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Comparing Healthcare SaaS, PaaS, IaaS Cloud Technology

Differences between SaaS, PaaS and IaaS healthcare cloud technology is vital to making the correct choice when selecting a vendor solution for all medical organizations.

By Elizabeth O'Dowd

- When it comes to healthcare cloud technology, not all service models are created equal and identifying which one supports the healthcare community most effectively isn’t always clear.

Basics of healthcare cloud computing.

Cloud is an umbrella term that refers to sharing computing resources and providing data to connected devices on demand.There are three standard service models available:  software-as-a-service (SaaS), platform-as-a-service (PaaS) and infrastructure-as-a-service (IaaS). These models act as layers or a “stack” that works together, with each service model providing different levels of control.

While most businesses can get away with various combinations of these service models, the healthcare industry has had a harder time making use of them, primarily because of restrictions on sharing protected health information (PHI).

Healthcare organizations must adhere to HIPAA and its guidelines for protecting patient privacy. These guidelines become harder to follow the more accessible files become. According to the Cloud Standards Customer Council, increased privacy and security rules have created barriers when it comes to utilizing cloud computing as part of health information technology.

Identifying the specific needs of an organization when it comes to cloud is a critical first step that must be fleshed out before looking into healthcare cloud vendors. It’s not always cut and dry the service models each vendor offers and more often than not they have names that are unique to that vendor. The one thing vendor solutions have in common relative to product descriptions is the inclusion of SaaS, PaaS or IaaS which makes knowing the difference between these models vital to understanding an organization’s cloud needs.

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Software-as-a-service is the most basic form of cloud computing and allows users to run the company applications from a remote location. An example of this would be web-based email or an interface reached via a web browser like Salesforce or Wordpress. SaaS solutions are managed by the vendor and do not require the client to maintain anything, including the storage of data and the network.

The immediate benefit of SaaS is not having to install application onto devices. Additionally, all technical problems are handled by the vendor tech support staff. It’s important to keep in mind that most SaaS vendors have a subscription model so it’s not a one-time purchase. A SaaS cloud model could be a good fit for a smaller physician practice with a small or non-existent IT department.


Platform-as-a-service gives the client more control over the applications by allowing control over custom apps created specifically for the institution by inside developers or outside developers contracted by the organization. The only real difference between SaaS and PaaS is the development and control of these apps. The overall management and storage of data is still left to the vendor. PaaS focuses on app development and will most of the time include a software development kit (SDK). Mid-sized medical practices with a decent sized IT department or specialist that could benefit from custom apps should consider PaaS as a healthcare cloud solution.

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Infrastructure-as-a-service gives the client the most control over the cloud infrastructure. According to NIST, this infrastructure consists of “the collection of hardware and software that enables the five essential characteristics of cloud computing.” These characteristics are:

  • on-demand self-service
  • broad network access
  • resource pooling
  • rapid elasticity
  • measured service

Infrastructure includes both the physical machines like servers, and abstraction layers like virtual machines.

Bigger institutions such health systems, hospitals, medical groups, and organizations with high numbers of employees and documents need to consider the importance of having control over operating systems, storage, and deployed applications.IaaS does not offer clients full control over the underlying cloud infrastructure, but it does give IT control over some networking components and firewalls. IaaS can’t be deployed without a skilled IT department which includes developers. Having this level of control over the cloud should be able to put to rest some of the concerns healthcare professionals tend to have when it comes to interacting and storing sensitive patient data in the cloud.

Each of these cloud service models caters to different consumer's needs. While some medical institutions can certainly get by with just SaaS, it’s important not to make a decision based on cost over functionality. IaaS solutions are going to be more expensive than PaaS or SaaS solutions, but if the need is there for an organization, cloud security and function is not a good place to cut budget corners. Before speaking with a healthcare cloud vendor, an organization must know how much it can realistically spend on the technology, its desired outcome for the cloud service, and service model best suited to realizing that desired outcome.

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