INDUSTRY NEWS • ISSUE III, NOVEMBER 2014

Do you feel a bit lost in the fog as you search for the right strategy, cost, and solutions relating to cloud computing? Fear not; we have a couple of beacons of light in the form of professionals from two segments of the market to help navigate.

Peak 10 has been providing data center services since 2000, and Vice President of Governance, Risk, and Compliance David Kidd says the cloud is “just one more piece of infrastructure for them. As a data center service provider we’re managing that shared infrastructureundefined physical security, and the power systems, and the environmental conditioning, and cameras, and the technical assistance center monitoringundefinedall of those pieces that make a safe and reliable home for a computer system that’s secure and available to our customers’.”

So Peak 10 is something of a veteran, whereas Carolinas Healthcare is in its “infancy in dabbling in this field,” according to Assistant Vice President Jeff Shaver. “We do have some equipment applications that we are currently testing in an offsite cloud-type environment.” He explains that this “is new for us as a healthcare system due to patient confidentiality issues.” In healthcare, current storage options have “cleared that hurdle.” But times have changed, and the Affordable Care Act (ACA) is driving much of that change. Jeff doesn’t believe that “with where healthcare is going, we will ever decrease the data storage needs. But can we at least decrease the acceleration of it.

“The reality,” he says, “is so much of our healthcare is starting to go electronic, whether it’s electronic medical records, digital imaging, virtual intensive care unit monitoring and data gathering, or even simple analytics. We’re just starting to evolve in that world. With a legacy data center, we’re at the juncture of exploring the cloud as a viable option to us because in healthcare, the ACA is reducing our revenue streams. So we’re getting paid less to actually do more. As a not-for-profit, it is limiting our ability to reinvest back into ourselves. That’s what we’re evaluating now. Do we manage our capital expense dollars for the future to broaden, develop, and expand our current data center environment? Or is our interest better served in a cloud-type environment that would give us more ability for flexing up and down to demands and needs than we would if we owned that site?”

David echoes this sentiment. “The flexibility of being able to turn up services very quickly, being able to expand and contract computing and storage resources on demand: That is a huge benefit.” He says it’s in keeping with “the 7×24 Exchange mindset, which is very keen on availability, on keeping systems always at the ready, and recovering them quickly when there are disruptions. One advantage that is key to a cloud environment that is not as easily handled in a traditional, physical hosting environment is in recovery options. When data is distributed over a geographically diverse cloud solution, you have a lot of resiliency and recovery capabilities by virtualizing that you simply don’t have with a physical server. When you have your computing infrastructure spread across multiple locations, you don’t run the exposure of a single disaster or crisis impacting you. When you look at the recovery capabilities available through cloud computing, it’s becomes really attractive.”

But what about the investment? “Being a cloud services provider as well as a data center services provider, we’re investing in cloud infrastructure,” says David. “Just as we tend to invest on the high end of the data center to achieve strong efficiencies, and a highly secure, highly available environment for our customers in the data center world, we’re doing the same thing in the cloud as well. For our cloud infrastructure, there’s significant investment in both the computing and storage equipment. It’s also an investment for us in terms of the expertise of the engineers and technical staff who are managing those systems. We’ve needed experts in storage systems and VMware and Cisco infrastructure. We’ve grown our staff as we’ve moved into the cloud, and it’s meant that they are now qualified in some unique specialties that they would not have been in the days prior to the cloud.”

Like any for-profit enterprise, Peak 10 invests profits from its services in upgrading and maintaining cloud solutions for its customers. But Carolinas Healthcare is a not-for-profit entity. How do their considerations differ when it comes to investing in the cloud?

Jeff says that for their cloud expansion, “capital expense is the prime driver, because as a not-for-profit, the excess revenues we make are purposefully reinvested back into ourselves. So if we’re reinvesting those dollars, do we reinvest in direct-care technologies or in support technologies in the form of IT? So as that capital becomes more limited, how do we put it at highest and best use? Increasing peoples’ skill sets to help us manage and deploy is the method of preferred operation today.” Capital investment is just one piece of the equation. Carolinas Healthcare offers connectivity and support for more than 36 hospitals and 900 care locations. Being able to provide what Jeff calls a “full continuity of care” also figures into the equation.

“When a person enters our system, we need to make that interaction and that transition through various levels of care in our facilities seamless to not only the patient but to the caregivers in terms of the information we gather,” he says. “That way we’re not constantly re-asking the same questions, repopulating the same information. An assessment completed at facility A needs to be readily available if the patient has to move to facility B to receive a different level of care. Technology has to be an enabler of that.”

Jeff believes that “Data is going to become more prevalent, but if capital becomes more scarce, we’ll be forced to choose between investing in an owned data center versus new technologies that improve the level of care we deliver to our patients. We’re going to invest in those technologies that have the direct impact on patient care. So we have to find other means to manage that information in a more cost-effective manner, and the cloud may be that way. But I think that’s still undetermined. With the tighter pressures on capital, though, the ACA may drive more people toward that dialog sooner than later.

Like Jeff, David sees the cloud as one piece of data management pie. “I’m not sure that it’s a zero-sum game where systems are being shut down in the data center world one for one as they move into the cloud. There are definite trends to move stuff towards the cloud. There is keen interest in the cloud, but there is also keen interest in traditional data center services. I wouldn’t say that one is going to eclipse the other.”

David Kidd is vice president of governance, risk, and compliance for Peak 10.

Jeff Shaver is assistant vice president, plant operations and maintenance, for Carolinas Healthcare