Cloud-enabled data automation is helping streamline clinical processes for physicians and nurses – breaking down data silos and surfacing relevant patient information where it's needed most. It's also helping ease the burden and burnout among health system staff.

It's well-known that healthcare data is growing at an exponential rate. Are healthcare organizations prepared to keep up?

Organizations that establish cloud-native infrastructure and supportive processes will not only be able to gain insights from their data to better serve their patients and staff, but also usher in an entire new set of tools that disrupts product development across the industry, said Anders Brown, managing director at Tegria, the healthcare and technology services company founded by Providence.

We sat down with Brown to talk about the cloud in healthcare. Prior to Tegria, Brown held multiple roles at Microsoft and built scalable consulting businesses at the intersection of software, hardware and new markets.

Q. What are the pros and cons of cloud infrastructure for a healthcare provider organization?

A. While we absolutely are believers in the importance of the cloud for healthcare – we see it as a positive trend for providers and payers – we also understand that it doesn't mean organizations should undertake everything, all at once. Our customers think about this in terms of balance and opportunity.

To start, there is certainly a consensus on the benefits of an "elastic" infrastructure. The ability to easily scale workloads up and down and pay for what is used as opposed to managing the fixed cost of IT infrastructure is most definitely a positive.

Another benefit is faster adoption of new technologies. It is easier to integrate the latest tools, which are cloud-native, into a cloud-based ecosystem.

You really can't use modern innovations like natural language processing or real-time data analytics with on-premise hardware. Those workloads really need the processing power that can today only be found with the cloud service providers.

The pace of innovation happening in and adjacent to the leading cloud service providers supports faster technology adoption. We'll increasingly see new technology first in the various cloud marketplaces, and we'll continue to see cloud service providers add more prebuilt features that can be deployed quickly and easily.

Along the way, customers can streamline their application portfolio by taking more accurate inventory of what is actually used and necessary and make follow-on cost reductions where appropriate.

Related to that is reduced cybersecurity risk. Abstracting core systems away from the user base, which is the most likely attack vector, is a benefit that is clear to our customers. Cloud environments also give our customers access to better log analytics, network and behavior analytics, and more sophisticated security and monitoring tools.

Finally, there's the data. The data around the patient from wearables, remote patient monitoring, etc., is growing exponentially. And while you might be able to store it on-premise, the cloud is really the only place you can effectively scale, organize and analyze all that data for better, more efficient care.

No question, there are also trade-offs and considerations that are unique to each of our customers. Cost, of course, is often the most common theme.

Determining value proposition for any specific customer depends on where they are and where they want to go next. It certainly exists, but it takes a reasonable amount of pre-work to identify and varies from one customer to the next.

Additionally, most of the IT teams we work with are stretched thin with little patience for projects that are purely long-term in their benefits. We get that. So, we try to help with the step-by-step to deliver quick wins.

Q. What are the pros and cons of a cloud electronic health record system for a provider organization?

A. Certainly, our customers benefit from moving off a capital expense "capex" model for IT investment requiring expensive infrastructure refresh every few years toward an operating expense "opex" model that is elastic to need and can scale up and down, depending on usage.

You can also take advantage of newer and faster technologies as they become available without having to wait for that refresh cycle. If your Epic database is running on a certain cloud server and Intel releases a faster chipset, you can easily swap to a new cloud server with that chipset and get immediate benefits from the gains in speed and reliability.

The offset of that won't surprise many readers. Most healthcare software is not cloud native, and some have a long way to go to get there. That has an impact on ability, effort and expense to take full advantage of the cloud's benefits.

IT administrators can leverage on-demand cloud services for non-production systems – to only pay for what they're using. And overall resiliency of customers' systems improves at a lower cost by deploying disaster recovery solutions.

Some of our customers also report more uptime stability, easier integration of third-party applications and easier real-time integration of data. But it's important to factor in the effort to up-level IT staff capabilities as you go – our customers are finding they need to invest in a shift in skillsets toward more cloud-based capabilities.

With each go-live for hosting engagements, there is palpable excitement from our customers – and not just as a measure of relief when everything goes according to plan. I see a growing recognition across the healthcare IT community for the opportunities available for their organizations in the cloud, whether they choose private, public or hybrid.

Q. You say that organizations with cloud IT can gain insights from their data to better serve their patients and staff. Why can't they do that with on-premise IT? Or how do you think it can be done better with cloud IT?

A. Great question. Most customers might not be facing this issue now, but ultimately – and we believe, soon – they'll be facing a constraint on their ability to utilize the data they're storing, unless they move to the cloud.

The data wave that is coming from remote patient monitoring, wearables, other in-home devices – all of that will dwarf the datasets generated by EHRs. To the extent customers want to move beyond pilot projects for machine learning and artificial intelligence models, on-premise solutions will become obsolete quickly.

What we're seeing from our work – which includes projects like de-identifying hundreds of millions of patient notes – is that advanced analytics is simply not possible without the cloud. You can certainly store petabytes of data on-premise, but you can't quickly do modeling and analytics that require immediate and significant scale.

You can try things, fail quickly and try again until you get an outcome that works. This is what the scale of cloud infrastructure provides you.

Q. You also suggest that cloud IT ushers in an entire new set of tools that disrupts product development. What are the tools, and how do they disrupt for the better?

A. Yes, there are a lot of great tools out there. For starters, we'd cite cloud and digital native tools from companies like Microsoft and their Power Platform offerings, as well as Amazon and their Honeycode and AWS for Everyone approach. These tools enable frontline healthcare staff to directly build products that integrate into a cloud-enabled infrastructure.

We absolutely believe more of this should and will happen. Clinicians are a relatively untapped population for incredible ideas on how to improve things. They are living the challenges each and every day.

Our thought is we should be democratizing healthcare IT invention by training clinicians how to build their own solutions, securely and reliably, with the right development tools and engineering support. We think this a powerful idea and one that will unleash unprecedented innovation in healthcare.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.