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Emerging Technology Webinar Cloud Computing in Canadian Health Care

Presented by:

Ron Parker

Emerging Technology Group

Apr 13, 2016 Copyright © 2016 Canada Health Infoway

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Disclaimer

• This webinar represents solely the views of Infoway.

• It is intended to be informative only, and cannot be interpreted as providing any indication of Infoway’s present or future strategies or investment criteria.

• Infoway does not implicitly or explicitly endorse any particular technology or solution of any vendor or any other person, it does not guarantee the reliability or any proposed results related to the use of such technology or solution, and this notwithstanding that reference may be made directly or indirectly to any such technology or solution in this webinar.

3 © 2013 Canada Health Infoway Inc.

Agenda

• Cloud Computing in Canadian Health Care

• Introduce Cloud Computing

• Describe its features

• Illustrate relevance to health care

• A possible scenario for use

• Infoway key messages regarding cloud in health care

• Cloud as an enabler of innovation and sustainable transformation in health care


Research over the past several years has identified the independent evolution of four powerful forces: information, mobile, social and cloud. As a result of consumerization and the ubiquity of connected smart devices, people's behavior has caused a convergence of these forces. Information is the context for delivering enhanced

social and mobile experiences. Mobile devices are a platform for effective social

networking and new ways of work. Social links people to their work and each other in

new and unexpected ways. Cloud enables delivery of information and

functionality to users and systems.

Source: Mobile and the Nexus of Forces: Creating the New Experience, Gartner Research, June 25, 2012

Nexus of forces

The forces of the Nexus are intertwined to create a user-driven ecosystem of modern computing.


Other examples of cloud enabled solutions


Introduction of “Cloud Computing in Health”


Introduction of “Cloud Computing in Health”

• The first in the Emerging Technology white paper series

• Designed to address cloud computing from a Canadian health care perspective

• Intended to:

• Scope and provide insight on the potential applicability and utility for this technology

• Provide some context for business opportunities and challenges

• Suggest some possible approaches

• Be a call-to-action for further focused conversations on this topic


Next: The three major components of cloud

1. Computing infrastructure

2. Three service models

3. Four deployment models


First major component of cloud computing

1. Computing infrastructure (network, CPU, storage) that is “virtualized”, meaning:

• On demand and self-service

− Capacity is there when you need it

− Services are readily available and accessed transparently

• Broad network access

− Reliable and stable bandwidth across a broad range of devices

• Resource pooling

− A pool of resources is shared among many users

• Rapid elasticity

− Capacity increases and decreases virtually instantly

• Measured service

− Service provision is carefully managed and you pay by usage


Second major component of cloud computing

2. Three service models

• Cloud Software as a Service (SaaS)

− Software provided “over the Internet”

− Little to no configuration or installation locally

− Available wherever a user has a connection

• Cloud Platform as a Service (PaaS)

• Cloud Infrastructure as a Service (IaaS)


Third major component of cloud computing

3. Four deployment models

• Private cloud

− Typically a cloud customized for one organization

− Totally controlled by that organization

• Community cloud

− A cloud used by a community of organizations for shared purposes

− Share governance and management

• Public cloud

− A cloud totally open to the public

− Managed by the vendor

• Hybrid cloud

− A combination of the first three models


How do I know what model to use?

• Each deployment model has different implications for use in health care:

• Degree of organizational control, transparency and accountability

• Governance of cloud use and infostructure

• Privacy and security of personal health information manipulated or held in the cloud

• Capital expenditures versus operational expenditures

• Complexity of managing multiple cloud service providers to delivery highly available solutions

− No one vendor may “do it all”

− What happens when one service is unavailable?


Private cloud

• Advantages

• Secure and accountable

• Ability to start up new applications rapidly

• Better utilization of technology capacity – some reduction in cost

• Disadvantages

• Organization has capital costs to set up the private cloud

• May not be significantly cheaper overall

Private

Health Centre

Application

Application Application

Application


Community cloud • Advantages

• Secure and accountable

• Ability to start up new applications rapidly

• Broader reach

• Shared utilization of technology capacity

• Capital costs shared

• Disadvantages

• Requires governance of shared resources

• Some costs shifted from capital to operational on a demand basis – may be hard to budget for

Community

Health Region

Application

Application

Application

Hospital

Application

Clinics / FP


Public cloud

• Advantages

• Costs to the individual user for actual usage

• Lower per-usage costs for large pools of users

• Almost instant-on

• Disadvantages

• Very limited accountability

• No transparency

• Potential privacy/security challenges

• Difficult to budget for

Public Application

Application

Application

Application


Hybrid cloud

• Advantages

• Not one-size-fits-all

• Cloud usage matched to different models as appropriate for the application

• Compartmentalization of capability

• Disadvantages

• Requires thoughtful strategic plan and incremental roadmap

• Requires coordinated procurement principles and practice

Community

Health Region

Application

Application

Hospital

Application

Clinics / FP

Private

Public

Application

Application


Possible use scenario

Community Chronic Disease Mgmt Care Collaboration Care Transition e-Referral Scheduling

Health Region Hospital

Home Care LTC

Private Operational systems Clinical systems Specialized apps

Public Reference Information Clinical Decision Support Social Apps (no PHI)

Clinics / FP


Key messages

• Cloud is one of the top three CIO technology priorities

• Cloud is becoming increasingly visible to the public and health care providers


Key messages (continued)

• Cloud and SaaS are necessary computing models for:

• Data anywhere

• User anywhere

• Use from any device

• Access anytime

• This is very aligned with the five Rs of the EHR and digital health:

• The right information

• About the right client

• Available to the right person

• In the right place

• At the right time


Key assertions

• There are many opportunities for use of cloud in health

• Greenfield deployments in community settings or at program levels

• A necessary computing model for e-referral, clinical decision support, PHRs, chronic disease management and remote monitoring

• We need roadmaps and business cases to support the gradual migration of existing infostructures to private or community clouds and to determine how to deliver health care programs in a hybrid environment


Privacy and security considerations

• All computing models have similar set of privacy/IT security risks and requirements, such as authorized access to information and information resources (e.g., consent, RBAC), cloud computing is no different

• Privacy and security issues are manageable, but must be “by design” and take into account cloud context

• Key privacy and security differentiators of cloud deployment models

• Level of transparency, oversight, governance, and management of privacy and security controls


Cloud as an enabler

• The scalability and extensibility made possible by virtualization and service oriented architecture will be a critical success factors for coping with the proliferation of mobile devices and “apps”

• The pace of cloud adoption in health care is likely to quicken

• Financial constraints

• Demand for increased agility in response to social and mobile drivers


Health information is the context for delivering enhanced collaborative and coordinated care experiences.

Point of service systems and mobile devices are the platforms for effective social networking and new ways of work.

The health IT eco-system links people to their work and each other in new and unexpected ways.

Digital health infostructure as Software-as-a-Service in the cloud enables delivery of information and functionality to users and systems.

Nexus of forces in digital health

The forces of the Nexus are intertwined to create a user-driven ecosystem for digital health.


Questions?

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