Welcome!

Microservices Expo Authors: Liz McMillan, Pat Romanski, Karthick Viswanathan, Elizabeth White, Mehdi Daoudi

Related Topics: @CloudExpo, Java IoT, Microservices Expo, Containers Expo Blog, Agile Computing, @BigDataExpo

@CloudExpo: Article

Healthcare IT and the Cloud

Moving healthcare data into a Cloud Ecosytem

Over the last few weeks I've been hearing a lot of discussion around HIPAA. When we speak about HIPAA, invariably the two components of data security and data privacy arises.

In the traditional data centers, database managers and data owners know where their data resides and implement the necessary processes to preserve privacy and audit access.

However, when we move to the cloud, the cloud being all about data, we are looking at servers, network, and storage that are abstracted. This raises concern that data owners may not necessarily know where their data sets physically reside and we are looking at Cloud Service Provider (CSP) employees who will be handling confidential patient data or Personally Identifiable Information (PII).

Of importance here is that when it comes to leveraging the cloud ecosystem for healthcare segments, the foremost concerns are around HIPAA and the  HITECH Act compliance capabilities and meaningful use provisions.

So what is meaningful use? According to HealthIT.gov

"Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria."

The goal of meaningful use is to promote the spread of Electronic Health Records (EHR) to improve health care in the United States.

Benefits of meaningful use of EHRs include:

  • Complete and accurate information.
  • Better access to information.
  • Patient empowerment.

In the healthcare world, organizations are positioning to attain meaningful use. This to capture the incentives allocated by the Federal Government as well as to ensure that reimbursements do not face jeopardy for providers not in line with the meaningful use provisions.

As healthcare practitioners and organizations increase the use of technology solutions in delivering clinical care, their IT departments are faced with additional stress to provide availability on demand and operate data center approaching 99.999 percent availability. In most cases this is a major challenge that can lead to the risk of unscheduled outages and costly solutions.

Assuring high availability for healthcare applications, means meeting uptime requirements; and in today's environments will require access to more than one data center. This can significantly impact the overall capital investment in data center infrastructure for healthcare organizations.

Looking to the cloud as a solution is not only the next step in services but will ensure high availability of clinical applications. This will allow a healthcare organization to leverage the expertise and financial stability of an established CSP. Another advantage of leveraging a cloud ecosystem, is that of rapid provisioning and deployment, with the ability to change compute capacity as demand changes.

Thus in the event of failure, server instances can be seamlessly moved to alternate hosts or in anticipation can be clustered to provide redundancy.

Some may ask whether it is risky to transfer data from site to cloud. The answer is no as a majority of organizations move data over the Internet via encryption channels. Where we can see concerns arising is with the hand-off of data into the (CSP) environment.

In a seamless environment all data will have site to site encryption up to and including storage. Where we can see some separation is with healthcare application vendors support.

In the cloud, it is a given that we can have a number of people with access to the physical servers and storage that cloud consumers have no control over. For an IT Security person this will elicit conflicting concerns as on one hand there is the presupposition that complete control is being relinquished which can only be assured with prescriptive precautions defined by a CSP.

The cloud computing ecosystem is still evolving and as such there is still a lack of industry-wide certifications. As we mature within this ecosystem the intent is to drive toward processes, best practices and certifications which would provide legal protection that can reduce the complexities of a long negotiation and complex SLA requirements.

Within a regular data center or even a small IT shop, as an IT Security leader one of my first expectation for any shop is some form of centralized logging with automation. Similarly by transferring such a mindset into the cloud ecosystem (they are after datacenters) any healthcare customer security leaders expect the assurance that detailed reporting is a given.

Having worked on the security strategy and assessment separately for a few cloud computing projects I have seen first-hand, that access rights was a major focus. In light of this, it is not a complex process to segment solutions for healthcare. As a result any access to servers and storage dedicated to a healthcare customer by anyone within a CSP organization will be logged and thus can provide the assurance of controls around access.

From a legal perspective, more specifically talking contracts, healthcare customers expect the provisions of strong financial penalties to indemnify against a breech as well as to hold the CSP accountable.

Some CSPs are moving to providing a HIPAA Business Associate Agreement (BAA) for their healthcare customers. The assurance provided by their BAA demonstrates meeting the compliance requirements (enabling the physical, technical, and administrative safeguards required) of the HIPAA and the HITECH Acts.

In closing, I will state that HIPPA compliance and cloud computing do not have to be in conflict. Rather healthcare entities can leverage the benefits of the cloud, coupled with the necessary due diligence and legal contracts to meet their needs.

