Odds are good you’ve seen your doctors using computers a lot more in the past three years. During appointments or while at the hospital, they’ve stopped at a desktop computer or taken a tablet out of their pocket. It’s not because technology lets them provide better care, it’s because federal legislation is changing the way health care providers and insurers use computers.
After the 2008 economic crash, a piece of legislation called the American Recovery and Reinvestment Act (ARRA) was signed. Although the name doesn’t have much to do with health care, the provisions strongly encouraged providers and insurers to adopt electronic health records by 2013–organizations which adopted them received significant government incentives in return. This, coupled with technology requirements inside 2010’s Affordable Care Act, has inevitably led many doctors offices’ and hospitals to take the next step… and adopt cloud services.
IT giant Cerner is one of the world’s best known vendors of electronic health records. The company is in the middle of the $1.3 billion purchase of Siemens Health Services, and dominates the American cloud health care market alongside rival Epic (Epic declined to speak with Fast Company for this story). I recently connected with Cerner vice president and chief medical officer Bharat Sutraiya to get a better idea of why doctors, hospitals, and insurers are migrating to cloud services instead of the locally based programs they have been using for decades.
Sutraiya, a busy emergency physician by training who still does some ER shifts in addition to his corporate job, says health care providers are going through cultural changes, process changes, and tech stack changes all at the same time. The cloud has become a way to simplify the process and make current technology investment a little bit more future-proof.
Cerner’s main cloud products are Skybox (a mobile infrastructure for health care providers that guarantees privacy and information security) and a host of cloud hosting solutions. Because the health care industry is restricted by a set of privacy regulations called HIPAA (Health Insurance Portability and Accountability Act), it is one of the hardest industries–along with finance–to provide cloud storage services for.
For software companies that can work within those constraints, there’s a massive opportunity to crunch “data across a broad continuum of care,” says Sutraiya. Health records now include patient medical and financial data, along with satisfaction metrics for insurers and providers. And soon personal health information fed from quantified-self systems like Apple Health. But the applications tackling everything from analyzing the quality of provider networks to chronic disease management have yet to be built.
One example of how patient data could lead to improvements for everyone comes from Microsoft Research. In 2013, a team there wrote a paper on what they called web-scale pharmacovigilance. The paper explained how Internet search queries could be data mined to find previously unknown adverse drug interactions.
Eric Horvitz, Microsoft Research’s managing director and a prominent health care and technology researcher, spoke with Fast Company about where this could lead last year. He explained that, for health care analytics specifically, discovery of extremely rare events in data sets could be very fruitful because they give insights that would otherwise be very difficult to find. By leveraging services such as Bing and Google, the paper argues, researchers could find out about previously unknown drug interactions. Search engine records are much easier to use in bulk than anonymized electronic medical records.
In the meantime, there’s Iodine. Officially launched last week, the website combines clinical data with user feedback to better understand the side effects of medications as well as the ways they potentially interact. Its founders come from Google and Wired, and as a result the site feels more consumer-friendly than most health-care-provider-backed solutions.
Companies who come from outside of the traditional health care technology space are increasingly entering into the medical space and looking to attract long-term partnerships to share knowledge and risk. One example comes from a recent agreement between Philips Healthcare and Salesforce. In July, the two companies entered into a strategic partnership to build a cloud-based health care platform. The two initial products built on the platform, eCareCompanion and eCareCoordinator, are aimed at chronic disease management and are built on top of Salesforce’s software development kit.
Anthony Jones, chief marketing officer for patient care and clinical informatics at Philips Healthcare, says that a major benefit of the Salesforce partnership will be to make it easier for doctors to enjoy greater interoperability among systems. The health care tech ecosystem today is full of competing standards which are often incompatible. Jones argues that switching to cloud infrastructure makes it easier to share data across these different systems–thus improving patient care and saving money.
“A lot of things that happened with cloud computing in health care can be traced back to tablet computing,” Jones told me. “The emergence of iPads and and tablet computing in general moved technology forward in the whole idea of mobility, which really took off with health care providers. It meant we could do things we couldn’t do on smartphones like EEG tracing and looking at radiology imaging–things where the screen was normally too small. The tablet really hit that sweet spot in the middle between a workstation and phone.”
Health care tech is big, big business. Cerner had $2.9 billion in revenue in 2013, and Epic made $1.7 billion in 2013. And more and more health care companies are adopting cloud technologies–a recent survey by HIMSS Analytics found 83% of health care organizations are currently using cloud-based apps. New health care products could save lives and save money… and make tech companies a lot of money in the process.