April 2012
Ah, the cloud. It evokes images of an ethereal blue sky, within which floats a white fluffy ball of cotton. Then there’s cloud computing: Neither ethereal nor fluffy, it will likely soon be more ubiquitous than the personal computer.
There are two aspects to cloud computing: One is the data management side, where clients pay a monthly fee to rent storage space in the cloud for digital files; the other is the apps side, where a subscription service provides software from the cloud that previously would’ve been purchased and manually installed on each machine that needed to utilize that program.
Conventional wisdom seems to favor the cloud as the way of the future. In fact, IT research firm Gartner predicts the cloud will replace the PC as the center of users’ digital lives by 2014.
At this point, most of us who have used a computer have encountered some aspect of the cloud. For example, if you’ve ever utilized a Web-based email service, listened to music or streamed a movie over the Internet, you’ve most likely used the cloud. Downloaded an app to your smartphone? That’s the cloud at work.
Admittedly, I initially had difficulty wrapping my mind around the cloud and how it could be beneficial until I discussed the topic with some experts at a mobile health conference last year in Cambridge, Mass. I couldn’t understand how the cloud could conserve resources, such as power and space, until someone mentioned the term “multi-tenancy.”
Clients can share space and resources, allowing servers to run at full efficiency at or near capacity. The cloud will also serve to level the playing field and improve communication: All subscribers will automatically receive updates for their respective apps and programs, so that each will be running the latest version.
But the technology is not without its detractors.
“Cloud computing will never come to full fruition,” I overheard someone say at HIMSS12 (which was held Feb. 20-24 in Las Vegas).
I asked why.
“Because they are afraid of their own shadow,” he answered, implying that prospective client fears about how best to implement security protocols could be the cloud’s undoing.
Indeed, there are numerous concerns with the cloud environment, the possibility of security breaches and private data not remaining private certainly chief among them.
Right now, cloud computing is like the Wild West. On the positive side, the door to creativity is wide open, and those with good ideas and the foresight to implement them should be able to walk right through and be justly rewarded. On the negative side, rules and regulations will have to be implemented to maintain security and protect privacy. (Here, we already have a head start in healthcare IT, but it’s all about logistics and implementation.) History has shown us we can’t depend on companies to do the right thing, for they are beholden only to their shareholders.
Like the early days of the Internet, the advent of cloud computing makes this an exciting time for IT. It will be interesting to see what storms the cloud brings …
Written by Phil Colpas March 2012
Admittedly, the United States is not often painted in a favorable light where healthcare is concerned: In general, healthcare lags behind its business counterparts in many areas of technology; the U.S. is ranked 37th globally in healthcare, according to the New England Journal of Medicine; and though we continue to struggle with ICD-10 conversion, many other countries made the switch decades ago. Full compliance to ICD-10 remains federally mandated in the U.S. for Oct. 1, 2013, although there remains much debate over deadlines and logistics. Meanwhile, the first version of ICD-11 is slated to debut in 2015.
Accenture, a global management consulting, technology services and outsourcing company, recently released findings of a year-long study on the impact of technology across eight country health systems: Australia, Canada, England, France, Germany, Singapore, Spain and the U.S. Among the findings: More patients in the U.S. can access health records electronically than in most of the other countries; more U.S. doctors send prescriptions electronically to pharmacies than anywhere else in the world; and U.S. doctors increasingly share patient data outside their organization to improve disease management.
Good news, indeed. But can we really call ourselves healthcare IT adoption leaders when we’re still struggling with implementing ICD-10, a system that many other countries have been using for at least 10 years?
We’ve all heard the ICD-10 backlash: Deadlines are too tight; conversion will disrupt workflow and revenue; training coders is too costly and labor intensive. The American Medical Association recently sent a letter to Congress requesting that ICD-10 implementation be stopped and a more-appropriate replacement for ICD-9 be utilized.
As we were preparing to go to press, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that HHS intends to delay ICD-10. By how much wasn’t clear, although an announcement from Center for Medicare and Medicaid (CMS) is expected soon.
And lately, there have even been rumblings to leapfrog ICD-10 altogether and proceed directly to its successor. Not a good idea? Consider this:
If CMS does ask for a two-year delay to 2015, it may indeed make more sense to simply skip ICD-10 and move directly to ICD-11, which is slated for a 2015 release. Especially when you consider that if ICD-10 implementation proceeds, by the time it’s actually in place we’ll need to start considering the logistics of conversion to ICD-11. And if the goal of this implementation is improved efficiency, reduced cost and better healthcare, it doesn’t make sense to follow one costly, time-consuming sea change with another. If we’ve learned anything so far through this process and from the countries that preceded us, it’s that we don’t want to do it again. And certainly not right away.
Enjoy the issue.
