Emerging cloud computing models are based on user need. The software as a service (SaaS) and infrastructure as a service (IaaS) models are increasingly popular. The SaaS model provides an EMR/EHR and a database with access typically delivered through the Internet. It is sometimes referred to as “on-demand software.” This model’s service providers initially focused on managing third-party software and their associated databases, but now these providers are starting to develop and manage their own software. There is also a steady migration toward web-based applications that require only an Internet browser to access. This model is very common in accounting and customer service.
Explore this issue:February 2012
The IaaS mode takes care of the networking, routing, data storage and retrieval, but the software is housed on the users’ computers and is not part of the service.
Security and Backup
Security is another major issue in health care, and vendors are expected to have special expertise and monitoring in this area, along with improved backup services for power, cooling and recovery of data. It goes without saying that your organization would need to perform due diligence to make sure that your vendors provide appropriate security, database backup and disaster recovery protocols.
There are now strict security measures in place for this industry, and you would want to make sure that your vendors comply with Statement on Auditing Standards No. 70 (sas70.com) and other best-practice security standards. Your organization, unless it is very large, would have a difficult time matching the standards adhered to by a hosting site, and you are unlikely to have the IT expertise necessary to manage disaster recovery plans yourself.
Small practices with limited capital and IT support, which currently represent most of otolaryngology, may find that the SaaS model makes the most sense for their needs. The cloud vendor would likely provide better security, backup, availability and disaster recovery than the practice could ever manage on its own. Connections to other providers’ systems (e.g., radiology, labs, pathology) would likely be easier to access through the cloud vendor. Larger practices or institutions are more likely to benefit from the connectivity of an IaaS system that allows more control of the data they already house. One solution will certainly not fit all, and you will likely need the help of vendors and consultants as you assess your options.