What a New Research Report Tells Us About Healthcare and the Cloud

Where Are Healthcare Organizations on Their Cloud Journeys?

Healthcare is not new to the cloud but, based on findings from the report, the industry still hasn’t reached cloud maturity. We asked healthcare IT leaders about business benefits their organization has received from the public cloud. Sixty-three percent agreed that greater reliability and recovery capabilities have been the biggest benefit. Greater accessibility of data and applications for remote users was the second most popular choice, with 56% seeing it as a benefit.

This is in stark contrast to benefits such as reduced total cost of ownership, flexible spending and scalability, which were each selected as benefits by approximately one-third of respondents.

I wasn’t shocked by these results. Targeting disaster recovery workloads for cloud migration is still a major trend in healthcare due to organizations being seen has high-value targets for ransomware. A successful attack can lead to extended down time and huge impacts to patient care and the business. CIOs and CTOs have to do everything they can to ensure that business operations can continue in the event of a disaster, whether that be a natural disaster or a ransomware attack.

READ MORE: Minimize turbulence in the modern cloud with a "cloud smart" strategy.

Electronic health record vendors such as Epic are also starting to offer limited recovery environments. That’s why it doesn’t shock me that disaster recovery is the first capability they’re targeting. That aligns with what we’re seeing.

It also doesn’t shock me that flexible spending isn’t one of the top benefits. With disaster recovery, there are definitive ways to save money. However, for production-level workloads there’s not going to be huge cost savings. In fact, it might even cost healthcare organizations a little more. The main question is: Is the increased cost worth the benefit?

Many organizations that are on the lower end of the cloud maturity curve are focused on cost because that’s the main reason they’re migrating to the cloud. They start with cost savings and disaster recovery. However, as organizations grow along the cloud maturity curve, other business drivers become more important than cost — not that cost isn’t important, but it stops being the top driver behind the decision-making process. Organizations start shifting toward flexibility and scalability as opposed to solely focusing on costs.

What this finding shows me is that the healthcare industry is still on the first half of the cloud maturity curve.

How Can Organizations Overcome Cloud Security Concerns?

Security is the top reason that healthcare IT leaders decide to keep an application on-premises instead of moving it to the public cloud. The research also found that security concerns were cited by 71% of healthcare IT leaders as the reason their organization moved its cloud applications back to on-premises.

This finding also is not surprising. There’s a lot related to security that healthcare organizations cannot fully control because they do not usually develop their own apps. Health systems typically are not custom developers. Organizations purchase apps that have been developed by somebody else, and then they run them. The inherent security of that application comes down to how the partner or vendor has designed it and is maintaining it. The same can be said for medical devices. These devices aren’t replaced often, meaning they may be running aged software if the vendor hasn’t updated it.

However, organizations that can shift some of those workloads to the cloud do start to see some benefits immediately. For example, take Windows Server 2012 or 2016. Microsoft has incentivized organizations to shift these older server operating systems onto the cloud by offering extended support. If that OS is left on-premises, then an organization can’t patch it because support has ended. But if the organization moves it into the cloud, it gets extended support, which means more patches for another year or two. That helps organizations improve that asset’s security even though it’s an earlier version.

Other ways to improve security in the cloud is to follow general security best practices such as the five pillars of zero trust. Ensure the organization has strong identity management, data governance and application management best practices in place. Regular security hygiene and patching should be a big focus in the cloud.

Network segmentation, another best practice, actually becomes easier in the cloud. When it comes to on-premises network segmentation, most healthcare organizations probably aren’t doing it. And if they are, they aren’t doing it well. However, due to the nature of cloud environments and Infrastructure as Code, network segmentation is easier in the cloud than it is on-premises.

If an organization wanted to implement microsegmentation on-premises, it would have to completely redesign its entire network. In the cloud, the organization has software to build out the infrastructure from scratch, meaning it can build those concepts in from the beginning.

EXPLORE: Empower innovation through stronger cloud security.

How Can Organizations Manage Cloud Environments Effectively?

According to the research report, 50% of all respondents across industries say they can manage their cloud environment very effectively. For the healthcare industry, only 43% of IT leaders say they can manage their cloud environment very effectively.

