The ViVE conference this week brought together the leadership of CHIME and the digital marketplace of HLTH to create a technology event focused on the business of healthcare systems. 

An important discussion I had between 3 health system CIOs was around how cloud computing has increasingly become important in how applications and infrastructure decisions are made to support the clinical and business goals of their organizations. 

Let’s start with a definition. Microsoft defines cloud computing as “the delivery of computing services —including servers, storage, databases, networking, software, analytics, and intelligence—over the Internet (‘the cloud’).” Three essential goals of cloud computing are to offer faster innovation, flexible resources, and economies of scale compared to computing services that run and are maintained locally, or as many say, “on-premise” within an enterprise. 

The most common categories of cloud services provided today are:

  1. Infrastructure as a Service (IaaS)
  2. Platform as a Service (PaaS)
  3. Software as a Service (SaaS)

Examples of IaaS are Microsoft Azure and Amazon’s AWS. Examples of popular SaaS solutions are Zoom, Slack, Dropbox, and Salesforce CRM. Healthcare SaaS solutions span clinical communication and collaboration (CC&C) platforms, telehealth solutions, digital cloud fax, digital document and signature and many other essential applications for provider and care team workflows.

The days of managing infrastructure data centers and telecom as a core job function are over. The next generation of CIOs must recognize that                                       –           David Chou, CIO 

How to Get Started

One common mistake that the group shared was in the developing of a portfolio of use cases. Individually, these use cases can generate some benefits, but collectively they lack the scale to generate the full potential value.

The Learning: Pursue a Clear and Focused Use Case

A business case for cloud should be grounded in a clear understanding of cloud economics across cost savings (rejuvenate) and business acceleration (innovate). It should be adjusted to transformation risks and prioritized by business domain, and it should include the required resource allocations and sequencing tasks. For example, the business-innovation case for a payer can refresh its analytical underwriting models twice as fast on public cloud as on traditional on-premise infrastructure should calculate both the improvements in return on investment and the value of freeing up capacity for additional innovation. Although the details will vary by organization, finding a holistic, focused business case can help gain agreement across functions and build organizational momentum to hit targets sooner than later

Adopt agile, Cloud-Native Ways of Working

All 3 healthcare CIOs in the discussion at ViVE agreed the cloud was important, but outside of the usual value statements of cloud, including cost savings and agility, downtime and resiliency were added value features not typically they have heard to be part of the cloud value statements.

The scope of the change needed to harness cloud requires companies to have real expertise: leaders, staff, and partners with deep experience in cloud and cloud transformations; expert practitioners; and a broad ecosystem. Further, successful cloud efforts are possible only when organizations transform their operations. Adopting rapid iterative cycles, policies that embed security into development, and end-to-end process automation with API-based services to provision workloads securely and resiliently on cloud platforms.

The acceleration in digital engendered by COVID-19 is likely to continue far beyond the COVID crisis, and companies must be prepared to respond and adapt rapidly. Cloud can help companies move fast and redirect quickly with reduced cost and a supportive platform for partner and internal development.

Brenda Hopkins MBA, BSN, RN is the Chief Health Information Officer and CEO of Healthcare Disruptors where she is focused on strategy, interoperability, and usability of healthcare offerings. Her experience includes clinical and technology transformation and leadership roles in healthcare systems and partner organizations.


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