Healthcare Data Storage Options: On-Premise, Cloud and Hybrid Data Storage

Healthcare organizations are challenged with selecting the on-premise or cloud storage solution that best suits their health IT infrastructure.

Source: Thinkstock

Healthcare organizations are building their IT infrastructures to be more flexible and scalable to meet the growing data demand. With value-based incentives for data analytics and the increased number of connected medical devices constantly collecting data, organizations are challenged with storing clinical data in a way that is both HIPAA-compliant and easy for authorized users to access.

Traditionally, healthcare organizations have shied away from cloud data storage in favor of on-premise options because of the control IT administrators have over physical datacenters. However, entities are recently more likely to implement cloud storage into their IT infrastructure to some extent because of the reduced maintenance costs and improved HIPAA-compliance.

Cloud data storage options offer a flexible and scalable environment at a lower cost than on-premise deployments, which is appealing to covered entities. Organizations exploring data analytics are expecting their storage requirements to steadily increase as Internet of Things (IoT) and mobile devices collect data that needs to be stored.

One of the biggest data storage challenges healthcare organizations face is how to piece together legacy systems while integrating new systems into the infrastructure. Many entities cannot afford to mass migrate data from one storage system to the other, which is why interoperability between different cloud vendors is necessary for a smooth transition.

Not every healthcare organization will benefit from the same type of data storage, which makes choosing a storage deployment a challenge for any organization. HITInfrastructure.com will discuss the benefits and drawbacks of different storage options and explore the potential of on-premise hosted virtualized storage solutions. 

Defining the Basics of the Healthcare Big Data Warehouse

Comparing On-Premise, Cloud, Healthcare Data Stroage Solutions

Reviewing potential benefits of on-premise deployment options

Pure Storage Vice President and CTO of Healthcare Vik Nagjee explained that healthcare organizations are more likely to lean toward on-premise storage than other industries because the control they have over an environment kept in-house.

“Hospitals tend to want to build their own datacenters,” Nagjee told HITInfrastructure.com. “It happens all the time. Uptime is super important in healthcare; you can’t afford to have these systems go down.”

On-premise storage does not require a wireless internet connection to retrieve clinical data, making it considerable less risky. Due to the nature of healthcare data, organizations want to deploy the storage solution they feel is the most secure, which is often the solution they have the most control over.

Forward Health Group CTO Jeff Thomas told HITInfrastructure.com that there is a comfort level for organizations in knowing that their data is in their data center.

“They can walk up and touch it, and sometimes it's that emotional comfort factor that has some healthcare organizations leaning toward keeping data in house,” Thomas noted.

On-premise storage has also evolved over the past several years to include rack servers and hyper-converged solutions.

Rack servers are more scalable than dedicated tower servers because they contain racks where more hardware can be placed. Rack servers also don’t take up as much space or require the same cooling energy costs, which makes them ideal for smaller organizations that want to host their datacenter on premise but don’t have much space or resources.

Many rack servers use flashed-based array, which brings down operating costs even more because of how they’re built. Flash-based arrays use solid-state drives (SSD), meaning they do not have fans or get as hot as traditional datacenter hardware. This also helps bring down maintenance costs significantly.

Hyper-convergence can also be hosted on-premise, but uses cloud and virtualization technology to store and run a health IT infrastructure.

“Cloud solutions are very beneficial from the standpoint that as you migrate data, you don't need to maintain your own datasets which can be costly and expensive,” said Forward Health’s Thomas. “I’m saying costly but maintaining datasets on-site can also be expensive in that it takes up real estate which can sometimes be used for something else.”

Servers hosted on-premise are costly because of the resources they require to maintain. Healthcare organizations have to find the physical space within the organization to host the servers. Cooling costs are also a big expense required to ensure the servers do not malfunction. 

Healthcare IT Budgets Restrict On-Premise Server Deployments

Rack Servers Assist Flexible HIT Infrastructure Datacenters

How healthcare cloud data storage options could benefit the industry

Cloud data storage options have become more popular in healthcare over the past several years as the general stigma of hosting data off-premise has worn off. As organizations adopt mobile applications, storing clinical data in the cloud gives users more complete access.

Cloud data storage also saves organizations money by allowing them to purchase more storage space as needed, rather than investing in additional on-premise servers.

According to a HIMSS survey ,“Connectivity should easily ‘scale up,’ as more applications are moved to the cloud or more compute cycles are accessed for analytics.”

Healthcare organizations are demanding more storage space for big data analytics and the volume of unstructured data needing to be stored for analytics initiatives.

A SADA Systems survey conducted late last year found that 89 percent of healthcare organizations are currently using cloud-based health IT infrastructure, including cloud-based apps. The vast majority of providers are likely to increase their investment in these tools over the next few years.

“Cloud-based IT infrastructure and applications are apparently providing healthcare organizations the opportunity to operate more efficiently, innovate faster and better engage so-called Millennials,” SADA Systems President and CEO Tony Safoian said in a statement.

“This is consistent with what we’re hearing from customers and partners,” Safoain continued. “Cloud apps and tools that connect administrators to suppliers, doctors to patients and hospitals to staff are increasingly important – not only because they improve productivity and enhance patient care and satisfaction, but because they distinguish modern organizations from legacy providers, which is attractive to the younger generation of healthcare users.”

