© 2015 IBM Corporation

Integrating Healthcare in the Cloud - AEC-2064

Amy McCormick

Product Manager

Healthcare & Life Science Industry

Shifts in the Healthcare Industry

Expectations for better quality outcomes and values

Escalating incidence and cost of chronic disease

Changing demographics and lifestyles

Globalization of healthcare

Critical resource shortages

Increased competition and new entrants

Expensive advances in technologies and treatments

3

Consumer Expectations are Changing

More than half of

“connected” consumers

state social media

interactions influence

decisions including spendTop area for health plan

innovation:

Convenience and Ease

“Serve me”

Personalize offerings, experience and services

“Know me”

“Listen to me”

As Consumers Change, Multi Speed IT is Vital

Facility Call center Website Mobile

Traditional IT

Hardware focus

Terminal access

Build in house

Project based rollout

Centrally hosted

Delivery in years

e-Commerce

Software focus

Browser access

Buy in packages

Commodity hardware

Centrally hosted

App Stores

Apps & Data focus

Mobile access

Crowd source

IaaS, PaaS

Continuous delivery

Instant deployment

90%of growth in IT will come

from cloud-based solutions Source: Forbes quoting IDC The Marketing Software Revolution:

Strategies for Buyers and Sellers [Link]

Cloud Adoption in Healthcare

9.3%Plan to Adopt

Cloud 83%6%

Already Using Cloud

Do Not Intend

to Adopt

37.1% 36.3% 23.4%Private Cloud Hybrid Cloud Public Cloud

Source: HIMSS Cloud Survey 2014

Why is Cloud Relevant to Healthcare?

Unforeseen health pandemics

Drug recalls

Regulations, policy and budget changes

Move to digital projects sponsored by the CMO

Support of big data

Crossover between Web, physical and mobile channels

Facilitate sharing among authorized physicians & hospitals

Drive to the market-of-1

Analyze information to act (treatments, costs, performance)

Cloud allows scale and/or reduce your IT as needed.

Recruit partners or crowds to innovate for you. Time-to-Market.

Virtualized infrastructure blurs the silos.

Draw on 3rd party services for insight and demographic info.

CAPACITY

BUDGET

DELIVERY

ANALYTICS

Deciding on Cloud Deployment Model

Considering types of applications

• Clinical Applications:

• EHRs

• Physician Order Entry Systems

• Imaging

• Pharmacy

• Non Clinical

• Revenue cycle management

• Automatic patient Billing

• Cost accounting

• Payroll management

• Claims management

Deciding on Cloud Deployment Model

Software as a Service

Platform as a Service

Infrastructure as a Service

IaaS

PaaS

SaaS

IBM BlueMix

Amazon Web Services

SalesForce

iPaaS

HRWorkforce

Management

Types of Cloud Service Models

GoogleAppEngine

Caspio

EPIC

EHR

Private Cloud Hybrid Cloud Public Cloud

Rackspace

Healthcare Organizations Responsibilities with Cloud

IaaS

PaaS

SaaS

Source : DSS Cloud Guidelines

Com

plia

nce R

esponsib

ility

Healthcare Organization

Service Provider (CSP)

All physical, hardware and software

infrastructure provided by CSP

HCO responsible only for

Data and interfaces to

system

HCO responsible for

applications, solution stack,

Data and interfaces to system

Physical infrastructure, hardware and

operating environment (OS, virtual

machines etc) provided by CSP

Physical hardware and virtual

machines/ hypervisor infrastructure

provided by CSP

HCO responsible for network

and operating system,

applications, solution stack,

Data and interfaces to system

Cloud Options – The bigger picture

Supply Chain

eCommerce& Mobile

Dynamic Infrastructure

• IaaS

• iPaaS

• Virtualized middleware

SaaS • CRM

• EHR

• HR

• Marketing

• Analytics

CRM WMS

.NET App

ServiceDB2

IMS

CICS TS

MDM

Files

Rules

Process

Analytics

SAP

EHR

Dynamic Infrastructure

• Virtualized middleware

• Virtualized apps

HC Facilities,

External Orgs.

SaaS for easy cloud adoption

• Most prevalent

• Easiest to adopt

• Pay as you go subscription

models

• Likely use more than you realize!

• Salesforce.com, SugarCRM

• Workday

• EMM - IBM ExperienceOne,

Silverpop

50%of CRM systems deployed

as SaaS by 2015 … SaaS

deployments of CRM to reach a

maximum of 80% to 85% by 2025 Source: Gartner

Gartner CRM Vendor Guide 2014

Virtual private cloud as a capacity savior

• Virtual Capacity when you need it

• IaaS - Bare Metal or pre-configured

software stacks

• Testing and development

• Pay-as-you-go SW capacity

• Third party services – partners

• Pricecheck, location based

services

• IBM Softlayer

• IBM Cloud Marketplace offerings

• IBM BlueMix Dedicated

OMS WMS

.NET App

ServiceDB2

IMS

CICS TS

MDM

Files

Rules

Process

Analytics

SAP

EHR

Private Cloud

• Local and behind own firewall

• IaaS - First wave of adopters taking advantage of virtualized

hardware and solution stacks

• DevOps savings through shared hosted infrastructure

• Savings in TCO and rollout overheads

• Cloud infrastructure offerings based on virtualized containers

• IBM PureSystems

• IBM BlueMix local coming

Questions to Ask & Pitfalls to avoid

• What data do I consider as business differentiating?

• Passing large data volumes between on premises and cloud –

would it be better to integrate the data from where it is?