More Stories By Jon Shende

Jon RG Shende is an executive with over 18 years of industry experience. He commenced his career, in the medical arena, then moved into the Oil and Gas environment where he was introduced to SCADA and network technologies,also becoming certified in Industrial Pump and Valve repairs. Jon gained global experience over his career working within several verticals to include pharma, medical sales and marketing services as well as within the technology services environment, eventually becoming the youngest VP of an international enterprise. He is a graduate of the University of Oxford, holds a Masters certificate in Business Administration, as well as an MSc in IT Security, specializing in Computer Crime and Forensics with a thesis on security in the Cloud. Jon, well versed with the technology startup and mid sized venture ecosystems, has contributed at the C and Senior Director level for former clients. As an IT Security Executive, Jon has experience with Virtualization,Strategy, Governance,Risk Management, Continuity and Compliance. He was an early adopter of web-services, web-based tools and successfully beta tested a remote assistance and support software for a major telecom. Within the realm of sales, marketing and business development, Jon earned commendations for turnaround strategies within the services and pharma industry. For one pharma contract he was responsibe for bringing low performing districts up to number 1 rankings for consecutive quarters; as well as outperforming quotas from 125% up to 314%. Part of this was achieved by working closely with sales and marketing teams to ensure message and product placement were on point. Professionally he is a Fellow of the BCS Chartered Institute for IT, an HITRUST Certified CSF Practitioner and holds the CITP and CRISC certifications.Jon Shende currently works as a Senior Director for a CSP. A recognised thought Leader, Jon has been invited to speak for the SANs Institute, has spoken at Cloud Expo in New York as well as sat on a panel at Cloud Expo Santa Clara, and has been an Ernst and Young CPE conference speaker. His personal blog is located at http://jonshende.blogspot.com/view/magazine "We are what we repeatedly do. Excellence, therefore, is not an act, but a habit."

