By Mario Chao*

X Clinic is a small medical facility located in an inland city of the country. It has 20 beds and a strong focus on serving its clients, making it stand out in the local panorama for many years. They are recognized for their proximity, and proudly showcase their quality achievement awards. For a number of years they have been concentrating on the incorporation of information technologies, particularly Electronic Health Records, to improve and modernize patient care, but also because it is a requirement to maintain their accreditation. It is a huge challenge since they do not have an IT department, nor do they have large capital to invest in costly projects.

Hospital Y is a mid-sized medical facility located in the second most important city the country. It has a large portfolio of services and specialties, as well as the best healthcare technology in the city, thus preventing patients from traveling to the capital and capturing patients from neighboring cities. A few years ago they invested a large sum of money in computerizing the administrative processes, including billing, since this part was vital for the financial health of the institution. Nevertheless its clinical processes continue to be mainly paper-based, although the laboratory and the medical imaging are computerized. Its clinical staff is demanding a modern and computerized medical history and the expansion of digital channels to communicate with patients. It is a very economically sound institution but they fear that the technological transformation project will greatly jeopardize the investments of the coming years and most importantly, the functioning of its traditional processes, especially since the ​​IT department is 100% focused on day to day operations.

Hospital Z is an extremely prestigious medical facility within the country, and anytime the conversation turns to healthcare, its name inevitably comes up as one of the foremost references. To maintain this position they have kept a clear and constant commitment to information technologies, pioneering in investments in ERP systems, administrative systems, LIS, RIS, and in the Electronic Health Record. It has a strong IT department that has grown as the hospital has become increasingly computerized. Hospital administrators, however, are concerned about the growing challenge of incorporating technologies. It is no longer just about the more traditional systems, but that local competition requires more innovation to remain leaders, constant updates in technologies, incorporation of new personal computing devices used by their clinical specialists, as well as facilitating for their demanding patients that every possible interaction with the hospital and its specialists is done through digital channels. Not only do the IT bills skyrocket, but it also costs a lot of work and money to incorporate eHealth specialists, who are still very scarce in the country. The complexity of the infrastructure is exponentially increasing and it becomes increasingly difficult to control the uptime of the systems while ensuring IT security. The IT team is overstretched and cannot keep apace with the demands of the user areas. In short, the pressure to be always ahead makes for a frenetic pace in changes and incorporation of innovation, very different from just a few years ago. The hospital begins to wonder if developing and maintaining information systems with their own resources should be a central focus of their activity, or rather if it is time to start thinking about more innovative and modern technology management models.

X, Y, and Z are real examples that could well constitute profiles for the three common scenarios faced by different hospitals and clinics in any Latin American country, depending on their market segment (size, complexity, geographical location). The challenge of digital transformation is not an option, it is a requirement and a requirement by the users, the patients, the regulatory body, and in the long run, the market and the world in which we live.

Regardless of the specific context in which each hospital can be found, it would be worthwhile to understand, analyze and consider how Cloud computing technology can help all these hospitals to meet their current and future challenges.

Overall, we see a growing demand for health services in our region, determined by several factors, including economic growth, the aging of the population, and the increase of chronic degenerative diseases, to mention a few, which exert significant pressure upon operating and investment costs, resulting in the need to do more with less and make the most of existing resources. On the other hand, the patient expects the best for his or her health: the best results, the best treatments, simpler, more effective and safer ways of sharing information and interacting with caregivers. And insurers demand more effectiveness, a payment based on value and results of the clinical process, instead of a payment based on volume of activity.

In this context, hospitals need to be rethought as innovative, agile, efficient and modern organizations. To do this, they should think in digital terms and use Cloud computing technology as one of the key levers to their digital transformation. The Cloud offers significant benefits over systems developed and deployed in a traditional manner, advantages that are evident in three planes: operational, functional and economic.

Operational level

From the operational point of view, Cloud services allow you to consume computing resources based on real needs and quickly adjust computing capacities according to hospital demands. This flexibility and agility offer enormous benefits, since the infrastructure can scale as we incorporate new technologies, new applications, or new users to the existing ones, responding dynamically to what the operations need and paying only for what we actually consume. A clear example could be the Electronic Health Record solutions, such as ehCOS solution, where we can benefit from these advantages to grow in computing equipment (processing capacity, or storage) as the hospital really needs it. Another example are the medical imaging applications, which are huge consumers of storage space, but whose pace of demand we can also manage, avoiding acquisitions of expensive and oversized servers that end up becoming obsolete in no time.

Furthermore, Cloud services, contrary to popular belief, offer much better security and privacy for hospitals than keeping them in-house. Cloud service providers are constantly investing and acquiring the best technologies to protect their customers against attacks and threats of all kinds. Cloud services offer sophisticated control techniques, ranging from data encryption, access control, comprehensive logging, security analytics, and so on. Of course, given the scale with which these services are offered, Cloud providers have professional teams that are highly specialized in cybersecurity and which they capitalize on by providing services to multiple customers. However large and powerful they may be, hospitals have difficulty attracting and retaining staff with similar skills and performance.

By migrating applications to the Cloud, hospitals can operationally adjust supply and demand, be more responsive to user areas, simplify internal DPC, increase application and data security, and have more qualified staff for purely technical functions that are not their core-business, freeing up their IT team so they can perform value-added functions and accompany the business and/or technological innovation.

Functional Level

It is precisely the Cloud, due to its nature, that has triggered innovation in the sector. Numerous businesses have launched products and services that take advantage of the Cloud, simultaneously enhancing health data integration and interoperability capabilities, or massive and cost-efficient deployment of mobility solutions, or exploit the so-called Internet of Things (IoT). The Cloud enables opportunities across the entire value chain of a hospital, from the clinical to the administrative planes, front office or back office.

Specifically, the Cloud represents a unique opportunity for hospitals to acquire and use the Electronic Health Record in an intelligent way: the EHR as a Service. It is well known that the EHR is one of the key systems for any hospital, since it registers each patient encounter and stores all their medical history properly documented and easily accessible in real time. However, many hospitals that have developed their own EHR face the enormous challenge of constantly updating it, both functionally and technologically. In a Cloud scenario, the health records that take advantage of this model, such as ehCOS CLINIC v5, allow the hospital to benefit from innovation and constant investment by the technology provider, by paying a monthly subscription.

For hospitals that want to move from paper to electronic health records, a simple solution with core operational modules may be sufficient to start transitioning through this momentous change process, eliminating the stress of a radical change and a much riskier decision such as the acquisition of a new and complex system to be configured, managed and administered by the hospital itself. The Electronic Health Record solution in SaaS format enables progressive, modern and efficient technological adoption that is also economically viable for all.

Economical level

The economic aspect is precisely one of the greatest drivers of the adoption of Cloud technology in hospital settings around the world, and we are sure that it will also be a crucial element for the growth and consolidation of this model in Latin America. Hospitals benefit from the acquisition of key technologies and systems through monthly fees that are absorbed into operating expense, instead of the large investments that must be absorbed into CAPEX in the traditional acquisition models. Additionally, the operating costs of personnel to maintain solutions in the Cloud entail significant savings over the traditional mode of maintaining the technology in-house.

In summary, the healthcare industry in general, and the hospital setting in particular, is shifting towards a healthcare model that depends on and revolves around digital data and information, opening up ample spaces for innovation and disruptive models in the way that their processes and operational models are organized. Information technology plays a crucial role in achieving modern, sustainable and efficient hospital management. In that context, Cloud computing models and applications as a service will be key to achieving these goals.

*Global VP Healthcare.  everis America

Source: www.everis.com / ehcos.com