Why Should a Hospital Move to the Cloud?

A hardware breakdown prompted Deborah Heart and Lung Center to outsource its data storage services. How do other health systems decide if and when to make that move?

Health systems have different motivations for migrating to the cloud. A catastrophic disk failure may be the best reason.

That’s what happened at the Deborah Heart and Lung Center, an 89-bed New Jersey-based hospital that focuses exclusively on cardiac, vascular, and lung disease. In 2015, the hospital’s systems pretty much shut down for close to two days after a drive ceased to function on its in-house electronic health record (EHR) system.

As the healthcare industry embraces more technology (especially digital health tools) and ramps up its data collection and analysis capabilities, how that data is stored and protected becomes critical. A July 2021 online survey by the College of Health Information Executives (CHIME) found that more than 80% of health system executives are conducting at least some services in the cloud, while nearly 10% are fully invested in the cloud and some 60% are adopting a hybrid approach.

The reasons for moving to the cloud are numerous. According to KLAS, roughly half of health systems are doing so to reduce costs and capital expenses, while 40% see the cloud as an opportunity to expand resources they don’t have on-site. Almost 30% are using the cloud to enhance services or capabilities, while 11% are looking to improve system performance and 9% see opportunities to improve data security.

That was the motivation for the Deborah Heart and Lung Center.

“It took everything down,” says Rich Temple, the hospital’s vice president and chief information officer, who’d come onto the job just six weeks prior. “It kind of came right out of the blue. We were struggling mightily to try to get backup [up and running]. It was the longest two days of my life.”

Temple says the health system had backups in place just for this occurrence, but the initial disk failure was so profound that some of the backups were corrupted as well. Ultimately, a backup file was restored and, two days later, the system was finally brought back up.

Shortly thereafter, leadership decided to outsource data storage and management for its EHR to CloudWave, healthcare data security experts.

Rich Temple, vice president and chief information officer, Deborah Heart and Lung Center. Photo courtesy Deborah Heart and Lung Center.

Moving to the cloud isn’t cheap—that’s the top concern and barrier that health system executives cite in making the decision whether to outsource those services, though studies have suggested it doesn’t take long for a health system to recoup those costs in savings. In a tight economy, with many health systems struggling to stay in the black, giving the green light to a costly capital expenditure isn’t easy.

“We knew then we couldn’t risk that happening again,” Temple says. “But you don’t do this as a money-saver. You do it for risk-avoidance.”

Aside from the initial cost, many health systems struggle with the operational changes required to make the switch. Every department is affected by the transition, requiring the C-Suite to get out ahead and develop a comprehensive change management strategy.

“It’s truly a multi-dimensional project,” says Temple. “We knew there were going to be a lot of twists and turns, and there were even more twists and turns than we expected.”

One familiar problem, he says, was getting buy-in. Despite the chaos caused by the disk failure, some providers were hesitant to want to adapt to a new system and expressed worries about what are commonly called “last-mile issues,” or problems unforeseen and encountered just as the new system is turned on.

“We’ve always done down-time drills, but everyone is so dependent on electronic health records,” says Temple, noting the health system has been using EHRs since 1998.

Temple says the health system worked long and hard to make sure the transition from on-site to cloud was as seamless as possible. That meant identifying everyone who would need access to the system and determining what they could and couldn’t access, creating licensing and multi-factor authentication and understanding the bandwidth needed to support back-and-forth operations, even understanding all the different platforms within the health system that have some interaction with the EHR.

In addition, he says, the fallout caused by the disk failure gave the Deborah Heart and Lung Center’s leadership the opportunity to look more closely at how the hospital handles its technology at a time when things aren’t working. What should a disaster recovery and business continuity model look like? And how should that model be adjusted when outsourcing certain operations to the cloud? Additionally, how does a health system create a plan to stay up and running after a data breach or a ransomware attack?

“Make sure your eyes are wide open before you start,” Temple concludes.