This year marks the 10th anniversary of Genomics England and the 100,000 Genomes Project, which paved the way for a new era of genomic medicine. What may be little known is that cloud technology was instrumental to the success of the project
Each person’s genetic material is a large data set, equivalent in data to more than 100,000 photographs. When multiplied at a population level, analysis of these data requires computational and analytical capabilities that far exceed the possibilities of an individual computer. Cloud-based platforms host the research infrastructure needed to achieve the Genome Project’s ambitions. Today, similar platforms are increasingly being used to process molecular and genomic data rapidly and at scale. They make it possible to identify treatments that are suited to the unique genomic profile of an individual.
It’s not just diagnostics; there are many more applications of the cloud in healthcare under development. Complete data around a person’s health can be directly transformed into precision medicine and targeted treatment plans. This will be here quite soon.
Prof. Dr Torsten Haferlach, Munich Leukemia Laboratory
What is cloud technology?
The definition of cloud technology is somewhat elusive, but put simply, the cloud is an IT infrastructure delivered as a scalable and measured service, with a cloud service provider managing the underlying network infrastructure. The cloud makes it possible to pool, store and connect numerous types of data across multiple locations, giving all users access to a shared virtual space. Its applications are, in theory, endless.
Cloud technology can strengthen health systems
The fact that the cloud is a scalable service has a significant impact on the way hospitals and other healthcare settings purchase their IT services. Instead of multiple on-premises computers and computer servers, organisations can use IT services and computing on a metered and flexible basis in the cloud.
The service provider takes responsibility for reliable data storage and connectivity, including server maintenance and software updates. They also implement appropriate cybersecurity measures, which are embedded in the cloud infrastructure. Transitioning to cloud-based services requires an upfront investment, but over time, means a reduction in cost, as operational expenditure can be individually adjusted to a hospital’s changing needs.
The cloud can also help address the longstanding inefficiencies in healthcare that stem from the fragmentation of data and lack of coordination between providers. Electronic health records (EHRs), which are powered by cloud technology, allow for every encounter a person has had with a healthcare professional and all their health data to be centralised in a secure, virtual platform.
These records are accessible to all healthcare providers, preventing the risk of duplication and lost information and saving healthcare professionals time better spent caring for patients. Database queries at a hospital that transitioned to EHRs used to take a clinician 15–20 minutes, but now they only take 15–20 seconds. Cloud supported EHRs also have a significant impact on the quality of care, with adherence to clinical guidelines up by 30%, a fall in medication errors by 54% and adverse drug events by 36%.
The importance of system readiness
As with many innovations, securing appropriate, timely and sustainable integration of the cloud across the health ecosystem requires an understanding of potential barriers to this process and how these can be overcome. Implementation science, driven by systems thinking, is needed to ensure that all facets of a health system – including financing, workforce, and governing regulatory frameworks – are compatible with cloud technology.
Training is key to help the healthcare workforce understand the benefits and risks of using externally hosted IT services. This includes hospital IT specialists, data protection officers, administrative staff, and clinicians. At the same time, cloud service providers must maintain consistent, advanced cybersecurity requirements and uphold stringent data security standards to help mitigate known risks around data storage and sharing. As security is the shared responsibility of every user, workforce training is essential.
Health system leaders transitioning to the cloud should also be aware of system-level barriers, such as a lack of interoperability between data sets. The absence of standard definitions and methodologies for health data means different data systems often cannot ‘communicate with each other’, even within the same hospital, hindering the ability to pool any given data sets. Without the ability to compare and group data, it is often difficult or impossible to identify the trends and patterns behind better health, best practice care and health research.
Reuse of medical data leads to much more attention being given to data quality and how data are stored. Then the insight arrives about the enormous volumes of data that are actually out there and relate to health and health outcomes. Hospital administrators are asking, ‘How can we best construct our storage architecture?’ and ‘How can we efficiently interpret and understand all the data?’.
Prof. Pascal Verdonck, Ghent University, Belgian & European Association of Hospital Managers
The role of policymakers: driving a multistakeholder dialogue
Governments and health system decision-makers have a central role in ensuring the transition to the cloud is safe, efficient, equitable and always done in the best interests of people receiving care. Policymakers can support system readiness by ensuring that policy frameworks are adapted to reflect the growing role of cloud technology across health systems and research.
They can also help foster a multistakeholder dialogue that engages patient organisations, health professionals, health system leaders and cloud service providers. Such a collaborative approach will be needed to ensure this innovative technology delivers on its potential as a critical facilitator of more data-driven, efficient and person-centred healthcare for future generations.
Disclaimer
This article is based on a report developed by The Health Policy Partnership (HPP)
with support and funding from Amazon Web Services (AWS). HPP led the research and drafting, with input from the European Institute for Innovation through Health Data (i~HD) and insights received from expert contributors. Other than HPP and i~HD, none of the contributors to the report were remunerated for their time. HPP held editorial control over the final content.
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The Health Policy Partnership: Health system changes for the betterFounded by Ed Harding and Suzanne Wait in 2014, The Health Policy Partnership (HPP) is a specialist health policy consultancy that works with partners across the health spectrum to drive policy and health system changes.
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