"So they don't really do the setting up of the hardware, the application, or supporting that anymore. We actually get that service through the cloud offering that GNAX provides.”
One such niche system being served up in the cloud is Emory's cardiology images, Cantrell says. "We actually acquired two new hospitals that have their own systems that we're in the process of consolidating and moving to the Emory Healthcare systems,” she says. "We need to be able to store these images in a secured location and not have to do a lot of up-front investment for hardware. The cloud offering allows us to do a subscription-based approach, so we're using operating dollars instead of the capital dollars that are so hard to come by these days.”
Some software controlling Baxter infusion pumps is now being provided via software as a service. Cantrell says migrating these types of applications over to the cloud has realized Emory a 30% savings by avoiding unneeded hardware, hardware maintenance, and related infrastructure components.
Sheer speed of deployment is driving many hospitals to implement their ambulatory medical records via software as a service. Three years ago, Continuum Health Partners—a New York City–based system with seven major facilities, 2,180 certified beds, and an annual operating budget of $2.8 billion—selected eClinicalWorks as its ambulatory EMR.
"We really didn't want to expand our internal staff organization to the degree necessary to really support the implementation and the rollout at the same time,” says Mark Moroses, senior vice president for information technology and CIO at Continuum. "We could move quicker by not having to support the application infrastructure as well as the complexity of going from practice to practice and dealing with the application integration issues, the data migration issues, the workflow issues, and the adoption issues.”
By the end of 2012, Continuum will have more than 500 physicians utilizing eClinicalWorks, Moroses says. "So that's been pretty successful for us.”
Moroses makes the point that the software-as-a-service industry has attracted vendors who now have their own clinical resources on staff, supporting the rollout of cloud services in healthcare in a far more knowledgeable way than just a few years ago.
"These are companies that are specifically focused on healthcare, so they understand the HIPAA regulations,” Moroses says. "They understand all of the privacy concerns. So when we express those, they have a better answer, and they also are able to provide and are more willing to provide different things that we would insist upon, like a biannual audit of their data center that they have to provide us with their own internal audit documentation.” Moroses says the software can review the audit trails on a consistent basis.