The growth of technology has and will continue to bring in changes across various industries. And thanks to increasing need for automation, extra storage, more security, many businesses are encouraging the growth spurt and adopting it too.
And the healthcare industry is no exception.
As more and more healthcare companies start externalizing their IT needs, cloud-based storage is causing quite a stir. And what’s more, you can get on-demand computational services anytime, anywhere without having to worry about the security threats.
Cloud computing in Health Care:
Health care is one of the many sectors in which information is of vital importance. Amid the hundreds of machines whirring away saving lives along with the doctors and nurses, there is another important force that supports them i.e., cloud computing supporting the everyday operations.
For instance, if a patient complains about chest pains, then the doctor can pull up the required information quickly and the diagnosis can be made quite easy and also reduce costs for treatment. Cloud Computing needs from the healthcare industry drove $3.73 billion in healthcare spending on cloud services last year and will push that number nearly threefold to $9.48 billion by 2020.
But there are some considerations to be looked into before choosing a cloud vendor. Below are a few of them:
Security is one of the most critical concerns of any industry. Because the cloud (whether public or private) stores business’s critical data. The cloud provider should offer world-class data and access, infrastructure, and physical security, backup storage options in case of a crisis, anti-virus protection, and customizable security options. Data needs to be safe and the vendor needs to have systems as per the healthcare security and privacy regulations.
Few important certifications that should be looked into before opting a cloud provider are:
Information security management (ISO/IEC 27001 Certified)
ISO/IEC 27001 is an internationally acknowledged management system standard for information security. By implementing an information security management system compliant with ISO/IEC 27001 the vendor identifies and mitigates the risks related to handling sensitive and vital data.
PHI data safety (ISO/IEC 27018 Certified)
ISO/IEC 27018 relates to one of the most critical components of cloud privacy: the protection of personally identifiable information (PII). By implementing a system compliant with ISO/IEC 27018 the vendor mitigates the risks related to exposure of PII.
AWS: Amazon’s cloud security similar to the security offered in an on-premises data centers i.e., there are no IT equipment or maintenance costs. AWS Cloud enables a shared responsibility model i.e., AWS will manage the security of the cloud, while the client is responsible for managing the security on the cloud.
Azure: They provide multi-layered security across physical infrastructure, and operations with cybersecurity experts’ continuously monitoring the cloud assets.
Google Cloud: As a younger service than AWS and Azure, the security levels lie in between them. They have some amazing in-built security features like Cloud Security Command Center, Stackdriver Logging, and they offer the open-source Forseti for managing security configurations.
Health care teams need to have full awareness of the business’s compliance standards like government, patient regulations, data privacy, security laws, and other legal regulations. The vendor platform needs to help us meet compliance standards applicable to the health care and life sciences industry.
The client needs to be aware that when investing in a cloud provider they are investing in the technical infrastructure but also their staff and expertise. So the client needs to ensure compliance of hosted-data when moving over to the cloud.
Vendor systems consistent with privacy and security obligations under the HIPAA framework. The HIPPA safety rules consist of technical, administrative, and physical safeguards.
GDPR (Within Europe)
GDPR the general data protection rule applies to businesses to safeguard data of the citizens of the European countries. Healthcare institutions need to register for being GDPR compliant.
HITRUST is an attempt to help vendors better prove their security and to help covered entities streamline security and compliance reviews. HITRUST certification is a bonus to provide full data privacy to the vendors.
Readiness to execute a Business Associate Agreement
Simply put, BAA is a legal document signed by the health care provider and a contractor. It creates a liability bond between the two parties, satisfying the HIPPA regulations. It is ensured so that the cloud vendor is obligated to protect health information.
Signing a BAA will provide the customer with an edge as the cloud provider has to adhere to the HIPAA Breach Notification rule in case of any security breach incidents. Also, signing the BAA, the cloud vendor appropriately restricts permission to access the cloud.
AWS: Philips being one of the healthcare providers has availed AWS, thus we can say that there are compliance checks that are AWS does are compatible with health services.
Azure: With more than 90 compliance certifications, including over 50 specific to global regions and countries, Microsoft has been providing cloud compliance over various industries including healthcare.
Google Cloud: Google has support and certifications against the Personal Health Information Protection Act(Ontario), HIPAA, HITRUST CSF, thus proving Google’s compliance in health care.
Service Level Agreement (SLA)
Service Level Agreement is negotiated between the cloud vendor and the client regarding the performance of the cloud. The client has to formulate the SLA to get guaranteed services from the vendor. The 3 major components of SLA are service level objectives, remediation policies, and penalties/incentives related to these objectives, and exclusions.
SLA is vital to establish expectations with the Vendor on security, uptime, and support and the role of the vendor in case of any security breach. According to the HIMSS survey, two-thirds reported challenges such as lack of visibility of the operations, undisclosed costs, and customer service with their current cloud vendor.
It is imperative that the client has to carefully go through the SLA to avoid any unforeseen consequences in the future.
AWS: Amazon Elastic Cloud offers an annual uptime of 99.5% and Amazon Simple Storage Service has a monthly uptime of at least 99.9% for a billing cycle.
Azure: Microsoft Azure offers an uptime of 99.99%. Its high redundancy gives clients low downtime.
Google Cloud: Google Cloud Platform offers a monthly uptime of 99.95%.
