David Chou, Global Digital Healthcare Advisor
I recently wrapped up a meeting of the minds with several healthcare executive IT executives that was put together by NetApp. It was a great event of networking and collaboration, and the topic of the cloud came up, as is usual in all conferences these days. As I had mentioned in a previous blog, we must utilize the cloud as a core function of the CIO. But we are now seeing many vendors market their solution as “cloud computing” without meeting the cloud definition that I have highlighted below.
When I think about the “cloud,” there are a few key words that comes up to mind: on-demand, scale, and convenience. If it does not meet those criteria, then most likely it is not cloud technology. Enterprise document storage vendors Dropbox and Box meet all three criteria where you have access to the data anywhere anytime on any type of devices, you have the ability to add scale anytime, and it is very convenient.
The definition of cloud from National Institute of Standards and Technology (NIST) is extremely lengthy, but I found a great summary from Rackspace. The summarized definition of cloud computing is a model for enabling convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. That was a great definition of cloud. We must also keep in mind that cloud computing consists of three technology stacks, as illustrated in the cloud-computing stack in the diagram below, which includes Software as a Service, Platform as a Service and Infrastructure as a Service.
Software as a Service (SaaS)
Here are a few characteristics for software as a service.
- Web access to commercial software (CRM, ERP, EHR)
- Software is managed from a central location
- Software delivered in a “one to many” model
- Users not required to handle software upgrades and patches
- Application Programming Interfaces (APIs) allow for integration between different pieces of software
Healthcare is still working on developing API for most enterprise software, but we are making progress. SaaS is great for organizations that want shift the work of maintaining an application to the vendor. I am starting see a big shift where healthcare applications are moving toward the SaaS model; it is also becoming the preferred choice of application management that executive IT leaders are leaning toward. Prime examples of SaaS are email with Office 365, Google Mail, CRM such as Salesforce, customer service management (Zendesk), and expense management (Concur).
Platform as a Service
PaaS can be defined as a computing platform that allows the creation of web applications quickly and easily and without the complexity of buying and maintaining the software and infrastructure underneath it. One challenge for developers is that they have to rely on the infrastructure team to build out the computing platform (server, storage, DR), which may take longer than desired. PaaS is especially useful in any situation where multiple developers are working on a development project or where other external parties need to interact with the development process. Some examples of PaaS are IBM Bluemix, SalesForce Force.com, Google App Engine, and Microsoft Azure Services.
Infrastructure as a Service
This is a way of delivering Cloud Computing infrastructure — servers, storage, network and operating systems — as an on-demand service. The typical path of building an infrastructure involves purchasing servers, software, datacenter space, and network equipment. Now we are able to purchase the infrastructure resources from a vendor. Characteristics of IaaS are:
- Resources are distributed as a service
- Ability to scale
- Pricing is similar to an utility company
- Generally includes multiple users on a single piece of hardware
Some examples of IaaS would be the public cloud of providers such as Amazon AWS and Microsoft Azure. The private cloud model that is emulating the public cloud features on the private network is also an example of IaaS. The majority of IT organizations in the future will have a hybrid cloud model that is a mixture of public and private cloud.
As you can see, when we refer to cloud computing it describes the three components of Infrastructure as a Service at the base, through Platform as a Service as a development tool and through to Software as a Service replacing on-premise applications. Senior executives must understand the different components of cloud computing in order to make the right decision on which solution fits the organizational needs. I foresee that the future executive IT leader will become a broker of cloud computing services where we are provisioning and managing all three cloud stacks as part of the core IT infrastructure. The days are managing infrastructure will not be the core competency anymore.
[David Chou is a global healthcare digital advisor who most recently served as CIO at University of Mississippi Medical Center. He also held the roles of Senior Director of IT Operations at Cleveland Clinic Abu Dhabi, and CIO at AHMC Healthcare. To follow him on Twitter, click here.]
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