In recent years, the healthcare industry has witnessed a significant shift toward embracing cloud technology, especially in the field of medical imaging. Radiology Business spoke with Monique Rasband, vice president of strategy and research for imaging, cardiology, and oncology at KLAS Research, at the Healthcare Information and Management Systems Society (HIMSS) 2023 meeting to shed light on this emerging trend.
With nearly a thousand vendors present on the HIMSS exhibit floor, it was evident that cloud technology has become mainstream, with many healthcare providers now exploring its potential benefits. Radiology PACS and enterprise imaging vendors are also pushing cloud solutions more at the upcoming Radiological Society of North America (RSNA) meeting.
Changing perceptions of cloud use in healthcare
There has been a noticeable transformation in the last five years toward accepting cloud data storage across healthcare and radiology. Before the pandemic, there were concerns about sending sensitive and HIPAA-compliant data off-site for storage. However, with the COVID-19 pandemic forcing providers to use telehealth and open up access for remote employees, the attitude has shifted post-pandemic. There is now a growing acceptance of the idea. Rasband attributed this to increased familiarity with cloud services, drawing parallels with consumerism trends seen in platforms like Amazon.
"It's more familiar. With security concerns and staffing shortages causing a lot of problems, we are seeing providers say, 'now we're ready to look at it because we have other things that have been introduced that we did not expect,'" Rasband explained.
But, she said there are varying interpretations of what "cloud" means in the context of healthcare. Rasband emphasized the importance of understanding the specific problems healthcare providers aim to solve with cloud solutions. From applications to full-fledged picture archiving and communication systems (PACS) in the cloud, the diversity of offerings is contributing to the ongoing evolution of its definition.
Cloud offers advantages for healthcare systems
For healthcare organizations contemplating a move to the cloud, the advantages are multifaceted. One key benefit is the liberation of physical space previously occupied by on-premises servers. This newfound space can be repurposed for other critical needs within the hospital. Additionally, the potential cost savings in areas like air conditioning and electrical usage, coupled with the ability to redirect IT staff to more strategic initiatives, make the cloud an attractive option.
She said KLAS discussions with providers showed there has been a big change in the perception or cloud. During COVID, many health systems realized their servers are not always on the site where their clinicians are working, so they were already accessing and sending patient data off-site. Hospitals also realized inside of expanding with more build outs, it might make more sense to outsource the care and maintenance of the servers someplace else and reuse that physical space in the hospital for something else.
What is the ROI of adopting cloud storage?
While cloud adoption brings several advantages, questions about return on investment (ROI) and future storage costs remain prevalent. The conversation acknowledges that these concerns are still in the early stages of being addressed, indicating a need for further exploration and understanding of the long-term implications of cloud storage in medical imaging.
"One thing that is a bit interesting is what is the ROI? It is still too early where providers are saying, is that going to be a good thing, a bad thing? What will storage cost in the future? What does that look like going forward? So that's probably the question we get the most now from providers is what cloud will look like in the future," Rasband said.
Addressing IT and radiology staffing shortages
One of the significant drivers for cloud adoption, particularly in imaging, is the shortage of IT and clinical staff. Rasband underscored the challenges faced by healthcare providers in addressing staffing shortages. Cloud solutions provide relief by allowing organizations to offload responsibilities like cybersecurity to specialized providers, freeing up internal resources for more strategic initiatives.
"We are hearing quite a bit about the staff shortages. I believe every segment of healthcare, every space has been hit, but we really hear a lot in imaging, both in cardiology as well as the radiology. My other KLAS colleagues also talk about shortages everywhere for IT clinicians. So cloud has been helpful for a lot of the providers.
Cybersecurity and the cloud
Many healthcare organizations lack the expertise to maintain robust cybersecurity measures 24/7, so there is a growing willingness to entrust this responsibility to cloud providers with the dedicated resources. The shift is seen as a pragmatic response to the increasing complexity and sophistication of cybersecurity threats.
"Providers are saying they now don't have the staff to keep up with it and there are so many things they need to work on. They want to work on a strategy broadening their enterprise imaging offering, what are they going to be putting in the VNA or replacing a legacy PACS. They have a lot of problems to solve, so all of a sudden giving up cybersecurity to somebody else sounds really good. And so, we have definitely seen a shift post-pandemic of them not being more willing to hand that piece over," Rasband said.
Hybrid approaches and future considerations for cloud storage in radiology
Notably, some healthcare organizations are considering hybrid approaches, combining on-premises archive storage with elements of the cloud. This approach aims to balance the advantages of cloud technology with the need for continuity in case of internet outages or other disruptions.
"We have had people say they think they will do some sort of a hybrid. We are talking about being able to open large image datasets quickly, and what does that look like if the internet goes down? Those sorts of questions are coming up and people are still trying to vet that out."
In some cases, radiology is moving older studies to cloud storage and keeping more recent ones on-prem to enable faster access for the day-to-day work they do.