Parag Someshwar, Vice President of Engineering on Jun 28, 2016

    Accountable Care Organizations (ACOs), Patient-Centered Medical Homes (PCMH) and other value-based care models are demanding a more comprehensive view of patient information than ever before. With the right information in hand, it's possible to detect and treat health conditions at earlier stages, manage specific individual and population health, and utilize resources more efficiently.


    However, to manage patients under risk-sharing arrangements, providers need access to tools to make data integration, aggregation and management efficient. It's not possible to succeed when information is siloed-it must be combined, reconciled and cleansed to enable effective data-driven decisions that improve patient care and decrease healthcare costs.


    As the need for and generation of data increases, healthcare organizations are facing a data deluge. The sheer number of data sources and volume of data of varying types are staggering. Traditional technologies and data warehouses are unable to keep pace, and newer big data technologies come with their own challenges. With so much data to process, these technologies often cause hardware bottlenecks, requiring costly additional resources. With long IT procurement cycles and short equipment lifecycles, planning accurately to support the necessary IT infrastructure is more difficult than ever.


    Healthcare organizations know they need to manage large amounts of data in order to make better decisions regarding patient health. They also know that new big data technologies, such as Hadoop and NoSQL, are effective tools for working with huge amounts of data at high speeds - real-time and near-real-time - using features such as replication, horizontal scalability and high fault tolerance. So, what can healthcare organizations do to take advantage of new solutions while combating the many challenges?


    Look to the Cloud


    An attractive option for many organizations is hosting big data applications on public clouds, such as Amazon Web Services (AWS) or Microsoft Azure. Cloud support for data ingestion, computing, storage and analytics are specifically built for scale, making them extremely efficient for processing large volumes of data. In addition, critical infrastructure components are available as platform features. As a result, cloud customers do not need to concern themselves with individual machines or virtual machines (VMs), but rather only use the platform services as required.


    A key benefit of using a cloud solution is that the cloud vendor takes full responsibility for the underlying infrastructure and its maintenance to ensure availability and reliability. Cloud providers are also continuously upgrading their underlying infrastructure so that processor, storage and networking technology upgrades can be availed by their customers.


    On the software side, most cloud vendors also support the ability to upload data and run analytics, using technologies such as Hadoop. For example, the cloud can support traditional Hadoop ecosystem components, such as MapReduce, HDFS, HBase, Spark, Kafka, Storm, etc. This allows organizations to port their on-premise applications to the cloud and take advantage of the added reliability and availability.


    Another benefit of cloud systems is pricing flexibility, such as the pay-as-you-go option that allows organizations to pay per use. Other pricing features include the offer of lower pricing when commitments are made and marketplaces for trading capacity. Such flexibility can make cloud deployment more economical for healthcare organizations in the long run.


    An Eye on Privacy & Security


    With the large influx of patient data and the number of organizations who have suffered data breaches, cloud vendors have focused on assuring privacy and security kfor customer data. Most vendors are now willing to sign HIPAA Business Associate Agreements (or equivalent) with their healthcare customers. In addition, cloud environments now allow strong integration with existing enterprise authentication and authorization mechanisms. Servers and services on the cloud can be fenced off and connected to the enterprise network so that common policies can be applied where required.


    Some pointers for implementing a data strategy on the cloud:


    Identify the cloud provider: When it comes to public cloud, top vendors are highly reputable. As part of the selection process, organizations should assess the range of relevant services, their uptime and reliability, and price. Many times, organization's IT teams have pre-existing enterprise agreements and a cloud subscription may already be available as part of that.


    Choose platform services instead of infrastructure services: Platform services will allow healthcare organizations to focus on building their data-intensive applications instead of focusing on issues of maintenance and upkeep of the infrastructure. Services such as ingestion, computing, storage and databases are available on the platform provided by the cloud provider and choosing the same allows scalability and growth as needs increase.


    Check compliance: For PHI and PII use cases, use only those platform and infrastructure components for which the cloud vendor is willing to sign HIPAA Business Associate Agreements (or equivalent). Cloud vendors are continuously increasing the scope of their compliance across services, so always keep an eye on new announcements from vendors.


    Ensure business continuity: Make sure applications and services are deployed across multiple instances and data centers and even geographies (where appropriate) of the cloud vendor, and data and policies are replicated. Use cloud platform features to backup and restore data.


    Cloud Convergence

    As cloud computing becomes more standard, healthcare organizations have shown more willingness and confidence in choosing this approach, as evidenced in the latest IDC Health Insights report.


    As comfort levels with regards to security and compliance of cloud increase, barriers to adoption reduce. The report also states analytics spending is expected to grow and big data processing will become more important as means of data preparation and analysis.


    The convergence of cloud and big data technologies delivers exciting capabilities for healthcare organizations that enable effective, data-driven decisions, leading to improved patient care and decreased healthcare costs in today's value-based care environment.