Should healthcare abandon the cloud final

PowerPoint Presentation

Should Healthcare abandon the Cloud?Antonio Piraino, CTO, ScienceLogicwww.sciencelogic.com@antoniopiraino

Track: Mobile, Telecommunications/Unified TelecommunicationsExploiting the cloud through next generation managementAs more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services. Similarly, Good enough and available are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.In this session, organizations will learn how to exploit the opportunities presented by The Cloud by implementing successful Management systems that:Create contextual visualizations that are key to exploiting the depth of cloud resources and assist in Smart IT decision making.Accelerate productivity and business policy implementation though automation of operations and other manual workflows.Modernize IT operations management for optimized application performance that legacy tools cannot control.Manage IT workloads and applications that reside in Hybrid Cloud environments through a single pain of glass.Associate the cost of cloud use with best application deployment and use of cloud services.1

Why consider the cloud? Healthcare Success and Failure why has this happened?Considerations on day 1Considerations on day 2So do you abandon the cloud? Should Healthcare Abandon the Cloud?2

2013 ScienceLogic Inc. All rights reserved

Drivers of CloudLatest TechnologiesImproved PerformanceRetain Security and UptimeMore data analytics availableFundamental to business operationsMore RegulationGreater IT ComplexityMore Pressure on ITGreater Financial Containment

HIPAAICD-10EHR adoptionAccounting of DisclosuresFISMADisaster Recovery HITECH ActInternal GovernanceAuditabilityPerformance and availability demandsHybrid architecturesHA and high performance AppsConsumer, OSS, Bus Productivity AppsStaffing levelsHosted AppsReducing TCOLess CapexShrink OpexIT Unit costing, ChargebackIT spend ratiosProjections

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As far as total cost of ownership and return on investment go, Roy noted a key consideration when his company began looking at alternatives to its Oracle/Java system. The legacy app had a fixed-cost model, whereas Salesforce expenditures would increase as the company added users, customers and so forth. On paper, Salesforce was considerably more expensive than Oracle in AWPRx's cost comparison, largely because the infrastructure was already bought and paid for. Yet by Roy's math, his annualized cost with Salesforce -- including labor, licensing, servers, and such -- is actually less than half (47%) of what it was previously. A big chunk of that savings comes from reduced headcount -- his IT team went from eight people to five after the switch. Roy noted that three people -- expensive ones, at that -- is a "big deal" in a company of his size.

A long-overdue omnibus package that includes HIPAA modifications tops the list of regulations dealing with health data privacy and security issues that are pending for 2013.Also pending is an accounting of disclosures rule that, in early draft form, called for providing patients, upon request, with reports listing everyone who accessed their electronic health information. Plus, rules for Stage 3 of the HITECH Act electronic health record incentive program, which begins in 2016, are in development. Another much anticipated regulation is the accounting of disclosures rule. A notice of proposed rulemaking included a controversial requirement to provide patients, upon request, with reports listing everyone who accessed their electronic health information.next year will see continued development of rules spelling out requirements for Stage 3 of the HITECH Act electronic health record incentive program. For Stage 3, ONC will publish an updated meaningful use rule, spelling out requirements for how hospitals and physicians must use EHRs to earn additional incentives, as well as a software certification rule, outlining the required functions of EHR software that qualifies for the program.Some 25 countries use ICD-10 for reimbursement and resource allocation in their health system. All of these require further Digiiziation of records, agility, TCO, virtualziation of apps, greater IT efficiency

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Cloud Failures & Successes

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We all know about the famous healthcare.gov fiasco. However, what about its latest outage? HeathCare.gov is the front door to a system for registering for insurance and shopping for policies under the 2010 health care overhaul. Since launching on Oct. 1, it has been plagued by errors and long waits for service on the user interface side, and problems in delivering information to insurance carriers on the back end. This is the first reported outage related to a failure at a cloud provider. Impacted by Verizon Network component failure and Terremark faciltities.Healthcare and other sector failures. Too many tactical decisions, based on public clouds that simply will fail as with anyother datacenetr and IT group. You get what you pay for.Since Salesforce.com is hosted in the cloud, pharmaceutical reps can use the tool anywhere with Internet, or from their mobile device. Also, managers can instantly monitor activities in the field with robust reporting. The MDPHnet Project is the marriage of two software systems created by Harvard Medical Schools Department of Population Medicine (DPM). The first system, Electronic Support for Public Health System (ESP), is a disease surveillance software application that can extract and analyze data from electronic health record system for events of public health importance. Resides on Lincoln Peake Infratsructure.

