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Canada's Healthcare IT Infrastructure Forecast - Only Partly Cloudy

April 2012
Canadian Healthcare Network "Tech Tonic" Blog

By Tim Wilson

As government agencies cobble together a strategy for cloud adoption within Canada’s healthcare system, the primary challenges will be how to deal with the inevitable “hybridization” of IT infrastructure.

Which is to say, none of us in our lifetime will have a healthcare system that is running 100% off the cloud. Instead, we are going to have an IT infrastructure that will be a mix-and-match of installed systems and native, cloud-based infrastructure running off remote data centres.

When people discuss the security issues the system will face, we should keep in mind that the problem is not necessarily that the cloud is insecure, but more that the proliferation of integration points with legacy infrastructure can be a real headache.

In fact, having security and privacy policies driven from a central, cloud-based repository is a great idea. But that only takes us so far, because we then have agencies and hospitals with their own internal systems, which in turn require another set of protocols. This makes sense insofar as these institutions are also the owners of a lot of technology, and are working within their own mandates.

However, it also creates some fairly complex scenarios. And it makes it practically impossible for us to get to a “pure” cloud-based system, although in my opinion that would be most desirable.

As it stands, hospitals are investing in additional software to make sense of the complex systems they already have. One example is PatientKeeper, a physician portal that has mobile data capture abilities. Five Ontario hospitals, Huron Perth Healthcare Alliance (HPHA) and Alexandra Marine & General Hospital (AMGH), recently announced that they will deploy PatientKeeper’s Physician Portal, Mobile Clinical Results, and NoteWriter solutions.

What this means is that physicians can work “with information from systems across the hospital and community.” That’s good news, but of course one also hopes that the purchase decision was done with an eye to the cloud. As Canada rolls out more cloud-based infrastructure, it will be crucial that software solutions like PatientKeeper integrate, and do so easily, while also ensuring that security and privacy are top of mind.

That shouldn’t be a problem, given that together HPHA and AMGH serve a population of about 135,000 people, and PatientKeeper got the sale with a full understanding of the hospitals’ requirements. The beauty of web portals is that even if they are not technically cloud-based, they comply with technological standards that make integration fairly straightforward.

In fact, for both AMGH and HPHA the decision was part of a larger EHR strategy that included a clear sense of requirements for expanded automation. The idea is to expand workflows without ripping and replacing previous investments, and create a platform that is web-based and can work with the cloud, if need be.

Which is to say, the future of healthcare infrastructure in Canada will only be “partly cloudy,” but that isn’t necessarily a bad thing. In fact, as the years – and decades – progress, we may find that this hybrid infrastructure will have remarkable staying power.