Monday, September 5, 2011

Cloud in Healthcare

A recent discussion on LinkedIn reminded me of my past exploits in deploying cloud solutions in Healthcare. I was involved in several projects with great organizations including Kaiser Permanente, The Diabetes Foundation, St Judes Children's Research Hospital, the LSU Eye Center and the Mayo Clinic. During these efforts we applied cloud in some really interesting ways including the following:

Diabetic Retinopathy: We presented on this at HIMSS in 2005. Our project addressed the rampant increase in diabetes among the poor of Louisiana. The two challenges were getting people to visit the doctor because the doctors were only available on certain days of the year, travelling to remote areas as part of their humanitarian efforts. The second challenge was finding qualified doctors who cloud leave their practices to travel. Our solution used low cost imaging devices to capture images of the back of a person's eye. It turns out the eye is one of the earliest ways to detect diabetes. The images were then uploaded to a cloud from which remote Doctors could identify early onset diabetes. Our goal was to improve service by using an automated filter to flag potential issues reducing the number of images reviewed by physicians. The approach resolved both challenges making the imaging locations available for a significantly longer time, some permanent, and didn't require the doctors to travel.

Long Term Digital Medical Image Archive: Digital medical images are captured in PACS systems which typically use expensive SAN technology for performance and redundancy. The challenge is that 98% of medical images are never used again after their first two weeks. As a result healthcare providers want to move the images to a low cost, long term archives as quickly as possible. HIPAA requires providers to keep the images for the life of the patient plus seven years, so retention is required. We developed a private cloud solution which provided an economical model for storing the images while also improving the ability to share the images between imaging centers, the hospital, ER/trauma centers, out-patient facilities and the primary physician's home office.

Electronic Medical Records: to be of use an electronic medical record (EMR), a folder containing a person's entire medical history from allergies and blood pressure readings to digital images and prescriptions, requires ubiquity in availability but strong security. Our solution used a cloud for the storage and management of EMR's. Each EMR was accessible through three methods. First, a person can grant others access to the account by creating logins. Second the person can grant temporary access by using their finger scan or RFID necklace. Third, a Doctor can request a limited version of the EMR in an emergency. Using WiFi enabled tablet devices the EMR's were visible via a browser from any enabled site (each site had it's own unique key which provided an additional layer of security so someone could not access the records from an unapproved location such as from home or the parking lot).

Disease Modeling: One area I found fascinating was the ability of medial researchers to create mathematical models to predict the course of a disease in a patient. They could identify with amazing results how weight, diet and even some genetic factors impacted the disease which could then be used to identify treatment regimens. Pharmaceutical companies could use the models to develop advanced chemical compounds. The compute power needed for even a simple analysis mandated the use of a cloud.

There is one other germane application I worked on however due to its proprietary nature and the potential value of the program I don't want to disclose it since I'm not the owner.

As I have repeatedly found, cloud really unlocks us from classical linear thinking in how we create solutions. We are in the early days of clouds and people way smarter than me will come up with solutions that will make us all stand in awe.

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