Carpathia has a strong track record engineering and hosting healthcare-compliant systems for companies of all sizes and IT complexity, system integrators and small A8 businesses. Clients such as INRange Systems and Portal|Ascend Group rely on Carpathias healthcare compliance experience and expertise to ensure their information systems achieve and maintain healthcare compliance standards throughout the lifecycle of their systems.

In Sep 2013 Two of G2's clients in the Boston area, prescription management startup ZappRX Inc. and genome sequencing firm Courtagen Life Sciences, Inc., have signed on to use AWS' Elastic Compute Cloud (EC2) under G2's BAA.

AMAG pharmaceuticals: Then they discovered a small startup called CloudLock that proposed to do exactly what AMAG was looking for."We said, 'We'll pay you if you let us beta test your product. We'll give it a full run, and if it works, you will have solved ourcompany's problem.' They came in, met with us, spent whole day talking about all ourproblems -- a huge developmentsession. A month later, they came back said 'Here you go.' They hand-delivered their product, which we use religiously."McBride continues, "CloudLock gives us full control over every single document -- all 1.5 million documents in our GoogleDrive space. We use policy engines to report on keywords, who's doing what, who shared what with who. We know everything that happens to every single one of these docs from genesis to deprecation. Once they gave us that, we immediately commenced moving everyone to GoogleDrive."

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Enterprise Cloud VendorProvisioningOrchestrationMonitoringBillingSecurity1. Trusted PartnerFocus on Security & Compliancy?????2. Transparency & ControlEasy Access & Control?????3. Meeting KPIsKnow their Business?????4. Better ToolsTools that are monetizeable?????5. Strong ROICompelling time to Value?????6. Granular/meaningful SLAsService-oriented SLAs?????7. Orchestrating WorkflowsHolistic & Intuitive Portal?????8. PersonalizationCustomizable configurations?????9. Scalability & FlexibilityExtensible API?????10. Solutions OrientedMove away from IaaS selling?????

What Healthcare Enterprises are Looking for

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This is generally what the healthcare industry is looking for. Then breakign it down between day1 and day 2 operations comes next.5

Considerations on Day 1MigrationInvestment in Provisioning & Orchestration technologiesSecurityAssurance, IPS, IDS, encryption, etc.Regulatory (Privacy, Audits)ICD-10, EHR, DR, etc all demand better IT operationsAccessibilityOf Data, and differentiated by user.Governance parameters52% of Enterprises have no cloud strategy {Logicalis Australia, Aug 2013}50% have a private cloud and 46% use cloud in the form of SaaS72% believe the role of the CIO will change6


Considerations on Day 2Better VisibilityContextual per constituentLong term verifiability of ones cloud assetsMeeting KPIs & SLAsValidationMore Control Better toolsOperational OptimizationBest execution environmentCostChargeback and expenditureFuture-proofing7


How is your operations team doing?How is the integration? How long has it been?Whos working on it? Why is this so complicated?Where are my SLAs?So you launch a cloud service

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Not quite as cleanly as youd hoped it would be..If your constituents have to think about this for longer than a second, youve lost your attractionMeans More workload complexityMeans more challenges in meeting SLAsMeans more Cost without proactive management

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Traditional IT Management Systems 9Traditional IT management systems are threatenedMainframeClient / ServerMSP / Cloud

9Virtualization and Cloud Computing driving to Agile IT game changer. Technology drivers, economic drivers. Service Providers model extended to enterprise operations.

Exploiting the Cloud Requires a New Wayof ThinkingSo should you abandon the Cloud?

