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How the Cloud Can Address Infrastructure Issues in Healthcare

Technology

Nov 23, 2020 - 6 minutes read

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Objectivity Innovative leader in technologies

Our specialty is designing, delivering, and supporting IT solutions to help our clients succeed. We have an ethical framework that underpins everything we do. Our underlying philosophy is that every client engagement should result in a Win-Win and this is supported by our four values: People, Integrity, Excellence, and Agility. Our clients are at the heart of our business and we are proud to form long-lasting working relationships, the longest of which is 29 years. Our goal is to continue to grow our business whilst remaining true to the ethical framework and values on which we are founded.

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In our eBook on The Top 3 HCO Technology Challenges & How to Solve Them, we provided insights regarding the three most important issues that the healthcare industry has to face, identified by the Forrester report—The COVID-19 Technology Priority List For Healthcare Leaders. In this article, we’re going to touch on the fourth identified key problem—infrastructure.

The lack of good network connectivity and other issues related to the IT infrastructure are wellknown facts that became even more apparent during the pandemic. Currently, this sector is facing an immense demand for virtual visits, telemedicine and remote patient monitoring which makes the hardware issues even more critical. The lack of connectivity causes troubles with digitalising current workflows, makes accessing patients’ data more difficult, and limits patient engagement.

The 2019 Deloitte report ‘Closing the digital gap: Shaping the future of UK healthcare’ describes how HC professionals in the UK perceive their organisations’ level of readiness to adopt digital technologies. Circa three-fifths of survey respondents believed their organisations are prepared well or reasonably well. The staff in Northern Ireland felt the most confident, and in Wales the least. At the same time, workers in secondary care felt their organisations were the least prepared while those in primary care were the most optimistic. However, this survey was conducted before the COVID19 pandemic—now, the responses could be less favourable.

Let’s take a closer look at some of the issues and answer the questions below:

  1. How the cloud can alleviate the lack of infrastructure?
  2. How to approach security concerns?
  3. Can we rely on open source projects?
  4. How to deal with network issues in software solutions?
  5. How to start new IT projects?

Cloud as a Solution to Infrastructure Gaps

It’s advised to consider cloud as a replacement for legacy infrastructure. Its advantages include flexibility and scalability, meaning the infrastructure can be easily adjusted and extended according to organisations’ needs. In addition, areas such as disaster recovery, backup, availability or even security are all well supported in cloud solutions. Many organisations from multiple different domains have already decided to move to the cloud. In the UK, the National Health Service (NHS) went a step further, including the “public cloud first” principle in their Service Standard and the UK government is making it part of the Future of Healthcare initiative. Interoperability and open standards are at the heart of cloud solutions. This creates the possibility to use many programming languages and multiple approaches (from traditional applications to no-code systems). Countless companies offer such services for the healthcare domain. This is an area where the accepted interoperability standards are of great importance.

The pandemic created the need for multiple ad-hoc solutions. A large number of them are cloudbased as they can be easily implemented and, when they cease to be necessary, decommissioned. There’s no need to buy hardware if you’re dealing with a temporary problem. It’s a matter of a monthly fee for the cloud server’s rental. Being able to scale up and down whenever the organisation needs to is one of the cloud’s great benefits.

Use Proven Solutions to Take Care of Security

This may come as a surprise to many people, but the cloud is a great option in terms of data security. The top cloud providers (Microsoft, Amazon, and Google) made enormous investments into their cloud solutions. One of their goals was to ensure that their services adhere to proper security standards. Exposing unsecured crucial data in the cloud is, understandably, not allowed, thus there are standards and legislations such as HIPAA or GDPR to protect the data. In most countries, IT companies are required to pass certifications to prove they can securely deliver healthcare solutions in the cloud.

At the same time, security-related help comes from the cloud providers themselves. Microsoft spends over $1 billion on cybersecurity every year. An Azure (Microsoft cloud) subscription comes with security assistance. There is an automated service called Advisor that makes recommendations concerning the security of your infrastructure in Azure. It offers guidance each time you set up workloads or modify the configuration, by showing that there’s a specific threat to deal with.

