that healthcare organizations’ current efforts to migrate data to the cloud is akin to the experience of waiting at the airport. “Healthcare organizations are not 100 percent convinced that cloud storage is safe for the PHI of their patients and therefore remain grounded for takeoff,” the report states.

Almost 40 percent of respondents said they don’t see a clear business value in migrating to the cloud, and an even larger portion (50 percent) of those surveyed cited concerns about security as a primary worry when it comes to cloud migration.

A move to the cloud is slowly accelerating for a variety of reasons, and evidence shows one is simply demand. Healthcare professionals need access to simple-to-use secure messaging; applications that will improve patient safety, and the ability to analyze data for research, business, and patient care purposes.

The presence of some of tech’s heaviest hitters at HIMSS18—Microsoft, Amazon Web Services and Google—also signaled an indication of cloud’s importance to healthcare, if not at the current moment, in the very near future.

Healthcare systems that have taken an on-ramp to the cloud are still in the minority, but the survey respondents who have made the cloud shift a reality are learning what works and what doesn’t, according to the report.

In 2015, and prior to cloud hosting becoming a mainstream topic in the medical industry, a paper from the Journal of Healthcare Informatics Research concluded that hospitals of all sizes would use cloud-based Healthcare Software-as-a-Service (SaaS) Platforms to deliver healthcare information services with low cost, high clinical value, and high usability. Now, three years later, roughly 20 percent of hospitals have adopted those cloud-based infrastructures.

Of those executives who completed the survey, roughly 34 percent of those healthcare technology professionals surveyed said their organizations presently use the cloud to develop applications or manage PHI. But, of those, the majority (nearly 64 percent), expect to have two to five internally-developed, cloud-based applications deployed in the next two years. About 70 percent of respondents are using the cloud to create applications for data analytics—other purposes included population health (46 percent), community care applications (37 percent), and applications specific to a clinical specialty (36 percent).

About 32 percent are using the cloud to build machine learning applications for healthcare, which are likely to open the door for the many possibilities that artificial intelligence (AI).

The report also found that compliance, security, and privacy are the three primary concerns for those hospital CIOs who have considered implementing digital health technology from outside vendors. More than half of the respondents (52.5 percent) have concerns, and slightly less than half say they are comfortable assessing compliance of vendors (44 percent). A mere 3.43 percent stated no concern for cloud-hosted applications because they weren’t allowed.

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Can CDs Be Eliminated From the Image-Sharing Process?

April 5, 2018
by David Raths
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‘The concept that we provide people with CDs is ludicrous,’ says one imaging informatics exec
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The dream of imaging informatics executives is to get CD-ROMs out of the workflow. But they are stubbornly persistent — like fax machines in physician offices.

During a recent webinar put on by the Society for Imaging Informatics in Medicine (SIIM), two executives described their strategies for handling images arriving from other organizations.

Alexander Towbin, M.D., associate chief of radiology informatics at Cincinnati Children’s Hospital, said the hospital gets medical images from around the world because it is a center of excellence for many conditions. Historically those came via CD, but that is changing.

Putting it bluntly, Towbin said, “CDs suck!” There are so many opportunities for error to be introduced. Some institutions put passwords on them and don’t share them. Some forget to burn them. Some CDs arrive with the label on the readable side. “They do everything they can to screw it up and then they do it over again,” he said.

As Cincinnati Children’s has moved to cloud solutions for image sharing, there are still problems they have to deal with, such as accession numbers that are too long and can’t be ingested into the PACS. But automation tools allow them to fix those problems across all a patient’s files. “That has been huge,” Towbin said. “The decrease in the number of problems from CDs has been huge for us.”

In its own region, the healthcare organizations previously were on one image-sharing platform, but the vendor went out of business. Now the provider organizations are on multiple cloud-based solutions, and Cincinnati Children has created a hub-and-spoke gateway, which sends imaging studies into its PACS. “That works well for ones we have relationship with,” Towbin said.

Putting images on CDs is also bad for patient engagement, Towbin stressed. “The concept that we provide people with CDs is ludicrous. We are asking them to act as delivery people. Apple got rid of them six or seven years ago. Most computers don’t have them. Even in radiology, we have to buy add-ons for computers.”

Kevin McEnery, M.D., director of innovation in imaging informatics at the University of Texas MD Anderson Cancer Center, said, “We see the cloud as indispensable for moving forward. We see it decreasing complexities of image transfers. It simplifies the logistics of moving images between institutions without sacrificing security.” His organization is migrating away from CD-ROMs as well. But with 16,000 to 18,000 studies processed per month, there is still a lot of investment in employee time in getting images into the PACS. “We could use a lot more automation than exists with the current infrastructure,” he said.

Rather than having patients shuffle CDs to other providers, MD Anderson has hired a third-party company. Once someone is an MD Anderson patient, the vendor calls and asks where they have had imaging and takes care of it from there. “It decreases stress and increases the number of studies available to get a more complete picture of the patient’s condition,” McEnery said.

Towbin said the hub-and-spoke approach with other institutions has had its challenges in terms of project management. The other organizations might not necessarily see working on this as a high priority. “It is a way for them to send images to us — an above-and-beyond thing we are asking them to do. It is a huge stressor on our informatics team — getting external providers interested in using our solution,” he said. There is a lot of trial and error to get it working, and understand work flows. The experts on our teamwork to understand the best work flow for each institution. It was and continues to be a challenge to roll this out to everyone else.”

Beyond getting images into the PACS, another issue is getting access to prior imaging reports, McEnery said. “They are coming through a different pathway — on that fax pathway. We are putting a bigger emphasis on not just improving how we get images but also how we get reports from the institution the image is coming from on their understanding of the disease process.”

On Cincinnati Children’s roadmap is image-enabling its patient portal to allow patients to push images elsewhere or download them. “It is doable and where we need to move. It is difficult to image-enable the patient portal, but not impossible.”




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