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The battle of the health clouds

At a recent event, I witnessed a panel discussion featuring senior executives from top tech firms discussing their plans for healthcare. They were steadfast in their belief that health care is going to be disrupted by the big cloud tech providers, which led the moderator to call it the battle of the clouds.

I refer to it more as the battle of the health clouds.

The battle for the clouds has already sorted out the market share winners. They are Microsoft, Amazon, and Google, with IBM somewhere in the mix. However, these market shares refer mostly to cloud computing as a service, or more precisely infrastructure as a service (IaaS). By and large, IaaS providers are looking to shift enterprise computing workloads from traditional data centers to the cloud (their cloud). They facilitate the shift with pay-as-you-go models, similar to how a power utility would charge for power consumption with an electricity meter in our homes.

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At the other end of the spectrum, an entire generation of “born in the cloud” and “only in the cloud” startups is leading the charge for innovation in healthcare, with billions in venture capital (VC) chasing potential winners. These startups, especially the ones from Silicon Valley, are focused on developing “last mile solutions” and are mostly operating on a “build and hope they will come” mindset. Nevertheless, the startup ecosystem is addressing a critical gap today in the digital health space as I discussed in a previous column here. From a cloud perspective, these startups are mostly offering their solutions in a software as a service (SaaS) model, leveraging the IaaS models of the major cloud providers as a backbone for their applications.

Health systems, EHR and the cloud

However, what about healthcare enterprises and the big enterprise B2B technology firms that serve them, or want to serve them? Firstly, health care has been a slow mover in the migration to the cloud. Secondly, health systems, recovering from over a decade of high investments in expensive electronic health record (EHR) implementations, are focused on ways to optimize the EHR systems and improve the returns on their investments. In this light, notwithstanding the strong pushback from the physician community to the poor user interfaces and additional data entry work (read Dr. Atul Gawande on  Why Doctors Hate Their Computers), hospital administrators and CIOs are looking to their primary EHR vendors such as Epic and Cerner as their default option to turn on advanced analytics and digital health experiences.

However, it is far from clear if EHR vendors are the right choice for advanced analytics functions and digital health solutions, given their primary positioning as systems of record for clinical workflows and transaction processing. Against this backdrop, several major technology firms have stepped in with what they refer to as health cloud platforms. Big tech firms such as Google, Microsoft, Salesforce, and GE Healthcare have all launched health cloud offerings in the past couple of years, as have several smaller firms, and more are on the way.  However, what exactly do these firms mean whey they refer to their health cloud offerings?