Healthcare information technology follows the trends and fashions of ICT technologies. Today we are in the era of the cloud that has become the goal of public administration and health care. But are we really sure that this is the right way to contain costs and increase efficiency?
In order to answer this question, we must first examine the processes of the different care settings that make up the health system.
In the hospital environment many processes are critical, in particular those related to emergency/urgency (acceptance, triage, diagnostics, treatment), operating activity, resuscitation and intensive care.
The criticality concerns different application systems, some of which produce large amounts of data (e.g. PACS), as well as basic components such as the clinical repository (health dossier).
The processes of territorial assistance are less critical at the moment and less digitized than the hospital ones.
Imagine delivering all applications to the cloud appears a gamble for two main reasons:
- the current application park is generally not cloud- but web-based (there are also many systems still client-server). It is true that a web-based application can operate in the cloud but, in this case, we are talking about hosting, which is a remote server. Web-based applications do not allow you to take advantage of one of the main advantages of the cloud, namely scalability.
- there are systems that produce large amounts of data and that must interact with machinery and medical devices that are physically located in health care facilities. In theory, there is nothing that cannot be transferred to the cloud, but you must be equipped with high or very high-capacity connectivity.
There is also a further consideration to be made: the longer the IT infrastructure supply chain is “extended”, the greater is the possible “point of failure” which, in the case of the cloud, is internal and external to the healthcare facility.
The simplification of the cloud and the push towards it even by institutions and government agencies find unprepared health care companies and application providers, raising in both doubts and concerns.
Technologies such as edge computing or fog computing, which I will talk about in a future post, seem to be better suited to managing clinical processes in healthcare, moving to the cloud those that are less critical and applications that are truly cloud-based.
Technological fundamentalism is a risk that healthcare cannot afford!