One reason that healthcare might be behind other industries is a lack of staffing. Many healthcare organizations — especially smaller, rural or nonprofit hospitals and health systems — can’t pay as much as organizations in other industries. While remote work has created a larger talent pool, that can hurt smaller organizations that can’t offer competitive salaries. As a result, many healthcare cloud positions can’t be filled easily, and the people who do have these skill sets tend to leave healthcare to work with large cloud vendors or in more competitive industries.

In addition, the number of full-time employees in IT is always under scrutiny from healthcare leadership. It represents a large percentage of an organization’s budget, but it’s not a revenue center. It is straight cost, which results in the IT team having to justify those expenses to the CFO. As costs rise across the board in healthcare, leadership begins to assess staffing levels. These challenges can have an impact on an organization’s ability to effectively manage the cloud.

However, to mitigate this issue, organizations can turn to a partner for managed services. A partner can help health systems manage the cloud more effectively at scale than the organization could do on its own.

It’s also crucial for organizations to focus on automation and Infrastructure as Code, as well as tying that back into the IT service management system. Doing so can make a difference in the IT team’s ability to move its staff up the stack. With cloud colocation, an organization can move away from lower-level staff work and instead offload those tasks onto somebody else via the cloud. This allows the organization’s staff to move up the stack toward the application level where they can be tied definitively to the overall healthcare business strategy.

LEARN MORE: How can healthcare use the cloud to its fullest potential?

How Can Healthcare Organizations Evolve Their Cloud Strategies?

Healthcare organizations are more likely than organizations in other industries to have moved workloads back on-premises after migrating them to the cloud. This finding from the report further emphasizes that healthcare is still early in the cloud maturity curve. Healthcare organizations are likely focused solely on cost, and the numbers also tell me that there was probably something wrong with their overarching journey into the cloud.

A successful cloud journey and program start with strategy. The organization should know why and how it is migrating to the cloud and managing those cloud workflows. There should also be an appropriate level of understanding about the cloud among internal stakeholders — from executives all the way to the technical team. The strategy should include a roadmap and governance.

When I heard this statement about healthcare moving workloads back on-premises, it made me think the organizations probably started their cloud journeys solely focused on the technical aspects of cloud migration, rather than the business aspects. It’s likely that they tried to start moving workloads to the cloud indiscriminately, leading to cloud bloat. They likely didn’t take the time to truly understand the architecture of their applications and rationalize them to make them as efficient as possible in the cloud.

The idea of “cloud first” was a tactic to get organizations to start working in the cloud. Now, the focus is on “cloud smart,” which emphasizes moving to the cloud effectively in a way that makes sense for each organization. Sticking with a 1-to-1 approach to cloud migration can create inefficiencies and high costs.

A normal application has several tiers, including app servers, web servers and database services. If all of those are running on-premises today, then it’s likely that the organization overprovisioned every server. It probably asked for way too much storage. If an organization takes a lift-and-shift approach to that application, it will be overpaying for storage in the cloud as well.

If instead the organization takes a rightsized approach and minimizes resources, then those costs will be optimized. It’s crucial that IT teams consider each application individually, as well as how their applications talk to each other. That’s another area in which most organizations have failed. They pick a single workload to move, but they forget that it’s integrated with 10 other systems. That can create more network costs going back and forth.

How Can CDW Help Healthcare Organizations Navigate the Cloud?

Working with a qualified technology partner such as CDW can help healthcare organizations better navigate their cloud journeys and manage workloads once they’re in the cloud. We’ve structured our program based on all of the challenges that we’ve seen across the industry.

We have a definitive cloud strategy and roadmap engagement. First, we start with a conversation about vision and business goals. Then we take a high-level look at the existing environment before moving on to building up the cloud infrastructure — building the core landing zones, getting the basic shared-services ready and undergoing application discovery and rationalization.

CDW can also help with programmatic aspects of the cloud migration, including governance, creating a cloud center of excellence and staffing. How do you upskill your staff? We look at all of that as a holistic, overarching program rather than one piece at a time. Finally, we align everything with those business drivers to help the healthcare organization achieve its vision.

This article is part of HealthTech’s MonITor blog series.