PACS Backed by the Cloud

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David FinnWhile cost reduction initially prompts many health-care organizations to investigate cloud computing, there is an even more compelling reason to use it. By making your internal IT resources available for projects needing immediate attention, you enhance your agility, according to “Cloud Computing: Taking It to the Next Level,” presented on February 21 in Orlando, Florida, at HIMSS11, the 2011 annual conference of the Healthcare Information and Management Systems Society.

David Finn, CISA, a former health-system CIO who is now health IT officer for Symantec (Mountain View, California), explains that a newly nimble, cloud-backed IT department can then support the organization during acquisitions, service-line expansions, and volume increases. Brian Comp, MBA, PMP, chief technology officer, information services, for Orlando Health in Florida, adds a real-world view of Orlando Health’s expectations for cloud storage.

While Finn and Comp both cite major cost savings for cloud users, they point out that increased agility should probably be ranked first among several additional benefits, even though its dollar value is difficult to quantify. Because the IT department can respond to unforeseen needs immediately, without the need to acquire more equipment or hire additional staff, the organization can take advantage of opportunities as they arise, with none of the delay that would be necessary if it had to wait for traditional, on-site IT support to be readied.

Cloud Basics

Finn says, “The cloud means different things to different people, and not all clouds are alike. Cloud is a term used to describe a very broad range of computing models and technologies, and with all that hype, there’s a certain amount of confusion. The cloud consists of scalable and elastic IT capabilities, provided as a service, using Internet technologies. Typically, these services are metered in a pay-as-you-go model.”

Finn adds that within the broader category of cloud services, three separate types are emerging: software, platform, and infrastructure. The first two are less typically applied in health care, but providing infrastructure in the cloud has become more common. He says, “Infrastructure as a service includes storage, servers, databases, archiving, and services of that nature. The specific technologies are less important. What makes it a cloud is the service. The potential for the cloud to transform the IT landscape is less about the technologies and more about the service.”

For example, Finn says, the elasticity of cloud services can allow an organization to purchase a chain of imaging centers, knowing that it can obtain immediate storage from the cloud-services provider for the centers’ data output, with no need to purchase additional archiving capacity of its own. Storage can be purchased as needed, from the operating (not capital) budget, with no time required to acquire and deploy on-site storage.

This kind of cloud storage is not the off-site deep archiving often used as part of disaster recovery plans in the past, with slow data retrieval unsuitable for immediate diagnostic use. Depending on the institution’s needs, cloud storage should be able to provide clinicians with images as quickly as the organization’s own data center can. Therefore, cloud storage can be used for PACS images and reports generated today, not just as a backup for older studies.

Cost Considerations

“Locating IT services in the cloud is big business,” Finn says, adding that US cloud computing is expected to be worth about $42 billion per year by 2012. The actual figure might be even higher by then; Finn says, “There was an uptick during the economic downturn because there are savings. By using cloud computing, organizations can tap into cost savings over traditional self-hosting models (with self-maintained infrastructure and software) and can enhance system performance.”

Obviously, cloud computing eliminates expenditures for hardware, maintenance, and software, but there are additional savings to be found in the form of reduced operating expenses, Finn says. It’s not necessary to hire staff for routine IT tasks, and the reduction in software licensing fees can be considerable. “A lot of cloud services are sold as a subscription, so the traditional model of paying capital dollars for licenses and then depreciating those is going to change,” he adds.

In comparing cloud-based and on-site storage costs, it is also necessary, according to Finn, to