Healthcare Process Improvement: Is the Future Cloud-Based?

Public clouds like Amazon Web Services (AWS) have matured to the point where they can pass the most rigorous compliance concerns and find efficiencies in healthcare process improvement. The companies that market them have also matured in their understanding of the business relationships required (such as a BAA for HIPAA) to support them.

For enterprises with large computing and data problems (such as genomics analysis) to solve, the economics can be as much as 1/10th the cost for comparable solutions with shorter ramp times. Coupled with the ability to apply scalable computing to those arbitrarily large data streams in both near real-time stream and batch modes, the message is clear.

The cloud isn’t just healthy. It is the future of healthcare.

Building large scale healthcare solutions with AWS

Offerings are now as wide as they are deep. This includes a large number of “big data” capabilities able to handle large input quantities in a variety of structured and unstructured formats from multiple sources including IoT devices, voice, imagery, manufacturing and lab equipment.

Not only is the “shared responsibility” model for compliance well understood and codified, but it has been tested many times over by organizations large and small. There is even a healthy market of value-added resellers providing templated services to simplify HIPAA compliance for startups and established companies alike.

Soon using the suite of AWS services, cloud architects can begin realizing large scale healthcare solutions with interconnected services that can be secured and scaled flexibly to manage healthcare process improvement.

The challenge? Selecting correctly from the multiple options available and knowing that you are trying to hit a moving target. The things you build to bridge gaps today will probably be rendered obsolete within the next year or be easily replaced by new services.

The state of AWS

Amazon Web Services (AWS) saw measurable growth in 2016. Amazon announced twenty major services spanning literally a thousand or so important features for new and past services Over the next few years, AWS is projecting that the total market size for cloud managed services (including partner delivered professional services, managed services and migration services) will grow to over $75 billion in the next few years.

As an engineering services provider, AWS is a solid investment. AWS itself netted $13 billion revenue in the trailing 12 months and 55% year-over-year growth. Those numbers are impressive, but the partner ecosystem around them is growing even faster. Many are reporting gross margins as high as 75%.

Now that cloud migrations (of databases in particular) are commonplace in the enterprise tier, “the cloud” has become mainstream. Even relative laggards like healthcare and public sector businesses are expected to grow rapidly in the coming year or two.

Leaning into healthcare process improvement

I attended my first AWS re:Invent 2016 in December. While I’ve been through basic certifications before and have used AWS in a variety of hosting situations as more than casual user for years, little prepared me for the onslaught of people, new products and in particular, the overwhelming representation of healthcare and life sciences at the conference.

AWS describes the foundational elements for cloud-related service providers as:

• Big data
• Dev/Ops
• Mobile
• IoT
• Security
• Cloud management

While most of the sessions I chose to attend leaned into healthcare process improvement, compliance, security, genomics or life sciences in general, I came away impressed by the sheer number of large biotechnology and pharma organizations that have already committed to the cloud. They are realizing dramatic reductions in the time and cost required to manage large datasets and compute farms for problems including genomics processing.

Related AWS re:Invent presentation videos:

• Continuous Compliance in the AWS Cloud (Merck)
• AWS Infrastructure for a Global Population Health Platform (Cerner)
• 20k in 20 Days – Agile Genomic Analysis (AstraZeneca)
• Case Study: Data-Heavy Healthcare: UPMCe’s Approach to Healthcare (UPMCe)
• Meet Requirements for Education, Healthcare & Public Safety (Claritas Genomics)
• Embracing DevSecOps (ClearDATA)

Compliance, security and integration

There is an important transformation occurring referred to as “continuous compliance.” Our tools have matured to the point where — just like with test automation or continuous integration — we can easily build systems that do the logging, monitoring and alerting needed to actively police compliance with rules established for securing cloud environments.

As demonstrated by presenters, AWS is well-equipped to handle healthcare process improvement, governance, compliance, security, HIPAA and the underlying cloud capabilities to support these. This approach to “DevSecOps” seems much easier to accomplish in AWS than it would be in proprietary data centers as the tools are already available and designed to work well together.

The cloud is not a fad or even cutting edge anymore – it is a reality that must be faced by enterprise businesses. In the coming year, architects and solution providers will have the opportunity to provide architectural, development, DevSecOps and testing services at an accelerating pace.