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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
2
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
4 © 2013 Canada Health Infoway Inc.
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.
5 © 2013 Canada Health Infoway Inc.
Other examples of cloud enabled solutions
6 © 2013 Canada Health Infoway Inc.
Introduction of “Cloud Computing in Health”
7 © 2013 Canada Health Infoway Inc.
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
8 © 2013 Canada Health Infoway Inc.
Next: The three major components of cloud
1. Computing infrastructure
2. Three service models
3. Four deployment models
9 © 2013 Canada Health Infoway Inc.
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
10 © 2013 Canada Health Infoway Inc.
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)
11 © 2013 Canada Health Infoway Inc.
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
12 © 2013 Canada Health Infoway Inc.
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?
13 © 2013 Canada Health Infoway Inc.
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
14 © 2013 Canada Health Infoway Inc.
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
15 © 2013 Canada Health Infoway Inc.
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
16 © 2013 Canada Health Infoway Inc.
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
17 © 2013 Canada Health Infoway Inc.
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
18 © 2013 Canada Health Infoway Inc.
Key messages
• Cloud is one of the top three CIO technology priorities
• Cloud is becoming increasingly visible to the public and health care providers
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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
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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
21 © 2013 Canada Health Infoway Inc.
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
22 © 2013 Canada Health Infoway Inc.
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
23 © 2013 Canada Health Infoway Inc.
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.
24 © 2013 Canada Health Infoway Inc.
Questions?
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Website: www.infoway-inforoute.ca
ETG Resources: https://www.infoway-inforoute.ca/index.php/resources/technical-documents/emerging-technology
E-mail: [email protected]
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Thank you