While many big names in cloud service and technology are increasingly tapping into the growing cloud market in Asia-Pacific, healthcare organisations are advised to keep their focus on quality service and service availability when looking for cloud providers.

In the keynote session "​​A Case for Cloud-based Solutions," Dr Hee Hwang, CEO of Kakao Healthcare, and Aster DM Healthcare Group CIO Veneeth Purushotaman highlighted the challenges and opportunities for cloud adoption in APAC's healthcare scene.

Dr Hwang noticed that most countries in the region are availing cloud services mainly from global providers except for China and South Korea, which tap into local providers like Naver and Kakao. There is hesitance from these markets about the capability of global providers to offer security when they supposedly have one backup centre in one area.

Over in India, it has been a "natural transition" from a digital-first to cloud-first strategy as the pandemic has given an impetus for many providers and solutions to move onto the cloud, said Purushotaman. 

India has a huge cloud market, which he said is expected to rise from around $3 billion this year to $13 billion over the next three to four years. Most industries in the country are said to be already on the cloud.

However, some have adopted a hybrid approach, particularly for hospital information systems, given the locations of hospitals and clinics where there could be potential disruptions. "Even if I got a primary and a secondary network [running], they could still end up in trouble, which is why we consciously keep it as a hybrid model where there is an offline-online feature," Purushotaman said.

"In a country like India, this part of the world where the volume of transactions and the scale are very high, so you want to be nimble enough; being on the cloud and using cloud computing is the best way to go," he said. 

For smaller health systems that are just getting into the market now, Purushotaman suggested focusing on what service the cloud providers are "bringing to the table than just their names."

Hurdles to cloud adoption 

According to Hwang, it has been difficult to get CIOs on board cloud adoption given two major concerns. One is about privacy and security. While this may not be an issue for the top 1% of university hospitals in the country, the remaining 99% find this a significant concern. "No one single hospital can guarantee the same levels of privacy and security," he said. 

Another major worry is the efficiency of cloud systems. Hwang said vendors are partly responsible for the misunderstanding of many hospital executives regarding the cost benefits of moving to the cloud. "Many hospital management expect some kind of decreasing total revenues related with [setting up cloud] infrastructures, bringing down 70% or 80% of total revenue cost. But in reality, it is actually nearly the same as, sometimes even higher than, on-premise systems."

"I think vendors need to [rec]consider their strategies in selling their solutions to hospitals," he suggested.

Meanwhile, government regulations too can be an issue for cloud adoption, Dr Hwang pointed out. In South Korea for example, global cloud service providers are finding it difficult to meet requirements to comply with national regulations. There are two evaluation systems of cloud solutions for privacy and security while there are more specific guidelines for utilising the cloud in the public sector. "I think there are some ridiculous points in those guidelines but still, every government has its own rules and regulations," he said.

Moreover, software solutions that are mostly being provided in many APAC countries are not cloud-ready, Dr Hwang mentioned. "These are originally designed for on-premise services, which lack some critical architecture such as microservice architectures, DACA containers, etc." 

"For scalability, more flexible operation, and efficiency, we need to have [appropriate] software which meets all the requirements for the cloud systems," he advised. Nowadays, many hospitals and vendors in South Korea are developing innate, cloud-oriented EHR systems for different types of hospitals.

Also, Dr Hwang proposed that hospitals keep their data within their systems, whether it's hybrid, cloud, or on-premise. "The main point is the hospital should handle the ownership of their clinical data."

Getting into cloud

When considering the next generation of technologies such as metaverse and IoT, Dr Hwang emphasised the critical role of cloud technology in capturing and manipulating data. "For the hospital side… having a cloud system is going to be critical in meeting the technical requirements [for enabling emerging health technologies] and making your operations efficient."

Meanwhile, for Purushotaman, "it is no more a question of whether or not we need to get into the cloud; It's more of how much of your assets are on the cloud and how much or not and when will I make the rest of them go onto the cloud."

"Affordability and accessibility [of care] can only come through digitisation, from which cloud and cloud computing have an important role."