Moving HIMS Core to
Cloud in Healthcare:
What, Why, and How?

Healthcare and its numerous avatars are exploding. Rising patient numbers, employee fatigue, and workforce shortages are constant concerns that need solutions. It's evident that technological transformation in healthcare is less a choice, more an imperative.

Thousands of patients visit healthcare institutions every day, stressing core operations - clinical, operational, and financial. Health Information Management Systems (HIMS) is at the center of these activities, providing a set of technologies that aid in data organization, retrieval, storage, and analysis of patients' medical records. The major purpose of a HIMS is to enable better healthcare delivery by facilitating informed administrative, regional, and national decision-making, as well as to lead to health equity at all levels of the health system, while providing the highest quality patient-centered treatment. However, with the increasing volume of data, ease of data access, and the scarcity of competent health information management experts, there is an increasing demand for HIMS to migrate to a more advanced IT framework, such as the cloud!

In this blog, we will discuss HIMS modernization, why healthcare providers move to cloud, challenges of migrating HIMS on cloud, some real-life cases of healthcare providers who have successfully moved their HIMS core systems to the cloud and some more. Let us dive in!

HIMS modernization: What is that?

HIMS, HMIS, or Health management information systems, can be considered as one of the building blocks that are necessary to strengthen the healthcare system. This centralized information management system is used to streamline different activities of healthcare providers, patients, and medical insurance companies to make sure activities such as patient care, billing, CRMS, HRMS, and other services, run smoothly.

But, as if the medical industry didn't already have enough challenges, the constantly increasing medical costs, rising patient expectations, tremendous health data pulls, and interoperability demands pile up, are bringing even more pain to the already stressed-out sector. The worst part is, using the old ways no longer cuts it, only adding costs and slowing the industry down. This makes HIMS modernization not just necessary but inevitable. But how do you go about with this modernization process to achieve end objectives seamlessly; improving the quality of healthcare services by providing faster access to patient data, enabling better decision-making, and reducing or rather mitigating catastrophic medical errors once for all.

Healthcare Providers Are Moving HIMS to the Cloud - But Why?

Because of the complexity of the healthcare system and the compliance jitters around it, there has been a fair amount of apprehension about moving data—particularly sensitive patient data—to cloud applications. Generally speaking, the industry started with moving business applications, such as human resources, email, and operational data, to the cloud first. Healthcare providers are moving HIMS on cloud for several reasons:

From Patient Care POV:

Less Friction, Especially with Insurance

In theory, if the healthcare industry can adopt a widely compatible system, processing insurance for visits, prescriptions, special procedures, etc. should be as simple as notifying your insurer electronically and being approved for your plan's coverage. Since medical issues can cause patients to see different doctors and try different procedures, an accessible and sharable version of this data would be extremely beneficial for patients.

More Personalized Care

Everyone wants their doctor to be aware of their medical history, but no one wants to fill out intake form after intake form or answer the same questions each time they see a new doctor. What if each doctor you saw was familiar with your medical history, from a complete, accurate family history to your most recent visit—even if you were traveling or seeing a specialist? This isn't currently doable, but the cloud is assisting healthcare organizations in making this progress.

Patient Data Ownership

Because patient information may be easily archived and retrieved when data is stored in the cloud, data is democratized, and patients gain ownership over their own health. It increases patient participation in health-related decisions and leads to informed decision making by serving as a tool for patient education and engagement.

Telehealth and Remote Monitoring

Telemedicine and remote monitoring programs are supported by cloud-based HIMS. Patients can have virtual consultations with healthcare providers, making it easier to receive timely medical advice, especially when actual visits are difficult. Continuous remote monitoring of vital signs and symptoms can provide early warnings as well as proactive interventions.

For Healthcare Providers:

Cost-efficient Cloud IT Strategy for Healthcare

Server computers and other data-center equipment are very expensive. Moreover, this type of gear demands considerable and continuous investment to maintain:

• Recruiting competent technicians and IT administrators
• Paying extra energy expenditures to power and cool your servers
• Managing hardware upgrades when current capacities are insufficient to meet the expanding demands of healthcare applications.

With cloud, healthcare organizations won't have to worry about onsite servers or other IT tools. This is the job of your cloud provider, in charge of maintaining remote data center equipment, keeping communication channels fast and functional, internal and external networking environments functioning at ultra-low latencies and managing other critical infrastructure and hardware.

