Why Hybrid Cloud Computing is Critical to the Frontier of Equitable Personalized Medicine
World-renowned academic medical institutions, early-stage healthcare startups, and legacy electronic health record companies alike have the stated common objective of putting patients at the heart of their business.
Sitting center-right to the patient, and often acting as a proxy, are massive amounts of healthcare data. Data is generated constantly as patients float in and out of the healthcare system: booking a virtual mental healthcare visit, missing a breast cancer screening, showing up unannounced to an emergency department with chest pain. Each of these interactions generate dozens and dozens of data points–some of that data is structured, some semi-structured, and some entirely unstructured.
The new frontier of medicine, often called personalized or precision medicine, hopes to take advantage of advancements in machine learning and the seemingly limitless attributes generated by humans as they interact with health systems to predict disease and to provide lower acuity, preventative care earlier. This means less expensive costs for healthcare systems and better health outcomes for individuals. In order for healthcare providers to deliver on this vision, it will require even small healthcare businesses in rural communities to adopt hybrid cloud computing.
What is hybrid cloud computing?
Hybrid cloud computing refers to a computing environment that combines elements of both public and private cloud models. In a hybrid cloud model, data can move seamlessly between private and public cloud infrastructure, offering greater flexibility and security.
Public clouds are owned and operated by third-party service providers, like Amazon Web Services (AWS) or Microsoft Azure. They offer computing resources, such as virtual machines, storage, and applications, over the internet to the general public or multiple customers.
On the other hand, private clouds are operated solely for a single organization, and can be hosted on-premises or by a third-party provider. Private clouds offer advantages like added security, customization, and higher performance, but are typically higher cost.
Why is hybrid cloud computing advantageous in healthcare?
It is not a new notion that healthcare organizations should take advantage of hybrid cloud computing. This model allows for sensitive protected healthcare information (PHI) to be stored on private clouds with more robust security, making it less likely to be infiltrated by bad actors than public clouds or on-premises computing. Private clouds also provide more control over the infrastructure, making them particularly suitable for healthcare organizations that must abide by strict compliance requirements.
Meanwhile, less sensitive data can be housed in a less expensive and more easily scalable, public cloud solution. A public cloud can also act as a redundancy, ensuring continuity of critical health services in the event of a system failure.
High cost of cloud computing may lead to widening health disparities
Although the usefulness of hybrid cloud computing in healthcare has been established, healthcare providers in more rural, low-income settings continue to use traditional on-premises computing. The reason for the lag in cloud adoption is both obvious and familiar: prohibitive costs.
Not only does this leave these healthcare businesses more vulnerable to cyber attacks and less agile, but also can create gaps in data that would be used by machine learning algorithms to predict disease in order to provide personalized, preventative care. Without the availability of data sets from low-income and minority populations, AI and machine learning algorithms are bound to drive even larger health disparities between the rich and poor. That can mean spitting out higher insurance premiums for someone from a low-income zip code, providing incorrect diagnoses due to perceived race basis of disease, or recommending less care overall due to algorithmic preferences to allocate more resources to patients of a certain race.
Antitrust laws must be applied to cloud providers
Given the consequential magnitude of not democratizing cloud computing, I believe government regulation of cloud computing leaders like AWS, Microsoft, and Google is critical. These three industry leaders already own 65% of the cloud market, meaning prices are bound to steadily rise and as competition dies off. Increasing prices will lead to continued lack of access to cloud computing among smaller healthcare businesses, leaving the people they care for left out of the machine learning equation.
The promise of personalized medicine should be its ability to equitably predict health outcomes, allowing physicians to provide preventative care to all patients. As experimentation with healthcare data sets and development of healthcare-specific algorithms advance, we must ensure hybrid cloud computing services are accessible to all healthcare institutions.
