We Bring the Cloud to Healthcare

What The Future Looked Like a Week Ago Hopey, Feary, Changey Edition

August 26, 2016

What The Future Looked Like a Week Ago Hopey, Feary, Changey Edition

I have to confess; I went back to sifting through my own SPAM folder a little while ago. Not that I am a big fan of the electronic equivalent of dumpster-diving, and the algorithms behind the SPAM filters on Office 365 have gotten so good that there is rarely anything I want in there, but there is an occasional gem buried in the murk that I like to pluck out. Some of the “stuff” beckoning me to click through to the inevitable cheesy marketing YouTube video really isn’t all that bad and sometimes I accidentally learn something about a new technology or application. Excuse me, “app”. That being said, the stuff not marked as spam, because I somehow signed up for it, is certainly indicative of the trends in our healthcare IT community. Today, I have already deleted 5 offers for a whitepaper on ransomware, 3 on Data Analytics, 1 on Digital Health, and 4 on the transformation to cloud computing (really? I had no idea!). Right behind them on the ad pile is the industry’s current version of the future, increasingly virtual, hyper-converged, and hybrid cloud. I happen to agree but not with anyone as the end all and be all.

It occurred to me, as I left-swiped and tapped through my erstwhile electronic purge, that discussions of the future state of technology are often manipulated for less-than-savory purposes. As is so currently and painfully the case in politics, editors, advertisers, and opinion-makers use our lesser instincts (fear, mainly) to try to drive us to action, sometimes before we have fully formulated a sustainable plan or integrated the “solution to our fear” into our overall strategy. Those of us like me, who like to think we are at least a little technical, are just as easily lured by hope. The hope that if we can just adopt this new technology platform or the hope that we can undo a bad technical decision by layering something better on top of it, all our operating problems will diminish. Fear needs a plan to harness its energy in order to solve the real problem and hope needs a framework within which to invest its visions.

To me, this feels like an unusually dangerous moment for those of us trying to work together to create sustainable IT environments for healthcare. Fear often drives us to respond to how we feel about things, rather than explore all our options for solving a problem. As stewards of patient data, we have a healthy fear of ransomware, which drives us, often rightfully, to consider a lot of expensive security solutions. The actual reality is that the three best defenses against ransomware might well be to 1) have good, tested, recoverable backups; 2) to train users to turn a critical eye towards attachments; and 3) to subscribe or implement a virtual pre-execution environment that safely tests attachments, like Office 365 with ATP (Advanced Threat Protection) or a stateful firewall or IDS with FireEye-like technology. Fear of cloud security or data sovereignty loss drives decisions to buy yet another SAN or NAS and put it in the hospital data center with inadequate cooling, water pipes overhead, n+1 power, and an untested recovery plan, when in fact most connections are safer, more available, and more stringently managed in a well-constructed cloud service. Hope, on the other hand, can encourage our operational fantasies.

Hope feeds the popular delusion that we can make things simple. Anyone around IT long enough knows that the real secret to success is to embrace complexity with all your might and intelligence and then break it down into manageable chunks with a set of processes for controlling the chunks or components. The latest installment in converged or hyper-converged infrastructure, as awesome as it may be, is not going to make network or security problems go away and it is not going to reduce operational costs unless we are willing to “sweep the floor” and go with one consistent design. Flash storage, with IOPS galore, isn’t going to make badly implemented utility or O/S software run any better nor make our systems any more recoverable if they rely on distance replication and network virtualization doesn’t reduce operational costs until you get rid of all the legacy network schemes and don’t have to manage both anymore.

By the way, substantially all of the interesting technology I name-dropped in the prior two paragraphs is either in production or being implemented in services managed by CloudWave. We are pro-technology with an emphasis on pro and, as unrelenting as the Cylons in Battlestar Galactica (but with a heart), we have a plan. We do not make blind investments hoping for unlooked-for positive effects. We make intentional investments to get measurable effects which we turn into service commitments.

This is the way mature IT organizations take care of their customers. For our part, we are still happy to help customers strengthen their own internal IT with on-premises infrastructure, while using hybrid strategies to deal with backups, management, recovery, storage tiering, or archiving. Not only do we have the engineering talent to help with that, we now have hard-won and production-proven design knowledge that comes from managing IT services for 70 hospitals. Increasingly, we see customers deciding that they want to shift their IT focus from infrastructure management to applications and user experience management. The unfolding cloud era is really less about technology and more about managing what matters to your internal customers the most.

I realize that not everyone agrees with my perspective. What’s yours? Send me an email at jfitzgerald@gocloudwave.com with your thoughts and let’s show the politicos what a civilized conversation between intelligent people looks like in the next installment of our blog.

Jim Fitzgerald, EVP and Chief Strategy Officer is recently returned from a summer vacation, and shares that it isn’t a real vacation without at least one chewy science fiction novel and a peanut butter and bacon sandwich.