Security Standards Are Open Source, Don’t Hesitate to Use Them

At first glance, using open source solutions to write code that secures IT systems might seem counterintuitive. Why would we want to show everyone how we try to protect ourselves? The open source community exposes the code to make sure that all the code is well tested and that there are no problems that could lead to information leaks.

The code is, in fact, open and it transparently shows the security mechanism in place, but the systems are protected by certificates and secret password keys, which aren’t visible in the OSS codebase. They parametrise each system setup. This data should be kept away in certificate vaults. When requesting a software solution, ask the IT supplier which security standards are going to be used and what’s their validity time. Some standards go out of use while still being open source. You should always pick the up to date, leading ones, and let your technology partner check them for you.

The Flexibility of Design to Address Limited Connectivity

Even though we are approaching the 5G era, it’s still common for patients and HCOs to complain about network quality or its cost. Cloud and other digital solutions bring countless benefits, but the connection availability might be a serious limitation for them. As mentioned above, this applies to both the HCOs’ as well as the patients’ settings. When designing software, it’s essential to apply a solution that will consider the availability and bandwidth of the network connection. In rural areas, we often have to deal with a poor connection, a complete lack of network coverage, or a connection that’s only available some of the time.

This issue may rule out an application which downloads megabytes of data or has to be online at specific hours, e.g. to attend live physio classes. Remember this when collecting requirements for your project. This is a quality attribute—depending on the application type, ensure that the app works on a small bandwidth network or with the connection that’s only available at random, limited times.

When a midwife wants to pull a given child’s health record, there needs to be a sufficient connection. In case of occasionally connected devices, the application can, for instance, collect the data before the midwife leaves the setting and starts the appointments. She will then have it downloaded and available even offline.

What about zero paper solutions? When designing software that covers an extensive process and a large population of users, don’t assume that everything can be done in the digital form. Leave the door open for paperwork, make sure that your solution is inclusive for all groups of patients.

Understand Your Needs with New IT Projects

Companies often forget to ask for specific quality attributes (or in other words, non-functional requirements, NFRs) when discussing a new software solution. This sin isn’t exclusive to the healthcare domain. It goes without saying that the application should be reliable, secure, and fast. However, these areas should always be discussed in detail and specified by exact numbers. If you fail to do so, it may leave too much room for interpretation and misunderstanding, which then results in a project that doesn’t meet stakeholders’ expectations. By default, IT suppliers should apply the current industry standards when it comes to processing speed, page loading times, and accessibility levels. However, during the solution design process, an important requirement for the infrastructure may be overlooked if it goes undiscussed.

When approaching a new IT project, ask the key stakeholders and users for participation in the initial phase. Jointly define the parameters of the solution. These parameters should be: required system performance, its interoperability needs, data access levels, decision auditing needs, etc. It’s important to look at them from today’s perspective but also to try to prepare for the future. As the recent increase in demand for telemedicine taught us, the future can come earlier than we originally expected.

About the Authors

Maciej Komorowski
Solution Architect

Solution Architect with over 20 years of experience working in software design and development of projects of all sizes. Technical project lead, Architect, Product Owner. Cloud practitioner with a strong interest in system integration and messaging scenarios.

Łukasz Mielczarek
Cross-Programme Business Analyst

Senior Business Analyst with over 15 years of experience in software development. He’s responsible for developing healthcare IT services at Objectivity.

Healthcare Ebook News Insights
Objectivity Innovative leader in technologies

Our specialty is designing, delivering, and supporting IT solutions to help our clients succeed. We have an ethical framework that underpins everything we do. Our underlying philosophy is that every client engagement should result in a Win-Win and this is supported by our four values: People, Integrity, Excellence, and Agility. Our clients are at the heart of our business and we are proud to form long-lasting working relationships, the longest of which is 29 years. Our goal is to continue to grow our business whilst remaining true to the ethical framework and values on which we are founded.

See all Objectivity's posts

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