Cloud computing improves health information analysis for the decision making on public health

Introduction

Cloud computing is a technology of data processing where computer resources and capacity are available to business or private users through Internet services (Arutyunov, 2012).  These users should not be worried about infrastructure, operating system and software since their own information is permanently stored in servers on the Internet and it can be accessed at any time from any computer. John McCarthy founded this concept in the 1960s; however, this ideology gained popularity in 2007 due to the rapid development of communication channels and the need of users to expand their information systems. Cloud computing has different uses according to the sector to which it is directed and it has been recognized as a choice for reducing IT expenses (Venkatraman, 2009) since organizations rent the use of IT services instead of buying a solid infrastructure. This paper will be focused on how cloud computing is being used to improve health information analysis for decision making on public health.

Background

            Public health is a dynamic field that includes all social factors that affect health: violence, poverty, economic development, income distribution, natural resources, diet and lifestyle, health-care infrastructure, overpopulation, civil rights among others (Rothstein, 2002). Given that the concept of public health embraces a broad meaning, many responsibilities have been assigned to public health organizations in order to improve life quality of the population. In this context, the use of IT technology has been necessary to support and help the decision making of public health professionals.

            The first cloud computing systems created to collect data on emerging diseases used e-mail or Web for evidence (Brilliant, 2012) like ProMed (founded in 1994) and GPHIN (founded in 2000).  After that, many applications have been used for health public actions having the following benefits (Chatman, 2010):

• Cloud computing accelerates deployment of technology and supports business process change (flexibility);
• Costs of cloud computing are lower and it depends on users’ needs (prices per month and per user) in comparison with on-premise software licensing fees, IT support costs, hosting, networking and real estate costs;
• Cloud computing improves allocation of IT resources due to the fact that the costs of hosting, security and networking are responsibilities of the cloud computing provider.  IT resources are not necessary to support and maintain a large, complex application and in addition, companies can assign these resources to other activities or needs to move the business forward.
• Related to health care services, cloud computing uses platforms that can enable health care and insurance companies to rapidly set up operational call centers providing data on procedure, patient history, case management, funding management, etc. In addition, cloud computing also allows financial tracking, improves current sales processes, manages sales pipelines and improves customer insight.
• Related to health research, cloud computing helps researchers to do analysis of clinical and genetic data using simulated representations of patients. It is predicted that many research groups will migrate to hybrid private-public cloud because of the variable capacity and cost savings in data analysis work (McGee, 2008).
• Related to public health surveillance, clinical organizations will be able to exchange specified types of data with public health systems such as electronic immunization surveillance data and electronic disease reporting.

Examples of current use of cloud computing in public health

            Cloud computing is used in several applications for decision making on public health in the United States and also in other countries worldwide. The following are three samples of cloud computing technologies applied to public health in the U.S. (2 cases) and in a foreign country (1 case):

• irms|360 Enterprise is the first cloud-ready suite for secure, fast, accurate and complete visibility in public health and the private health system.  This technology tracks people, products and processes in healthcare facilities, hospitals and clinics and integrates all data enabling a global view to improve supply and demand planning in order to increase operation efficiencies, optimize inventory levels and reduce costs.  Emergency Management (irms|EM™) is one attractive solution for Web-deployed and mobile disaster response providing different information, such as stockpiles inventory, patient management and sheltering among others that are necessary for quick reaction in emergency cases.
• Amazon Simple Storage Service and Amazon Elastic Compute Cloud are being used by Harvard Medical School for translational science and simulation research, for example analysis of clinical and genetic data (McGee, 2008). These platforms provide access to the lab through the Web regardless of physical location.
• Software as a Service (SaaS) is a technology used in India (Karthikeyan, 2012) as an on-demand software service that is hosted in the Internet cloud and accessed through a web browser by users.  This application is helping to cover the gap of miscommunication between patients and health care providers about patient information related to their medical history.  This information is highly needed when emergency medical care is provided and patients are mentally affected or unconscious and they cannot communicate about their medical records.

Ethical and Social Implications

            According to the information previously exposed, there is no doubt that cloud computing is helping to the decision making in health field.  Advantages from this technology allow finding the best practices to improve health policies in countries in order to obtain a better quality of life for people since the information can be shared quickly among different actors even through countries, regions or continents.  

Also, emergency management systems have been adopted to be alert for the occurrence of any health emergency cases, such as outbreaks, through different public health organizations like the Center for Disease Control and Prevention, the Pan American Health Organization, the World Health Organization among others.

Nevertheless, there is still a controversy about the equity of access to information in developing countries. Although, cloud computing technology is increasing, there is a need to expand this technology to all countries around world.

Legal and Security Concerns

          Data security is one of the main concerns about cloud computing in the health care field (Chatman, 2010). There are still some reactions from public health organizations if patient related data can reside on a third party’s cloud infrastructure (McGee, 2008).  Moreover, in countries such as U.S. where there is a law about health information confidentiality, data security is a relevant aspect to considerer when health organizations use cloud computing.  In order to have a reliable cloud computing technology, it is necessary the following from the hired company (Watt, 2010):

• An IT company that understands who will be the responsible to access personal health information.
• An IT company which can define the quality of the background checks on people who manage these systems.
• Review if the IT company has certifications showing compliance with regulations related to data security according to each country or region such as SAS 70 Type II, FISMA, CFR Part 11, EU 95/46 (Europe), PIPA (Asia).
• Evaluate if the cloud provider has the flexibility to adjust to new regulations.
• Establish a security policy and anticipate an audit process to evaluate the safety of the cloud system.
• Review carefully the provider’s terms of service and also its data backup process.
• Finally a custom cloud (combination of private and public clouds) can be configured to assure the highest levels of security through techniques that provide public information to the cloud computing as well as to deny general access to certain data by keeping it behind a firewall and by specifying which combination of data should not be displayed.

Conclusions

            Cloud computing applications are increasing around the world but it is necessary to take advantage of the social impact of this system to improve the human well-being.

Public health applications are improving through the use of cloud computing due to the fact that this system is reducing costs and also, it is helping to obtain information efficiently and effectively.  Cloud computing has been used in public health for several years and for different activities like heath systems services, research, surveillance actions among others.  However, it is necessary to consider all aforementioned recommendations and requirements to have a good, reliable and accurate cloud system that shows its compliance with national or regional regulations of information security.