Healthcare organizations have embraced cloud computing and storage for a variety of business and clinical systems, from financial tools to electronic health records to connected medical devices and healthcare applications.
But increasingly, organizations are looking to diversify with a multicloud approach — using a combination of private and public cloud services and infrastructure to store their caches of ever-expanding data.
Before taking that step, organizations must carefully weigh the costs, benefits and drawbacks of a multicloud approach and understand the architectural implications, says Susan Snedaker, director of IT infrastructure and operations at Arizona’s Tucson Medical Center, who’s also a certified information security manager, author and consultant.
Migration Challenges Must Be Addressed in a Multicloud Environment
The cost of a multicloud deployment is “significant,” she says, because it requires building an abstraction layer between an organization’s IT infrastructure and the cloud providers’ interfaces. “For some organizations, a multicloud solution makes a lot of sense. For others, it simply adds cost and complexity,” Snedaker says. “Be sure you’re moving to a multicloud solution for the right reasons and not just because it’s the latest buzz in healthcare IT.”
A multicloud architecture can also introduce security risks, Snedaker says. It requires solid planning and execution along with well-trained staff to carry out the work on an ongoing basis. “A solid multicloud strategy is a forever project. There is no set-it-and-forget-it mode,” she says.
Munzoor Shaikh, a director at West Monroe Partners who leads the consulting firm’s health systems practice, says that while a multicloud setup may come with risks, cloud providers generally deliver a high level of security. “There’s a lot of fear, still, about going to the cloud. I tell my clients, ‘You are way more secure when you go to the cloud’” using solutions such as Microsoft Azure, he says.
“Any kind of data center or any kind of cloud has way more professional-quality disaster recovery, business continuity and security,” he says. “Very few hospital IT departments can provide all three of those at a strong level.”
Improving IT Options with Multicloud Solutions
University Health Care (UHC) in Miami has migrated to a multicloud architecture in part due to concerns about the region’s weather. During a natural disaster such as a hurricane, keeping healthcare IT systems up and running even in the face of a power outage is crucial, says CIO Jose Bellas.
“If the internal network is unavailable but I have a connection to the internet and that resource is there, then, boom — I’m going to use that. It’s seamless, it’s transparent to the end user, and they stay up. Which will allow us, if there is a natural disaster, to open up at a different location, run the operations out of there, or work at another location — as long as they have an internet or cellular data connection. It just gives us that added flexibility,” Bellas says.
UHC uses Nutanix’s hyperconverged infrastructure platform, which combines networking, storage and computing into a single appliance. The company’s Enterprise Cloud OS software converges the full infrastructure stack to manage applications across server platforms and in the public cloud.
One of the crucial decisions that organizations must make when contemplating a multicloud strategy is what to keep on premises and what to host in the cloud. The answer depends on a variety of factors, including performance requirements that could be affected by latency in cloud services, and even how end-users interact with the system.
For example, latency issues related to cloud applications could add seconds to each transaction made through a hospital’s cafeteria and gift shop payment systems, Shaikh says. When those seconds start to pile up, customers may face serious delays.
The Power of Cloud Diversity
“You could take every single application — not just your EHR but everything that a hospital runs — and send it over to the cloud. But that is not the right thing to do,” Shaikh says.
In fact, it may be a good idea to host high-value applications — such as EHRs and data analytics — in separate clouds, he says.
“Data analytics has special needs,” Shaikh notes. “It’s not just storing data. It’s storing large amounts of data, ingesting large amounts of data, doing so very quickly with a lot of different capabilities.”
Resources are also a practical factor. “Depending on how fast we need to roll out the workload and whether we have the on-premises resources to run it, we’ll decide, ‘OK, maybe this workload needs to live in the cloud,’” Bellas says. “More often than not, it’s a necessity of what that workload is and how fast we need it and whether or not we can maintain it on-premises.”
Those calculations, along with the expertise to evaluate, design, implement, maintain and troubleshoot disparate systems from multiple vendors, are among the keys to a successful project, Snedaker says. “In many respects, a multicloud solution offers failover, high availability and traditional risk mitigation, and it introduces complexity, cost and new risks that must be evaluated,” she says.
The fact is, there’s no one-size-fits-all solution — nor is there a perfect one. Health IT leaders should plan and set expectations accordingly. “Organizations often view the cloud as a magic cure-all without downtime ever,” Snedaker says. “Yes, using various platforms provides fault tolerance. But swinging a function from one provider to another in a downtime scenario, for example, will involve additional downtime.”
For Bellas, the technology is more than a utility — it’s a business driver. “We’re really leveraging technology to make us more efficient, to make us better,” he says.