The future of the healthcare cloud is trending upward as analysts indicate that cloud is becoming the preferred choice for healthcare back-office applications, backup and disaster recovery, revenue cycle management and patient engagement. Advantages of the cloud can also include, cost savings, scalability, speed, freed up internal storage, a mobilized workforce, and improved user applications.

While cloud data storage has many advantages when it comes to cost and scalability, there are still several drawbacks organizations should consider.

The most prominent concern organizations have when moving to the cloud is the lack of control over where the data lives. Organizations can choose between public and private hosting services. While private cloud options give entities more control, they still do not offer the same level of control as on-premise servers.

Private clouds give IT administrators more control over the storage environment, but deploying a private cloud can be costly because of the expert staff required.

HIPAA compliance is also a concern for organizations looking to migrate to the cloud. Many organizations are still hesitant to trust a third-party vendor to host EHRs and PHI, fearing that lackluster security could lead to a data breach.

Most HIPAA-compliant cloud vendors make it known, and are willing to discuss how their solution complies with HIPAA regulations, Forward Health’s Thomas told HITInfrastructure.com.

However, not all vendors claiming HIPAA compliance are truly compliant or are the best solution for a healthcare organization.

“Organizations should always be leary of any vendor selling a HIPAA-compliant solution,” said Thomas. “Even if a cloud solution enables you to use it in a compliant manner doesn’t mean it solves the compliance problem for you. There’s a few different key points when you’re ensuring that the technology will work to enable HIPAA compliance.

"Is the vendor you choose willing to sign a business associate agreement? If they hesitate or don’t know what that is, they aren’t the right vendor to choose because they don’t understand your healthcare compliance needs when it comes to HIPAA.”

Cloud solutions often come with many features or tools that may be produced by another vendor and offered in collaboration or because the primary vendor does not have their own comparable solution for a certain feature.

While most cloud vendors are upfront about their HIPAA compliance, organizations are still concerned about ensuring patient data is completely protected in the cloud. 

Understanding HIPAA-Compliant Cloud Options for Health IT

Comparing Public, Private, Hybrid Healthcare Cloud Storage

Source: Thinkstock

Are hybrid cloud data storage options the answer for healthcare?

Cloud data storage solutions cater to more advanced infrastructure technology because they give users a more flexible way to access data. Several different types of cloud deployments are available to healthcare organizations.

However, IT decision-makers need to decide how much control over their data these deployments require, which often leads to hybrid cloud solutions.

Healthcare organizations have many kinds of data, from EHRs to unstructured patient data, some of which needs to be accessed quickly and frequently. Other types of data will be held in a repository until it’s needed.

Entities don’t need to choose between on-premise or cloud storage deployments. Instead, healthcare organizations can choose what data is stored using a variety of methods that suit each unique infrastructure.

Most organizations choose a form of hybrid data storage when scaling up or implementing a more advanced storage solution. Organizations may choose to store more bandwidth intensive data, such as images, on an on-premise server so they can be accessed quickly.

Entities may also use multiple cloud vendors and service models to host different parts of their datacenters or multi-cloud storage models.

Multi-cloud data storage is similar to hybrid data storage, but uses multiple clouds to perform different tasks. Multi-cloud data storage also uses different cloud service models or providers for data because different clouds are better suited for different tasks.

Hybrid data storage uses more than one cloud or server option, accessing data that is blended together between two or more infrastructure hosting solutions.

Hybrid solutions are also important for data backup and recovery. Many cloud data storage solutions offer backup and recovery services which can also duplicate on-premise data into the cloud so in the event of a disaster where the on-premise server is compromised, the data is not lost.

The ability for data to be recovered in a timely manner to reduce downtime for clinicians and patients is where cloud really shows its value.

Zetta CEO Mike Grossman explained to HITInfrastructure.com that recoverability is one of the key challenges for healthcare organizations.

“Even if the data is stored in an off-premise cloud server, being able to restore the data rapidly ends up being a challenge,” Grossman stressed. “When organizations have backup solutions, they don’t really have a good way of recovering data, or in the disaster recovery context, recover their applications.”

While hyper-convergence isn’t technically categorized as a hybrid storage solution, it uses both on-premise and cloud/virtualization technology to converge systems and better connect infrastructure systems.

Hyper-convergence virtualizes elements of datacenter infrastructure from storage and networking to process and memory. The entire infrastructure is managed from a single place, which gives IT administrators more visibility and control over the entire environment.                                                                                                                          

Hyper-convergence can also be run in a cloud or on-premise environment and lets IT administrators control all virtual deployments from one place. This allows for less user error and faster technology speeds.

Pivot3 Chief Marketing Officer Bruce Miline told HITInfrastructure.com that many organizations are seeking out quick turnkey solutions to streamline this process.

“A lot of organizations are demanding quick turnkey solutions that are easy to deploy, easy to maintain, easy to configure and they don’t have to take a lot of time integrating all the components in the data center before they can deploy them,” Miline explained.

According to Miline, hyper-converging infrastructure systems reduces the amount of time it takes for clinicians to access EHRs and other data from the datacenter.

As healthcare organizations continue to embrace advanced health IT infrastructure technology, the volume of data collected and stored will increase accordingly. Organizations need to ensure their data is stored securely and is accessible to protect patient data. Clinicians must also have access to data where and when they need it for a successful data storage option. 


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