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    To Cloud or Not To Cloud

    shakespeareIs it time to take a look at your infrastructure?

    It’s nothing new that there is a migration to the “Cloud” for IT shops across a broad spectrum of industries. Healthcare is no exception. So should you go ahead and jump in because the CMIO, the CFO and other tech wannabees are pushing for it?

    Let’s face it, most of us IT types are loathe to let someone else take care of our servers. Even if we have a strong investment in VMware, letting the data center go to the public Cloud is kinda like, your daughter moving out for the first time (and yes they usually come back).

    Before you let the CFO kill your capital budget, or even if you are a champion of that approach yourself let me give you a little food for thought.

    Let’s talk about what a Cloud really is. A very practical definition is “on demand computing capacity”. That is to say, flexible application server processing and disk space capacity when you need it.  There are the following types:
    • Public cloud: where the assets are available from anywhere that is internet connected.
    • Private cloud:where the infrastructure is owned and controlled by the company and is not easily accessible to the rest of the world.
    • Virtual Private: Then there is, in my humble opinion, the only option to consider when thinking about moving to the “Cloud” and that is the virtual private cloud. This exists on any hosting company’s infrastructure and is only accessible through virtual private network (VPN) connections and your security infrastructure. This keeps all network traffic nicely encrypted and under your access controls.

    So you have to ask yourself, do we want to pay for the secure access portal from Amazon as well? Of course they can provide it and it’s totally feasible. The point is that instead of jumping totally into the Cloud pool, take a more measured approach and consider a hybrid solution. Those of you in the cloud already are most likely using the mixed approach and have realized that migrating some of your legacy applications isn’t so easy. Plus you likely already have a large investment in access control systems, firewalls, etc. do you just toss that? Don’t forget you will have to migrate all that as well if you go all in.

    Yes the server/disk space is cheap and you don’t have to maintain it. Yes, a lot of EHR’s and other healthcare related systems are SaaS based apps. Yes, there is no doubt there tons of advantages. But there are also a few things you need to consider before rushing off down that path:

    • Connectivity – how comfortable are you with the reliability of your network and the Internet connection. Do you have a dual homed auto fail over backup in place? If not then all the reliability advantage of Amazon’s redundant infrastructure are less meaningful.
    • Response times – nothing makes a physician more irate than wasting time waiting on a system to respond. Before you sign up for your EHR’s SaaS offering, do some research on response times, reliability and failover resources.
    • Customer service – are you confident that the vendor will provide app support and troubleshooting as good as or better than your own? What about Amazon, do you know what their customer response policy is?

    Please share with us what your organization decided or is thinking about when it comes to the cloud?

    Alan Baldwin is a versatile, solutions-driven IT professional with over 25 years’ experience in mission critical technology engineering, project management, security and administration. He holds a CISSP and PMP certification and has solid expertise in all aspects of IT project planning, business analysis, requirements gathering, system development life cycle, and stakeholder relationships.
    Alan is an innovative problem solver with the ability to quickly assess situations and implement cost-effective solutions. For the last ten years he has been working in the healthcare arena with extensive knowledge of clinical and financial datasets and the specialized needs for IT infrastructure, security and compliance issues.
    Alan lives outside of Nashville, Tennessee with his wife Virginia and enjoys working with wood and RV camping as hobbies.

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