Reduced Hardware Maintenance Costs and Routines

All of these technical tasks are typically outside the scope of healthcare organizations and medical experts. Hospitals and medical centers/offices are brimming with high-tech medical equipment, and assigning additional square footage, resources, and budgets for IT infrastructure is not a viable option.

Instead of the high costs associated with procurement and ongoing support, cloud offers subscription-based services with optimized rates thanks to economy of scale and delegation of technical duties to third-party companies. This includes:

• Hardware-agnostic IT infrastructure for medical applications
• Scalable data storage for massive medical databases
• Secure medical data exchange and other security measures
• Remote server capacities for healthcare software operation
• Technical expertise, maintenance, and upgrades without direct investment from clients.

Enhanced Cloud-backed Security for Healthcare Companies

The goal of moving HIMS to the cloud is also improvement of data security-related aspects, which are usually beyond the competencies of healthcare professionals but can greatly enhance compliance with international standards such as HIPAA:

• Better backup strategy and faster disaster recovery to help prevent painful PHI loss in case of technical emergency
• Controlled data access policies at the hardware layer, including smart behavior pattern monitoring and advanced logging
• Database health checks and maintenance, including regular data storage defragmentation and other procedures required for keeping medical data safe and consistent
• Reduced the risk of data breaches and enhances patient data privacy, aligning with industry regulations such as HIPAA

Better Patient Information—and more of it

Being able to keep track of patient information across appointments can be drastically improved. At the very least, digitization has allowed quicker updates of information and faster back-and-forths between people within the healthcare systems.

Health providers will also have more aggregate data, which can help in a variety of ways. Imagine if hospitals in neighboring regions were able to automatically compare, for example, the number of flu cases coming in during flu season. A networked cloud system will be able to support non-individualized uses of aggregate medical data.

Unifying Disparate Systems

Healthcare organizations are moving HIMS to cloud because cloud-based HIMS can unify data layers across disparate systems, enabling the health providers to access patient data in real-time and personalize treatment plans. What we mean by “Disparate systems” is - different systems that do not communicate with each other, which can lead to inefficiencies and errors in patient care. Cloud-based HIMS also enables professionals to communicate essential information with increased agility, which is a critical transition, particularly in an era when patient care extends far beyond the hospital walls.

Reallocates time and energy from maintenance to innovation

The primary purpose of transitioning from on-premises hardware to the cloud is to save time, money, and energy so that resources may be redirected from maintenance to innovation and strategic development. By reallocating time and energy from maintenance to innovation, healthcare providers can focus more on patient care and improving clinical outcomes, increase clinical workforce productivity and reduce costs, enabling better decision-making and reducing medical errors.

Structured Data Storage

Cloud-based HIMS provides a centralized location for storing patient data. One of the biggest trends in Healthcare informatics is the wider adoption of cloud data storage and a movement away from keeping all health system data in on-premise data centers. Failure to update data systems, platforms, and applications on a regular basis can cause crucial data to deteriorate or be lost, risking the integrity and availability of vital healthcare information. Consider the large amount of data managed by hospitals, as well as the effort required to continuously manage, upgrade, and maintain the underlying infrastructure that enables data storage and the smooth operation of every application that relies on it. This transformation reallocates the health IT personnel to patient care IT systems while lowering the risks associated with on-premises data storage.

At the Health Information management Systems Society (HIMSS) 2023 meeting in April, this trend was visible across the expo floor. According to HIMSS Sr. Director of informatics, "healthcare has done a very good job of transitioning to electronic health records over the past 20 years, but that data needs to move into a more modern IT framework”.

Advanced-Data Analytics

The focus of utilizing cloud-native data technologies is in leveraging advanced data analytics to improve patient outcomes and reduce medical errors. Processing huge datasets and retrieving essential patient information also becomes more viable with the cloud's enhanced computational capacity. It enables health IT systems to examine patient records for better and individualized patient plans. It guarantees that all important patient information is recorded and that nothing is overlooked when prescribing treatments. Big Data analytics and artificial intelligence algorithms applied to cloud-stored patient data can also boost medical research.

Disaster recovery management

Cloud-based disaster recovery platforms are better suited over conventional disaster recovery solutions for healthcare organizations, because it offers continuous system availability irrespective of private, public, multi or hybrid cloud framework. Cloud-based disaster recovery solutions are also more cost-effective and flexible. With a cloud disaster recovery strategy, critical HIMS data and applications can be backed up to a cloud-based server, enabling quick data recovery for businesses in the wake of an event, thus reducing downtime (which is inexcusable in the healthcare industry) and minimizing the effects of the outage.

