Healthcare information systems, high availability, and the cloud

Healthcare information systems, high availability, and the cloud

August 28, 2020
Jason Aw
By Jason Aw

Information is ultimately the lifeblood of any healthcare system. You know the forms it takes: Patient records, standard operating procedures, claims, PPE inventory levels. Yes, there are costly MRIs and surgical suites. There are frontline doctors and nurses (and even more people behind the front line), but even they are tethered to information: Their time needs to be scheduled and tracked; they need information about the next person they’re going to see; they add more information to the EHR. It’s all bits and bytes; it all needs to be captured, organized, and presented to the person who needs to perform the next action—whether that’s to save a life, process a claim, order supplies, or prepare a room for the next patient.

To say the least, it would be utter pandemonium if suddenly the information everyone needed were unavailable.

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Healthcare information systems consultants and healthcare information technology (IT) providers are well aware of the importance of information availability. Back in the day, when healthcare IT systems were built on-premises, the IT teams configured physically redundant systems, with one system standing on standby in a remote location. If an active system crashed, mechanisms were in place to fail over to the standby system, which could immediately provide continued access to critical information.

Today, though the cloud is becoming an increasingly attractive home for the deployment of healthcare technology. MEDITECH, to take but one example, is offering its entire Expanse electronic health record (EHR) system as a web-based system that lives in the cloud. For MEDITECH and its customers, offering its EHR system as a cloud-based solution can accelerate initial deployment, facilitate feature development, and optimize costs.

But healthcare IT departments need to take special precautions when deploying any critical IT solutions that will live in the cloud. The major cloud infrastructure providers—AWS, Azure, and Google—provide impressive infrastructure availability and durability guarantees, but those guarantees really are for infrastructure only. They can guarantee that at least one virtual machine (VM) in your infrastructure will be accessible and operating 99.99% of the time. That translates to less than an hour of downtime over the course of a year. If your critical EHR system is running on that infrastructure, that may sound like a level of vulnerability that you can live with—except that the infrastructure guarantee doesn’t guarantee the availability of your critical EHR system.

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