Dr. David Gruen was traveling when his mother-in-law called him, asking for a favor. Her husband had just had an MRI and requested that Gruen, a radiologist, take a look at the results.
Yet the seemingly simple request ran into roadblocks. Gruen’s father-in-law had undergone two MRI scans recently: one at a hospital and another at an outpatient imaging center. Because these medical systems weren’t connected, his 87-year-old mother-in-law drove to each medical provider to pick up two separate CDs with the images. She also had to get reports printed and delivered to Gruen’s house. Back at home, Gruen scrambled to find a CD drive to give him access to the data, which also provided no comparative details.
“It is 2023, this should all be in the cloud,” says Gruen, who serves as chief medical officer at Merative, formerly Watson Health. “She should be able to give permission, load those studies up, and have me get access to them. There are so many obstacles to providing optimal care.”
Worldwide spending on the infrastructure-as-a-service (IaaS) cloud market totaled $91 billion in 2021, according to research firm Gartner. Five IaaS providers account for over 80% of the market: Amazon, Microsoft, Alibaba, Google, and Huawei. Industry experts say the health care industry is at a critical inflection point to use the data that’s at hand, but sometimes just out of reach, and improve the health care system overall. One solution is cloud computing, which enables hospitals, drug researchers, and health care providers to collect data and share it.
“If you look at it as compared to financial services or retail, the health care industry has typically been a laggard in terms of adoption of the cloud,” says Shrikanth Shetty, chief growth officer for life sciences and health care at HCLTech.
Shetty says the past decade has seen a pivot, with greater adoption of the cloud in health care, further accelerated in the wake of the COVID-19 pandemic. Cloud allows health care providers to order computing power in a pay-as-you-go manner, rather than putting too much investment upfront. That cost effectiveness aids an industry facing rising prices and higher demand in the aftermath of a yearslong public health emergency, a shortage of skilled labor, and new spending needed to support additional compliance requirements.
Before COVID, data showed that as few as one out of every 10 patients was comfortable using telemedicine or an in-home diagnostic tool. That figure has leapt to seven out of 10 today.
“The challenge you run into is how you then take that data and make it actionable, other than creating paper copies or email,” says Ashkan Afkhami, global leader for the health care practice at Boston Consulting Group. “The beauty of all this is that we all carry a cloud computing device in our hands. Essentially, in a secure HIPAA-manner, you can take the data off any device—from a testing device to a continuous glucose monitor—and in a really efficient manner, deliver it back to the hospital or physician to help make the right clinical decision.”
Both the financial and health care industry are highly regulated because they deal with sensitive customer data. But the financial industry already has plenty of services online that offer easy access to its clients. Consumers can bank online, pay their taxes, share their data from one bank to another, all securely driven by the cloud. Health care isn’t as prolific.
“We’re not close to that in health care,” says Gruen. “To me, that’s aspirational. Can we catch up with another business that’s similar, and yet has more data than that business, to do as good of a job to democratize that data?”
Dr. Yan Chow, global health care lead at Automation Anywhere, says storing anything akin to protected health information in the cloud has been very difficult owing to regulatory compliance. But with all the pressures on health care, the industry’s players have been compelled to consider new tools and strategies.
“They are starting to differentiate between things that are high-risk to put in the cloud and things that are not so high-risk,” says Chow.
Drug development can greatly benefit from investments in the cloud. One out of every 10 drugs fails in clinical trials, and it can take over a decade and more than $1 billion to bring a drug to the commercial market. “The need to optimize that process is pretty dire,” says Dr. Jared Saul, global head of health care and life sciences for startups at Amazon Web Services (AWS). “These technologies hold that promise, and we are actually seeing it manifest now.”
AWS is the cloud provider that Moderna uses to bring mRNA medicines to market, including the drugmaker’s COVID-19 vaccines. This tech-first approach allowed Moderna to determine the structure of the COVID-19 vaccine within 48 hours of being given the genome, compressing hundreds of hours of compute time.
“We are seeing a massive shift to cloud, in both health care and life sciences,” says Dr. Rowland Illing, chief medical officer and director of international public sector health at AWS. “And the real reason why institutions are doing it is because it democratizes access to enormous amounts of compute storage power that’s available on tap.”
AWS runs health care accelerators for startups and is more broadly training 29 million people around the world to learn cloud computing skills by 2025, part of a campaign to raise awareness of the power of this technology.
The cloud provider also goes to great lengths to assure clients that their data is secure. “The cloud brings a huge level of automation to security, which increases that security level,” says Illing. That said, end users ultimately have a responsibility for their own security; AWS doesn’t have access to their data, it merely serves as a custodian of the infrastructure.
GE HealthCare says its customers, patients, and providers are using the cloud to drive better patient outcomes. “There have been significant investments and innovation in building products that bring patient records and the clinical data in a way where our health care service provider can access them and make timely and quick decisions,” says Abu Mirza, head of digital product and engineering at GE HealthCare.
Imaging is an especially complex health care data challenge but one that shows great promise. Take the example of a radiology exam, says Mirza. It starts with pre-scan activity including confirming who the patient is and what medications he or she is taking. The relevant data then goes into deciding the protocols of the machine, to ensure it is configured to provide the best outcome for that patient’s image. In the background, there are compliance activities to make sure hospitals operate properly, which can be standardized in the cloud. Algorithms can improve the scan efficiency, and the cloud can manage the exam’s entire workflow, which is called post processing.
“Patient data, and the large sets of imaging data, and the computing that we need to process some of this imaging, all of these things are made possible through the adoption of cloud,” says Mirza.
Today, the application of cloud in the health care space is choppy. Pharmaceutical manufacturers are doing a good job leveraging cloud alongside generative A.I., a hybrid model that helps them with clinical trials. Medical device firms are using new tools to help physicians provide improved care for patients. But cash-strapped hospitals, which operate with thin margins, aren’t likely to experiment unless they are part of a larger system. To have the greatest impact, experts say, the system needs to dream big.
“We’re not going to transform health care at a scale of one patient at a time,” said Gruen. “We have the best health care in the world, but arguably, in some cases, we have the most mediocre health care. And the way we are going to transform that is by using the data to improve lives.”
