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The only solution for Healthcare is complete cloud based everything with the exception of pacs systems. Healthcare providers, in general, lack the leadership, w

The only solution for Healthcare is complete cloud based everything with the exception of pacs systems. Healthcare providers, in general, lack the leadership, will, resources and talent to do security in any fashion resembling correctly. The only onsite equipment should be networking gear with redundant uplinks. All inpatient data generating equipment should route directly to the cloud for storage and processing. pacs excluded.

mschuster91 9y ago
> The only onsite equipment should be networking gear with redundant uplinks. Good luck if the "redundant uplinks" fail, e.g. due to a large-scale terroristic attack (no matter if physical or electronical), or if the cloud breaks down - even Amazon can have multi-hour outages - or if there's a virus propagating through the cloud system. For what it's worth, the NHS got hit by both a virus (Wannacry, 2017 http://www.telegraph.co.uk/news/2017/05/13/nhs-cyber-attack-everything-need-know-biggest-ransomware-offensive/ http://www.telegraph.co.uk/news/2017/05/13/nhs-cyber-attack-...) and an email-bomb DoS (2016 http://www.bbc.co.uk/news/technology-37979456 http://www.bbc.co.uk/news/technology-37979456). With on-site IT you can at least make daily (or hourly) tape backups of everything and can properly store and retrieve them, good luck doing so with Amazon Glacier. Just imagine an entire country unable to provide qualified medical assistance because a cloud provider goes down. And yes you do ALWAYS need access to a patient's background info, for example to look up if the patient is allergic to some medicine.
- phil21 9y ago
  I agree with both of you. The state of software and systems in IT is untenable, and it will be huge anchor on productivity. Absolutely no mid-sized medical practice is capable of maintaining these systems to any level of standard, and I do believe this is one of those areas that is far better served as a centralized SaaS model. As you mention, this opens up a new set of systemic vulnerabilities that should not be ignored. I see this becoming more like a large app that lives in the cloud, with a "black box" that acts as a local cache for any medical records assigned to the practice in question. Basically you get access to the "global interchange" of medical records/billing/whatever - and you still have the digital equivalent to a basement full of filing cabinets for the records you need on-site. Yes, if the "uplinks" go down you will lose access to the wider network - but at least the problem of accessing things you need during emergencies and outages is very solvable. Nothing I've seen related to healthcare IT has be very optimistic of something like that being implemented in a competent manner however.

mschuster91 9y ago

> The only onsite equipment should be networking gear with redundant uplinks. Good luck if the "redundant uplinks" fail, e.g. due to a large-scale terroristic attack (no matter if physical or electronical), or if the cloud breaks down - even Amazon can have multi-hour outages - or if there's a virus propagating through the cloud system. For what it's worth, the NHS got hit by both a virus (Wannacry, 2017 http://www.telegraph.co.uk/news/2017/05/13/nhs-cyber-attack-everything-need-know-biggest-ransomware-offensive/ http://www.telegraph.co.uk/news/2017/05/13/nhs-cyber-attack-...) and an email-bomb DoS (2016 http://www.bbc.co.uk/news/technology-37979456 http://www.bbc.co.uk/news/technology-37979456). With on-site IT you can at least make daily (or hourly) tape backups of everything and can properly store and retrieve them, good luck doing so with Amazon Glacier. Just imagine an entire country unable to provide qualified medical assistance because a cloud provider goes down. And yes you do ALWAYS need access to a patient's background info, for example to look up if the patient is allergic to some medicine.

phil21 9y ago
I agree with both of you. The state of software and systems in IT is untenable, and it will be huge anchor on productivity. Absolutely no mid-sized medical practice is capable of maintaining these systems to any level of standard, and I do believe this is one of those areas that is far better served as a centralized SaaS model. As you mention, this opens up a new set of systemic vulnerabilities that should not be ignored. I see this becoming more like a large app that lives in the cloud, with a "black box" that acts as a local cache for any medical records assigned to the practice in question. Basically you get access to the "global interchange" of medical records/billing/whatever - and you still have the digital equivalent to a basement full of filing cabinets for the records you need on-site. Yes, if the "uplinks" go down you will lose access to the wider network - but at least the problem of accessing things you need during emergencies and outages is very solvable. Nothing I've seen related to healthcare IT has be very optimistic of something like that being implemented in a competent manner however.