No the answer is in Hybrid cloud. Cloud is revolutionary, but you want an eviolutionary move to better, faster and smarter systems.What is better in the cloud vs your own IT systems?

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Bringing Efficiencies to the Architecture

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Bringing Efficiencies to Operations

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What makes us different?

Narrow in scopeHard to extend Non-integratedRequires manual correlationOld technology Loose integration between acquired productsRetrofitted for cloudRetrofitted for multi-tenancy Expensive to maintain

Point Tools

Big 4 Frameworks

Simple unified productFully Multi-TenantBreadth of CollectionHighly CustomizableDynamic DashboardsExtensible and OpenCommon Data ModelRapid Time to Value

Vendor Lock-in

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Good Enough not good enough

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As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services. Similarly, Good enough and available are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.

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Attestation Server Trust Architecture15Orchestrator/Scheduler(ex. CloudStack, OpenStack)PortalPolicy Engines (e.g. Hytrust)GRC(e.g. RSA)SIEM (e.g. ArcSight)RESTful API

Gather platform status (TCG,XML)Provide platform trust status for trusted pools, Compliance, etcMonitor display trust status (HTML5)

VMware vCenterESXi HostESXi Host

CUSTOMER BCUSTOMER AIntel TXT Based Attestation ServerAttestation Server

Privacy CA

ESXi HostESXi HostVMware vCenterAttestationHandler/CacheProvisioning+ AutomationMLE Whitelist ManagementCredential Management

= Attestation Server Componentshttpshttpsssl Citrix XenTrust Agent Linux/KVM Citrix XenTrust AgentTrust Agent


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Why are we moving toward Hybrid Cloud?16

Your MSP/CSP


As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services. Similarly, Good enough and available are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.Have been told by Enterprise customers they have to move to Windows 365 will stop Hosted office solutions. Large enterprise is telling you they have to do it.If you dont like the cloud irrespective you desktop will be in the cloud like it or not. MS will move you to the cloud like it or not. And you will end up in the Hybrid model and managing complexity is going to become pivotal.But you also have greater options Google and AWS for example.16

Managing Hybrid IT can be tricky

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Cloud Expectations Changing the Model

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As more businesses have become familiar with the core concepts of The Cloud, IT organizations are challenged to maintain a balance between their core IT environment and cloud services. Similarly, Good enough and available are no longer acceptable when it comes to running Cloud based applications as there is a new benchmark of expectations.

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Picking the Right CSP


How to pick the right vendor, and diminish your concerns?How to map the variety of monitoring and management technologies available, and the context for which they become relevant to various business needs and network architecture. Optimize your cloud management

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Noisy Neighbor Concerns with the Cloud20


The Noisey neighbor issue20

InstantTime to valueVisibilitySmart Actions & AutomationIntelligentDiscovery Application MappingContextual Quality of Service VisualizationIntegratedAll-in-OneTrue Multi-TenancyOpen Architecture

ScienceLogic Today21


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Next Generation Monitoring Platform

Cloud

Application

Virtualization

Compute

Network

Storage

Physical

Orchestration

ProvisioningService Desk

CRM

Billing

3rd Party

Assets

EventsAutomation

Service Levels

Reporting

Performance

Customer Portal

Intelligent Discovery & MonitoringInstant ManagementIntegratedDatastoreVia RESTfulAPI

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Monitoring the Entire Cloud Estate

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Open Extensibility

APM / DaaSTechnology ExtensionsCore Product ExtensionsConfig ManagementUnified CommunicationsNetwork Config MgtBig DataNetFlow / sFlowStorage / Server MgtService DeskSecurity / TrustVideo SchedulingNotification / RemoteMulti-tenant Datastore

INTELLIGENT MONITORING

Cloud

Application Virtualization

Compute

Network

Storage

Physical

SERVICE MANAGEMENT

Service Desk

Event Performance

Service Levels

Reporting

Customer Portal

Automation

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Antonio Piraino, CTOScienceLogic

For more information:

[email protected] @antoniopiraino

Anticipate performance issues in your cloud
