HealthLeaders: And then over on the far side is the public cloud, and putting your medical records on Amazon Web Services. I saw someone demo something last week that helped people do that by encrypting some of that before it gets put on the public cloud.
Fasano: It's moving in the right direction. I'd like to see it mature a bit more, and I'd love when the IT industry can come to me and give me the guarantees I'm looking for on protection and privacy and security. To the extent they're willing to do that, then that becomes an available option for us. We do use private clouds at Kaiser Permanente. They're broadly used across our institution. We love the technology, but we want to make sure that the security standard is to our expectations.
HealthLeaders: I do wonder, though, whether we're headed for some rough bumps in healthcare privacy and security, just because so many other industries—and you would know better than anybody coming from financial services—really thought that through very carefully before they deployed. In this rush to deploy with meaningful use, I'm not so sure that those steps are being taken in healthcare the way they were in financial services.
Fasano: You're probably not too far from the truth in some cases. Most organizations take very seriously the responsibility they have to protect people's privacy. That said, I can tell you that the steps necessary from the ground up to build secure data centers, to manage those centers in a particular way, so that they're always on in support of life-critical systems, and then to make sure they're truly secure, and that you're managing end-to-end the relationship between data at rest and data being used by anyone who has the right to use it, [are a] very complicated set of issues.
And they do require a high level of professionalism from an IT staff or a technology partner, that understands not only implications today, but can kind of forecast and is looking out into the future about the threats that we might experience, and is engineering their capabilities to really solve for those future threats.