Cloud Applications in the Healthcare Setting

By Jon Darnell, Director, Medical Imaging, Texas Health Harris Methodist Hospital Alliance

Patients are better able to connect with a provider and the provider has access to a complete patient medical record. Both of these were made possible and improved through cloud-based services.

Cloud computing is delivering shared resources, software, and information to computers and other web-connected devices from a central system. Cloud computing benefits can include flexibility, cost-effectiveness, security, and enhanced teamwork/collaboration. The ability for staff and customers to work or access service from “where they are” is invaluable. Having virtual staff offices, which do not require patients/customers to come into a brick-and-mortar building, save businesses from the costs associated with constructing and maintaining a physical facility. Cloud-based systems also offer better security and flexibility to alter the system once to all users’ benefit. Lastly, the ability to collaborate by all team members is enhanced as no matter where they are, they all have access to the same data which allows for greater innovation and creativity.

Prior to 2020, the implementation of cloud services within healthcare was inhibited by factors which are difficult to overcome. The development of cloud-based applications is one of the main inhibiting factors. Healthcare had not been as fast to adopt cloud-based applications as other industries, mainly due to privacy and security concerns with patient information to maintain HIPAA compliance. Many of the systems and applications that hospitals utilize in their business and clinical areas had never been developed with cloud-based operations in mind. The idea of cloud-based, mobile, and or virtual healthcare operations was considered more of an eventual convenience but not one that needed acute attention. Some virtual health businesses had been launched and a few major health systems had some type of virtual care set up with their outpatient provider networks, but it was not very common. Recently, the need for this type of service has skyrocketed due to the pandemic. Internal and external customers’ ability to have access from remote locations has become an acute need rather than a convenience. These services can include business and accounting software, project management, virtual patient visits with their providers, access to radiology and imaging databases for viewing diagnostic images, and utilizing artificial intelligence to assess radiology images for diagnosis on-the-fly.

Hospital executive teams and financial officers can benefit from cloud technology in assessing budgets and creating game plans. Especially with regard to making decisions about financial standing, the ability for everyone to access the same files at the same time from wherever they are is invaluable.

In Project Management, whether it’s a construction project or a quality improvement initiative, cloud-based computing dramatically enhances the process. The ability to share files, spreadsheets, and other important documents with everyone involved is a game-changer. It offers them the ability to edit and review data during a live virtual format.

Patient visits were tremendously improved, especially in 2020. This technology enhanced both the growth in the number of virtual visits and the quality of those visits. Patients are better able to connect with a provider and the provider has access to a complete patient medical record. Both of these were made possible and improved through cloud-based services. This year saw a massive improvement in technological innovation for cloud-based virtual visits spurred out of the necessity of the pandemic. The reimbursements for these virtual visits also changed in 2020 to allow medical providers to generate revenue and operate for profit while providing care for patients in a socially distanced manner. As an added benefit, underserved populations saw an improvement in their access to healthcare as this technology increased the availability of care. Having to travel or other limitations which previously would have prevented them from seeing their provider are removed. The greater need for services induced by the pandemic were alleviated by the enhanced availability this technology provides.

Another great benefit of cloud-based services is its ability to provide broad access to multiple providers and clinicians to radiology and imaging services. Providing diagnostic images on a cloud-based platform provides centralized storage, access, and retrieval of images for review and report generation. This decreases unnecessary repeat studies or additional studies as everyone has access to the complete imaging history. If a second opinion is requested or an acute care provider (i.e., ED physician) needs access, the studies are available along with the report. Having the imaging studies on a cloud, the performing facility can easily share them with a requesting facility or physician via email or a direct link if they are trusted access to the cloud service the performing hospital is using. This not only saves valuable time, but allows those images to be shared and viewed immediately in cases of acute care needs such as life flight to another facility. Typically, the link sent to the receiving facility or caregiver can be accessed via a computer, tablet, or mobile device, making it available in almost any environment (i.e., ED, OR, or outpatient visit).

Adding artificial intelligence (AI) to a cloud-based service for medical imaging can significantly decrease the turn-around-time for the result of an imaging study. For instance, there are stroke applications where a CT of the head is immediately sent to a cloud-based software with integrated AI that will compare them to a “baseline” CT and determine if the study is normal or has an unexpected anomaly which in most cases it will be able to categorize. After that, the software can then message an individual or group of caregivers. An ED physician and Neuro Interventionalist who would be collaborating in the patient’s care would both be notified of the AI results and then text live inside the app which will be noted in the patient’s file. This dramatically increases efficiency and saves time for the stroke patient by speeding the creation and implementation of a care plan, where time is the brain. In closing, as with any potential hardware or software purchase, getting the correct people on the vetting team, asking the right questions of a vendor regarding what your facility needs from a cloud service, and ascertaining how to implement the service correctly are all critical in getting a service that will enhance both your facility and the patients/customers you serve.