Venyu Blog

Time and again I find myself in agreement with George Crump, President and Founder of Storage Switzerland and regular contributor to Information Week so when George suggests that Health Care is a Good Match for Cloud Computing I “get it” and believe, generally, we’re on the same page.

In that context, Crump writes:

“Cloud storage has a role to play in many organizations. It can be used as part of the backup and archive processes and in some cases even used for primary storage. There are specific enterprise vertical markets however where cloud storage can be especially beneficial. The markets share a common need to be able to not only retain information but also retrieve that information. A good example of this is the healthcare industry, potentially the most regulated industry in the world. This is also an industry that has seen a massive conversion to digital records. It is now commonplace to see doctors walking into patient rooms with iPads that provide them with complete access to a patient’s history at their finger tips. They can see more patients per day while providing better care than ever.”

Still, I do have to wonder what cloud computing portends for healthcare when doctors can use it to either accept or deny patients from being added to their practice when that prospective patient’s data is archived, accessible and available via the cloud for subjective evaluation.

This turn-of-events reminds me mightily of the days of pickup basketball, either on the school playground or in the neighborhood park. You know the routine. It’s called choosing sides. Two “captains” are designated and along with everyone else you stand in line waiting (and hoping) to be picked. Time goes by and one by one each member of opposing teams is selected. Soon you’re down to the last pair and mostly these are the kids who don’t bring either the physicality or the perceived mindset to the game at hand. Inevitably at least one of these last two has to stand on the sidelines because they weren’t picked or, more often than not, pack it up and just walk home, dejected they weren’t picked and wondering what they can do to convince their friends they’re worthy of an opportunity to prove themselves, just like everyone else who got “picked.”

Case in point: this Information Week article by Marianne Kolbasuk McGee – “Cloud-Based Images Help Montefiore Doctors with Referrals.”

Montefiore Medical Center, based in the Bronx, NY has uniquely harnessed “the cloud” in an effort to better screen referred patients described as those who are not yet official patients. They achieve this screening and patient disposition based on a review of medical images that helps them determine if the case warrants their clinical expertise. As described in the article these use cloud-based services to view high-quality medical images. Things like MRIs and CT scans where, thanks to cloud computing, physicians can collaborate on the diagnosis and treatment plans of high-risk, referred patients without having to trade film, disks, or order new tests.

That said, not all referrals are accepted as medical center patients and as a result these images are not immediately added to Montefiore’s picture archiving and communication system (PACS). But the images–which are often sent to Montefiore on disks or film, aren’t easily physically shared among the number of specialists who may need to review them. “Doctors will say, I have a disk that I need to share with another doctor across campus,’” adds the spokesperson. “If we get images on a CD or film, consults are very time consuming, we often need to share these images faster among groups of physicians,” he said.

With that in mind, Montefiore recently launched a project that allows its doctors to view medical images of patients without having to send a disk to multiple physicians. It’s storing and sharing medical images of transient patients on a cloud-based image sharing platform offered by a provider of cloud-based medical image e-sharing services and products.

The applications allow doctors to upload a CD with medical images into the cloud so that multiple physicians can securely view and share high-quality images via a Web browser or Mac, without the images having to be part of the medical center’s PACS.

As a result of this cloud-based service Montefiore can send images from its PACS to the cloud provider so that doctors at other institutions, such as the University of California, Los Angeles, can study the images, conducting a full clinical study with the images.

A spokesperson for Montefiore defends the practice this way: “Doctors here get a lot of referrals from around the world. A lot of patients need consults to see if they’re eligible for our care.”

To my ears that sounds more like an exclusionary than inclusive system of healthcare “adjudication” — a perennially out of balance construct that will never be quite in synch with the requirements and demands of patients in the real world.

Much like a medical test that’s been ordered and the resulting diagnosis, I agree in principle with George Crump that healthcare and cloud computing go hand-in-hand. I even understand the litmus-like practice by Montefiore physicians to screen and accept patients by what they “find” and view in the cloud, especially when demand outstrips supply.  However, I can’t help thinking of that player not picked for the line-up who has to make his way home, alone, with no chance to join the pickup game that day or maybe ever simply because his body wasn’t up for the demands about to be placed on it. Cloud or no cloud what do you say to a patient who faces that same dismal outcome?

In spite of its detractors maybe Obamacare does have its advantages after all.