Cloud Computing
Cloud Computing and Software as a Service (SaaS) are the hot topics in business? Do they carry the same weight in healthcare? You see some of this in grid computing initiatives but less so in clinical applications. Here are some examples of cloud computing in healthcare.
Acumen Solutions has been selected by The United States Department of Health & Human Services - Office of the National Coordinator for Health Information Technology to provide a cloud-computing customer relationship management and project management solution (i.e., Salesforce.com).
Rural US cloud application: Image Movement of Montana shares radiological data among 30 healthcare facilities.
European healthcare organizations have been slow to adopt cloud computing with only 6.5% indicating any plans to include data storage in the cloud. Read more in this Next Generation Healthcare article that reports on the findings of the Data Management Healthcheck 2010 survey,
Practice Fusion is a web-based EHR free to clinicians - at least the basic version. Salesforce.com is playing a role in the future of Practice Fusion's cloud computing initiative. Dr. Robert Rowley of The Healthcare Blog points out the data safety features that a cloud application such as Practice Fusion provides over an in-house data center (or for most small healthcare organizations a server in the closet).
TC3 Health is utilizing Amazon's S3, EC2, and SQS services in the cloud for claim processing. While not a real-time clinical application when we think of Healthcare IS/IT the system does require HIPAA compliance. TC3 Health kept the majority of protected health information (PHI) in-house and encrypted whatever data was sent to the cloud. Does that mean the PHI in-house is unencrypted?
Chillmark Research presented an assessment of personal health records (PHR) which are "in the cloud" for the most part. This slideshow dates to January 2009 but the trends haven't changed that much.
Rationale for Cloud Computing in Healthcare
Does the business case of cloud computing in healthcare make sense? Many of the arguments being made for personal health records is the foreign tourist scenario (e.g., SearchCloudComputing.com article). How often does this happen? What about the efficiency argument (e.g., outsourcing) such as made in a CMIO article? Will cloud computing remove the IT function from healthcare organizations or just its heavy computing services? What level of IT (and legal) expertise is needed to make the tradeoff between cloud computing and in-house data center? What arguments should we be using? I hope to explore these questions in the future.
Cloud computing healthcare related articles of interest from academia
TBD
Here is my article about the operational challenges for a healthcare grid computing system:
KING N (2008) Operational stakeholder relationships in the deployment of a data storage grid for clinical image backup and recovery. Communications of the Association for Information Systems 23(1), 1-16. (AIS eLibrary pdf -downloaded 291 times since October 2008)
Abstract: A data storage grid (DSG) is under development for a federation of clinical sites to provide a cost-effective backup and recovery solution for their clinical images. Geographic separation provides fault-tolerance against localized disasters. Pooling of storage resources across organizations utilizes economies of scale associated with storage area networks. However, the control and administration of a DSG is now spread across multiple organizations increasing the complexity of deployment. Socio-technical issues specific to a DSG arise as there are now multiple stakeholders linked together in a network of new relationships.
General Resources for Cloud Computing
Here are some interesting e-articles
* Cloud computing development for beginners
http://go.techtarget.com/r/11323349/4872572
* Securing data in the cloud
http://go.techtarget.com/r/11323350/4872572
* Want to build a private cloud?
http://go.techtarget.com/r/11323351/4872572
* Intrusion detection in a cloud computing environment
http://go.techtarget.com/r/11323352/4872572
Articles I've compiled for cloud computing (in genera)l to prepare a CaseIT 2010 team. I looked for a range of articles that described the basics of cloud computing but also the emerging issues. Daniela El Saghir wrote the notes here (numbers in parentheses refer to articles to the right). The notes will be organized shortly.
