How Cloud Computing Can Reinvent Enterprise Imaging

While doctors and nurses are still the driving force behind delivering excellent care, technology is playing an increasingly important role. And it’s not just new devices or robotics that are disrupting healthcare. The evolution is being propelled by software and AI that are central to everything from EHRs for sharing patient information among providers, to systems that improve clinician efficiency and quality of care by speeding diagnosis and determining the best treatments.

To truly be able to deliver coordinated care and the best patient experience, however, the healthcare industry needs to overcome several challenges, the most prominent being full integration and interoperability of diverse systems to support data sharing. This is not an insignificant barrier, since many healthcare IT solutions operate as a single-function, dedicated system.

Hospitals realize they can’t continue on this same technology path. In a world that strives for efficiency, lower costs and better care, simply expanding ineffective legacy systems is foolhardy. Yet, hospitals remain hesitant to change, citing concerns about security, patient privacy and cost, when considering adoption of new cutting-edge solutions-such as cloud computing-that are widely and effectively used in virtually every other industry.

Clearing the air

When vendors advertise “cloud-based” offerings or hospitals are asked about “cloud” solutions, they aren’t typically referring to cloud native applications. Instead what they’re talking about is often remotely hosted servers that lack the benefit of horizontal scalability (load balancing) or vertical scalability (flexibility in the type of hardware used). In addition, access to these remotely hosted software solutions is typically achieved through VPNs, which negatively impact the performance of the software by limiting bandwidth.

Related article: Cloud Computing: Is It Right for Your Radiology Practice?

Cloud native applications, however, offer tremendous benefits, the most significant of which is requiring far fewer management updates than a hardware-based solution. These solutions also provide the necessary computing power to process data and can scale more easily to meet the needs of a growing enterprise. Other advantages of cloud solutions include:

• Scalable storage, which improves efficiency and enables easy, yet secure, access by clinicians
• Disaster recovery
• No capital outlay or ongoing service costs related to hardware procurement
• Ongoing maintenance and upgrades with little or no obsolescence
• Improved security profile to maintain HIPAA compliance, especially crucial in light of the millions of dollars of penalties already assessed in 2018.

Radiology claims first-mover advantages

Even though about 75% of imaging systems are still stand-alone-primarily used for image viewing, storage and distribution-radiology departments at many hospitals are taking the lead in cloud adoption for image management and access.

Many radiologists are evaluating flexible and cost-effective enterprise-wide solutions to address the limited scalability, storage capacity, computing power, and image distribution options common to legacy PACS systems. As part of this evaluation, forward-thinking radiology leaders are examining cloud solutions, since the software-as-a-service (SaaS) model requires minimal capital outlay. This helps protect both their initial, and long-term, investments.

Benefits of moving to the cloud far outweigh the risks of maintaining the status quo with silo-based solutions, particularly as value-based care-and value-based imaging-become the norm:

• Enhanced processing power – Inherent to the cloud is processing-on-demand. This enables radiologists to leverage solutions that speed interpretations, which is crucial as new technologies, like AI, gain widespread adoption. New imaging technologies often increase the number of images a radiologist must review, extending the read time per case and reducing radiologist productivity, as well as revenue. Cloud-based solutions-especially when combined with new image analysis applications enabled by AI, deep learning and predictive analytics -are helping radiologists quickly identify areas of concern, gain greater understanding of certain diseases, and accelerate diagnosis and treatment.
• Greater accessibility – Cloud-native image management solutions enable easier, more secure access to imaging studies, reports, results and other vital patient information. A cloud-native image management system can be accessible via a web browser or zero footprint viewer. From there, radiologists and other physicians will have a single source for patient information, and can follow patient progress regardless of their location. We believe this will significantly improve the continuum of care and response time to patients’ needs.
• Increased workflow, reduced spend – When implementing a cloud-native image management platform, hospitals don't have to buy or maintain hardware or redirect FTEs from an already overwhelmed IT staff. This helps prevent obsolescence and reduces both capital and operating expenditures. In addition, the processing power and scalability of the cloud enables radiologists to process images faster, with access to real-time advanced analytics. Improved collaboration via the cloud reduces the spend on burning and shipping CDs, a common complaint among enterprise managers. When you look at the cost to generate a single CD (as much as $15 each), combined with a 25% reading failure rate and the fact most PCs today do not have CD readers, using a web browser or zero footprint viewer makes the most sense. Finally, the speed at which radiologists and other healthcare professionals can do their job will ultimately increase patient throughput, improving the bottom line and return on investment.
• Heightened Security – There's a common assumption that patient data is more secure when kept on premises versus the cloud. Interestingly, of the nearly 4.5 million records exposed in breaches during the first half of 2018, none were cloud-based. Highly-visible malware attacks, ransomware, and the potential for nefarious behavior by accessing hardware are evidence that onsite systems are not foolproof. Cloud-native solutions offer significantly higher levels of security than onsite systems-from state-of-the-art data encryption to address patient privacy concerns and limit access to personally identifiable information, to the security experts employed by cloud providers to create as close to an iron-clad, secure environment as possible. This level of security cannot be matched by hospitals themselves, where only a handful of employees may be tasked with securing onsite systems as part of their broader IT responsibilities.
• Disaster recovery – Rather than having to physically back up all data and experience sometimes significant downtime in repopulating an onsite archive, cloud solutions can automatically replicate data, enabling complete redundancy and access to information 24/7. These capabilities are especially important in situations, like hurricanes and natural disasters that we’ve seen in recent years, most notably New Orleans, Houston, Florida, and North Carolina.

Many health system leaders remain hesitant to adopt new technologies, including cloud computing, because of the strict requirements designed to protect patient information and privacy in a highly regulated industry. However, much of the skepticism and initial fears about the cloud is simply perceived. The combination of cloud native applications with AI are helping hospitals drive greater efficiency, reduce costs, and increase data security across the entire organization.

Fabien Beckers is CEO and co-founder of Arterys, a medical imaging AI company building disruptive software for improved diagnoses and outcomes. He earned a PhD in Quantum Physics from the University of Cambridge and an MBA from Stanford University.