Delivering Care Services Through the Cloud

 

Plunket is a New Zealand based, community-owned and governed, not-for-profit organisation that provides support services for the development, health and wellbeing of children under 5 years old. This is carried out through “Well Child visits and other services such as parenting education courses, car seat safety schemes, education in schools and toy libraries,” says Craig Le Quesne, General Manager Information, Communication and Technology at Plunket.

 

The majority of people that assist in the services outside of the Well Child visits are volunteers who are scattered across New Zealand and silos of information have evolved. Before Plunket implemented a cloud based solution these individuals were not fully supported through IT. “Cloud based computing now offers a fantastic opportunity for Plunket to manage all IP (intellectual property) created by all the volunteers that make up Plunket,” explains Le Quesne.

 

This ability for cloud computing to offer “cross organisation access and cross boundary collaboration” is where Rijpma thinks the cloud can really make a difference.

 

In addition to providing a platform for sharing expertise and knowledge, cloud based services also offer an opportunity for Plunket to save on costs. This is due to the fact that a larger portion of the tasks associated with internal technical support and administration would be managed by the service provider.

Plunket is currently piloting an online space for volunteers. “This will give our large volunteer ‘workforce’ access to tools that we haven’t had in the past,” Le Quesne says. The live meeting features built into the Plunket branded portal will allow remote committees to hold their meetings online, saving the time and cost of travel in rural communities while allowing volunteers to connect when it would not have been possible before.

 

One challenge for Plunket is that, due to the nature of the health data they collect, they are unable to use the cloud to support nurses or store health related data. Plunket does, however, offer a significant number of community related services that don’t have the security requirements of health data. Le Quesne believes that “the benefits of an inclusive community linking cloud based service are so compelling that the risks are well worth managing.”

 

Plunket is currently taking part in the beta programme of Microsoft’s cloud based CRM system and is “excited by the opportunities it could bring to the way we support the services offered by Plunket.” The potential rollout of the cloud based service to approximately 6500 volunteers will support the Plunket vision of the best start for every child. “Providing our people with free tools and access to Plunket information delivered in a Plunket managed space,” Le Quesne concludes.

 

Another organisation that is pushing the boundaries of care related services through the cloud is HSAGlobal (HSA). HSA provides a Shared Care Management solution which includes an electronic patient record and care management solution for chronically ill patients or patients with long term conditions that are being managed across multiple organisations. This spans across primary care, secondary care and community based care.

Based out of Auckland and with clients in Singapore, Australia, New Zealand, USA and Canada, HSA’s software is designed to be international. To achieve this they included international standards for healthcare data from the first day of design. “We’ve built a lot of the standards into the software, and [in countries] where standards don’t exist we’ve built ways around that into the software using built in configuration tools,” states Matt Hector-Taylor, President and Chief Executive Officer of HSA. This is a cloud based solutions forte: customisation and configuration for different customers and user requirements. Hector-Taylor expands on this: “For a country wide implementation we can configure [the software] at a national level, a state or provincial level and an individual customer’s level based on their exact requirements.”

 

There are two levels of benefits that cloud computing brings according to Hector-Taylor. Firstly, at a financial level. Most healthcare organisations like the idea of a lower entry cost and a faster to implement, faster to benefit model. After all, when you decide on new software you want it now and you want it as cost effectively as possible. The second main benefit is that cloud computing can bring together fragmented healthcare institutions. “Organisations require a distributed approach and this is where cloud computing comes into its own,” explains Hector-Taylor. Even large organisations that have the capability to host and provide the infrastructure themselves may go with a cloud based model because it overcomes the fragmentation issues and the client no longer has to manage it themselves.

This is echoed by Rijpma who is seeing Microsoft Online services “being adopted by organisations because it makes it much easier and more cost effective to provide these types of enterprise class services to a broader base of people including nurses and mobile staff who need access while out of the office.”

 

The main hindrance to cloud uptake is in data sovereignty. But according to Hector-Taylor this is something that can easily be rectified. “All of the applications that work in a cloud environment can be designed and built to work in a private cloud environment and still leverage cloud computing benefits. The web server could be in another state, province or country but as long as the data is in your state, province or country it shouldn’t make a difference,” Hector-Taylor feels. Rijpma states that due to the strong concerns over this and the length that cloud vendors go to in order to protect data, “it could be that the cloud actually provides more security and privacy for their data than they get today, even if hosted in another country.”

 

The next big challenge will be dealing with what Hector-Taylor calls “concentric circles” of healthcare information requests. If you go to the outpatient clinic of a hospital the nurses and staff on duty should see your record, after that your GP should see your record – all the people who want and need to see your information can see it with some of it held in the cloud and some not. The challenge is, who sees what and where is it stored? According to Rijpma this is “a matter of trust and people becoming comfortable with the fact that privacy and security can be managed effectively and that organisational risk issues can be addressed.”

 

The other hindrance is that of ingrained finance problems and the fact that cloud computing is a new technology that requires a new way of balancing the books. According to Hector-Taylor, “The CIO is hindered by the organisation’s finances being based around CapEx and OpEx. The idea of a recurring fee does not sit well with them.” People are only now becoming confident enough in the technology to spend, what is often government money on more creative financing models.

“Ultimately,” says Hector-Taylor, “people need to see [cloud computing] as a delivery model, it has its advantages and disadvantages and people need to figure out what is best for them. They need to be more sophisticated about what they are asking for.”