- DA: bandwidth expensive to send data to datacenters (1)
- DA: standardized API’s that would work across vendors (1)
- MATLAB and Mathematica apps on (1)
- Surge computing: where a private datacenter can temporarily overflow into a public cloud to support unexpected surges in workload. (1)
- DA: technical issue, gang scheduling (1)
- Improvements: be more flexible to adapt to unexpected workload and crashes (1)
- It’s better to outsource basic processes than to devote specialized IT resources and comps on them.(3)
- Automatically "farms out" work to other computers when there's an unusually high need for computer resources. (3)
- alleviate the response-time issues that come with peaks in demand (3)
- allows to pay for the results you need -- not for the cost of the technology it requires (3)
- organizations are still uncomfortable bearing the risks associated with consumer-like service models that involve turning over security, privacy, and data protection to an external service provider. (4)
- Storage is placed in close proximity to the access point, storing the data in the best location to optimize network performance; (4)
- Storage is protected in several ways, making it private, indestructible, resistant to denial of service, and able to withstand wide-scale disasters; (4)
- The storage is auto-managed, meaning diagnosis and repair must be completely automated and simultaneous with operations (i.e. self-healing and non-disruptive); (4)
- The system is able to ingest new hardware and software technologies as they become available; (4)
- Coherence of data is compulsory, i.e. copies of data that are spread throughout the network are consistent; (4)
- The underlying storage is dirt cheap to support this type of scale. (4)
- AD: Anywhere/anytime access to data; (4)
- AD: Improved reliability and security of data (relative to laptop storage); (4)
- AD: Wider access to free software supported by advertising; (4)
- AD: Software that’s up-to-date with less malware. (4)
- AD: Outsourcing of infrastructure maintenance; (4)
- Candidates include backup of remote desktops, file services, certain user application licenses, email most importantly, and a growing list of social networking and Web 2.0 applications. (4)
- NOTE: experiment and get understanding from low risk activities such as archiving.
- Power utilization efficiency and less power consumption (due to the elimination of UPSes) (6)
- Decrease cost of renting space and databases (7)
- Save money on IT support (7)
- Improve privacy (authentication, name password, auth format) (7)
- It’s the hosts reputation in hand, so he has no other choice than to provide the best security for the customers.(7)
- Haagen-Dazs uses cloud computing such as Salesforce.com to track the franchises and train employees (9)
- Microsoft’s Danger crashed lost all of T-mobiles customer information (11)
- The concept of cloud computing has gotten attention, since most people are worrying about Danger’s crash, which shows that they acknowledge that the old methods of running IT infrastructure is expensive and at a lower scale (11)
- The secondary processes such as running an email server would never reach its maximum quality and security and be fragile because the company wouldn’t focus on it, but will rather do t he minimum to get back to working and continue with the core activities (11)
- DA: Business leaders need to read the provider's privacy information and the terms of service. In some cases, providers have the right to read -- and make public -- information that is put in the cloud (12)
- DA: It is easier for the governments to check an organization’s information without having to ask the organization directly (12)
- Encrypting data that is put in the cloud might solve many of the data privacy issues. But on the down side, it might make it harder to access the data, Gellman said. (12)
- Companies need to analyze if the cloud server is providing them with the following security methods: PCI certified, encrypting, isolating and separating data, intrusion prevention and authentication, logging systems. (12)
- The executive branch is repeatedly taking the position that data stored in the cloud does not have the same assumptions of privacy and due process as does data stored in your own infrastructure. (13)
- Small companies can really benefit from cloud computing: using SaaS ERP/CRm systems to double or even triple their productivity without increasing their staffing/ fixed costs. (No IT departments or internal servers.) (14)
- Some new cloud computing servers: Google App Engine and Amazon Web Services (15)
- DA: high dependence on provide, in case hard to move to other (15)
- DA: Companies using CC may become homogenized and lose the competitive advantage from building their own custom systems. (15)
- Another source argues that it does not homogenize the companies using it. Because if we apply the CC on the processes we are not differentiating and then focus on building custom services more rapidly and cheaply on the existing cloud, it would maximize the performance of the business and improve productivity. (16)
- USA.gov has moved its website operations to cloud computing. It has found several advantages from this move such as avoiding idle server costs, responding to user’s requests in real time and applying security constraints. This helped in cost saving as well as capability improvements. (18)
- Cloud computing also helped CryoPort to improve communication and information transfer to its consumer hospitals. (18)
- Surveys showed that mid-sized firms were more informed about CC and were planning to use it while most of the small firms surveyed did not know what it was, and were not planning to use it (22,1)
- Small businesses worry more about how to keep their business operating and how to satisfy the employees and customers, thus they do not really think about CC. However it could help them in their invoice and billing system if integrated with their purchasing department (22,1)
- Small businesses do use CC like gmail and hotmail without knowing it’s a cloud (22, 1).
