Going through the concept of placing servers connected to each other on the machines (Cluster Computers) and moving on to what really revolutionized the use of the distributed environment was the concept of virtualization (Concept already existing in mainframes (eg IBM VM)) that allowed the use of virtual servers and storage, as if each user had a physical computer but actually shares the physical resources of the servers between them. This virtualization grew and also reached the area of telecommunication networks which allowed a concept of sharing of computational resources and universal network, or Cloud Computing.
Associated with this come the contexts of commercialization of SW for payment of use or SAAS (Software as a Service) that broadens the horizons of what we call Cloud Computing.
Therefore, Cloud Computing or Cloud Computing in definition is the possibility of using computational resources (Mainly processing and storage) on demand, that is, we pay according to the service we use, which may decrease or increase the extent of our needs, often associated with internet connection.
Also important to note is that the physical computing resources no longer belong to the client company (it only pays for the services), including the applications and their maintenance.
Forms of Cloud Computing
There are three ways of Cloud operation:
Infrastructure as a Service (IAAS)
Platform as a Service (PAAS)
SAAS (Software as a Service)
IAAS is basically the use of computational resources as a service (Infrastructure) that allows you to reduce investment costs and bring them to operating costs, as well as scalability and flexibility that would not have in the client company’s proprietary physical environment.
PAAS, whose benefits are the same as above, allows you to share platforms whose tools include Software Development, Big Data, Interoperability, Security, etc.
SAAS brings application sharing with the same benefits as above.
Healthcare is already badly affected by cloud services today. What are the reasons health companies are seeking these services?
The main one is cost, ie cost savings, followed by scalability, the use of streaming tools, image manipulation, use of Big Data (eg Population Health Management), Artificial Intelligence tools, the ability to interoperate data. (Information Exchange), and mainly use Cloud applications (Ex. HIS).
1-Health Concerns and Recommendations:
2-Reduced application customization
3-Patient and doctor data is in the cloud ie outside the institution’s environment and this concerns in terms of privacy and security.
4-In the matter of security LGPD also affects the concern of Cloud use in the healthcare market.
5-Incidentally controls will always be required on the user side to ensure that even if the cloud provider is not fully aligned with the required information security and privacy rules (It is strongly recommended to read the rules created by the US HIPAAA for this purpose in use cloud computing, and check if the provider is really bringing this type of implementation in your cloud (Not only does it say that it is in compliance, you need to check the certification)
Trend in the market as a whole and health does not escape this, we will have hybrid environments where part of the physical computing resources will be owned by the client company and part will be offered as a service through a cloud computing provider, which will require integration concerns. and interoperability
6-Ideally, the choice of which applications, platforms and consequent infrastructure will be brought to the cloud should follow a plan made by the IT department of the institutions with the focus of assessing costs, security and reliability issues, information needs and interoperability, among others. This is a typically consulting project that does a gap analysis to assess this context.
Medical Images in the Cloud
Demands in the area of medical imaging are many and therefore the area can be considered one of the precursors of using cloud computing in healthcare. Important features include:
1-Scalability – The volume of medical images is increasing and exponential as imaging equipment is updated, or new equipment appears (Es. Breast tomosynthesis that achieves images of the entire breast field no longer focusing on a planar section or bow)
2-Technology Management – Not everyone who invests in medical equipment can have an IT structure and people to manage the equipment and software inherent there.
3-Medical Evolution – Nowadays many images are stored in a storage called hot ie available in real time so that doctors in institutions can access them. However, this storage period is often very short, as due to high storage costs, images after a few months are transferred from these storages to media not available to many doctors. (It has been heard from a doctor saying that after a while TI threw the images away).
Thus, with cloud storage there is a reduction of investment costs allowing a longer period of maintenance of images available to the doctor. Worst of all, one does not take into account the high costs of having to repeat images already taken to monitor the patient and the safety of the patient who is exposed to more radiation apart from the job of having to do the tests again.
4-Imaging Analytics – Using the cloud allows for greater data distribution and storage capabilities allowing you to make use of advanced image analysis techniques such as big data, radiomics and machine learning.
4-Standard Assurance – It is also quite interesting to think that the DICOM imaging environment can be more controlled if we have interoperability in the hands of a single cloud medical imaging provider.
Some Market Numbers
Today nearly 50% (ie the majority) of cloud-based healthcare services are focused on applications (SAAS), typically HIS, RIS and PACS, among others.
The market, according to Markets and Markets research, is expected to reach nearly $ 45 billion from an estimated market of nearly $ 19 billion by 2018.Recent studies from around the world show an astronomical growth in data use as studies by Data Never Sleeps Report:
1-By 2020 it is estimated that for each person on the planet, 1.7MB of data will be created every second.
2-90% of all existing data today has been created since 2015 being 2.5 quintillion bytes per day
3-Every minute in 2019, Instagram users post 277,777 stories and over 50,000 photos, 188 million emails, 4.4 million Google searches, and 700,000 hours of video on Netflix.
Thus, the growth of information and data is very large and large cloud providers have to take up large spaces for their resources and greatly increase their infrastructure costs to meet market needs, but it would be much worse if we had to. only in our own computing environments.
Recent Israeli research is beginning to spawn a new idea for data storage at no cost to maintain the storage needed for this growth. It is the use of DNA as a storage medium.
With regard to security, the use of blockchains and the possibility that instead of being controlled by institutions, having centralized control by the provider, can facilitate the use of tighter and more robust information security solutions than the current environments. their on-premises.
We will surely have many things to do in terms of trends and computing facilities available to our institutions in the future.