Cloud Enabled Healthcare Presented by: Ron Parker and Stanley Ratajczak Emerging Technology Group Canada Health Infoway Inc. May 28, 2013Copyright © 2013

Cloud Enabled Healthcare

Presented by:

Ron Parker and

Stanley RatajczakEmerging Technology Group

Canada Health Infoway Inc.

May 28, 2013Copyright © 2013 Canada Health Infoway

Opportunities and Considerations

2© 2013 Canada Health Infoway Inc.

Faculty/Presenter Disclosure

• Faculty: Ron Parker, Stan Ratajczak

• Relationships with commercial interests:• Nothing to disclose


DisclaimerThis webinar represents solely the views of Infoway.

It is intended to be informative only, and cannot be interpreted as providing any indication of Infoway’s present or future strategies or investment

criteria.

Infoway does not implicitly or explicitly endorse any particular technology or solution of any vendor or any other person, it does not guarantee the

reliability or any proposed results related to the use of such technology or solution, and this notwithstanding that reference may be made directly or

indirectly to any such technology or solution in this webinar.


Agenda

• Cloud Computing in Canadian Health Care• Introduce Cloud Computing• Describe its features• Illustrate relevance to health care• A possible scenario for use• Infoway key messages regarding cloud in health care• Cloud as an enabler of innovation and sustainable

transformation in health care


Examples of cloud enabled solutions


Introduction of “Cloud Computing in Health”• The first in the Emerging Technology white

paper series• Designed to address cloud computing from

a Canadian health care perspective• Intended to:

• Scope and provide insight on the potential applicability and utility for this technology

• Provide some context for business opportunities and challenges

• Suggest some possible approaches• Be a call-to-action for further focused

conversations on this topic


Next: The three major components of cloud

1. Computing infrastructure

2. Three service models

3. Four deployment models


First major component of cloud computing

1. Computing infrastructure (network, CPU, storage) that is “virtualized”, meaning:

• On demand and self-service• Broad network access• Resource pooling• Rapid elasticity• Measured service


Second major component of cloud computing

2. Three service models

• Cloud Software as a Service

• Cloud Platform as a Service

• Cloud Infrastructure as a Service


Third major component of cloud computing

3. Four deployment models

• Private cloud• Community cloud • Public cloud • Hybrid cloud


How do I know what model to use?• Each deployment model has different implications for use

in health care:• Degree of organizational control, transparency and accountability• Governance of cloud use and infostructure• Privacy and security of personal health information (PHI) manipulated

or held in the cloud• Capital expenditures versus operational expenditures• Complexity of managing multiple cloud service providers to delivery

highly available solutions


Possible use scenario

CommunityChronic Disease Mgmt

Care CollaborationCare Transition

e-ReferralScheduling

Health RegionHospital

Home Care LTC

PrivateOperational systems

Clinical systemsSpecialized apps

PublicReference Information

Clinical Decision Support

Social Apps(no PHI)

Clinics / FP


By the way: the EHRS Blueprint?


Can be seen as Software as a Service

Jurisdictional EHR

Infostructure


Cloud as an enabler

• The scalability and extensibility made possible by virtualization and service oriented architecture will be a critical success factors for coping with the proliferation of mobile devices and “apps”

• The pace of cloud adoption in health care is likely to quicken due to:• Financial constraints• Demand for increased agility in response to social and mobile drivers


Privacy and security considerations

• All computing models have similar set of privacy/IT security risks and requirements, such as authorized access to information and information resources (e.g., consent, RBAC), cloud computing is no different

• Privacy and security issues are manageable, but must be “by design” and take into account cloud context

• Key privacy and security differentiators of cloud deployment models • Level of transparency, oversight, governance, and management of

privacy and security controls


Generic privacy/IT security considerations• Governance

• Data custodial responsibilities and delegation • Potential externalization of oversight, accountability and compliance

• PHI aggregation/consolidation • Shared data storage and IT resources • Support for multi-tenancy business solutions

• Alignment of privacy/IT security requirements• Defining privacy/IT security requirements and safeguards for PHI prior

to choosing a cloud deployment model • Assessing levels of assurance of IT security mechanisms


Generic privacy/IT security considerations (cont’d) • Confidentiality and integrity

• End-to-end confidentiality and integrity, especially in multi-tenant contexts

• Auditing, monitoring, compliance • Data custodial responsibilities for auditing and monitoring • Independent third party audits and compliance

• Risk management frameworks• Appropriate risk management framework

− Privacy impact assessments− Threat risk assessments − Vulnerability assessments − Result and remediation plan transparency


Cloud as an enabler• IT security in the cloud (SaaS)

• Typically greenfield deployments • SaaS encryption • Federated Identity Management• Cloud-based authentication mechanisms • Consent directives management solutions• Enterprise mobile device and app management • Secure e-mail (i.e., Government of Canada community

cloud)

• Public clouds• Use of anonymous or de-identified data can allow for

− Big data analytics− Diagnosis options − Predictive analytics


Key assertions

• Privacy/IT security risks and requirements are similar across all computing models; cloud computing is no different

• Privacy and security issues are manageable, but must be “by design” and take into account data classification and cloud context

• Key privacy and security differentiators of cloud deployment models • Level of transparency, oversight, governance and management of

privacy and security controls


Key assertions• Use of public clouds for storing and accessing PHI requires

• Serious consideration of risks • End-to-end encryption and control over encryption keys

• Public clouds can provide value when de-identified data is used

• Many opportunities for cloud-based privacy/IT security solutions• Greenfield deployments • Must be interoperable with existing infrastructures


Key assertions

• There are many opportunities for use of cloud in health• Greenfield deployments in community settings or at program levels • A necessary computing model for e-referral, clinical decision support,

PHRs, chronic disease management and remote monitoring

• We need roadmaps and business cases to support the gradual migration of existing infostructures to private or community clouds and to determine how to deliver health care programs in a hybrid environment


Key messages

• Cloud and SaaS are enablers for: • Data anywhere • User anywhere • Use from any device • Access anytime

• This is well aligned with the five Rs of:• The Right information • About the Right client • Available to the Right person • In the Right place • At the Right time


Discussion & Questions?

Emerging Technology resource documents:https://www.infoway-inforoute.ca => resources => presentations => emerging-technology

https://www.infoway-inforoute.ca/

https://www.infoway-inforoute.ca/


Thank you

Documents

Cloud Enabled Healthcare Presented by: Ron Parker and Stanley Ratajczak Emerging Technology Group Canada Health Infoway Inc. May 28, 2013Copyright © 2013