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The quaint English phrase “Good things come to those who wait” is apt advice to industry stakeholders bullish on the adoption of cloud technology for imaging IT. After a decade of wholesale change to imaging IT, there is little evidence to show cloud adoption has progressed towards the mainstream. Yet, a growing array of cloud-based imaging IT solutions are now available and cloud is again being widely debated. Could this latest breed of products signal the start of mainstream adoption?
Different Users Have Very Different Needs
“One size fits all” has rarely worked well in imaging IT. In fact, almost every imaging IT deployment today is different, nuanced by the unique complexity of pre-existing infrastructure, legacy software, organisational complexity, scale and user needs. This is too often overlooked by vendors and providers, leading to long, complex deployments and expensive professional services bills. Past products have also fallen foul of this critical fact and failed to cater for specific user groups.
The driving factors for selecting a cloud solution for imaging IT vary significantly between user groups. A large academic hospital will in general look at cloud as a means to improved accessibility to imaging data, with the ability to rapidly scale up new deployments and upgrades, while maintaining security and data ownership. Cloud adoption is not, as is regularly misunderstood, a cost-saving exercise for imaging IT in this scenario; frankly, the savings pale into insignificance in comparison to recent investment in electronic medical records (EMR) or cost-savings potential with better care pathway management. In contrast, a small community hospital usually wants to better manage cost, limit exposure to on-site hardware downtime and improve flexibility of use.
Small Providers to Drive Adoption?
At last it appears the industry is coming to terms with this and new cloud IT imaging products are being targeted to specific user groups. For small clinics and hospitals, this is more commonly in the form of SaaS-based products, with more predictable cost, integrated maintenance and support and full off-site storage. Moreover, the push towards modular imaging IT software will help to spur this change, leading to a common feature set of image ingestion, storage, workflow and viewing, in a secure, thin-client, hosted environment. Adoption to date has been slow -with the “trickle-down” effect of new technology from deployments at larger institutions. However, given the growing abundance of lower-cost solutions targeting this market, the adoption of hosted cloud for imaging IT solutions should outstrip that of the larger provider segment.
For larger providers and networks, tied to large capital budgets and long-term infrastructure investment, the managed service approach is a harder sell. Here the onus is on workflow capability and, above all, speed. Cloud is viewed as an enabler, to help develop inter-disciplinary information sharing, improve data access and improve the roll-out and scaling up of new software and features.
However, data ownership and security are also of tantamount importance to the provider and willingness to allow data “off-site” is uncommon. Consequently, vendors are now offering imaging IT software that better fits the “private cloud” model, either in a managed (third party administration and operation) or non-hosted model (software is located and managed by the health provider in its own data centre, but is accessible via a proprietary private cloud network). Cloud adoption will certainly ramp up in the larger provider market but with more focus on managed or non-hosted private clouds and far less third-party hosting.
External Forces
So, while user demand varies significantly and availability of user-specific cloud imaging IT solutions is improving, there are a few other factors further pushing the development of cloud technology towards a mainstream adoption tipping point. The focus on integrated care between disciplines and providers means data interoperability is top of many health providers’ agendas, while more common use of mobile technology is demanding data access from any networked location or device. Furthermore, a greater push for patient access and ownership of data is focusing the industry to utilise cloud as a means increasing the use of patient-provider data portals (enabling wider provider choice) and in improving security and data confidentiality. Add to this a global shortage of radiologists, stimulating growth for teleradiology and remote reading, and the digitalisation of pathology images, demanding more cost-effective storage options, and the case of cloud imaging IT becomes far stronger.
In the mid- to long-term, the influence of deep learning and artificial intelligence will also play an industry defining part in driving cloud adoption. Decision Support Tools and Computer Aided Diagnosis (CADx) software will be based on deep learning platforms that will need widespread access to large volumes of imaging data to be able to “learn” from it. Therefore, the common model today of on premise imaging IT and data-storage will be a major barrier to deep-learning unless cloud technology is embraced.
Taken together, these factors point to a need for more widespread adoption of cloud technology for imaging IT. Of course, barriers such as security concerns and data ownership still exist, but the direction and demands of future healthcare appear set to abolish them soon. So, while the tipping point for cloud-enabled imaging IT is probably still a few years-off, those “good things” are just around the corner.