If it's a Win-Win-Win, Why Hasn't Healthcare Moved to the Cloud that Aggressively?

While some healthcare organizations have embraced cloud-based HIMS, others remain hesitant. Here are some reasons why healthcare providers have been slow to move to the cloud:

Possible Roadblocks:

Digitizing Critical Files: It's no surprise that years' worth of medical data is time and cost-intensive to digitize. Different information (ex. prescriptions vs x-ray files) needs to be stored and input differently, increasing the time-intensive nature of the task.

Large-scale Technical Infrastructure: Should the healthcare industry try to build all their own infrastructure, or use an existing model to support themselves? How will this infrastructure be most securely accessible across the country—or across boundaries and countries of business presence? Healthcare organizations may also not have the necessary infrastructure to support cloud-based HIMS. These and other questions around the fundamentals of building a large, connected database need to be resolved while moving HIMS to cloud.

Data and Privacy Rights: One of the biggest areas of concern is legal rights about data and privacy. Not only are our laws about the internet, cloud computing, and health data changing all the time, they are non-standardized across regions. International agreements on healthcare privacy and how to hold cloud systems to an international standard are not yet commonplace.

Centralized Storage Means a Higher Risk: Up until just a few years back, there was also a strong belief in the industry that, on-premises servers are safer because they operate in an isolated and supposedly unexposed environment. However, the reality in today's interconnected world tells a different story. The vulnerability of a centralized repository to prospective attacks is also a major worry, in case of an attack that has the potential to disrupt and cause chaos in all related applications and systems. The industry is still figuring out maximum security for a shared healthcare cloud infrastructure.

Difficulty in Planning for Cloud Resource Allocation: Healthcare organizations must plan for cloud resource allocation, including storage, processing power, and bandwidth, to ensure that they have the necessary resources to support their HIMS.

Budgeting for Cloud-Based Healthcare IT: Moving HIMS systems to the cloud can be costly, and healthcare organizations must budget for cloud-based HIMS, which includes cloud services, migration, and continuing maintenance.

Choosing the Right Cloud Service Provider: Healthcare organizations need to look for cloud service providers that meet their needs, which include HIPAA compliance, specific data requirements, the volume of protected health information (PHI) and other sensitive data involved, cost effectiveness, and scalability.

Cloud Migration Strategies for Healthcare Ecosystems

The specific cloud transformation strategy that's the best fit for your healthcare organization must be selected and formulated by an experienced cloud consultant or provider to avoid unnecessary mistakes, operational disruptions, and cost overruns.

Re-hosting Cloud Strategy

Re-hosting (a.k.a. the lift & shift approach) means moving your HIMS applications and associated data to cloud servers without making any significant changes in functionality.

This method means using the infrastructure-as-a-service (IaaS) model if you're interested in outsourcing hardware capacity only. With the rehosting strategy, you can replace your own onsite hardware while improving software accessibility, medical IT integration & interoperability, and other technical system parameters.

Re-platforming Cloud Strategy

Re-platforming means migrating your current cloud HIMS operating systems from one cloud provider or platform to another (for example, moving from the public cloud to a private one) while optimizing and configuring your healthcare applications to meet the specifics of new cloud infrastructure.

Organizations can choose re-platforming of their applications when they are not happy with the conditions and/or limitations of their current cloud solution. This model may also require additional software development or advanced software engineering expertise to reconfigure software correctly.

Refactoring Cloud Strategy

Moving healthcare solutions to the cloud can be a great opportunity to re-architect and improve, not only in terms of cloud readiness but also through adding new features and capabilities.

This model takes a lot of development effort/skill and can be used to upgrade legacy medical applications that must go through deep software redesign and code optimization before they can be introduced to cloud platforms.

Replace/Rebuild Cloud Strategies

These strategies require retiring outdated healthcare solutions and replacing them with newer custom software products or ready-made cloud-native alternatives.

This approach can be used to handle deeply obsolete legacy software that is not available for profound code amendments, updates, or modification. This approach has two main scenarios for cloud transformation:

• Migration or export of current databases from outdated software to third-party cloud-based systems with corresponding software configuration, according to Software-as-a-Service (SaaS) model and licensing.
• Building a custom cloud-adopted healthcare system from scratch, including individualized functionalities while importing the old medical database.