@MicroservicesExpo Stories
Most of the time there is a lot of work involved to move to the cloud, and most of that isn't really related to AWS or Azure or Google Cloud. Before we talk about public cloud vendors and DevOps tools, there are usually several technical and non-technical challenges that are connected to it and that every company needs to solve to move to the cloud. In his session at 21st Cloud Expo, Stefano Bellasio, CEO and founder of Cloud Academy Inc., will discuss what the tools, disciplines, and cultural...
With the rise of DevOps, containers are at the brink of becoming a pervasive technology in Enterprise IT to accelerate application delivery for the business. When it comes to adopting containers in the enterprise, security is the highest adoption barrier. Is your organization ready to address the security risks with containers for your DevOps environment? In his session at @DevOpsSummit at 21st Cloud Expo, Chris Van Tuin, Chief Technologist, NA West at Red Hat, will discuss: The top security r...
These days, APIs have become an integral part of the digital transformation journey for all enterprises. Every digital innovation story is connected to APIs . But have you ever pondered over to know what are the source of these APIs? Let me explain - APIs sources can be varied, internal or external, solving different purposes, but mostly categorized into the following two categories. Data lakes is a term used to represent disconnected but relevant data that are used by various business units wit...
Today most companies are adopting or evaluating container technology - Docker in particular - to speed up application deployment, drive down cost, ease management and make application delivery more flexible overall. As with most new architectures, this dream takes significant work to become a reality. Even when you do get your application componentized enough and packaged properly, there are still challenges for DevOps teams to making the shift to continuous delivery and achieving that reducti...
21st International Cloud Expo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, will feature technical sessions from a rock star conference faculty and the leading industry players in the world. Cloud computing is now being embraced by a majority of enterprises of all sizes. Yesterday's debate about public vs. private has transformed into the reality of hybrid cloud: a recent survey shows that 74% of enterprises have a hybrid cloud strategy. Me...
"NetApp's vision is how we help organizations manage data - delivering the right data in the right place, in the right time, to the people who need it, and doing it agnostic to what the platform is," explained Josh Atwell, Developer Advocate for NetApp, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
The “Digital Era” is forcing us to engage with new methods to build, operate and maintain applications. This transformation also implies an evolution to more and more intelligent applications to better engage with the customers, while creating significant market differentiators. In both cases, the cloud has become a key enabler to embrace this digital revolution. So, moving to the cloud is no longer the question; the new questions are HOW and WHEN. To make this equation even more complex, most ...
Many organizations adopt DevOps to reduce cycle times and deliver software faster; some take on DevOps to drive higher quality and better end-user experience; others look to DevOps for a clearer line-of-sight to customers to drive better business impacts. In truth, these three foundations go together. In this power panel at @DevOpsSummit 21st Cloud Expo, moderated by DevOps Conference Co-Chair Andi Mann, industry experts will discuss how leading organizations build application success from all...
‘Trend’ is a pretty common business term, but its definition tends to vary by industry. In performance monitoring, trend, or trend shift, is a key metric that is used to indicate change. Change is inevitable. Today’s websites must frequently update and change to keep up with competition and attract new users, but such changes can have a negative impact on the user experience if not managed properly. The dynamic nature of the Internet makes it necessary to constantly monitor different metrics. O...
Many organizations are now looking to DevOps maturity models to gauge their DevOps adoption and compare their maturity to their peers. However, as enterprise organizations rush to adopt DevOps, moving past experimentation to embrace it at scale, they are in danger of falling into the trap that they have fallen into time and time again. Unfortunately, we've seen this movie before, and we know how it ends: badly.
Agile has finally jumped the technology shark, expanding outside the software world. Enterprises are now increasingly adopting Agile practices across their organizations in order to successfully navigate the disruptive waters that threaten to drown them. In our quest for establishing change as a core competency in our organizations, this business-centric notion of Agile is an essential component of Agile Digital Transformation. In the years since the publication of the Agile Manifesto, the conn...
The last two years has seen discussions about cloud computing evolve from the public / private / hybrid split to the reality that most enterprises will be creating a complex, multi-cloud strategy. Companies are wary of committing all of their resources to a single cloud, and instead are choosing to spread the risk – and the benefits – of cloud computing across multiple providers and internal infrastructures, as they follow their business needs. Will this approach be successful? How large is the ...
Enterprises are moving to the cloud faster than most of us in security expected. CIOs are going from 0 to 100 in cloud adoption and leaving security teams in the dust. Once cloud is part of an enterprise stack, it’s unclear who has responsibility for the protection of applications, services, and data. When cloud breaches occur, whether active compromise or a publicly accessible database, the blame must fall on both service providers and users. In his session at 21st Cloud Expo, Ben Johnson, C...
The nature of the technology business is forward-thinking. It focuses on the future and what’s coming next. Innovations and creativity in our world of software development strive to improve the status quo and increase customer satisfaction through speed and increased connectivity. Yet, while it's exciting to see enterprises embrace new ways of thinking and advance their processes with cutting edge technology, it rarely happens rapidly or even simultaneously across all industries.
One of the biggest challenges with adopting a DevOps mentality is: new applications are easily adapted to cloud-native, microservice-based, or containerized architectures - they can be built for them - but old applications need complex refactoring. On the other hand, these new technologies can require relearning or adapting new, oftentimes more complex, methodologies and tools to be ready for production. In his general session at @DevOpsSummit at 20th Cloud Expo, Chris Brown, Solutions Marketi...
Leading companies, from the Global Fortune 500 to the smallest companies, are adopting hybrid cloud as the path to business advantage. Hybrid cloud depends on cloud services and on-premises infrastructure working in unison. Successful implementations require new levels of data mobility, enabled by an automated and seamless flow across on-premises and cloud resources. In his general session at 21st Cloud Expo, Greg Tevis, an IBM Storage Software Technical Strategist and Customer Solution Architec...
Today companies are looking to achieve cloud-first digital agility to reduce time-to-market, optimize utilization of resources, and rapidly deliver disruptive business solutions. However, leveraging the benefits of cloud deployments can be complicated for companies with extensive legacy computing environments. In his session at 21st Cloud Expo, Craig Sproule, founder and CEO of Metavine, will outline the challenges enterprises face in migrating legacy solutions to the cloud. He will also prese...
DevOps at Cloud Expo – being held October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real r...
You know you need the cloud, but you’re hesitant to simply dump everything at Amazon since you know that not all workloads are suitable for cloud. You know that you want the kind of ease of use and scalability that you get with public cloud, but your applications are architected in a way that makes the public cloud a non-starter. You’re looking at private cloud solutions based on hyperconverged infrastructure, but you’re concerned with the limits inherent in those technologies.
As DevOps methodologies expand their reach across the enterprise, organizations face the daunting challenge of adapting related cloud strategies to ensure optimal alignment, from managing complexity to ensuring proper governance. How can culture, automation, legacy apps and even budget be reexamined to enable this ongoing shift within the modern software factory?