Mihailo Kaplarevic is the Chief Research Information Officer at Children’s National Hospital in Washington, D.C.

Aug 31 2022

Children’s Hospitals Find Space to Grow Through the Cloud

Children’s hospitals are using cloud-based solutions to drive pediatric research and clinical innovation.

Computer scientists are familiar with Moore’s law, which refers to the observation that computer processing power doubles roughly every two years. To most people, that probably seems like an impressive rate of technological expansion. But ask Mihailo Kaplarevic for his thoughts on the subject and he tends to view it from a different perspective.

“Moore’s law is rather slow-paced compared with the exponential growth in data we’ve been seeing,” says Kaplarevic, chief research information officer at Children’s National Hospital in Washington, D.C.

Children’s National is a world leader in research and innovation for pediatric medicine. The clinical scientists at its Center for Genetic Medicine Research, for example, are studying everything from childhood brain cancers to congenital brittle-bone disorders.

“Our need for storage and computer power is almost unimaginable,” Kaplarevic says. “It’s just the nature of the beast when you’re trying to analyze huge amounts of data.”

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Until recently, Children’s National researchers got around their computational limitations either by working with preprocessed data or by breaking large data sets into smaller portions that their systems could digest. But today, Kaplarevic says, they’re taking a different approach, leveraging what he calls the “enormous horsepower and versatility” of the cloud.

Children’s National, primarily through its electronic health records system, has been a cloud user for many years, he adds, but it previously had only minimal access to the type of cloud-based platforms that could handle the demands of medical research. That changed in 2021, when it opened the Children’s National Research & Innovation Campus (RIC), a 160,000‑ square-foot property the organization has described as “an ecosystem that nurtures innovation from discovery to commercialization.”

Key to the work the medical scientists are doing at RIC are the support and cloud-computing tools they’re getting from a new strategic partner, Amazon Web Services.

EXPLORE: The future of healthcare in the public cloud.

Children’s National researchers have deployed AWS in various capacities for the better part of a decade, Kaplarevic says, but this new collaboration is different. “In terms of what they’re able to do now, it’s literally like the floodgates have been opened,” he says. “Now, they can look at data on a massive scale. There’s really no comparison.”

Today, Children’s National scientists have a scalable and secure “landing zone” in AWS that they can get to through their personal accounts, Kaplarevic says. “Within that space, they can store data, spin up servers or use different workflows and services. There are over 350 different configurations to choose from that can be used in a safe and compliant way.”

In a typical scenario, a researcher who identifies a use case for the cloud — perhaps a study of DNA nucleotides present in certain variations of a genetic disease — would log in, enter basic information about the project and ­submit a request to Kaplarevic’s office. His team would then assess the proposal to determine the optimal computational environment (local, cloud or hybrid).

“At that point,” Kaplarevic says, “we would be available to assist with a full range of research computational services. With complex data analyses, data lifecycle management, software and database development, we’re always there to work closely with researchers on achieving their goals.”

Cloud Deployments On the Rise at Children's Hospitals

Though the COVID-19 pandemic has made it clear how important it is to have healthcare tailored to children, that’s something that institutions like Children’s National have known for more than 200 years. Since the first children’s hospital was established in Paris in the early 1800s, these organizations have become ubiquitous worldwide. Today, the U.S. alone has an estimated 250 children’s hospitals.

Children’s hospitals have adapted in recent years to make the most of digital technologies. Striving for better information mobility, and in need of powerful tools that can help their providers glean actionable insights from medical data, many are turning to the cloud for solutions.

Healthcare IT leaders, including those at children’s hospitals, are “making strategic choices from an array of new technologies that offer to improve efficiency and patient outcomes through advanced digital healthcare models,” according to a report by the College of Healthcare Information Management Executives. Cloud deployments “are on the rise,” CHIME notes, “as organizations begin to outsource the most technical aspects of keeping data on-premises.”

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One such organization is Children’s Health of Orange County in California. CTO Adam Gold says CHOC is using cloud services, primarily through AWS and Microsoft Azure, for a variety of tasks, including internal application development and hosting; the hosting of certain Domain Name System servers; and the virtual desktop infrastructure environment used by the organization’s clinicians, which involves a number of cloud deployments designed to support CHOC’s clinical researchers.

Years ago, Gold says, “I had to worry about how much rack space I had available and how much power I had available. It was a constant robbing Peter to pay Paul to stand up systems.” Now, he’s using services such as VMware Cloud on AWS, and that’s changed his calculus significantly.

“We’ve moved into more of an OPEX model, which lets me roll some of those costs into an ongoing operating expense and still have visibility into everything,” he says.

At the end of the day, Gold adds, the cloud gives CHOC not only what it needs to grow, but also the resources it needs to deliver high-quality care. “It allows us to be a lot nimbler than we used to be, and to better serve our patients,” he says.

Making the Switch to Cloud to Improve Pediatric Care

In Missouri, Children’s Mercy Kansas City is also using the cloud to drive improvements in pediatric care, launching several cloud initiatives over the past decade or so. But none compare in size or importance to the project underway at its Genomic Medicine Center.

Part of the Children's Mercy Research Institute, the center is known as a national leader in genomic sequencing focused on rare and inherited pediatric diseases. For the first few years after it was established in 2015, its researchers found that CMRI’s onsite data center was perfectly adequate for the purposes of their work. Eventually, though, they faced the same limitations as their colleagues at D.C.’s Children’s National.

“You have to do very sophisticated computational analyses to make sense of the data generated in DNA sequencing,” says Mark Hoffman, chief research information officer at Children’s Mercy Kansas City. “As our data volume grew and the tests became more complex, we realized how difficult it was going to be to sustain and expand that locally managed environment.”

Mark Hoffman
As our data volume grew and the tests became more complex, we realized how difficult it was going to be to sustain and expand that locally managed environment.”

Mark Hoffman Chief Research Information Officer, Children’s Mercy Kansas City

The Children’s Mercy Kansas City researchers ultimately decided to shift the bulk of their workflows to Azure, a platform they plan to use with a variety of open-source and commercial sequence-analysis applications.

“The first phase of the transition is complete,” Hoffman says, adding that they moved more than 4 petabytes of data offsite and into the cloud. Now, they’ve begun running analyses in Azure and expect to shut down the onsite systems within the year.

As Hoffman looks ahead, he expects the cloud will provide Children’s Mercy Kansas City with countless advantages. There’s improved data storage and processing, of course, but there’s also less to maintain. “The care and feeding is much more straightforward,” he observes.

Finally, Hoffman says, when researchers are working in the cloud, collaboration is often easier and more effective: “As far as their ability to innovate and make discoveries that could really change children’s lives, I’d say they’re in a better position now than ever before.”

DISCOVER: How virtual care expands patient access and engagement in pediatrics.

Photography By Ryan Donnell

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