- AD: affordability of the CRM on the cloud compared to that of buying a hardware and CRM. (22,2)
- AD: it is elastic: resources can be provisioned and de-provisioned to meet the workload(22,2)
- DA: Utility: Resource usage is provided on a pay-as-you-go basis, as opposed to the traditional approach of incurring the upfront capital expenses and ongoing operational expenses, even if the resources are under-utilized. (22,2)
- DA: Ubiquity: Services from the cloud are available from the Web, enabling user interfaces that go beyond traditional workstations and include cell phones and other appliances. (22,2)
- CC helps small and medium-sized businesses who wish to completely outsource their data-center infrastructure, or large companies who wish to get peak load capacity without incurring the higher cost of building larger data centers internally. (24)
- Grid Computing may have sever DA such as high degree of failure since if one part of the software fails the others might fail, plus it may have large capital and operating expenses. (24)
- In a data grid, the amounts of distributed data must be large for maximum benefit. (24)
- Companies far away from the location of the cloud server may experience latency (24)
- It is important to test the cloud application on a pilot study to check for unexpected behavior (24)
- For security reasons, test how the host can recover certain data by asking for old data put in the cloud and check how long it takes it to recover them (24).
- Cloud computing may be found to be environmentally friendly. Energy is reduced for running and cooling the hardware, due to the reduced amount of hardware needed (24)
- CC promotes telecommuting techniques( reducing need for office space and furniture) as well as less carbon dioxide emissions resulted by not having to drive to work (24)
- When a host go out of business, will the data and information be moved to another host? (25)
- Cloud security should be better than the company’s own (25)
- Open Cloud Manifesto, an general agreement made by IBM and Cisco Systems that in case a cloud provider goes out of business, customer data can be portable to other provider. (25)
- The laws of data protection must conform with the laws at the customer’s location (25)
- Preferably the data must remain a cloud in the customer’s location.(25)
- Lawyers should write detailed contracts including guarantees with cloud providers (25)
1. www.hpcwire.com%2Ffeatures%2FBerkeley-Releases-Cloud-Computing-Study-39502692.html
3. www.ceridian.com%2Fpayroll_services_article%2F1%2C6266%2C15806-72379%2C00.html
4. http%3A%2F%2Fwikibon.org%2Fwiki%2Fv%2FCloud_computing%3A_Seeding_the_cloud
7. http%3A%2F%2Fcommunication.howstuffworks.com%2Fcloud-computing2.htm
10. http%3A%2F%2Fwww.danger.com%2Fplatform%2Fdetail.php
11. http%3A%2F%2Fnews.idg.no%2Fcw%2Fart.cfm%3Fid%3D597B5F80-1A64-6A71-CEF9E3A39682BA98
12. http://www.scmagazineus.com/Report-Privacy-issues-plague-cloud-computing/article/127727/
14. http%3A%2F%2Fericbrown.com%2Frisks-and-issues-in-cloud-computing.htm
15. http://www.fastforwardblog.com/2008/04/15/issues-that-cloud-the-cloud-computing-promise/
16. http://itblagger.wordpress.com/2008/04/17/does-the-cloud-lead-to-homogenised-enterprises/
17. http://www.fastforwardblog.com/2009/06/03/enterprise-20-soa-cloud-ten-fearless-predictions/
18. http://blogs.zdnet.com/forrester/?p=307 future of CC
19. Lean principles (process and management) associated with CC http://searchcio.techtarget.com/news/article/0,289142,sid182_gci1371423,00.html (?)
20. cost comparison of cloud services (a bit detailed but example of considerations one makes in trading off systems) http://mescal.imag.fr/membres/derrick.kondo/pubs/kondo_hcw09.pdf (?)
21. debate ongoing - build data center or go to cloud http://www.businessweek.com/technology/content/aug2009/tc2009087_879073.htm
22. why small businesses avoiding cloud (even though most to gain?) http://www.readwriteweb.com/enterprise/2009/02/survey-finds-small-businesses-clueless-about-cloud.php and http://www.focus.com/articles/crm/how-crm-and-cloud-computing-can-rescue-small-businesses/
23. someone download this report and share with us all https://secure.hosting.com/corporate/media-center/cloud-computing-report.aspx (?)
24. good for identifying technical issues http://www.ibm.com/developerworks/web/library/wa-cloudgrid/
25. liability http://searchcompliance.techtarget.com/news/article/0,289142,sid195_gci1356753,00.html
A new iPhone to be announced June 7th by Apple at its World Developer Conference. The iPhone 4G (likely) name will be using the iPhone 4 OS. Expected improvements over the iPhone 3GS including multi-tasking. Also expected is a front-facing camera for video chat and the new A4 processor.