• Losing control of access to Core Data

• Bypassing your governance in a bid for rapid delivery

• Challenges related to Legislation

• Adherence to HIPAA and PHI security (patient consent)

41%of cloud users

concerned about

Integration with existing

architecture Source: KPMG Cloud Providers Survey 2013

Today - Right integration, right place

? ?OMS WMS

.NET App

ServiceDB2

IMS

CICS TS

MDM

Files

Rules

Process

Analytics

SAP

EHR

?Simplicity

Purchase model

Cost Privacy & Security

Throughput

Latency

Cost

Privacy & Security

Throughput

Latency

Cost

IBM Integration for the cloud

• IBM Cast Iron – deployed as iPaaS through Cast Iron Live

• SaaS to SaaS, data sync….

• Simple point to point SaaS to on Premise System connectivity

• Secure Connector between applications

• IBM DataPower appliance – deployed as gateway

• Secure connectivity to SaaS endpoints - individually managed VPN connectivity

• Physical in DMZ or virtual edition in VPC

• IBM Secure Gateway – today on Bluemix

• Secure connectivity to cloud endpoints – private cloud, private data in SaaS applications

• Part of new Hybrid integration Services

IBM Integration for the cloud

• IBM Integration Bus + Healthcare Pack - Market leading on

premises ESB supports multiple cloud configurations & building

of hybrid Cloud environments:

• Deployable to AWS, Softlayer, Azure as IaaS on virtual machine

• Install, configure, manage yourself - Monthly rental pricing

• Deployable as preconfigured PureSystem pattern virtual private

cloud

• PureSystem pattern on Softlayer

• Coming soon IIB Managed cloud on IBM Softlayer

• Hosted & Managed offering

• IaaS+ installed and configured ready for integration

deployment

• Tiered capacity based pricing

Today - Right integration, right place

OMS WMS

.NET App

ServiceDB2

IMS

CICS TS

MDM

Files

Rules

Process

Analytics

SAP

EHR

IBM Cast Iron LiveIBM integration Bus

IBM DataPower

secure gateway

IBM Integration Bus

Tapping into innovation – cloud and API’s

• Public API’s support innovation

• Engage innovators beyond your walls

• Protect your core systems

• Self Service API’s reduce overhead without giving up

control

• Internal/private API’s form the backbone of a private

cloud deployment – decouple silos / secure zones

• API’s accessible through PaaS platforms driving next

boom in composable services

• What do you want/need to expose to build a meaningful

application?

Example APIs in Healthcare

Patient Record• Demographics

• ADT

• Allergies

• Family History

Prescription• Prescription tracker

• Auto Refill Orders

• Fulfillment

• Education

Medication• Retrieve Medications

• Medication orders

Documents• Clinical Notes

• Transcription, images

Lab• Test requests

• Lab results

Dietary• Dietary orders

• Tracker & updates

Scheduling• Appointments

• Drop-in requests

• Visit Tracker

Procedures• Procedure Log

• History

Providers Data• Specialists

• Location based

A single, comprehensive solution to

design, secure, control, publish, monitor & manage APIsSaaS or on-premise, multi-tenant solution,

for API providers

Built on IBM DataPowerAPI Gateway for security, control, integration &

optimized access to mobile web and cloud

IBM API ManagementAvailable for

purchase on

Analyze & Monitor Manage & Share Create, assemble

On-premise

privateOff-premise

SaaSOff-premise

privateHybrid

A New Era of Teamwork

Photo Credit 1Photo Credit 2

Photo Credit 3

Traditional IT

Mobile Apps Team

External Digital Teams

CMO sponsored Internal

Mobile & Digital Teams

Core IT Systems

New innovation

Hackathons

Start-ups

The IBM Portfolio Supports Your API Ecosystem

Internal

developers

Developer

communities

IBM Integration Bus

LabScheduling

.NETApp

ServiceDB2

IMS

CICS TS

Rules

Process

Analytics

SAPEHR

Partners

IBM API Mgmt

API’s and Composable Services

• Compose not code -

Build apps by plugging

Services together

• Targeted at mobile and

digital teams

• Focus on rapid

development of

application not

infrastructure

• Relies on rich set of

services as API’s

My Application

The IBM Bluemix PaaS

All Driving a Hybrid Approach to Applications

Cloud based

Analytics

packages

SaaS based CRM data

Private Partner

Services

New Customer Application

Internal CRM Data

New Hybrid Integration Services on BlueMix

Shaping your

data for use

by apps

Deliver data

to analytics

engines

Rapidly

compose

and mix

APIs into

new apps

Exposing

APIs and

Data sets

Securely

connect

Bluemix to

your local

cloud

Passport

based for

total

control

Hybrid Integration Services

OMS WMS

.NET App

ServiceDB2

IMS

CICS TS

MDM

Files

Rules

Process

Analytics

SAP

EHR

Summary

• Maintenance costs

• Reduce total size of IT budget

• Shift from capital intensive to operating expense model

• Improve resource utilization

• Speed of deployment

• Improve internal service delivery levels and business

agility

• Access new functionality faster (public)

• Build revenue generating products & services faster

• Staffing Challenges

• Improve staff productivity and/or reduce headcount

• Give business units more direct control over sourcing

their own IT solutions

Simplify & standardize IT infrastructure and application platforms…

Summary

• Type of application will dictate the cloud deployment model

• Private, Hybrid, Private Public, Public

• Cloud service model that best addresses business requirement

• IaaS, PaaS, SaaS

With consideration as to the best fit for your organization

Software as a Service

Platform as a Service

Infrastructure as a ServiceIaaS

PaaS

SaaS

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