A Cloud Standards Consumer Council paper titled, “Impact of Cloud Computing on Health Care” states, “There is substantial growth in demand for health care services because of aging populations, the increasing prevalence of chronic diseases and comorbidities. Concurrently, there are cost pressures stemming from the need to do more and higher quality work with fewer and more costly resources and also reduced revenue.” Cloud providers, both internal and public, must be abstracted from a user perspective. Deploying and managing the cost and operations across providers becomes the primary concern for enterprise health care IT.
It all starts with deployment of resources
Health care is unique in our method of deploying and consuming applications. While many health care organizations are developing applications, nearly all applications deployed by health care IT are commercial, off the shelf (COTS) products. This often leads to the mistaken belief that automation is not necessary in health care. When deploying a new health care application, especially when it is an Electronic Medical Records (EMR) major version, much of the deployment time is spent creating the environment, including compute, storage, and networking.
Efficiencies in application deployments are not limited to internal private cloud. Leveraging the Advanced Programming Interfaces (APIs) provided by public cloud providers, vRealize Automation can deploy across multiple public and private clouds. Test and development environments may be provisioned in public cloud resources for short term projects, while longer term production workloads may be deployed within the private datacenter, spanning multiple public and private clouds, all with a single request for resources.
Cost as a user metric
Health care IT is often considered a cost center, something needed, but challenging to fund. Projects often fund infrastructure, but have limited means of tracking the actual value they are receiving from the acquisition. When an application shares infrastructure and needs additional resources mid lifecycle, reallocation is often required. This creates significant problems with right-sizing the environment during project planning.
VMware’s vRealize Business enables health care IT to provide actual cost to project teams. Costs can be gleaned from existing environments to forecast new projects. For applications which can be deployed on public clouds, cost comparison can happen in real time with forecasting to determine the lowest cost provider meeting the requirements. This also provides real time costing on migrating applications and resource reclamation as that becomes an option. Application owners are presented with the cost they could avoid, by shifting unused resources to new projects.
When automating bad process, the speed of bad process increases exponentially. One of the most often overlooked challenges in health care IT is the need for a better operational process. Deploying applications and looking at cost is beneficial, but a majority of the operational cost and struggle occurs in the shift from design and deploy to operate and maintain. Runbooks and instructions are helpful, but many of the operational tasks are repetitive, and tedious.
Adding resources, predictive performance monitoring, and capacity management can be easily automated using VMware’s vRealize Operations with Log Insight. Many functions can become self-documenting as lower level functions are abstracted. Fewer operational staff are then required to manage the system; enabling more focus on projects and less “keeping the lights on”, providing greater value back to the organization and, most importantly, to the patient.
Managing the health care cloud is a challenging proposition, made all the more difficult by the changes in reimbursement models, changing technology, and technical debt. Automation is one of the best ways to solve many of these problems but it must be treated as a complete solution, and one which accounts for future expansion and changes to technology. By building out a solution with complete lifecycle management, cost, and operational efficiencies, Health care IT can provide a superior provider and patient experience, while continuing to remain relevant in an ever changing world.