"In another industry, that maybe seems onerous or they may not be able to provide those as regularly, but because these guys are savvy in healthcare, our lawyers and the data people, anything that we ask, they weren't surprised at the request, and they had an approach to answer it,” Moroses says.
One place where the cloud and healthcare seem to have a natural fit is the build-out of health information exchanges. Cantrell says cloud computing makes image sharing in such an exchange much easier.
Likewise, Moroses says Continuum went live in January with a cloud-based HIE from Caradigm, the joint venture between GE and Microsoft.
"We didn't want to have to deal with the massive amounts of data and the complexities of integrating with every practice we brought on board,” says Moroses. "We wanted to focus on the use of the HIE and the use of the data, so it was really a strategic decision to say, ‘Okay, the things that are really most important to us are not the infrastructure nuts and bolts kind of stuff. That, we can just go to the cloud for. We can just rely on somebody else and pay a flat fee.' ”
Archiving in the cloud is also on Continuum's radar. "We're having conversations with people around the idea of putting images and long-term archive in the cloud, and that has some appeal to us, too, because as part of a medical record, it's a pretty dense element of data,” Moroses says. "Images are pretty large size, and for people to be able to access them anywhere and not have it really pulled across your network is appealing.”
Static storage media, such as DVDs or optical disks, have a lifespan. Pediatricians may have to keep images for 21 years, and even tape won't last that long, Moroses says. "Probably the safest thing is some kind of form of spinning disk that I can either mirror or have multiple copies. [of].”
Still, all three health systems are typical in that they continue to run their own data centers for storing their primary inpatient EMRs. A big reason: These systems were purchased so recently in the rush to attest for meaningful use, the institutions are still amortizing the cost of building and equipping these data centers with software licenses. "It is going to be a matter of finances as we look to do more migration,” Cantrell says. "One of the first things that we look at now, any time a new solution is approved for implementation, is [to] offer it through the cloud service offering through GNAX.”