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Survey: 70% of Providers Using Off-Premises Computing for Some Applications

December 14, 2017
by Heather Landi
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A survey conducted by KLAS Research found that 70 percent of healthcare organizations have moved at least some applications or IT infrastructure off-premises.

While most of those using off-premises computing are doing so through a hosting environment, future plans lean heavily toward the cloud, according to the survey results.

KLAS surveyed 144 U.S.-based healthcare organizations about the off-premises cloud and hosting options they are currently using, whether they are considering moving to the cloud, why they would or would not move to the cloud and which vendors that are considering or would consider for future off-premises computing needs.

Nearly 60 percent of those healthcare organizations using off-premises services have moved their electronic medical record (EMR) applications to a hosting or cloud environment. The KLAS study, titled “Off-Premises Computing Perception 2017,” found that Cerner is the most used off-premises computing provider in the industry and continues to garner interest from existing and potential clients.

Epic, a newcomer to hosting, has a handful of organizations using their hosting services. “Momentum is building—nearly a quarter of healthcare organizations considering off-premises computing services are considering moving their Epic applications to Epic’s data center, making Epic the most considered among EMR vendors,” the KLAS study stated.

About 69 percent of healthcare provider organizations would consider or are actively considering moving to or expanding their utilization of off-premises cloud solutions. The survey also evaluated the reasons providers are considering, or not considering, moving to the cloud. Reducing capital outlay and lowering costs were cited as top reasons providers are thinking of doing more in the cloud.

Several respondents cited freeing up capital investments in on-premise hardware and infrastructure for investment in other key areas as a key reason why they are looking at moving to the cloud. Other respondents indicated they will move applications or IT infrastructure to the cloud if it lowers the cost of ownership.

Despite these potential advantages, 31 percent of healthcare provider organizations who responded to the survey said they are wary of cloud computing, naming security and privacy vulnerabilities as their top concern. Many respondents said they are more confident in their own ability to keep their environment and PHI data secure, according to the study.

The study also found that the top area healthcare providers are or would consider transitioning off-premises is IT infrastructure, often to the cloud through an Infrastructure-as-a-Model (IaaS) model.

Among the surveyed healthcare provider organizations, cloud infrastructure providers are the most commonly considered, with Microsoft and Amazon at the top of the list. “Respondents most often consider Amazon for their future IaaS and PaaS needs, and many perceive them as an infrastructure leader. While Microsoft is considered more frequently overall than other off-premises computing providers, they are just behind Amazon among those who would consider or are considering broad infrastructure solutions,” the KLAS report authors wrote.

Many healthcare provider organizations start cloud computing with Office 365, adopt it for other Microsoft products, and then expand more broadly to IaaS. Many plan to use public cloud providers for storage, backups, file sharing, email archiving, websites, or non-clinical applications; however, they are apprehensive about putting sensitive PHI in the cloud, the KLAS study found.

The survey results also indicate that 17 percent of healthcare providers have moved their Enterprise Resource Planning (ERP)/Human Capital Management (HCM) applications off-premise, and, of those, nearly three out of four have done so through a hosted deployment model.

However, the KLAS researchers contend that this will shift strongly toward the cloud in the future. “All major software vendors except McKesson have developed cloud-based applications. Workday and Premier products are delivered exclusively through a SaaS model. While Oracle and Infor primarily support legacy customers, both have recently developed new cloud-based solutions that can be deployed on-premises or in the cloud,” the KLAS study authors wrote.

Of those healthcare provider organizations considering moving ERP/HCM applications off-premises, over 80 percent plan to do so in the cloud. Infor is by far the most used and considered for ERP/HCM off-premises computing, according to the KLAS survey.






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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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