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Health Care EMR & The Cloud

Healthcare, EMR and the Cloud

The Health Train Express exits the tunnel of meaningful use into the cloud.

The future for digitization of health records is cloudy.

This next decade will see a transition from client-server to solutions based in the cloud. The cloud is the virtual space located on a powerful server at a distant location.

It will facilitate adoption of more robust EMR applications and eventually serve as the ultimate health information exchange.

Rather than having expensive hardware and software at your office, requiring expensive maintenance and upgrades the applications and data are hosted at facilities designed as large enterprise secure sites.

Security is no more an issue than that for any present applications, and in most cases, better. 

Many physicians are uneasy with patient databases off site, and concerned with HIPAA regulations in their own offices. The burden for insuring security will be placed squarely upon vendors.

The likelihood of cloud computer solutions increasing for business and healthcare is increased as large enterprise hardware vendors such as Dell acquire ASAP software, Everdream (provider of SaaS software solutions and remote-service management), Network Storage Co., Exanet, Ocarina Networks,Boom (SaaS), Apple, and many others have invested in building or acquiring large data centers.

Hewlett Packard purchased EDS (Ross Perot) to form HP Enterprise Services, which in addition to large data centers has much experience in healthcare solutions for health plans, government health, and life sciences.A leader in healthcare solutions

HP is the largest provider of healthcare information technology (IT) services in the world,encompassing the health plan, provider, life sciences, and government healthcare segments. Their solutions bring together unmatched experience, proven capabilities, domain expertise and industry knowledge, strong applications know-how, and practical innovation.


In 2009 Apple acquired property in Maiden, NC and began to build out a 500,000 square foot 1 billion dollar data center.

The cloud is the last to arrive in the healthcare space and EMR in particular. Several years ago vendors began to offer ASP solutions which are similar to but less efficient that true cloud platforms.

Now clear weather in the EMR space will be replaced by clouds.

Other business spaces already use cloud solutions for many functions in CRM, Inventory, Process Management,

The functions, also known as SaaS (Software as a Service), are in operation and offered by Amazon, Amazon Web Services (AWS), and at the end of 2009 the largest ten companies in SaaS were: Tera, Netsuite,IBM,Joyent, VMware, Google, and Rackspace. And the winner is …..Amazon !

In 2010 Enomaly, GoGrid, and AT&T, and Microsoft Azure have emerged from the young additions to the cloud.

Competition in the cloud space involves the diversity of applications as well as response times. No one wants to sit and wait for a screen refresh while a patient sits in your examining room, or the receptionist and billers twiddle their thumbs (at your expense) waiting.

The basic robust hardware/software infrastructure is already present.

Health Train Predicts that it will take five years for this technology to evolve and mature. The overwhelming advantage of this computing power is affordability of advanced algorithms and solution analysis for diagnosis and treatment. EMR will approach the medical record with artificial intelligence .s It is green technology markedly reducing requirements for cooling, and energy for end users,

The feds, insurers, and CMS are doing the health system, doctors, patients, and ultimately the tax paying public a great disservice with pushing for meaningful use, premature incentives with unrealistic time frames that will cost us all in the long run.

For those us who have implemented a system, so be it.  Wait five  years, at which time your system will be obsolete, and you will be faced with  a major upgrade expense………consider a switch to the cloud……And for the rest of us, hold off, wait and do not be precipitated investing into already dated technology.  IT advisory panels have recommended that CMS modify stages II and III definitions for meaningful use.

The eHealth Initiative recently sent a comment letter to the Office of the National Coordinator for Health IT, expressing concern about the proposed timelines for Stage 2 of the meaningful use program, Health Data Management reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for incentive payments through Medicare and Medicaid.

The letter argues that the regulatory timeline included in the proposed criteria for Stage 2 provides "an inadequate amount of time for eligible hospitals to follow an implementation and testing schedule," adding, "A rushed process could potentially affect patient care."

The group did not explicitly ask for ONC to delay the start of Stage 2, but instead asked federal officials to "address the issue of inconsistent timelines" for regulations and the start of Stage 2

Additional Recommendations

In its comment letter, the eHealth Initiative also called for greater focus on health information exchange in Stage 2 of the meaningful use program. According to the group, the proposed Stage 2 requirements continue to focus on EHRs and do not give health care providers enough flexibility to use health data exchange to demonstrate meaningful use.

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In many cases users are already using cloud functionality, unknowingly with eRX prescribing via Surescripts either directly or via your EMR.

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