The top three popular cloud platforms employed by the medical industry right now include…

• Amazon Web Services (AWS)
• Microsoft Azure
• Google Cloud Platform (GCP)

At Cloud4C, we've built an array of services for our clients. There are various reasons why these vendors have the best offerings for healthcare. If you would like to discuss the specifics and applicability of cloud technologies for your healthcare organization, contact us!

Compliance Management for HIMS on Cloud

Healthcare providers are required to follow a number of regulations, among the most significant being the HIPAA guidelines. The following question arises:

Does Cloud Really Support HIPPA Compliances?

Between 2009 and 2019, there were over 3,054 data breaches and 230,964,151 healthcare records lost as a result of poorly managed patient sensitive data. This number is too high to take matters lightly!

The solution to this substantial challenge lies in the adoption of HIPAA-compliant cloud services. HIPAA compliance ensures the privacy and protection of patients' health records. Not being HIPAA compliant comes with the risk of severe fines and even losses of medical licenses. HIPAA (Health Insurance Portability and Accountability) Act establishes explicit guidelines for the storage and exchange of protected health information (PHI). HIPAA compliance is required of all entities that handle PHI. So yes! Cloud computing facilitates HIPAA compliance.

Healthcare organizations are increasingly turning to the cloud—it's an appealing option for HIPAA-compliant applications, storage, and networking options as it provides a cost- efficient way to develop the complex infrastructure required to support a variety of critical organizational activities:

• Storage and Easier Access of Electronic Protected Health Information (ePHI): Files stored in the cloud are accessible anytime and anywhere from any device, making it easy to share critical medical information.
• Data Backup: Cloud also protects healthcare organizations from losing sensitive data in the event of a natural disaster or data breach

So, a thing to keep in mind: When a CSP tells you they're “HIPAA compliant,” they mean that their underlying infrastructure is secure and that they provide tools for ensuring compliance. Healthcare organizations must then use these tools appropriately and follow up with appropriate monitoring and reporting. There are no official HIPAA certifications for compliance, and no government or industry certifies HIPAA compliance for cloud services.

Cloud Empowers Techno-inclusive Patient Care Experiences for a Multinational Healthcare Group

Facing the challenges of - Legacy IT Infrastructure Constraints vs. Ambitious Healthcare Transformation.

Despite the technology and digital care noise, leading healthcare groups are often constrained by their legacy operational foundations, limiting transformation visions. Modernization of the mission-critical core, hence, becomes the sole and primary objective to unlock future possibilities. This multinational healthcare group for instance, with 5.5+ million patient visits per year based in Abu Dhabi, moved its core Healthcare Information Management Systems (HIMS) to the cloud with the help of Cloud4C. Cloud4C modernized its core HIMS and migrated SAP applications to Azure Cloud with Integrated DR, advanced security, and managed services.

The move with minimum disruptions, resulted in several benefits, including:

• Reduced TCO, 55% cost savings
• High-powered IT infrastructure, robust security posture, and operational efficacy
• On-demand DR, a fail-safe & secure IT environment
• Industry highest SLA of 99.9% up to Application login layer
• Improved hospital response times by hosting sites on Azure

And other benefits including cost-savings associated with people, power, maintenance, and overhead, scalability, flexibility, reliability, cost-effectiveness, improved performance, and disaster recovery.

Empowering Healthcare with Cloud4C's HIMS Modernization Solutions

McKinsey article “Cloud's trillion-dollar prize is up for grabs,” shows that cloud capabilities have the potential to generate value of $100 billion to $170 billion in 2030 for healthcare companies. Information storage in healthcare today is becoming more digitized, and many factors are at play. This is an indication of the shift that's been happening for about a decade. The Healthcare Information and Management Systems Society (HIMSS) reports that about half of providers who don't have information in the cloud plan on moving it there. Healthcare providers understand that the cloud can simplify their operations and want to get their data there.

This is where Cloud4C steps in!

Cloud4C's cloud managed services, including hybrid and multi-cloud solutions can help healthcare industries move HIMS systems to the cloud by providing scalable and versatile healthcare cloud infrastructure. Cloud4C Healthcare-in-a-Box is an all-in-one cloud healthcare and Infrastructure-as-a-Service suite, addressing concerns with cloud-powered point solutions and mobile apps, Disease Surveillance and Medical Imaging (RICS and PACS), healthcare kiosks and tele-health services and much more. Cloud4C is one of the global leaders of managed cloud service, assisting enterprises with multi-cloud migration, AIOps, and improved cybersecurity all under a single SLA. Our cloud managed services are here for your healthcare organizations to migrate HIMS systems in a secure and compliant manner. Know how, contact us today