We Bring the Cloud to Healthcare

Location, Location, Location? Yes!

December 4, 2018

Location, Location, Location? Yes!

As in the physical world, Location is also a really big deal in the Information Technology MultiVerse. As the migration of IT services to cloud milieus proceeds apace, I’d like to think about the question, “where is your IT platform?” As an unrepentant cloud evangelist, you probably expect me to push either a particular managed private cloud solution, or some public cloud solution, or an on-premise private cloud solution, but no, the answer I had in mind is “e. All of the above.” People often ask me in social situations what I do. Depending on who is asking I go with either the innocuous “I help hospitals with Information Technology” or the somewhat more accurate “I help hospitals envision and execute multi-Cloud IT platform strategies that generally improve performance, security, and availability.” So, when I say, “e. All of the above.”, it’s simply human being for “multi-cloud”.

It seems to me that all cloud is multi-cloud. Most are familiar with Public Cloud, and many are using it both knowingly and (sometimes) unknowingly. Public Cloud is a loose label for IT services or resources sourced from one of the “Big 4” public cloud utility providers, Amazon, Google, IBM, and Microsoft. Most hospitals virtualized their IT platform years ago and are managing a neat little cloud of their own. We used to call that Private Cloud, but that tends to create confusion between assets on your premises or in your data center and assets managed for you by other providers. A new terminology for your in-house IT resources, Cloud Edge is probably here to stay. The industry is working hard in the area of technology convergence to reduce the footprint and ease management at the edge. There are also highly specialized Managed Private Clouds like our OpSus service for workloads that just don’t fly on public cloud yet. Managed Private Cloud typically combines the benefit of a best-of-breed hardware solution with elements of a Public Cloud solution. But the key difference between public cloud and managed private cloud is more about people and IT services than it is about technology. Simply put, the public cloud doesn’t usually come with people, and a managed private cloud usually does. Cloud Edge solutions are either managed by your internal IT organization like traditional capital hardware investments or are provided by a 3rd party as an on-premise consumption solution with bundled managed services. A multi-cloud solution draws on all 3 cloud models to form a cohesive IT services platform.

The fundamental difference is whether your organization decides it is going to manage IT services or create IT services. Some might argue that both are still an option, but if you think it through the skill sets to create and maintain IT platforms are fundamentally different than the skill sets to acquire and manage IT services. With the money in the healthcare industry aimed squarely at providers and consumers, the likelihood is that all but the largest IT shops will settle on managing IT services as illustrated in the diagram below. So, agent of IT change, your new mission, if you choose to accept it, is to start thinking Location, Location, Location. What is the best fit platform for each of your workloads? Where should each workload be located?
A good way to start is to work with your technology and applications team to do a searching and fearless inventory of every physical and virtual workload. There are tools in your existing environment that will make this relatively easy for your VMs. You may even be fortunate to have discovery and management tools in your environment that are aware of all your physical workloads. Get it all into a tool you can share. One immediate benefit is that you may find a lot of workloads you can simply shut down. Others you can map to your own Cloud Edge, to Public Cloud, or to Managed Private Cloud. CloudWave helps companies with this planning and migration. It is a particularly valuable exercise if you are on the cusp of upgrading your in-house hardware or considering a shift of workloads to a managed private cloud or public cloud. Culling old systems, perhaps safely retiring some old apps to archives, having a migration plan for key services and workloads can be a strong way to avoid bad investments and poor IT outcomes.

There is a common misconception that people dislike change. I’m not sure that’s true. I think what people often feel profoundly uncomfortable with is transitions. That said, those who manage transitions successfully are often heralded as leaders. This transition in IT has been brewing for a decade. For some, this new way of thinking about managing IT Services and Workloads may come as an unwelcome splash of cold water. For others, it may be the doorway to a saner existence. As in most things, our history informs our perspective. Few would argue that with IT taking center stage as a vital component of patient care, the pressure to create positive end-user experiences for patients, caregivers, and administrators alike is at an all-time high. Shortages in the IT labor market have persisted and expanded in the current economy, and shortages at skill positions, like networking and security, are especially acute. At the same time, the software has grown more intensive, more connected, more mobile, and therefore prone to more security threats. In the early days of healthcare IT, a handful of mysterious specialists working on a skeletal budget were applauded for improving the revenue cycle by a few days: today in time unless you are working at a multi-organizational scale the moment is coming or has already arrived when it takes a services management approach to solve the IT equation. The map above is merely an incomplete example, but perhaps it is a useful archetype for your 2019 plan.

Jim Fitzgerald is an EVP and founder of CloudWave, assisting the team with strategy, marketing, and long-term customer and partner relationships.