There is no point in health care units adopting the cloud environments if they are not reliable and also flexible. Any cloud vendor to provide a high uptime, data backup options, and disaster recovery mechanisms. Moving to the cloud eliminates the need for investing in extra security and infrastructure.
The cloud vendor should be able to provide 24/7 online availability and operational support. They should successfully avert issues, solve critical situations, and reducing downtime. The client should look for a cloud vendor offering high availability and uptime.
No matter how good a cloud vendor is, downtime is inevitable. How effectively they manage disruptions and recover your data when a disaster strike is what defines the reliability of the vendor. Along with data security, their other responsibilities include backup storage and scheduling.
AWS: Provides a set of cloud-based disaster recovery services with Amazon S3 often used as a back-up. It is considered to be one of the best disaster management cloud. It also had no additional DR costs.
Azure: Azure also has one of the best disaster recovery management. It uses DRaaS (site recovery) with the Azure platform used as a back-up and has no additional DR costs.
Google Cloud: When compared to AWS and Azure, Google Cloud is less profound in disaster management. It doesn’t have its own disaster recovery tools and is outsourced. It can replicate storage to Google cloud storage using carrier interconnect or direct peering service.
While it should never be the single or most important factor, there’s no denying that cost will play a big role in choosing the cloud vendor.
Though investing in the cloud can be costly more often than not, it has many long-term economic benefits that cannot be ignored. Moving to the cloud eliminates the ongoing costs like IT infrastructure, data center, and other maintenance costs.
The best part about moving to the cloud is the client can start small and then go on to scale on-demand, making it flexible. Also, the clients only pay for what they use, eliminating the need for investing further.
Also, the client has to remember that a high price doesn’t always mean high quality and service, and vice versa. It is vital that the client has to look for only the best features of the cloud before investing in one.
AWS: Amazon works on the ‘pay-per-use’ basis, which can quite helpful for small businesses and startups.
Azure: Microsoft Azure also works on a ‘pay-per-use’ basis so the pricing depends on the resources you use. The client can reduce costs by deallocating some resources when not needed.
Google Cloud: Google has an open-source nature to provide a flexible cost structure.
Support is crucial to keep systems reliable and available. Does the provider have staff that is aware of HIPAA compliance? Do they have 24/7 customer support?
Though the question seems simple enough, make the cloud vendor spell out all support details in the SLA. The clients have to look for a vendor who can be prompt in doing things like alerting about outages, providing quick disaster services, etc.
AWS: AWS provides 24×7 access to customer service, reference documentation, white papers, and supports forms. There is a proprietory trusted advisor check and a personalized view of the health of AWS services and alerts when your resources are impacted. They provide 3 plans, namely developer, business and enterprises
Azure: Microsoft provides multiple support plans varying from basic to professional. Of course, the plans support changes based on the premiums we pay. You can find more about it here.
Google Cloud: Apart from the basic which is free support, google provides 2 types of paid support services and customer support which comes at a premium price.
Different cloud vendors have different tools to integrate with other services. If there is a specific service that is important for your business, then the vendor should have tools to integrate or at least support your service.
The client should be able to access the central console to self-monitor performance, availability, history, and other information. The cloud vendor should also be able to provide time and support to manage other IT needs of the client.
AWS: With a single amazon account you can manage the services from any supported browser. AWS’s management console can be accessed from a mobile application including services like cloud watch alarms, resources, and perform operational tasks.
Azure: Using the Microsoft azure unified console, you can build, manage, and monitor everything from simple web applications to complex cloud apps. Thus it is one centralized way to control all.
Google Cloud: For managing your google cloud services all you need is a single google account. Hence like all google has its own advantages.
Architecture and Migration Strategy:
Depending on the type of infrastructure, migrating the existing data to a new cloud is usually a tedious process. Health care teams should select the cloud vendor who is capable of detecting and handling issues that may arise during the migration of data.
Existing app architecture and the migration strategy also plays a role in deciding the cloud vendor. For instance, if the application is heavily invested in Microsoft universe it would be easier to integrate with Azure offerings and will reduce time to migrate to the cloud.
AWS: Varying from physical storage devices like a snowball that helps you migrate small business and snowmobile, large hardware storage loaded on a truck for big business to online migration, AWS is dealing with architecture and migration in a unique way.
Azure: Microsoft Azure has its own comprehensive approach to migrate your applications and data. You can migrate from Windows, Linux server to architecture to Azure Virtual Machines, VMware, SQL services, etc.
Google Cloud: Google’s proprietary program in migration, google cloud RAMP(Rapid Assessment and Migration Program help you gain insights into your current landscape and also provides an estimate of the total cost for migration and architecture.
Adopting cloud for managing your daily IT operations, storage, etc, are growing by the day. In fact, 90% of the companies are on the cloud with the United States being the most significant public cloud market with projected spending of $124.6 billion in 2019. Various industries including health care, they should choose a cloud vendor that is agile and can provide secure access to the health care workers.
Fission Labs is a technology company with over a decade of experience across various technologies like building customized web & mobile applications, providing world-class business solutions using AI and ML, helping businesses build bug-free and error-free software by providing testing services, help them make insightful decisions by analyzing the data, and they also provide high expertise in building and deploying high-end, customized cloud applications.